Quoting osmium: "No one knows who Major Deegan is." Ah, but now they do!

Holland is actually my favorite. I wouldn't know him, if it weren't for his tunnel of course. I always heard he was sick due to overwork on the tunnel. Wonder if it's true.

There goes another of my illusions. I always thought the name of the Holland tunnel had something to do with the fact that New York was originally called New Amsterdam. Damn.

Quoting osmium: "No one knows who Major Deegan is." Ah, but now they do!

"I knew Major Deegan, and...."

I believe Tim and Megan misunderstand the significance of the Stupak amendment and why it is thorny. The issue is not that the amendment just prevents the government from funding more abortions. Rather, the amendment would make abortion more expensive for more people than in the status quo. This is because the healthcare plans under consideration will end up regulating (and for some, susidizing) the insurance coverage of many people who have private insurance now. The Stupak amendment would prevent those plans from covering abortions. The net result is that fewer people will have insurance coverage for abortions. This is what happens when the government becomes more involved in an industry. Formerly market driven decisions (like whether to cover abortion) become politicized. This is just a prominent example of a more widespread problem and one that happens to gore the ox of the left for a change,

Megan has a knack for needlessly complicating points she disagrees with to feign uncertainty and over-simplifying arguments she does agree with to score easy points. The abortion issue falls in the second category. I think examples of the first point abound, but the one I'm currently watching is Megan pretending that she cannot divine whether decreasing medical loss ratios for insurance companies, during a time of unprecedented insurance industry profit and health care cost inflation, is bad for the end consumer. She's happy to speculate on all sorts of other issues and "go out on a limb" by reiterating her point that health care reform is dead, but on this point "I just don't know".

Are food prices in the US set by the market? Are there not a lot of agricultural subsidies? I did not follow McCardle's argument to the effect that allowing the import of Canadian drugs would not "force" Canada to contribute more to drug R&D expenditures. First, why is it a matter of forcing Canadian drug firms to do anything? Isn't it a question of what they will do, given this new US market, not of what they are forced to do? Second, I am sure that I've heard McCardle saying that we need to allow US pharma to make tons of money so that they will be able to fund R&D, where the investment costs are high. So how can it be the case, by her own prior reasoning, that the implementation of a policy which increases Canadian pharma's profits overall, the policy being to hand them a huge new market, is not likely to lead to more R&D expenditures by Canadian pharma? Are Canadian drug firms going to lose money on their exports to the US? McCardle should not be paired with mild-mannered noneconomists like this guy, if there is going to be a lot

I didn't know that Tim and Rosa were now an item. That almost makes up for my sadness regarding Horgan and Suzy! Congrats, Tim - she's a catch! ADDED: was this their first date?! http://bloggingheads.tv/diavlogs/13719

Did anybody catch Megan McCardle's argument that food is cheap because it is produced using a free market as opposed to command and control measures-- and this is a reason to keep government out of pharmaceuticals ? Food has to be the most subsidized commodity on the planet, including in the U.S.A. Where do our agriculture subsidies go if not to subsidize the production of food ? Even if you discount direct subsidies (which are gigantic), there are also lots indirect subisidies like free grazing on Federal lands. Moreover, food is made even cheaper because of the immense agriculture subsidies of the EU and other industrial countries. Megan, if you read this comment, would you please clarify that argument ?

Quoting messwithtexas: I think examples of the first point abound, but the one I'm currently watching is Megan pretending that she cannot divine whether decreasing medical loss ratios for insurance companies, during a time of unprecedented insurance industry profit and health care cost inflation, is bad for the end consumer.

Does the health care bill only apply so long as insurance profits are high?

Quoting Joe: Did anybody catch Megan McCardle's argument that food is cheap because it is produced using a free market as opposed to command and control measures-- and this is a reason to keep government out of pharmaceuticals ? Food has to be the most subsidized commodity on the planet, including in the U.S.A. Where do our agriculture subsidies go if not to subsidize the production of food ?

Ag subsidies are, I believe, limited to a handful of products (they also tend to make food more expensive, not cheaper). Even if the market isn't completely free, there is a lot less government involvement than there is in health care (where, for example, nearly half of all health care spending is by the government).

Quoting ledocs: Are food prices in the US set by the market? Are there not a lot of agricultural subsidies?

I did not follow McCardle's argument to the effect that allowing the import of Canadian drugs would not "force" Canada to contribute more to drug R&D expenditures. First, why is it a matter of forcing Canadian drug firms to do anything? Isn't it a question of what they will do, given this new US market, not of what they are forced to do? Second, I am sure that I've heard McCardle saying that we need to allow US pharma to make tons of money so that they will be able to fund R&D, where the investment costs are high. So how can it be the case, by her own prior reasoning, that the implementation of a policy which increases Canadian pharma's profits overall, the policy being to hand them a huge new market, is not likely to lead to more R&D expenditures by Canadian pharma? Are Canadian drug firms going to lose money on their exports to the US?

My understanding is that the issue is reimportation of drugs (i.e. U.S. drugs imported into Canada and then reimported into

Quoting messwithtexas: ... Megan pretending that she cannot divine whether decreasing medical loss ratios for insurance companies, during a time of unprecedented insurance industry profit and health care cost inflation, is bad for the end consumer.

Quoting Blackadder: Does the health care bill only apply so long as insurance profits are high?

Health care cost inflation is given, but what are the "high" and "unprecedented insurance industry profit" margins that are being referred to here?

Quoting Blackadder: Ag subsidies are, I believe, limited to a handful of products

You mean like milk, corn, wheat, and soya beans? That kind of handful?

Quoting Blackadder: (they also tend to make food more expensive, not cheaper).

If by "more expensive", you mean that food is produced at some price, rather than none at all, then, yes.

Quoting Blackadder: Even if the market isn't completely free,

That's one way of putting it. "Not completely free" or, say, utterly distorted by the government.

Quoting Blackadder: there is a lot less government involvement than there is in health care (where, for example, nearly half of all health care spending is by the government).

But not all prices for health care are determined by the government. The prices of the handful of agricultural commodities you mentioned are determined by the government. That handful has considerable influence.

P.S. I hear the food business suffers some regulation, too.

Quoting Blackadder: (they also tend to make food more expensive, not cheaper)

P.P.S. For you and that other dude: it doesn't matter what subsidies do to a particular price. Raising a price or lowering it still amounts to a distortion of the market.

I agree with Megan that health care reform is dead or in a permanent vegetative state. How did up become down? How did a cornerstone of Change fizzle into something that will only dismay and piss off most voters? How did accountability for "greedy" insurers turn into a bonanza for the industry? Of course, Dems. will try to spin whatever legislation Obama signs ("Quick! I'll sign anything!") as a monumental victory, but this reform has basically nothing going for it that couldn't have been achieved with infinitely less fanfare. Losers: Obama, Congressional Dems., American people. Winners: Insurance industry, hospitals, drug industry, AMA, Republicans.

