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Comment by tombert | Hacker News Reader

Isn’t this the exact justification that Martin Shkreli used?

It’s not hypocritical; when your life literally depends on something, and they have a monopoly on the only thing that will save your life, it’s absolutely greedy to try and maximize profits.

When Apple overcharges for an iPhone, there are a few things that make this less evil:

1. There are lots of different smartphones out there that you have the option to buy instead. Even when I worked at Apple I found it surprisingly easy to get by on an Android for my first three months.

2. I don’t die when I don’t have an iPhone.

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Not justifying fleecing taxpayers, but you also generally don't pay for drugs, your insurance or Medicare does. Most pharma (including iirc shkreli's) companies have access programs.

Not justifying Martin or excessive pharma prices but it really is the case that we should disabuse ourselves from the notion that one should be entitled to life-saving care.

That process comes with a lot of externalities. Most drugs are incredibly costly to manufacture in terms of environmental damage (petrochemical solvents and cosolvents, water for purification, etc). I loved my dad but when he was dying I remember wondering why our society was bearing the ~100k per week cost because he didn't want to die. When mom was too weak to pull the plug I stepped in and made the hard (easy?) choice.

> but it really is the case that we should disabuse ourselves from the notion that one should be entitled to life-saving care.

I couldn't disagree more. If it truly is life-saving (as opposed to death-prolonging) care, we really should _dedicate_ ourselves to the notion that each of us should be entitled to life-saving care. That should be an explicit part of the social contract.

Oh, and btw, society was NOT paying ~100k to keep your dad alive. Assuming you're here in the U.S., if you were looking at medical bills to figure out that number, SURPRISE! those numbers are just made up. (Seriously, they're fiction)

That's not to say that you made the wrong choice with your dad, mind you. We do tend to prolong life way past the point of cruelty in this country.

Suppose the life saving technology requires you to mow down a rainforest to obtain. Is that still a right? This isn't even a thought experiment. For quite a bit of time, taxol was only obtainable from the endangered yew tree only found in PNW rainforests.

But thats just your opinion man.. not a single fact in all that gibberish. Until everyone has a will to live their best life, take care of themselves and you create a utopian society, the most cutting edge, life-saving drugs will be expensive and not an entitlement.

You should do some research on medical billing and R&D costs in pharmaceutical development; those are two totally different things.

I would say it is a fact that medical billing has little relationship to actual costs of care. You should do some research on it.

It's also a fact that the real cutting-edge R&D is invariably funded by taxpayers, while pharmaceutical companies spend their budgets creating patentable variants, often cherry-picking studies to show marginal improvements over existing drugs. You should do some research on that, too.

> it really is the case that we should disabuse ourselves from the notion that one should be entitled to life-saving care.

I can’t imagine this point of view being very popular in places where universal health care is available.

And personally, I can’t imagine living in a place where it isn’t.

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