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Comment by cpwright | Hacker News Reader

This struck me as the largest problem here. They can charge $84,000; and medicare/medicaid will pay nearly that because they have no choice. If they could refuse based on cost, then Gilead would have more incentive to lower the cost.

There is very little true price discovery going on when the largest payer for healthcare services has absolutely no choice to purchase the product at a given price. All they have to do is get a new treatment approved (i.e. show that it works and is safe), and then the government has no choice but to buy it.

I don't see anything wrong with Gilead charging $84,000 for curing a disease. I just see something wrong with the stats not being able to take it or leave it.

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> I don't see anything wrong with Gilead charging $84,000 for curing a disease.

Personally, I do. Helping other people is never going to be friendly with a free market. I accept that it may have a cost, but I reject the idea that people's health is something that should be traded on the free market. While it's great that this cure was developed, it was developed because there was a profit to it. That's the worst reason to develop a cure—how about working on diseases that aren't likely to return a profit? Curing the cold may not make you rich, but it would yield substantial productivity benefits for our society. Same with basic dietary habits. In fact, I'd be willing to bet that the US (not familiar with other countries) is worse off, mental-health wise, since the invention of Prozac, compared to basic research into public awareness of exercise, diet, and basic emotional well-being.

An easy fix here is for the patient to be evaluated for fault. If you got Hep C via botched transfusion, you're covered; if, however, you are a degenerate who chose to scrounge up used heroin needles from alleyways, then you're not.

This is, of course, for reasons nobody can adequately respond to with reason instead of feelings, unpopular.

But it's certainly 1. fair and 2. a large cost savings, given the sheer number of Hep C patients who brought it on themselves.

It's not a cost savings in the long run. 1. They will spread it to more people. 2. The disease causes more issues that will end up costing more than this drug.

This will not be an issue when the masses that have Hep-C now are cured. This is mostly a short term financing problem. Would you rather solve the issue for $1X now or pay $3-5X over time to deal with it. I would rather cure the masses now and lower the long term medical costs.

To punish addicts by denying them health care is extremely cruel and unfair. There is no basis for denying care because of your irrational hatred.

No basis?

The basis is that these people choose, of their own agency, to shoot up with used needles. This isn't some poor guy getting the cancerous genetic bit flipped by a cosmic ray or an uninsured single mom getting disabled by a drunk driver. These are consequences brought on by the patients themselves. By what moral basis should society be paying for the consequences of willful degeneracy?

How about people who are injured during the course of risky sports? Or while drunk? Or from tobacco? or fromvovereating? By what moral basis should society be paying for the consequences of such willful risk taking and harm?

>The basis is that these people choose, of their own agency, to shoot up with used needles.

They certainly chose to shoot up right until the point they achieved chemical addiction, but after that there is much less free will than people presume.

>By what moral basis should society be paying for the consequences of willful degeneracy?

I don't know about you but I hate seeing people self destruct. I certainly feel an obligation to assist them when possible. You might not, but please don't act like your moral compass is the only one that matter.

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