Quoting Ray: If by "more expensive", you mean that food is produced at some price, rather than none at all, then, yes.

I can't tell if this is meant to be serious, or if you were just going for pure snark. Do you really think that, absent farm subsidies a person in America wouldn't be able to go into a store and buy a gallon of milk or a loaf of bread? If you look at the example of a place like New Zealand (which got rid of its farm subsidies some time ago) it's hard to conclude that farm subsidies are necessary or even beneficial to a society.

Quoting Ray: P.S. I hear the food business suffers some regulation, too.

P.P.S. For you and that other dude: it doesn't matter what subsidies do to a particular price. Raising a price or lowering it still amounts to a distortion of the market.

Well sure. But since the context was food's being cheap, the existence of government interference that tends to increase the price of food would bolster rather than undercut Ms. McArdle's point.

Quoting Wonderment: ...health care reform is dead or in a permanent vegetative state.

How did up become down? How did a cornerstone of Change fizzle into something that will only dismay and piss off most voters? How did accountability for "greedy" insurers turn into a bonanza for the industry?

Can you say 100 U.S. Senators, plus the House of Reps, and an ineffectual or collusive White House?

Of course, Dems. will try to spin whatever legislation Obama signs ("Quick! I'll sign anything!") as a monumental victory, but this reform has basically nothing going for it that couldn't have been achieved with infinitely less fanfare.

Right you are.

Losers: Obama, Congressional Dems., American people.

Winners: Insurance industry, hospitals, drug industry, AMA, Republicans.

Sad but true.

I can't understand why so many people can't conceive of meaningful policy options between single payer and the status quo. The bill that will likely pass sure isn't ideal, but it does a lot of things that will help people. Sweeping reforms of the insurance industry, the establishment of insurance exchanges with subsidies for the poor, and the individual mandate are all big changes that will become even more significant as the employer-based system continues to unravel, and the bill is full of all sorts of small-bore stuff and various cost-saving measures like the MPAC that are worth doing in their own right. Sure, I would like to see a better bill too, but writing this one off as a handout to industry is absurd; it will easily be the biggest liberal domestic policy accomplishment in decades if it passes.

Wouldn't giving power to the Medicare Payment Advisory Commission be creating the "death panel" that received so much attention not to long ago?

Quoting Don Zeko: I can't understand why so many people can't conceive of meaningful policy options between single payer and the status quo. The bill that will likely pass sure isn't ideal, but it does a lot of things that will help people. Sweeping reforms of the insurance industry, the establishment of insurance exchanges with subsidies for the poor, and the individual mandate are all big changes that will become even more significant as the employer-based system continues to unravel, and the bill is full of all sorts of small-bore stuff and various cost-saving measures like the MPAC that are worth doing in their own right. Sure, I would like to see a better bill too, but writing this one off as a handout to industry is absurd; it will easily be the biggest liberal domestic policy accomplishment in decades if it passes.

I agree 100%. I actually worked for the public option: I phonebanked for it, I went in person to my Congresspersons' offices back in August, and I gave money through Act Blue to run attack ads in key states (Arkansas). The efforts of people like me and thousands of others shifted the needle well to

Sweeping reforms of the insurance industry, the establishment of insurance exchanges with subsidies for the poor, and the individual mandate are all big changes that will become even more significant as the employer-based system continues to unravel, and the bill is full of all sorts of small-bore stuff and various cost-saving measures like the MPAC that are worth doing in their own right.

Well, we'll have to see what "sweeping" means at the end of the day. The more coverage that is extended to the poor and near-poor the better. That may be the best thing that can be said for the reform (so far, since more chiseling away is still possible). However, Change for most people who get screwed by doctors, pharma, insurers and hospitals (in ways they don't get screwed in more civilized countries) will mean more of the same. I do agree with your assessment of Lieberman, however.* How come he never worries about spending too much when it comes to funding wars and occupations?** *FULL DISCLOSURE: My spouse and I are members of the 55-65 year old segment of the population who would have benefited from a Medicare buy-in option. I felt

I didn't know that Tim and Rosa were now an item.

That almost makes up for my sadness regarding Horgan and Suzy!

Congrats, Tim - she's a catch!

Amen to that! Color me (bloggingheads) green with envy. She's definitely one of the diavloggers I miss most. Hopefully she will come back if she ever abandons policy-wonkery and returns to journalism.

I think Ted Kennedy will be remembered as part of the three Kennedy brothers. I think it is because JFK was president and because his assassination was, is and will still be a very memorable event in history, and because Bobby was assassinated too that Ted Kennedy will be remembered as a part of all of that. If Ted Kennedy had the same Senate career but didn't have his two famous brothers, I don't think his senate record alone would put him above Everett Dirksen, Jacob Javitts and a whole bunch of other accomplished senators in history.

No, Death Panels referred to coverage for end-of-life counseling. Both it and the MPAC are good ideas, though, and the people persuaded by the "death panels" idiocy were never on board anyway.

Quoting claymisher: Joe Lieberman is still a world-historical asshole though.

Yes, yes, a thousand times yes

I agree the end of life consulting received the most press play but the idea was not just about that one issue. The panels in this legislation are not empowered to issue guidelines but to set policy, unless congress intrudes, truly does make death likely for some who are to be sacrificed to the gods of cost efficiency. Don't get me wrong I believe that the current system is also a death sentence for some as it too rations. Will the majority of voters, be in favor or against health care via government bureaucracy of accounts and actuaries or are the happy with the system that rations via a competing market driven bureaucracy of accounts and actuaries? The continuing, same say accelerating, slide that the legislation seems to be taking, may in part be driven by the most recent fiasco over breast cancer screening guidelines and the opinion of the voters is being expressed in the polling.

In a hundred years the only thing people will remember will be Chappaquiddick. He will be know as that brother of president Kennedy that killed a girl. No one is gonna care that he helped expand Medicare (which, in 100 years, will likely have collapsed under its unfunded liabilities, breaking promises to millions and crushing economic growth with brutal taxes or inflation or both).

Quoting Blackadder: Do you really think that, absent farm subsidies a person in America wouldn't be able to go into a store and buy a gallon of milk or a loaf of bread?

Yes. This is why we have agricultural subsidies. The price floor on agricultural products keeps American farmers working when competition from farmers overseas would have driven them out of business.

Quoting Blackadder: If you look at the example of a place like New Zealand (which got rid of its farm subsidies some time ago)

What happens when you look at New Zealand? The food business in the U.S. suddenly becomes a free market?

Quoting Blackadder: the existence of government interference

Completely undercuts her point that there is no government interference.

Quoting piscivorous: Wouldn't giving power to the Medicare Payment Advisory Commission be creating the "death panel" that received so much attention not to long ago?

