Instead of downvotes, I'm curious what evidence there is on either side of this claim.
https://fee.org/articles/curing-diseases-is-sustainable-gove...
https://www.bmj.com/content/363/bmj.k4351
https://theconversation.com/amp/how-pharmaceutical-companies...
https://yaledailynews.com/blog/2017/02/09/lewis-the-need-for...
https://www.medpagetoday.com/blogs/revolutionandrevelation/7...
https://pnhp.org/news/eliminate-the-profit-motive-in-health-...
On a website where products as a service are discussed regularly i'm confused as to how the parallels between that and profit driven 'healthcare as a service' are ignored or looked at with hostility.
[just gonna stop commenting on this site]
The problem is the generic ideological tangent. You can perhaps (maybe!) imagine a substantive article and thread on the economics of cures vs. treatments. But that would require different initial conditions—primarily an interesting, informative article that brought lots of relevant information. Relevant information is flame retardant.
The situation is different when the topic is "FDA approves first monthly injectable to treat HIV infection" and the comment is swerving generically into "capitalized medicine". Generic tangents, especially when the impetus is snarky or unsubstantive, make threads reliable less interesting, and generic ideological tangents almost always turn into flamewars. The reason is that there's very little specific information to discuss—that's the meaning of "generic".
Off-topic tangents can be great when they're unpredictable and curious, but generic tangents are the opposite of that. They're more like getting sucked into the gravitational field of a much larger body, if not a black hole, that pulls all nearby topics toward itself and renders them all the same. Avoiding repetition is the biggest problem that a forum like HN—dedicated to curiosity—actually has, so it's a big deal: https://hn.algolia.com/?dateRange=all&page=0&prefix=false&so....
I hope this helps explain things a bit. There are lots of past explanations at https://hn.algolia.com/?dateRange=all&page=0&prefix=true&sor... also, but you'll unfortunately—and ironically—have to wade through some generic repetition to find the interesting bits.
A little ironic perhaps ..
Moderation comments have multiple functions. If it were just about this specific case it wouldn't be worth spending so much time on it, but they're also opportunities to explain the principles of this site to readers who might not have encountered those principles yet.
For those who do already know this stuff, it's true that such comments are tedious. I'm sorry about that. If it helps at all, they're even more tedious to write than they are to read.
https://hn.algolia.com/?dateRange=all&page=0&prefix=false&so...
Lockdown in various countries is definitely bringing out the worst in people, some of the time; I obviously include myself this in this.
Can't be easy moderating during a pandemic. Thanks for doing a good job.
I do see now the flamewar aspect to it and didn't really stop to consider the initial topic of the article when I responded. I was just trying to focus on the actual topic of the commenter's statement and kinda got lost in searching up articles. I was hoping to maybe bring some data and information into the discussion that might steer it in a more productive direction.
It is an issue that could productively be discussed. It seems it didn't end up being the case though and probably wasn't the most appropriate comment thread to do so on.
I think it's because in our mind, the comment is blended together with the intention behind the comment, which is usually benign. We take our intent for granted and assume it will come across, but of course the people who read it have no direct access to that intent, and often it doesn't come across.
https://hn.algolia.com/?dateRange=all&page=0&prefix=true&sor...
https://hn.algolia.com/?dateRange=all&page=0&prefix=false&so...
It's not conspiracy thinking to look at the incentive structures within systems to predict possible negative outcomes.
Of course, there's a moral incentive to not keep people sick, but history shows that we can not rely on people acting morally. The pessimism is justified.
If we expect companies to provide cures over treatments, we at least must allow them to profit as much or more from a cure as they would from a treatment.
I think that’s where you go wrong. There are huge profit incentives for a cure. If a biotech company comes up with a cure they will instantly have the business of every afflicted person on the planet. The market for that and price they can charge will be way larger than a slightly different treatment.
Beyond that, there are labs all over the world funded by public dollars to research avenues to a cure, it’s just way more complicated than effective treatment.
Are you saying people that aren’t taking a monthly biologic injection for example will start coming out of the woodwork for a cure when normally they wouldn’t seek treatment for their malady?
And countries will always pick the best priced possible treatment.
It is when one mischaracterizes the system.
Medical research is not an oligopoly. It is oligopolistic within some domains, but as we've seen with the Covid vaccine, there are at least four nation-state domains (e.g. Russia, China, India and "the West") operating competitively, and within those domains, there are varying degrees of competitiveness (e.g. Pfizer vs. Moderna vs. AstraZeneca).
If you have a cure to something everyone else can only treat, you'll make a money selling the cure and taking your competitors' market share. Because if you don't, they will. It's a classic cartel / prisoner's dilemma problem with the added explosive of a multi-decade patent-protected monopoly for the first mover.
Looking at the list of the most deadly non-tropical infectious diseases [1], most can be vaccinated against and/or cured. The standouts remain lower respiratory infections, e.g. influenza, and HIV/AIDS.
When confronted with a novel coronavirus, it took a few months for the world's medical systems to devise various treatments and a vaccine. Neither of those are recurring revenue streams.
Most damning to this conspiracy theory is the recent Hep C cure. That's a real disease. It was profitable to treat. But it's more profitable to cure. Those incentives remain elsewhere. A cure for HIV is worth billions.
Dealing with mortality and sickness is difficult. It's more comforting to some to imagine an evil cabal holding back medicine, and I don't need to take that from them. But if you're entertaining these thoughts as anything more than a coping mechanism, the last half century--or even decade--of progress in curing, not treating, curing a variety of medical issues has been under-reported (lots of niche illnesses) and breathtaking.
Only thing I would embellish on is that, much like software - when something is wrong its easier to treat the symptoms than to fix the problem a lot of the times. So it's really no wonder alot of treatments are amelioration rather than cures.
I recently did a major refactor at work to fix database and caching problems in our backend. It took months but only yielded 50% scaling improvements. Past teams just kept stacking shit and adding hardware and we can all understand why.
You needn't use your real name, of course, but for HN to be a community, users need some identity for other users to relate to. Otherwise we may as well have no usernames and no community, and that would be a different kind of forum. https://hn.algolia.com/?sort=byDate&dateRange=all&type=comme...
They then had sales of $10.4B in the first year on the market. That’s one year and one drug (they’ve developed newer drugs and launched those too).
That's a pretty powerful motive, historically. If you want to argue that it doesn't apply here, the burden, I'm afraid, is on you, not us.
But one reason for the downvotes may be that it might be too narrow-minded. For one thing, it completely neglects to consider the relative difficulty of treating symptoms versus being fully curative. Secondly, it half undermines itself by lumping vaccines into the same bucket as symptomatic treatment. Clearly the economic incentives for vaccine, versus symptom management, versus cure depends on the disease being treated.
Finally, while it carefully uses the word "incentive" instead of talking in black and whites, it doesn't explain why "big pharma" makes cures at all. A lot of the the supporting material for "pharma makes more money on symptom treatment" references Gilead's experience with Hep C. But the economics of how that drug would have worked was clear as day before Gilead spent resources of it. So why would Gilead have gone to market with a cure at all?