The Big Lie, Pharma-Style (or Katie Porter is a National Treasure)

The “corporate greed”/corporate baddie" narrative is counter-productive because it reduces the problem to bad actors when the problems are systemic. Humans are gonna human. Businesspeople are gunna businesspeople.

The current US system involves setting off an avalanche and then engaging in piecemeal regulation, scapegoating and chiding of various lumps of snow and ice. It just isn’t going to work.

I understand the view that Porter is highlighting certain excesses with the goal of obtaining electoral support for change but I don’t think it works. If it was going to work it would have worked by now.

The approach of berating business for doing business has engendered distrust in pharmaceutical companies (and isn’t that going well during a pandemic?) and caused hatred of "“fatcats”.

What it has not done is cause people to change their fundamental views on basics like the role of tax and government, which is what would be needed for systemic change.

I disagree with this.
They do it because they’ve been taught this behavior. For years the thinking has been that the best thing a business can do for society is to become more efficient. That seems like a perfectly reasonable process at first glance. The more efficient you are, the better your product will be, and at the best possible price. Except that there is a big disconnect in what it means to be efficient. Efficient toward what end? Putting profits over the welfare of your customers may seem efficient from a certain point of view, but it’s not good for society. And this disconnect is not only taught in school, but is reinforced through behavior. “This is the way it’s always been done so it must be right!” “Businesspeople are gunna businesspeople.”
Pointing out the flaws in this way of thinking might seem to you to be berating people for their nature; for something they can’t help. But it does so much more. It changes how society looks at how business is done. And says that certain things are unacceptable. That the welfare of society is at least as important as profit.

And, more immediately, it reinforces the dictum that if businesspeople aren’t capable of doing this on their own, then it’s government’s job to step in and make them.

She’s my sister’s congressperson. My sister is big into politics and did a lot of work to help get Porter elected.

No they do it because it’s the nature of their job. A company is an investment vehicle for shareholders that want to maximize investment return. What you are saying is employees should take into account matters other than what the owners of the business want, because it would be better for society. That would be great but it’s not going to happen without systemic changes.

My view is not that berating people for their nature is pointless - my view is that berating people for doing what they are employed to do is pointless. Your berating is but a whisper, their employer’s prime directive is a shout. It isn’t going to work.

Someone who chose the wrong insurance plan, thinking they wouldn’t need good drug coverage or didn’t know they would need this particular drug that wasn’t covered. Granted, they hopefully have a deductible under $10k, which they will hit in a year. But they’re still out $10k, and AbbeVie gets their $77k from the insurance company, and everyone else in their insurance pool gets their rates raised the next year.

I had a high deductible HSA plan a couple years ago. I had to pay $700/mo out-of-pocket for a medication I didn’t know I needed when I signed up for the plan. My deductible was $8k, which I hit by July and my insurance then picked up the rest. I’ve since changed to a new plan that covers the meds.

I have a friend who’s insurance had separate doctor and prescription deductibles. It was like $6k for each. So her family was out $12k a year out-of-pocket for her insulin and doctor visits.

It’s really hard for small businesses to get good group insurance rates. You just have no bargaining power as a small pool of people. So while Medicare people are doing ok with Humira and a huge pool like Akaj’s company must belong to does ok with their Humira prices, there will be people who are paying out the nose for it and/or insurance companies who are paying out the nose for it (and thus passing those costs on to customers the next year).

I’ve said it before and I’ll keep saying it - I don’t know why small businesses and small municipalities aren’t rallying for universal health care. Private insurance is killing them too, and we’re all affected.

+1
Which is why, whenever there are trade agreements between the US and Australia, US Big Pharma demand that Australia dismantle the Pharmaceutical Benefits Scheme which is world’s best practice.

You say that like it’s some kind of law of nature. You do realize that business is something that we’ve made up, and just because it’s been done one way for a while doesn’t make it right or even necessary.