More than death panels, I worry about the death squads. These are going to incarnate in the cheap unsafe abortion clinics that low income women will need to use due to lack of funding for termination of pregnancy. More women will die. I can't wait until health care re-reform...

Quoting Ocean: More than death panels, I worry about the death squads. These are going to incarnate in the cheap unsafe abortion clinics that low income women will need to use due to lack of funding for termination of pregnancy. More women will die.

I can't wait until health care re-reform...

Maybe these low income women should use birth control, then.

Quoting Wonderment: FULL DISCLOSURE: My spouse and I are members of the 55-65 year old segment of the population who would have benefited from a Medicare buy-in option. I felt like a huge winner for about 48 hours. Thank you, Harry Reid.

From what I heard, only the people who weren't currently insured would have been eligible to enroll. Seems a little unfair and discriminatory, but that's what I heard. So if you drop your current coverage you might have been eleigible? What a mess!

Quoting Ocean: More than death panels, I worry about the death squads. These are going to incarnate in the cheap unsafe abortion clinics that low income women will need to use due to lack of funding for termination of pregnancy. More women will die.

I can't wait until health care re-reform...

Death Squads? Get a grip, dude. You do realize that "Death Squads" usually refers to paramilitary troops engaging in genocide or other atrocities, right? The Stupak Amendment might be terrible policy, but that doesn't mean that this kind of rhetoric is reasonable.

Quoting spandrel: Health care cost inflation is given, but what are the "high" and "unprecedented insurance industry profit" margins that are being referred to here?

Well, let's see. maybe he/she heard it on the Olbermann show or the Maddow show. The TV/ internet/radio is so full of these unsubstantiated throw away terms (on both sides) I feel like we're living in an Orwell novel.

Quoting Wonderment: Well, we'll have to see what "sweeping" means at the end of the day.

The more coverage that is extended to the poor and near-poor the better. That may be the best thing that can be said for the reform (so far, since more chiseling away is still possible).

However, Change for most people who get screwed by doctors, pharma, insurers and hospitals (in ways they don't get screwed in more civilized countries) will mean more of the same.

But this is what I'm talking about! Sweeping means community rating, garuanteed issue, eliminating lifetime limits, banning rescission, etc. etc. etc. In other words, no more denial of coverage due to pre-existing conditions, no more coverage that leaves you high and dry if you actual get a serious illness, no more pricing you out of the market if you're diabetic, have family history, etc.. These aren't everything, but they're in the bill and they will be a big deal for huge numbers of people. All of the attention lavished on the public option has gotten an astounding number of people to ignore everything else the bill does.

Ok so profit margin growth is an overstatement, but it is not an overstatement to say that gross profit has been through the roof as costs inflate. A lot of the bs you hear from the industry uses total insurance industry profit over the total US medical costs (including those contributed by consumers and employers) to make their profits seem lower than they really are. That article says profit margin is between 2-10% for the largest insurance companies, which is substantial considering they're run like conservative investment firms. However, if you look at profit compared to shareholders equity, the return averages even higher at about 20% for the largest five insurers. Fortune ranks "Health Care: Insurance and Managed Care" at number 24 in its 2008 fastest growing industries list with 7.9% growth in the past five years, ahead of both pharmacies and medical facilities, but behind pharmaceuticals and medical equipment. (side note: How could pharmaceuticals be expected to invest in R&D if they didn't have protectionism to help them grow 12% in just five years? Megan is selectively libertarian.)

Quoting Don Zeko: But this is what I'm talking about! Sweeping means community rating, garuanteed issue, eliminating lifetime limits, banning rescission, etc. etc. etc. In other words, no more denial of coverage due to pre-existing conditions, no more coverage that leaves you high and dry if you actual get a serious illness, no more pricing you out of the market if you're diabetic, have family history, etc.. These aren't everything, but they're in the bill and they will be a big deal for huge numbers of people. All of the attention lavished on the public option has gotten an astounding number of people to ignore everything else the bill does.

This bill and the 2000+ pages which are included in it will serve to impose more regulations which the lawyers employed by the insurance companies will find a way around because that's what they do. It seems to me that the issue of pre-existing conditions could have been addressed in a far more simplified way, if that had been the intent of the bill. It would have probably resulted in increased cost for others (which it will do anyway) but the hodgepodge of regulations which

Questions for messwithtexas So I have a few serious (to me) questions. It will soon becaome clear that I am no economist.

A lot of the bs you hear from the industry uses total insurance industry profit over the total US medical costs (including those contributed by consumers and employers)

Isn't that what profit is....what's left after all the bills are paid?.... even CEO compensation.

However, if you look at profit compared to shareholders equity, the return averages even higher at about 20% for the largest five insurers

Why is this significant and what makes this different from plain old profit?

(side note: How could pharmaceuticals be expected to invest in R&D if they didn't have protectionism to help them grow 12% in just five years? Megan is selectively libertarian.)

Why is this damning? And what sorts of protectionism are you refering to? Don't pharmaceuticals perform a valuable service and don't they take tremendous risk to develop their products?

Quoting badhatharry: ... Don't pharmaceuticals perform a valuable service and don't they take tremendous risk to develop their products?

Nope, not most of the time. Instead they develop just-different-enough-to-be-patented versions of existing drugs and try to poach pre-existing markets. How many Statin drugs are there? Beta blockers? Alpha-channel inhibitors? NSAIDS? (under-reported deadly side effects no extra charge!) Etc...

I am unaware of any reason why insurance companies are due any appreciable profit at all. They don't bring anything to the table. An insurance company collects money up front from a group of people who are pooling their risks, and doles some of it out to those unfortunate members of the pool who incur losses or injuries. The insurer performs some clerical and accounting functions, and those individuals employed in these tasks certainly deserve to be paid, but I'm at a loss as to what justifiable claim a group of third parties - the insurance companies and their owners - have to be there raking off a percentage of all the dollars involved. They don't provide any added value. An insurance company essentially runs a pari mutuel betting system and rakes off a vigorish. A smart professional gambler doesn't play in games where the house takes five or ten percent off the top.

Would you make this argument about any other kind of insurance? Does a company that provides, say, flood insurance deserve a profit? In theory at least, health insurance companies provide a very useful service: risk pooling to protect individuals from improbable catastrophic costs. THis isn't the way our system actuall works, but it's certainly possible that you could regulate it in such a way that health insurers have to operate on that model.

Quoting AemJeff: Nope, not most of the time. Instead they develop just-different-enough-to-be-patented versions of existing drugs and try to poach pre-existing markets. How many Statin drugs are there? Beta blockers? Alpha-channel inhibitors? NSAIDS? (under-reported deadly side effects no extra charge!) Etc...

