Hacker News Reader

This theory of patents as the method to fund medical research can be tested pretty simply. Let's assume an alternative universe where the market fully funds the medical research bill, and see if it succeeds.

That is $26.4 billion of tax money not going to NiH, nor would tax funded universities spend their budget on medical research. Medical research would no longer be considered tax-deductible, so fewer donation based systems.

Now let's ask how much would the current level of medical research decrease, and which areas of medical treatments would suffer the most. My guess, based on statistics that NiH published, is that research for curing life-threatening conditions (like Ebola) would grind to a halt, together with fundamental medical research. In the longer term, the lack of common research would slowly drive the collective research to a halt, basically killing the industry as it is.

If patents are carrots, government money is the base nourishment for the medical research industry. That makes carrots the optional part, not the necessary part.

I don't disagree with your point. I used to work in defense research, where there is a lot of co-mingling between government, academia, and the private sector. Lots of people starting companies based on initial work done in a research lab. What the structure lacks in tasteful ideological purity it makes up for in effectiveness.

Sounds to me more like an argument against leaving basic medical and pharmaceutical research up to the private sector. All of humanity benefits from this research, so all of humanity should fund it... and no subset of humanity should be permitted to monopolize it, much less be encouraged to do so.

He took his Ivy-league physics PhD to Wall Street, because you're never going to get rich working in a research lab.

Probably the right choice. I doubt he'll miss out any Nobel Prizes as a result.

Sure, maybe it belongs in the public sector. But with current estimates of $1-5B R&D per successful new drug, it's not exactly chump change. The US gov't doesn't have a couple spare hundred billion kicking around, ready to point at drug research. So that will be a long time coming...

How do you propose having all of humanity fund it? A country could pay for it with their tax dollars, but then it is only a subset of the world having their paycheck decreased in order to help the entirety of humanity.

You need a certain amount of wealth in the country to be able to fund all this research and the US probably could afford it, but since were not going to use patents, taxpayers may become upset that a large portion of their tax dollars are going to foreign aid rather than domestic aid.

Ideally, it wouldn't be a case where one country shoulders the burden. If there are any justifications at all for multinational cooperation, this would probably be an easy sell.

We already devote a massive amount of funding to foreign aid -- about $48 billion in economic and military assistance in 2012 according to Wikipedia (http://en.wikipedia.org/wiki/United_States_foreign_aid). We sent about $13 billion to Afghanistan and Pakistan alone in 2012, according to nationalpriorities.org. This is a pretty good match for private-sector pharmaceutical R&D expenditures, about $51 billion in 2013 according to one industry lobbyist (www.phrma.org).

I don't know if the 3+ billion in military aid to Israel sould really be in the same bucket as say fighting Ebola. Then again the pharmaceutical R&D numbers are also vastly inflated.

Yeah, I was just addressing the point about the American public being upset about so much money going to what could be construed as foreign aid. It already does, and nobody evidently cares.

$48million is a few cents per person.

The US private R&D spending is over $100billion. Spending $3000 per person on what would be mostly foreign aid (7bn vs 300mn people) would be controversial.

That's 48 billion in US terms (1 x 10^9).

Thanks for the correction. Anyways, at least tripling foreign aid (maybe multiplying it by 10-100) is something that would be controversial.

I agree that one of the main problems of science today is the brain drain from academic research to for-profit entities. If we're being honest, they both need each other; the academics need industry to produce instruments and perform speculative engineering projects, and the industry needs the academics to train fresh scientists and buy their products. A big problem is that academics are constantly reminded by the palpable superiority of their private sector brethren; the private sector people dress better (not ratty), drive better cars (not broken shitboxes), have larger apartments (not holes in the ground), flashier parties, shorter hours, and upward potential.

Here's a solution which doesn't disrupt the good aspects of the status quo: get the government and grant-giving entities to provide more money (read: 65-140k instead of 18-50k) specifically for researcher salaries.

That way, research that is created via public money is still completely open to the public and other researchers, and there isn't an incentive to leave research in order to make more money by leaving. The private sector can still try to poach academics with higher salaries, but now they'll have a harder time.

The alternative is a continuation down the current path of patent trolling and progress-halting intellectual property law. When you're blocked from making progress on an idea for many years because someone else thought of it first, there are real consequences... namely that a lot of the important fleshing-out of an initial idea isn't subjected to any kind of rigorous external criticism and refinement. It creates weird gaps where ideas that have been around for a long time are only recently free to explore, leading to realizations of potential past-applications lost.

