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Comment by mc32 | Hacker News Reader

No. Nationalizing it will politicize pharmaceuticals. (and parties change control every few years of so). Private industry may chase the longevity dollars (expensive drugs for rich people who want to make their later years easier), but they also do lots of research in lots of other mundane areas.

The problem is more in the healthcare _system_ whose incentives are not aligned with the patients foremost, but rather is more geared towards extracting as much as possible from insurance companies who in turn are disincentivized to give their patients decent care, in many ways.

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Agreed. Outcome based pricing is a pretty easy step in the right direction and helps to aligns the stakeholders.The drug company only gets paid if the patients get the desired outcome.

The current system is completely bonkers. Insurance company profits are capped at a fixed percent, so they want to drive costs as high as possible. Pharma Benefit managers get paid by insurance based on list prices, so they also want to maximize price. Lastly, the manufacturer gets paid by PBMs based on list price minus kickbacks, and obviously wants to turn a profit

> Nationalizing it will politicize pharmaceuticals. (and parties change control every few years of so).

That's easy to fix. Pass a law forbidding any non-progressive political parties from forming or having a say in government. What could possibly go wrong?

Considering how many politicians try to score votes through speaking against the HPV vaccine and how many lives are lost though entirely preventable cervical cancer, this kind of remark is completely unneeded. Statistics are here: https://www.cdc.gov/cancer/cervical/statistics/index.htm

> What could possibly go wrong?

Let's look to some one-party countries to find out!

Oh, look, everything.

> “Pass a law forbidding any non-progressive political parties from forming...”

What? That runs against the bill of rights right out of the gate.

You would think that's a big part of the problem, but some of these issues like:

- Pharmaceutical companies sponsoring/paying doctors to push their products

- Paying doctors to put their names on papers they haven't even written or reward for research they never actually did

- Companies that engage in patent thicketing and product hopping (drug companies abusing the patent system to hold onto market share and prevent any generic competition)

- Pharmaceutical companies engaging in price gouging tactics

And preventing these things are the role of government, not practicing them itself.

That happens in countries with universal or semi socialized medicine too.

Obviously these are two different things. What I’m saying is whether or not healthcare is private or nationalized, the pharma industry in those countries are not nationalized (like say the way they were in the eastern bloc).

Agreed. I also think that there are certain endeavors (medicine, space travel, etc.) where we need global cost sharing. Why are drugs cheaper in Canada? A lot of the drugs that go around the world are paid for by the US middle class. This cost sharing also removes the need for patent protections as everyone is opted in and buys from the global source. Obviously there are more details to solve but I'd like to see this approach tried.

As if medicine hasn't always been political and can somehow avoid that in private hands.

Nationalizing it will politicize pharmaceuticals

You need to keep the politicians out of the pipeline and put physicians and pharmacologists in charge. It's more difficult in a country where the public service has been gutted for 40 years, but it has to be done.

Right now there is insufficient research in antibiotics and tropical diseases and far too much in cancer. The market isn't going to fix that misallocation of funds.

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