OK, I am aware of the tricks that pharmaceuticals play, I'm not sure if it's most of the time or how often it is. But, what is the alternative? I think you might say the government should be involved with this enterprise. That there shouldn't be profits or that they should be capped. There are lots of ways to inflate costs to make profits seem to be less than they are. (as Megan pointed out). Or should drug development be taken over by the government? Are you willing to have the government (us) bear the cost of R&D? What happens when, after years of development and trials, the drug doesn't work as expected? Do the taxpayers just take it in the shorts? Or does the FDA, another governemnt agency, approve it because it would look bad politically not to? Or maybe we have enough drugs now...no need for any more. It might reduce the carbon footprint of the human race which would

In a hundred years the only thing people will remember will be Chappaquiddick.

Are you kidding? Most people I know in their twenties barely remember Chappaquiddick. I'm not convinced people outside Massachusetts will remember Kennedy as anything other than a Kennedy brother, but they definitely won't remember him solely for Chappaquiddick.

Quoting Don Zeko: In theory at least, health insurance companies provide a very useful service: risk pooling to protect individuals from improbable catastrophic costs. THis isn't the way our system actuall works, but it's certainly possible that you could regulate it in such a way that health insurers have to operate on that model.

So in what way isn't the system working in the way you describe? Is it the excess profits that bother you? It seems to me that the things which need to be changed are few and as you say could be handled with a few targeted regulations. But when we start talking about human rights and providing abortions and viagra, reason flies out the door and you get the Congress arguing about a 2000+ page bill.

Quoting badhatharry: OK, I am aware of the tricks that pharmaceuticals play, I'm not sure if it's most of the time or how often it is. But, what is the alternative? I think you might say the government should be involved with this enterprise. That there shouldn't be profits or that they should be capped. There are lots of ways to inflate costs to make profits seem to be less than they are. (as Megan pointed out).

Or should drug development be taken over by the government? Are you willing to have the government (us) bear the cost of R&D? What happens when, after years of development and trials, the drug doesn't work as expected? Do the taxpayers just take it in the shorts? Or does the FDA, another governemnt agency, approve it because it would look bad politically not to?

Or maybe we have enough drugs now...no need for any more. It might reduce the carbon footprint of the human race which would be good.

I just don't see an alternative which would be more efficient than what we currently have and believe me, I know it isn't perfect. But then nothing is.

I'm a liberal. I believe in regulation! Seriously, the line

Quoting kezboard: Are you kidding? Most people I know in their twenties barely remember Chappaquiddick. I'm not convinced people outside Massachusetts will remember Kennedy as anything other than a Kennedy brother, but they definitely won't remember him solely for Chappaquiddick.

Kennedy hatred is alive and well. I suspect Ted's reputation will survive better and longer than the lingering hatred of his political enemies.

The problem is that for many people health insurance companies don't risk pool, they discriminate. When someone has predictable large expenses to deal with from their health, then the basic model for insurance breaks down. In practice, health insurance companies spend a tremendous amount of time and money weeding people out of their coverage pools and avoiding actually paying for services. At this point, there are basically three ways to deal with the problem. You can leave things be, in which case lots of people are bankrupted by medical expenses or forgo treatment completely, because it doesn't make any sense for an insurer to cover them and they can't afford treatment on their own. Option two is to just provide those people with coverage through the state, but that's socialism, so we'd never do it in the United States if you aren't over 65, or poor, or a veteran, or a member of congress, or a federal employee. The third option, which is what this bill foes with, is to force insurers to ignore the information they have about people's health so that you can have a functioning pool to

Quoting Don Zeko: ...absurd; it will easily be the biggest liberal domestic policy accomplishment in decades if it passes.

And being that it really does little in the way of helpful reform really says what about "liberal domestic policy accomplishments". You are right while people worried about the stupidity of allowing 55 yo to buy into medicare and President Joe's smackdown they ignore much of the other damage this piece of crap will do to this country and how it goes about doing it.... These words from the CBO this weekend were a bit troubling: The CBO on Sunday issued a strongly worded memo on the proposal establishing all health insurance companies’ “medical-loss” ratio at a maximum of 10 percent — meaning 90 percent of premiums would have to go to medical claims. Companies would have to issue rebates to their customers if they fail to meet this standard. Alternatives would set the level at 80 percent to 85 percent, as included in the House-passed healthcare bill.

Considering the medical-loss ratio in tandem with the other strict new insurance regulations contained in the bill, the CBO predicted that such a policy would “reduce the

I'm a liberal. I believe in regulation! Seriously, the line between public and private development is blurry. And, yet very little of the profit gets back channeled to the taxpayers.

So here you are saying that the government supports the drug companies and yet the profits for that investment don't get channeled back to the taxpayer? Or that the advancements made aren't refunded back to the taxpayer in the way of cheaper drugs?

I don't grudge them their profits, but I think it needs to be made clear that they operate in a constrained environment - that, for instance, charging five figures for single dose of certain drugs is beyond the pale

So five figures is what? $00,000? I've never heard of such a thing, but I'm sure you wouldn't say it if it wasn't so. So the person who needs that drug may be covered by insurance which could be the reason insurance cost keeps going up.

that looking for cures to diseases like diabetes, despite the possible loss of the diabetes maintenance cash cow, is part of their mandate;

So here you are saying that all the current diabetes medicines which are

Bottom line is the majority of the people want nothing to do with this.

Quoting badhatharry: So here you are saying that the government supports the drug companies and yet the profits for that investment don't get channeled back to the taxpayer? Or that the advancements made aren't refunded back to the taxpayer in the way of cheaper drugs?

So five figures is what? $00,000? I've never heard of such a thing, but I'm sure you wouldn't say it if it wasn't so. So the person who needs that drug may be covered by insurance which could be the reason insurance cost keeps going up.

So here you are saying that all the current diabetes medicines which are profitable are keeping the pharmaceuticals from finding a cure? I suppose that is possible and I'm sure that charge has been levied (I think by you!)

We look at this problem from two sides of it. I see (through rose colored glasses) an industry which has provided miracles, has taken risk and will continue to search for solutions, partially because of the promise of wealth.

You see fat cats preying on the public, withholding help for the helpless and manipulating old technology for obscene gain.

We're probably

Quoting Don Zeko: The third option, which is what this bill foes with, is to force insurers to ignore the information they have about people's health so that you can have a functioning pool to pay for the sick. In this way, insurance moves from being a transfer of wealth from the lucky to the unlucky to being a transfer of wealth across time, since everyone will get old and sick eventually.