Scientific progress is a network of nodes which moves forward through the dimensions of sophistication and time based on how many connections there are between nodes; enough blocked connections leads to big slowdowns across an entire field. For this reason, I am against intellectual property.

Other things that the private folks have: talk more openly about their code, share their code under permissive licenses, routinely encourage others to learn more and help each other, reuse other people's code to build new things, specifically encourage development practices that scale horizontally, etc.

I wouldn't mind if we decided to start funding researchers on the public dime, full-time, but they had better do a damned sight better in terms of professionalism and communication and openness.

Also, the entire journal structure needs to be burned to the fucking ground.

The journal structure is quite destructive, but I think it's clear that we're in the midst of a major internet-driven disruption and trend toward openness. Many papers are published to reputable free journals these days.

I'd like it if the non-financial aspects of the journal structure remained the same, so as to group ideas/editorial groups/communities together, preserving the unique character of each journal and allowing people producing papers to target their submissions accurately. Freeness and openness of the information contained within is a must, though-- proprietary journal information is a racket which helps nobody.

I know a few people who do fundamental drugs research. They aren't poor, but they sure as hell aren't rich and don't seem to be trying to become rich either.

Obviously, if you got rid of patents, there is a question of funding, but I don't really think the laboratories can tell where the dollars came from to keep them going, they just need enough of them to function, so presumably there are other methods that would work to keep the funding levels up.

Show me these hordes of people who do basic research who become rich because of their patents. Because obviously the population of these must be rather sizeable for this to be a real alternative to, say, Wall Street.

I suspect your argument is pointless. I suspect you are focusing on lottery winners.

Right, this argument is bullshit. The only people getting rich off of patents are giant corporation CEOs and lawyers.

John Hennessy founding MIPS is the canonical example. Burt Rutan at Scaled Composites is another. But we're not just talking famous guys like them. At the root of most Pharma M&A are mid-sized R&D companies that get bought because of their patents. And it's not just pharma either. To pick a random recent Qualcomm acquisition, take Black Sand Technologies, which has IP in the area of power amplifiers. The company's chief technologist and co-founder is http://www.austinventures.com/team/entrepreneurs/susanne-pau..., MIT PhD with 45 patents to her name.

There is a huge blind spot on HN as to how other sectors of the engineering world work. If you're in wireless, you can't found a startup that directly targets consumers. If your innovation is a better power amplifier or more efficient transmission power control mechanism, your best bet is to start a company to develop the IP, and use that to get acquired by Qualcomm or Intel. And your alternative is to work for a big corp where all the fruits of your R&D efforts will go to passive shareholders. Or I suppose to work at a government R&D lab, where some private company will swoop in and take all the money once you've done the hard work.

I said "show me the hordes". I can come up with any number of anecdotes myself. But show me the numbers that say that it is a safer bet to stay in academia or in a technical job and file patents than, say, go to Wall Street.

I know lots and lots of people who have patents. Some of them have many patents. I know exactly zero people who have gotten rich off of their patents. I know a few people who have gotten bonuses for their patents. But nothing that would even buy a decent car. And these people are anything from independent practitioners to employees at large companies whose products you use every day.

Convince me that this is more than a mere anecdotes about lottery winners.

> so the folks who are bright but not selfless go into advertising and entertainment and consumer products, areas where it's "ok to get rich."

I think the answer is to figure how to stop people from getting rich off advertising and consumer products (and wall-street speculative manipulation of financial instruments).

More realistically, the answer is to make sure that science is well-funded and scientists get great pay without tying that to adding artificial restrictions to their results.

Take a look at the german research community with the Fraunhofer Society – the researchers don't really get rich, but they have save jobs, can continue doing what they can best (researching), while the money is completely invested in new research. And overall there are almost no profits made, because the prices are actually affordable.

Well if you want to talk perverse incentives, when can a pharmaceutical company make more money on a vaccine? When the disease is restricted to a couple thousand people in Africa? Or after it's widespread in Africa and beginning to enter advanced nations?

That's a great point. One of the reasons why we have people dumping billions of dollars into drug research is because there is the opportunity for huge returns.

Kill the profit motive and you'll kill (most, not all) of the innovative new drugs.

The profit motive is scary too though. It's a disincentive to finding a cure for something rather than a perpetual treatment.

Only if you hold a monopoly or participate in a cartel. If GSK has a perpetual treatment Merck has every incentive to release a cure to cut them out.

