That’s what one Slashdot reader asks in a story about Brazil basically voiding a patent on a Merck AIDS medication after long negotiations with the company failed to bring the price down.
The question intrigues me, in the sense that on the surface, it SEEMS to be a good question. Drug companies and doctors hold peoples’ lives in the balance. It certainly APPEARS that such activities are more important, and more basic, than the ability of a few people to make a lot of money, especially when so many of those activities are helped along by taxpayer money in this country.
Yet intellectually, I know there are probably some very good reasons; I just can’t articulate them in my mind effectively. Would anyone care to?
It’s not a question of why it’s allowed, that doesn’t make sense. It’s about what emerges as a necessary condition of the socio-economic context in which the question is being asked.
In other words, people make money off health care because it’s a necessary condition of capitalism that absolutely anything can become a commodity. If people will pay for it, a profit can be made, and if a profit can be made it should be made, as far as the mentality that drives, for example, pharmaceutical companies goes. Because if it’s not, then no one has any reason at all to work to save other people from horrible diseases, many of which are directly created by other profit-making machines.
I work in a medical clinic. God bless every one of my coworkers, but I don’t suspect that they’d last until Friday if they were told that all of their work would be on a volunteer basis from now on this Monday.
So, obviously money has to be involved in the system somehow, in spite of it’s importance and the extent to which we consider medicine to be beyond just money.
So, the for-profit system might (or might not) be the most efficient overall means to helping to organize nurses, doctors, assistants, patients, and the people that scrub the floors into a working medical infrastructure. And it’s the (main) system we’re attempting right now in the United States.
Would you say the same about people who build the houses we shelter ourselves in? We can live for decades without medical care. Medical care of any form we would recognize has only existed for maybe the last 150-200 years. shelter on the other hand is a much bigger deal for short term survival and arguably more “basic” than medical care.
One of the reasons generally cited for the high cost of medications is the high cost of research and development and approval of those medications. It costs money and time to bring a new drug to market. Drug companies (most US and Europe based) need to make money off the drugs they sell so that they can create new drugs. This leads to a system where drugs for “wealthier” ailments like heart disease and IBS and such are researched and marketed aggressively, while antibiotics and vaccines have to be subsidized because the the patents on them have run out, thus no money in it for the drug company.
Unless a government is willing to shell out serious money for R&D, drug companies have to support themselves. To make more drugs that people need they have to sell drugs that people want.
From what I understand, most researchers really want to discover something; the way to get ahead in science research is to publish a peer reviewed paper that will enhance your standing. That takes money; I’m thinking of Mouse_Maven 's posts about her lab. Unless you have a government willing to subsidize research, you’re screwed. This is what happened with HIV in the early days - the government was not willing to increase the size of the research budget in the US because the victims were mostly gay men, and that was politically inconvenient for the Reagan administration.
Even in countries with socialised healthcare, the profit motive is alive and kicking. Nurses exchange their skills and labour for money, at a profit. As threemae says, they wouldn’t turn up for work otherwise. So until humanity evolves to the point that the average person will do good deeds for free, healthcare needs to be profitable.
Great post, Quiddity! Very well thought out and insightful. Thanks for your contribution to Great Debates!
You and threemae are of course right, but I think the OP is talking about corporate profits, not pay for workers. Of course workers have to be paid, but if patients are not charged for care, then the workers are paid with tax revenue, rather than “profits” from the actual commodity that is being used.
My argument against socialized heath care is the same as drachillix’s. Medicare is a necessity, but so are a lot of things…housing, food, etc. Generally in our society, we expect people to earn their own necessities of life except in emergency situations. Currently, we will give people housing in emergency situations, give them food in emergency situations, and give them healthcare in emergency situations. No reason I can see that healthcare should be provided to all for free, when these other commodities aren’t.
Plenty of problems with our current system of drug development. But yes it is true. It takes money, big money, to develop useful drugs. For the most part governments are not interested in funding that kind of moolah. So the private sectors does. In return they get to set the price at what the market will bear.
This can be improved upon. More public support in areas that are not likely to produce blockbuster lifestyle meds but are needed for the pubic good. Limitting the term of patent protection more but offsetting that with limitting the degree of tort exposure for meds that are clearly in the public good (eg antibiotics for the next genration of resistant bugs) so on.