I agree with your assessment of the options, although I don't think that federal employees get their coverage from the state (in that the state is not the insurer) and Medicare has been paid for over a lifetime. The third option is what I think we as a compassionate people should be aiming for, but I don't think this massive bill addresses it. Or rather it addresses so much other stuff that I can't support it. People with pre-existing conditions need to be able to purchase coverage. People need to be covered in such a way that getting sick won't cause them to lose everything they have. Addressing these issues will cost us all something and that should be clear, but

Quoting AemJeff: By the way I love Pharma - I fully, personally, understand the benefits bestowed by the product of that industry. That doesn't quell my cynicism, however.

It's interesting to see the angle of repose you find in all of this debate, because that's just about where I rest as well. The longer one lives, the more apparent it becomes that the only sensible thing is to remain, if not cynical, skeptical.

Quoting Wonderment: **Elsewhere on the family front: My daughter's boyfriend who was set to deploy to Somewhere Else in August has now been given marching orders to Afghanistan in April. Thank you, President Obama.

and equal thanks to your daughter's boyfriend.

Quoting badhatharry: Maybe these low income women should use birth control, then.

too bad your mom didn't.

Quoting badhatharry: Well, let's see. maybe he/she heard it on the Olbermann show or the Maddow show. The TV/ internet/radio is so full of these unsubstantiated throw away terms (on both sides) I feel like we're living in an Orwell novel.

Quoting badhatharry: Questions for messwithtexas

So I have a few serious (to me) questions. It will soon becaome clear that I am no economist.

First of all, if you don't know much about the subject, you should not be so quick to judge what is unsubstantiated. You obviously have an ideological bias yourself, but I won't stoop to accusing you of listening to Beck or Limbaugh.

Quoting badhatharry: Questions for messwithtexas
Isn't that what profit is....what's left after all the bills are paid?.... even CEO compensation.

No. That's not what profit is. Insurance companies there don't compare their profit to their own expenditures (ostensibly for health care, although in reality that's only 80%). Instead they compare it to the overall national economy's spending, which includes individual costs, employer costs (outside of premiums), and government spending. Just read the damn article.

Quoting badhatharry: Questions for messwithtexas
Why is this significant and what makes this different from plain old profit?

Its just a different profit measure that captures the return to shareholders. There are

Quoting AemJeff: I've been laughed by more than one informed person when I asked about type II diabetes cures. It seems to me that if Novo is making a ton of money on maintenance therapies (e.g.) and Merck (again e.g.) can find a cure that the market would work in favor of the cure. What I've been told (take it for what it's worth) is that such an effort would never get funded, given the influence of Pharma lobbyists. This is a matter of personal interest to me, and I'd like to think this wasn't the case.

I'd count the HPV vaccine as a cure, in the sense of 'a way to wipe out the disease', but I can't think of any other such cures in the recent history of pharmacology. Actually, has big pharma ever cured any widespread, serious disease?

Quoting Don Zeko: Would you make this argument about any other kind of insurance? Does a company that provides, say, flood insurance deserve a profit? In theory at least, health insurance companies provide a very useful service: risk pooling to protect individuals from improbable catastrophic costs. THis isn't the way our system actuall works, but it's certainly possible that you could regulate it in such a way that health insurers have to operate on that model.

Jumping in, I wouldn't make the argument about other types of insurance, but I'm skeptical about the idea that we can regulate the health insurance industry to make it add value in the same way, especially given the direction in which we seem to be proceeding. Health insurance companies and the employer-provided model both filled needs, but neither seems to me particularly well-suited to the problem, really. With health insurance, one aspect of it -- catastrophic care -- seems really the type of risk that is normally insured against, but routine care doesn't seem to me to be such a risk, or really a risk at all. And of course the pre-existing condition problem just illustrates this, as with the normal

Quoting Ray: I'd count the HPV vaccine as a cure, in the sense of 'a way to wipe out the disease', but I can't think of any other such cures in the recent history of pharmacology.

Actually, has big pharma ever cured any widespread, serious disease?

Well, do you count antibiotics and antivirals? I think so. There's chemotherapy. I think steroid treatments count as cures for some conditions. Type I diabetes has a possible cure in islet cell transplants. Gene therapy, to the extent that it works, is an example of a class of potential cures for many conditions. Metabolic disorders like type II diabetes seem to be good candidates for that approach. I'm fairly certain that some basic work has been done looking into a possible basis for a type II cure.

Sure, I agree that we'd be better off just having single payer, but we're not getting single payer any time soon, so we've got to work with what we've got. Given the absurd political constraints in which we have to make policy, I think the plan we've got is reasonably good.

Quoting Don Zeko: Sure, I agree that we'd be better off just having single payer, but we're not getting single payer any time soon, so we've got to work with what we've got. Given the absurd political constraints in which we have to make policy, I think the plan we've got is reasonably good.

I'll take it, if I have to. But I want to see Lieberman in stocks with a "Kick Me!" sign pinned to his ass.

Quoting AemJeff: Well, do you count antibiotics and antivirals? I think so. There's chemotherapy. I think steroid treatments count as cures for some conditions. Type I diabetes has a possible cure in islet cell transplants. Gene therapy, to the extent that it works, is an example of a class of potential cures for many conditions. Metabolic disorders like type II diabetes seem to be good candidates for that approach. I'm fairly certain that some basic work has been done looking into a possible basis for a type II cure.

How many of those things are the product of 'big phrma"? How many are under patent? This just occurred to me, but if a major pharmaceutical did discover an important cure they might face even more popular pressure to loosen patent laws or charge less than he market would bear, which is another big potential disincentive.

Well, yeah. I don't see why Reid isn't telling him that he loses his chairmanship and gets a well-funded opponent for re-election if he doesn't back down from this shit.

Quoting messwithtexas: How many of those things are the product of 'big phrma"?

How many are under patent? This just occurred to me, but if a major pharmaceutical did discover an important cure they might face even more popular pressure to loosen patent laws or charge less than he market would bear, which is another big potential disincentive.

Chemo, antibiotics and antivirals? How do they not count? Gene therapy will almost certainly have components that qualify. The rest of that was just speculation about "cures." My guess in regard to your hypothesis is that the pressures wouldn't be more than could be born, but I couldn't quantify that.

Quoting cragger: I am unaware of any reason why insurance companies are due any appreciable profit at all. They don't bring anything to the table. An insurance company collects money up front from a group of people who are pooling their risks, and doles some of it out to those unfortunate members of the pool who incur losses or injuries.

The insurer performs some clerical and accounting functions, and those individuals employed in these tasks certainly deserve to be paid, but I'm at a loss as to what justifiable claim a group of third parties - the insurance companies and their owners - have to be there raking off a percentage of all the dollars involved. They don't provide any added value. An insurance company essentially runs a pari mutuel betting system and rakes off a vigorish. A smart professional gambler doesn't play in games where the house takes five or ten percent off the top.

