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Comment by zentiggr | Hacker News Reader

You're way overthinking this.

What needs to happen is, again and again with health care issues, transparency.

Manufacturers should be required to declare and with audits prove how much they're spending to manufacture everything. Then everyone can see the price they're being charged and figure in their head what sort of markup they are being charged.

Then we can start to push back on the companies need to recoup primarily marketing costs and dividends and bonus programs and all the other padding that they have built up over decades of never being held accountable.

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Actually, I think in practice my solution is much simpler than yours. For yours to work it is a precondition that these audits are of good quality. Perhaps they will be and perhaps not but at the very least we can note that the pharma companies have large incentives to game them. Also, the question becomes how much of a markup is reasonable. Clearly, for more innovative research more markup would be acceptable than for less innovative research if both of these would lead to working medicine. Innovativeness would need to be quantified for each and every medicine separately. This does not sound like an easy task.

I really am surprised that I am getting more downvotes than upvotes here. I think people are too emotional about this. I also note that a post dropping f-bombs is not getting downvoted which it really should be. It is not very mature.

Exactly what does the accountability process look like? Angry newspaper articles? We've got plenty of those. Boycotting their products? You realise we're talking about insulin, right?

Should anyone buying that insulin have to divulge how much money they make a year and what other things they spend their money on, so that the manufacturer can figure out how much to charge?

Nope. I don't think patient details are required for determining an equitable markup per drug. It's the companies that are relying on the relative invisibility of their pricing decisions that have all the power in the current dynamic.

A reasonable percentage can be arbitrated once the process is in public view.

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