Therefore we need to heavily incentivize researchers in the public sphere (who don't necessarily have the same type of perpetual treatment motive), along with allowing the free market researchers to operate according to their own goals.

It would be irrelevant that pharma companies benefit more from perpetual treatment if public research was a more effective balance against that. If pharma doesn't pursue a cure, and a cure is conceivable, then it would behoove academics to pursue it (as the acclaim, and hopefully financial incentive they'd receive would easily motivate them). However, due to the competition for public funding, people are less likely to go down an expensive and time consuming path like that. They're much more likely to pursue incremental discoveries that lead to continued funding rather than bet the farm on a longshot.

The main problem, in my opinion, is that there simply isn't enough science funding.

For potentially lethal and widespread problems such as cancer or infectious disease, I have to disagree-- even in the most cynical of research spaces, there is a baseline of good-faith effort and desire to improve the human condition by offering a permanent fix. Additionally, whoever is able to provide a functional cure for a big name illness will ascend into the hallowed halls of science-- a fact that nobody forgets. I don't doubt that a prospective cure would cost a tremendous amount of cash to buy for yourself, but I think it'd still be a win for the pharmas. If a pharmaceutical firm was able to cure one kind of cancer with one drug, they'd be able to shutter all of their other production facilities for the myriad number of drugs which formerly targeted that cancer, amounting to a big decrease in their operating costs. Pair that with an entire market of people needing your one very expensive product, and I think it'd work out in their favor.

Unfortunately, there is another side of this coin-- mental health. I believe that currently the problem with the profit motive which you identified is actively harming further research and development of effective cures. Cynically, the biotech companies want to make money, and psychopharmaceuticals are the ultimate cash cow as things are currently. A diagnosis of depression or ADHD means that they have a life-long customer. Thus, in order to maintain these customers buying the drugs at high prices, they must re-invent their cash cow drugs with minor changes in time with the patent cycle. There is no incentive to develop a cure, specifically because the system can be gamed in a very profitable way by rolling over patents and offering bandaid solutions.

Drug research is really hard. Researchers simply don't have the freedom to say "let's not work on a cure, let's work on a treatment instead." They throw a bunch of stuff into the hopper and if it works, they go with it.

We should fund medicine like we fund defense. Lots of innovation and lots of profits. The US has no problem spending billions developing new weapons systems or finding the $10 million per day it takes to toss bombs at a fairly low-threat (historically) issue like ISIS. Put that much into dealing with Ebola and the crisis is over fairly quickly.

Says something about priorities, I guess.

> We should fund medicine like we fund defense.

Pork barrel spending based on how many congressional districts the contractor can parcel out work to, irrespective of whether there is a need for the thing being purchased, or whether it cost-effectively meets the need, or whether there's even any realistic chance that the thing being purchased will ever have any practical application?

>Kill the profit motive and you'll kill (most, not all) of the innovative new drugs.

Of course not. The alternative is to make the research a public-supported effort. We can hire more scientists with the same amount of money since it isn't being lost to executives or shareholders. Second, all of their information would be open source, which would accelerate advances. Third, drugs don't have to be prioritized by what makes sense from a monetary standpoint and instead can be prioritized from a health standpoint.

You are not going to get anywhere near the amount of money invested in research if you go with a public supported funding model.

Agreed. The total NIH budget is $31B. Much of which goes to basic research, not drug development.

The total spend by pharma and biotech? The best number I could find is from PhRMA (a group of the largest pharma companies, but not all of them) and they spend $49B.

> And if you decry patents, you remove one of the few ways it is possible for researchers to get rich from their work.

I doubt that more patents make it directly easier for researchers' salaries to increase, and increase their participation in the field.

A lot of drugs these days seem to be sold as consumer products anyway, from what I see on television (“Ask your doctor if Newdrugplexastin is for you. Side effect might include death.”) Perhaps encouraging companies to redirect some of those costs to hiring better researchers could be the solution?

I think Jesus was up to something when he said that serving God and Mammon are two incompatible goals. Pursuing things like public health is desirable - it increases general wellbeing - but you can't earn money doing so. Consider the Ebola case in Dallas: black guy, likely uninsured turns up at the hospital, and they give him antibiotics and send him on his merry way, spreading the virus for two days more. It shows why the Libertarian approach of paying for public services through fees instead of taxes frankly doesn't work.

Actually it shows that the current hospital system doesn't work.