Great point about pari-mutuels. I'm a little surprised that Vanguard hasn't crowded out all the other 401K companies. It's a co-op and doesn't have to generate profits for its owners so it has

But this is what I'm talking about! Sweeping means community rating, garuanteed issue, eliminating lifetime limits, banning rescission, etc. etc. etc. In other words, no more denial of coverage due to pre-existing conditions, no more coverage that leaves you high and dry if you actual get a serious illness, no more pricing you out of the market if you're diabetic, have family history, etc.. These aren't everything, but they're in the bill and they will be a big deal for huge numbers of people. All of the attention lavished on the public option has gotten an astounding number of people to ignore everything else the bill does.

Yes, there were some insurance company practices so egregious as to border on sadistically criminal. Hopefully, those will be remembered by future generations with all the fondness of slavery and stoning adulteresses. However, what the Dem. base wanted was affordable coverage for all. The public option was a great symbol of Hope and Change and Yes-we-can-ism. Even the Medicare buy-in offered relief to millions of people between 55-65, with the hope the age limit would gradually be lowered (eventually becoming Medicare-for-all). People believed, perhaps wrongly, that if the insurers charged them outrageous

Quoting Don Zeko: Well, yeah. I don't see why Reid isn't telling him that he loses his chairmanship and gets a well-funded opponent for re-election if he doesn't back down from this shit.

There's strong political pressure from the White House to give Joe what he wants. Those guys are in a better place than I am to calculate the advantages, but I'd sure like to see Joe eating crow.

Quoting AemJeff: Well, do you count antibiotics and antivirals?

Sure. Which ones resulted from Big Pharma research, rather than government-funded research?

Quoting AemJeff: There's chemotherapy.

You're telling me we cured cancer? And that Big Pharma invented chemotherapy?

Quoting AemJeff: I think steroid treatments count as cures for some conditions.

Such as?

Quoting AemJeff: Type I diabetes has a possible cure in islet cell transplants.

Possible?

Quoting AemJeff: Gene therapy, to the extent that it works, is an example of a class of potential cures for many conditions.

Potential? Let me give you an example, in addition to the HPV vaccine: Jonas Salk, polio. That's the kind of thing I'm talking about. A big disease. Kills or debilitates lots of people. Cured. In other words, is there any reason to say that we're really getting what we want, on the largest scale, from Big Pharma?

Quoting Wonderment: However, what the Dem. base wanted was affordable coverage for all. The public option was a great symbol of Hope and Change and Yes-we-can-ism. Even the Medicare buy-in offered relief to millions of people between 55-65, with the hope the age limit would gradually be lowered (eventually becoming Medicare-for-all).

People believed, perhaps wrongly, that if the insurers charged them outrageous rates, they would have a truly affordable option with the government/Medicare.

Now that hope is gone. And it's not over yet. We may well see additional weakening of the bill before it becomes law.

Hey, I'm part of the Democratic base too, you don't need to tell me what we all want! Anyway, you're still ignoring what the bill does and vastly overstating the importance of the public option/medicare buy-in. You're right, affordable coverage is crucially important; that's exactly why the bill subsidizes health insurance for the poor and middle income, expands medicaid and S-CHIP, and introduces community rating so that sicker people won't be priced out of the market. This is definitely a case where the bill is far short of perfect, not to mention short of what Obama campaigned on, but remains a

Quoting Ray: Sure. Which ones resulted from Big Pharma research, rather than government-funded research?

You're telling me we cured cancer? And that Big Pharma invented chemotherapy?

Such as?

Possible?

Potential?

Let me give you an example, in addition to the HPV vaccine: Jonas Salk, polio.

That's the kind of thing I'm talking about. A big disease. Kills or debilitates lots of people. Cured.

In other words, is there any reason to say that we're really getting what we want, on the largest scale, from Big Pharma?

Since my initial point was explicitly about ambiguity, I think your first question is a non sequitur. I've known several people cured of cancer. (Defined as five years or more without recurrence after successful treatment.) I bet you have, too. I wasn't thinking about vaccines, although there's maybe a definitional problem between prevention and cure. Your terms are pretty idiosyncratic; and I stand on what I've said regardless of quibbles - but I really don't understand how that last question fits into the context of what I've said. I'm pretty explicitly ambivalent about Pharma. I'm damn sure we're not getting all we could get, especially at the largest scale; but we do get plenty of good stuff. I think their efforts could be focused a great deal more on

Really Polio cured?

Quoting piscivorous: Really Polio cured?

That's another language issue, I think. "Cured" and "eradicated" are not the same thing.

Quoting AemJeff: cured of cancer. (Defined as five years or more without recurrence after successful treatment.)

This happens. No one knows why. If you can't cure someone on purpose, you don't have a cure.

Quoting AemJeff: I think their efforts could be focused a great deal more on problems that haven't already been solved.

You're hoping for a market failure. As you pointed out, Big Pharma makes money from treatment, not cures. A cure for any major disease or an ailment would contravene the interests of the entire industry. Curing arthritis in one shot would cost billions in lost revenues from pain and anti-inflammatory medications, for example. Big Pharma will cure major diseases only by mistake--and not just a little mistake, but a colossal one. So what's the idea? Bring market forces to bear on the problem of disease and hope to get precisely the opposite outcome that market forces would encourage? This does not seem efficient to me.

Quoting Ray: This happens. No one knows why. If you can't cure someone on purpose, you don't have a cure.

You're hoping for a market failure.

As you pointed out, Big Pharma makes money from treatment, not cures. A cure for any major disease or an ailment would contravene the interests of the entire industry. Curing arthritis in one shot would cost billions in lost revenues from pain and anti-inflammatory medications, for example.

Big Pharma will cure major diseases only by mistake--and not just a little mistake, but a colossal one.

So what's the idea? Bring market forces to bear on the problem of disease and hope to get precisely the opposite outcome that market forces would encourage?

This does not seem efficient to me.

When I'm sticking a needle full of insulin into my belly, I have a hard time really caring about market efficiencies.

Two posts that I think are worth reading about Obama, healthcare, public option etc. From Matt Y: One, Two Looking at the reality of the political landscape, I tend to lean towards the flawed-bill-that-can-be-changed-is-better-than-no-bill-at-all category.

Quoting AemJeff: Chemo, antibiotics and antivirals? How do they not count? Gene therapy will almost certainly have components that qualify. The rest of that was just speculation about "cures."

My guess in regard to your hypothesis is that the pressures wouldn't be more than could be born, but I couldn't quantify that.

I'm not saying they "don't count", I'm asking if you know if these are actually a result of "big phrma" because they are far from the only source of medical and pharmaceutical research. I think if a pharmaceutical company came out with a cure for cancer or AIDS they would be under huge pressure to not patent it and it would almost certainly cause people to reevaluate patent laws. Not saying anything would happen. It's usually pretty safe to cast your bet with the status quo, especially with regards to big business.