Because some business book says it is?
I say a company is a way to make society better and it’s only true purpose should be to act in the best interests of society ( and I’m not alone in this) Now a company can’t benefit society of it goes under, so profitability is important. Just not the most important thing.

I’m probably not explaining myself well.

The nature of a corporation under current US law is that it is an investment vehicle for shareholders. This is not from a “business book” it’s from US law (and the law in most other places).

Shareholders invest to get a return and it’s a rare shareholder that doesn’t want to maximise their return. This isn’t by law or from a business book but feel free to change this about people if you know how.

I have said that I think systemic change is required and it sounds to me like what are describing is a need for systemic change. I think where we disagree is that you think that the problems under discussion could be alleviated by effecting wholesale cultural change without systemic change. I disagree for reasons given.

This is not true.
What about companies with no investors? What about not for profit companies? Those are just two types off the top of my head.

Anyway…you said that businesspeople act like businesspeople, as if all businesspeople would act the same in the same circumstances and we know this isn’t true because not every CEO is called on the carpet in front of Congress. Just the ones that deserve it.

It isn’t possible to discuss anything sensibly if you are going to point out quibbling irrelevant exceptions to the overwhelming reality. Yes there are some unusual types of corporate entity that don’t involve shareholder investment. This has nothing whatever to do with the legal structures behind the vast bulk of the economy.

And if you are suggesting that the economy switch over to a non-profit model that’s fine but that is a systemic change which is what I’ve said throughout would be required. Do you actually need to be disagreeing with me or are you just arguing for argument’s sake?

As to your second point… damn boy. You don’t want to think about that some more?

I can tell from your posts that you don’t remember a time, as I do, when American corporations understood they had a civic responsibility to not harm our greater society. It was part of the capitalist bargain and social contract. Yes, make a profit. But don’t do it at the expense of weakening our country.

In 1968, the corporate tax rate was 52.8%. The top marginal tax rate in 1960 for personal federal income tax was 91%. We don’t need to go back to those days – nor should we. But understand that such things were possible only in a society that valued the welfare of its citizens.

It took 60+ years, and it all changed. I choose to believe it can change again. But it won’t change without people pointing out the unbridled greed that now infects our corporate culture. That’s what Katie Porter is doing. I applaud her for it. She wasn’t trying to elicit shame from the corporate executive. She was trying to educate Americans as to their plight.

You still haven’t answered my question about your proposed solution, since you don’t seem to feel anything we Yanks are doing is right.

I quibble that the vast bulk of the economy is investor based.
Only 1% of US companies are traded on stock exchanges. And US law doesn’t apply to private investors other than to prohibit fraud. The laws that apply to public investors say nothing about maximizing investor profit. They codify transparency and fiduciary responsibility.

You may have a point about Congress only calling out people who deserve it, but damn child, when you place the CEO of Abvie in the company of CEOs from Big Tobacco and Insurance it sure looks to me like they’ve got a good track record.

This is utter nonsense. First of all, Porter rather famously has a reputation for asking direct, pointed questions specifically about costs. Anyone appearing in a Congressional hearing before her expecting to get a bunch of softball questions that they can tap dance their way out of is an obtuse fool. Second, Porter often makes clear what her line of questioning is going to be (as she did in the Dr. Redfield interview). The people she questions–business executives and senior government officials–all have staffs whose job it is to compile and provide exactly those kinds of answers, which in fact is the point of holding such hearings to begin with. Anyone showing up to a Congressional hearing without the minimal preparation of having summary figures and facts about their business or department is inept beyond normal incompetence.

And as for the claim of “Gish galloping”–a rhetorical technique of overwhelming an opponent in a debate by presenting disconnected and often nonsensical arguments in rapid succession, too quickly for response–that is precisely the opposite of what Rep. Porter is doing. In fact, she is asking very straightforward questions that any non-incompetent, marginally-prepared witness should be easily capable of fielding, and then when the witness cannot or will not respond, providing the answer for them. The notion that she is making up or exaggerating figures is also absurd on the face; as a former law professor who has done academic research in personal finance and bankruptcy law, she is certainly capable of checking citations and understands the consequences of presenting false or misleading testimony, which is why it is rare for any witness to contradict her or dispute her statements.