Ensign is partly right except it is not a “condition of the socio-economic context”; it is in context of the human condition.
Why would a drug company take on the very heavy risk of developing a drug if there was not the high reward of profit on the other side? You can’t limit reward and not expect there to be an affect on risk.
“Nonprofit” doesn’t mean unpaid, it just means that the main focus of the organization providing the services isn’t to make piles of money. Depending on the organization, employees of nonprofits can be paid quite decently. (Many aren’t, but then many employees of for-profit organizations aren’t paid very well either. I’ve done work visa petitions for one of the world’s largest pharmaceutical companies, and frankly their R&D employees don’t make nearly as much as people with other advanced scientific degrees who aren’t doing R&D. I think a lot of them are in the field for the love of what they do.)
Some organizations that provide medical care already are nonprofits, as are tons of organizations that do things most of us consider to be socially worthwhile or socially necessary. I couldn’t begin to knowledgeably weigh all the pros and cons of making all U.S. healthcare and medical research not-for-profit, but it’s certainly not a crazy question.
I have a PhD and do science for a company. I love what I do. So do all of my colleagues. But, if our salaries were halved tomorrow, I would find something else that I love to do, and so would all of my colleagues.
It may make me sound like a horrible person, but I have a mortgage and want to have children some day too. I’ve sacrificed quite a bit to do science. I’m not willing to sacrifice anymore.
Which reminds me of a question I’ve been meaning to ask for awhile.
When I was growing up, back in the 1960s, hospitals were almost all owned and run by governments or nonprofits; they’d have names like Fairfax County Hospital, or Baptist General Hospital. Now it’s largely reversed itself: hospitals are mostly corporately owned, and have names like Inova Fairfax Hospital. Yet I don’t believe I’ve ever seen a newspaper or magazine article on this transition. How and why did this happen, and what have the consequences (positive and negative) been?
There is a limited profit to pour into further research into a particular disease, so I have to do some triage to decide how to spend it. If that profit is further limited, I’m going to have to decide whether to pour that limited money into a project that has fantastic implications for disease, but has a low probability of success. If there is enough profit, that project might get funded. If profit is limited, it probably won’t. That’s just good sense.
Is this a joke? I have to assume so. The flip side is that you no nothing whatsoever about how the world works or economics in general.
Development of Drug A is attempted. Hundred of people are hired to work on it, laboratory space is leased, expensive equipment is bought, lawyers are brought in to cover all the implications. Drug A is a failure.
Drug B - There is none because there aren’t anymore resources.
I apologize, for I am apparently arguing a different point. Profit for the purposes of furthering research of course makes sense. I was thinking more along the lines of the billionaires heading the big pharmaceutical companies.
As others have already stated, how is a corporation like Merck, for example, going to be able to develop resources (including personnel) to perform the research, process all the permitting requirements and then absorb the liability if they are not allowed to charge more for their products than it costs to produce.
I fail to see why that concept is so hard to understand.
There’re huge risks in drug development; overall, their profits are not excessive given the sheer risk they take every year. One reason drug costs in the US are so high is that other countries refuse to pay for the actual cost of developing the drug. And sometimes they refuse to pay for the drug itself, demanding it be made below cost on “humanitarian” (read: they want to look good to their idiot constituents) gounds.
Fact is, governments sometimes manage some good with the shotgun method of research (toss the money around and it may get somewhere good). It may even be very helpful when the profits from an expensive drug couldn’t possible may for its development (i.e., there aren’t many potential customers). Even there, it’s a toss-up. Do we help these peole with that drug or those people get cleaner water? Not an easy question.
Which is one reason I’m always steamed by people who simply declare that we should annihlate the entire drug industry and effectively nationalize it thriough universal healthcare. This would basically nationalize drug research: drug developers and hospitals alike would be squeezed to the last dime by self-interested government bureaucracies. It might even help people today (though they have no rpoven this at all) but only at the cost of removing access to advanced treatments for rarer illnesses and sdiminishing the potential of future gains.
Because, no matter how much you might need health care or want others to have it, someone has to pay for it. The only thing that needs to be decided is who. Do you want a voluntary system, an involuntary system, or a combination?
No matter what system you have, someone has to pay for it.