...maybe one day you won't have to

Quoting messwithtexas: I'm not saying they "don't count", I'm asking if you know if these are actually a result of "big phrma" because they are far from the only source of medical and pharmaceutical research.

I think if a pharmaceutical company came out with a cure for cancer or AIDS they would be under huge pressure to not patent it and it would almost certainly cause people to reevaluate patent laws. Not saying anything would happen. It's usually pretty safe to cast your bet with the status quo, especially with regards to big business.

"Big Pharma" is responsible for plenty of development on those classes of drugs. But I was explicit about saying I don't believe Pharma is solely responsible; in fact, that was a major plank for my overall point.

Quoting Don Zeko: Would you make this argument about any other kind of insurance?

Absolutely

Does a company that provides, say, flood insurance deserve a profit?

No. At risk of spawning diversions, nobody but nobody deserves profit. If I purchase a quantity of GM stock do I deserve to profit from that investment? Is there some moral principle or practical consideration that obligates somebody else to pay me more for that stock so that I profit? Is it you who owe me this profit? If so please advise and we will be doing regular business. That likely tangent generator aside, and more to the point under discussion is the fundamental fact that the insurance company does not provide insurance. Yes, the check when your house burns down may have their name on it, but that is no more than ink on paper. It's not where the money comes from. The members of the risk pool share collective risks, covering each other and incurring the requisite costs in order to ensure this sharing. The money that those who incur covered losses receive comes from the other pool members. The company administers collection of payments and disbursement of payouts. This is

Quoting AemJeff: "Big Pharma" is responsible for plenty of development on those classes of drugs. But I was explicit about saying I don't believe Pharma is solely responsible; in fact, that was a major plank for my overall point.

I didn't get that from your original answer. Here's the original question:

Actually, has big pharma ever cured any widespread, serious disease?

And your response...

Well, do you count antibiotics and antivirals? I think so. There's chemotherapy. I think steroid treatments count as cures for some conditions. Type I diabetes has a possible cure in islet cell transplants. Gene therapy, to the extent that it works, is an example of a class of potential cures for many conditions. Metabolic disorders like type II diabetes seem to be good candidates for that approach. I'm fairly certain that some basic work has been done looking into a possible basis for a type II cure.

I don't see where you mention phrma being only one part of this. That's all I was addressing. I don't think it's fair to just assume they had a major role in any of that without evidence, given the size of the government and academic medical research worldwide and the resistance of phrma to taking on unmarketable

It is not a language problem it is a conceptual problem. Diseases are seldom if ever "cured". With viruses you can inoculate a sufficient percentage of the population to mitigate the spread or ideally eradicate the virus and yes big pharma plays an important role in this. With cancer you can kill the mutant cells through radiation or chemo therapy, another big pharma contribution. But to speak of a cure, presently, is premature as this warfare against the disease is actually warfare against the body itself and while dosing amounts are much better understood now still in many cases and types of cancers comes close to poisoning the patient to near deaths door. With diabetes it is either a genetic defect type I or a resistance of the cells in the body to the effects insulin in conjunction with the bodies ability to produce enough insulin to overcome this resistance (simplified I know). If it is ever able to be "cured" it will be through genetic engineering for type I and for drugs to control or reverse type II which big pharma is spending

Quoting Don Zeko: Death Squads? Get a grip, dude. You do realize that "Death Squads" usually refers to paramilitary troops engaging in genocide or other atrocities, right? The Stupak Amendment might be terrible policy, but that doesn't mean that this kind of rhetoric is reasonable.

I know what a death squad is, and most likely much better than you do. You didn't understand the metaphoric use of the phrase. It may be that it is a very poor use of a metaphor or that you lack the context to consider the possibility that this was not a literal use of language. In any case, your response is grossly inappropriate. Dude.

Quoting badhatharry: Maybe these low income women should use birth control, then.

Yes, that's much better for everyone. Please, make it so, will you?

Quoting messwithtexas: I didn't get that from your original answer.

Here's the original question:

And your response...

I don't see where you mention phrma being only one part of this. That's all I was addressing. I don't think it's fair to just assume they had a major role in any of that without evidence, given the size of the government and academic medical research worldwide and the resistance of phrma to taking on unmarketable treatments.

Way back in the thread:

Quoting AemJeff: Like I said, the line between public and private development is blurred. A lot of basic research is academic, some funded from government sources, some from private sources. When a drug s marketed, I don't know of any attempts to disentangle its provenance, though there may be.
...
By the way I love Pharma - I fully, personally, understand the benefits bestowed by the product of that industry. That doesn't quell my cynicism, however.

You mean like the welfare state instituted by the Democratic Congress and President Johnson, that destroyed the family structure of poor families, of the 60s, 70s, 80s and most of the 90s, that was finally mostly corrected under the Republican Congress and President Clinton. It takes a long time to correct the "flawed-bill-that-can-be-changed-is-better-than-no-bill-at-all" and the damage that it does can take generations to correct.

Quoting AemJeff: When I'm sticking a needle full of insulin into my belly, I have a hard time really caring about market efficiencies.

Your disease totally gives you a privileged position in this discussion. If you want a cure, then Big Pharma has no track record of providing any and a strong disincentive to provide you with one. If you want to keep sticking needles in your belly, then Big Pharma is the choice for you.

Quoting piscivorous: Diseases are seldom if ever "cured".

Diseases are seldom cured lately--like, since the '60s.

Quoting piscivorous: Quite simply with out big pharma life would be considerably less pleasant and more deadly today.

Ran a control experiment in alternate history, did you? Big Pharma produces next to nothing of any value, certainly nothing compared with the greatest medical advances of the second half of the twentieth century, i.e. 'don't smoke' and 'eat better and exercise'.

I tend to lean towards the flawed-bill-that-can-be-changed-is-better-than-no-bill-at-all category.

I'm leaning that way too. But it is still tragic that with 60 seats in the Senate and a huge majority in the House (numbers they will probably never have again) this is the best they can do.

Quoting Ray: Your disease totally gives you a privileged position in this discussion.

If you want a cure, then Big Pharma has no track record of providing any and a strong disincentive to provide you with one.

If you want to keep sticking needles in your belly, then Big Pharma is the choice for you.

I'm not sure what position you think I'm taking in this discussion. I'm pretty strong skeptic in regard to claims that all Pharma needs is a libertarian free market utopia as incentive to cure the world. But, I know for sure that my life is directly, measurably better than it be without them. I'm all about a fettered market, where, in exchange for the multiple tens of billions in renumeration they receive as providers of critically important goods, we hold their feet to the flame and demand they behave according to a set of standards that we get to determine. If you have a better plan, I'm all for hearing about it.

Yes you have already shown the extent of your knowledge in this discussion. While academics discovered and isolated insulin it was the Eli Lilly and Company that was responsible for devising the process of mass production of pure insulin. Perhaps the academics would have eventually hit upon the solution; but it was big pharam, or at least one of it's progenitors, that made it a an affordable treatment.