All of these complaints about how Rep. Porter is “rushing through a bunch of stuff so that the witness is swept off their feet” is essentially a bunch of whining about how mean she is for asking tough questions and not suffering the fools who show up unprepared. And the only reason that this is in any way exceptional is because Porter, unlike the majority of her Congressional colleagues, isn’t beholden to corporate interests, bothers to do the appropriate research, and presses the straightforward questions that witnesses don’t like to answer. If you are the CEO of a multibillion dollar pharmaceutical conglomerate being called before a Congressional hearing to inquire about why the price of your life-saving drug has increased sharply over the last few years, you ought to be prepared to answer a few pointed questions about the underlying nature of your business.

As for that this is the result of systematic problems in the health care and insurance industry, that is absolutely true…but it is also the case that people like AbbVie CEO Richard Gonzalez are personally responsible for taking extreme advantage of the situation instead of demonstrating responsible corporate leadership, and by the way taking home a lucrative compensation package for excelling at avarice:

Cry me a fucking river for this guy having to answer direct questions in a public forum for a few tens of minutes.

Stranger

Sole proprietorships and partnerships with no other investors also exist to profit the owner(s).

Yes.
Your point?

The only salient point is that almost all businesses exist in a structure that legally gives ultimate control to the investors in that business (whether sole proprietors, partners, private investors, public investors or whoever-the-hell). The officers and employees involved must do the investors’ bidding. Those investors demand maximised return on investment.

Why you are wriggling like an eel on a hook to try to avoid this basic, obvious reality I have no idea.

If your proposed solution is to keep the system’s fundamental drivers the same while chiding and cajoling businesspeople to act against their prime directive then that’s, uh, interesting.

But as Einstein probably never said “The definition of insanity is doing the same thing over and over again and expecting different results”.

Those glasses you’re wearing are so rosy it’s amazing you can see through them at all. One doesn’t have to think too hard to come up with examples of naked corporate greed from any era in US history. The answer is systemic change. To something more like this (although as you say hopefully not to the same extreme):

We are as suspected in furious agreement. Go back and read my first post. You know what a society is that values the welfare of its citizens above corporate greed don’t you? It can be described using the “s” word although I don’t recommend you do so.

The social change necessary to cause the society to value the welfare of its citizens above corporate greed is not gonna be generated by a bit of congressional CEO bashing.

You asked for my solution. I’m not sure there is one. US society at the moment is pretty much a clusterfuck as far as I can tell. In very rough terms about half of your electorate are so ignorant/ill- educated/tribal/disenchanted that they will vote a conman buffoon into office and vociferously oppose a policy they like if it has the word “Obama” attached to it. Long term social mending is what is required but I don’t know how that is achieved.

If it’s any consolation Australia is only a little different. Historically we have had more of a “mateship” and less of an “every man for himself” thing going on, which has helped.

Your post is about 80% irrelevant and/or a strawman and/or shows your lack of experience with XXN and I’m not going to bother sorting out what little remains after that.

Businesspeople gonna businesspeople. But government gonna government too, and it is one of the main roles of government to mitigate harms arising to society as a whole, particularly where they disproportionately impact those groups with the least ability to mitigate them themselves.

Complaining that businesses are being demonized for doing what businesses are supposed to do while simultaneously demonizing the government for doing what the government is supposed to do doesn’t strike me as a particularly balanced approach.

Translation: “I don’t have any reasoned response so I’m going to flounce instead.” The rhetorical response of someone standing on crackling ice.

Stranger

Actually, we’re only about 50 people. We have a high deductible, and if I was told, Welp, that Humira is just going to eat up your deductible and then we’ll pay the balance, I’d actually be OK with that. But we’re really fortunate to have access to the copay assistance plan, so of course I’m taking advantage.

With you 100%.