Quoting Ray: Diseases are seldom cured lately--like, since the '60s.

Ran a control experiment in alternate history, did you?

Big Pharma produces next to nothing of any value, certainly nothing compared with the greatest medical advances of the second half of the twentieth century, i.e. 'don't smoke' and 'eat better and exercise'.

You don't seem to suffer from any significant chronic illnesses. I can attest that there are a number of drugs whose patents either are still in effect, or have expired within the last decade, without which many people would live significantly worse lives than they do currently. There's a difference between flawed and useless.

Quoting Wonderment: I'm leaning that way too. But it is still tragic that with 60 seats in the Senate and a huge majority in the House (numbers they will probably never have again) this is the best they can do.

59 1/2. At least the Republican fence sitters tend to come out with their party on the close votes - they tend not to get all "mavericky" when every vote counts. Lieberman is a disgrace. The Senator from Hartford.

Quoting piscivorous: it was big pharam, or at least one of it's progenitors, that made it a an affordable treatment.

Sure; one of "it is" progenitors came up with a treatment. Jonas Salk wiped out polio with money from a non-profit. Wiped it out. And he didn't patent the vaccine. I'll meet you halfway: when your Big Pharma wipes out diabetes--even if through a patented treatment--I'll eat my hat. Until then, you've got nothing.

Boy that is some solid argumentation, of the school yard variety, you got there!

Quoting AemJeff: If you have a better plan

Seize the pharmaceutical companies. Maintain all research staff. Triple their salaries; triple their budgets. Fire all management and marketing staff. Let a non-profit run the show. Set research priorities by inverting the priorities determined by the market. See how that works for a while.

Quoting AemJeff: You don't seem to suffer from any significant chronic illnesses.

I'm not the kind of guy who would make a t-shirt out of it, so how can you tell?

Quoting AemJeff: ...drugs...without which many people would live significantly worse lives than they do currently

So? The question isn't "what crumbs have we gathered from our backasswards system of pharmaceutical research?" The question is: do we as a society provide our scientists with incentives that work best for us? We do not. We incentivize treatments over cures, just as our system of health insurance incentivizes denial of care, rather than delivery of care. Again, market forces simply do not work with health care and medicine. Just as they don't work with food, if I may return to an earlier part of this thread.

Quoting uncle ebeneezer: Looking at the reality of the political landscape, I tend to lean towards the flawed-bill-that-can-be-changed-is-better-than-no-bill-at-all category.

Yes.

Quoting cragger: The company provides nothing. No added value whatsoever beyond a simple administrative function.

Huh? My whole point is that insurance companies provide an administrative function which is valuable.Would you rather create a risk pool to ensure against home fires or floods on your own? I'll agree with just about any point you want to make with regard to the morally abominable business models of health insurance companies in the current market, but the idea that any insurance company of any kind is producing zero net benefits is crazy.

And of course this brings me back to the absurdity of the filibuster. For future reference, I would be happy to debate, in an Apollo Diavlog, any member of this forum that thinks that the filibuster is a good thing in its current form.

As I said earlier, the folks performing the accounting and clerical functions certainly deserve to be paid for their time. Beyond that, nothing. The third party company and owners provide no additional value to the members of the shared risk-pool. If you go to a tax accountant who spends several hours helping you file various tax forms correctly, that person deserves to be paid for their time and effort. They do not have any valid claim to a percentage of your income as added "profit" above and beyond those hourly charges. It's the same thing. Insurance is not a normal good in which someone must put up resources up front to obtain materials, provide tooling, and build a product in the hopes that it will sell, and incur losses if not. Insurance is essentially a cooperative arrangement between the risk-pool members. The pool members provide the resources. A few people perform clerical functions for which they are due wages. The insurance company provides nothing.

I think you're getting perilously close to the labor theory of value here. Someone that starts an insurance company brings together a potential risk pool and the administrative resources necessary to pool those risks and pay out to the unfortunate members of the pool. It's not like you can start an insurance company without personal financial risk, nor are the owners of existing insurance companies immune from personal loss if things go poorly. I think you need to consider what you're saying before you start making straightforwardly communist arguments that could apply almost as well to any other priate enterprise.

Quoting AemJeff: Kennedy hatred is alive and well. I suspect Ted's reputation will survive better and longer than the lingering hatred of his political enemies.

The whole section on Kennedy bothered me because first they are bemoaning how little people know about history and then they are engaging with how significant Kennedy was and neither of them mentions Tip O'Neill? Shame.

No, insurance is not the same as any other form of private enterprise, for such reasons as I sketched out in my last post, however spun up you feel about -ism's. I don't particularly care about a labor theory of value. I care not at all about the labels capitalism, socialism, communism, libertarianism, or any other damn -ism. An argument that such and such is good or bad, desirable or undesirable because "it sounds like -ism" is meaningless verbiage. I look at this from pure game theory - rational decision making. That part of economics that makes sense.

You're just talking in terms of Game Theory? Then why are you making value judgments about who "deserves" a profit?

If you reread the thread, you will see for example that in responding to your question:

]Does a company that provides, say, flood insurance deserve a profit?

with:

do I deserve to profit from that investment? Is there some moral principle or practical consideration

The discussion has admittedly used the term "deserve" in common parlance without strict regard to the dictionary, but the two concepts with which I responded, moral and practica,l cover the range of considerations within which I answered the question. The latter, practical consideration, is well handled by game theory. As I previously noted, I am unaware of any moral principle that overrides the practical realm and thus provides some other reason that justifies insurance industry profits.

I always thought Major Deegan was the guy Sargent Shriver reported to.....

Quoting osmium: "No one knows who Major Deegan is." Ah, but now they do!

I'm finally getting around to this one, and this was my favorite bit. We've played this game in Chicago for a while now, as who knows who Dan Ryan or Bishop Ford, etc., were these days. On the other hand, some of these roads, who'd want to be named after, as you'd just be associated with the hate.

Quoting Blackadder: That said, I didn't find her argument all that compelling. She says that there's nothing the drug companies could do to get higher prices in Europe and Canada. But that's not quite true. Pharma could, if it wanted to, simply refuse to sell to these countries unless it got a better price. Right now it isn't in pharma's interest to do this, as the reimportation ban allows them to price discriminate. But without the ban they would pretty much be forced to charge the same price for all countries.

Agreed. If they didn't make money at those prices in those countries, they could refuse to sell there. Presumably (and based on their own income statements) they do. Megan is interesting in that I suspect libertarians on the whole would support free trade (including a removal of the reimportation barriers) and assume that the free market would pay for drug research if the US stopped paying more than its share (as measured by higher drug prices here). That she argues otherwise shows she's less a real libertarian than a defender of the status quo.