speaking of unrepresentative branches of government...

by russell

In the SCOTUS post, Sebastian raised the problem of the Supreme Court making rulings that result in laws and policies that do not reflect the will of the people, i.e., do not align with what the majority of people want.

Which is something to be concerned about.  If governance drifts too far from the popular will, we have trouble.

Then, this, from the Washington Post, appears in my in-box.

The take-away:

by 2040 or so, 70 percent of Americans will live in 15 states. Meaning 30 percent will choose 70 senators. And the 30% will be older, whiter, more rural, more male than the 70 percent.

30 percent of the population will elect 70 percent of the Senate.  That 30% will, by and large, be unlike the other 70%.  Will have different interests, require different things from government, want different laws and policies enacted.

Un-representative SCOTUS rulings may be the least of our troubles.

 

Comments

[Tony P.]

It ain't just He, Trump playing ball.

At the start of His No-means-Yes "meeting" just now He, Trump received the usual warm tongue-bath from some Republican doofus whose name I did not catch from the TV in the other room. As best I can judge from the footage currently available on the web, all the other Republican doofuses (doofusi?) around the table did NOT rise up and spit on He, Trump for using them as catcher's mitts. They "played ball".

--TP

[cleek]

oh, McTx...?

The solution comes in a pill: Taken daily, Truvada, the brand name for a type of pre-exposure prophylaxis, or PrEP, is up to 99 percent effective at preventing H.I.V. infection. Used as directed, it’s one of the most effective methods of preventing a viral infection ever discovered, as good as the polio vaccine, the miracle of modern medicine.

...

Less than 10 percent of the 1.2 million Americans who might benefit from PrEP are actually getting it. The major reason is quite clear: pricing. With a list price over $20,000 a year,..

Infuriatingly, American taxpayers and private charities — not Gilead — paid for almost all of the clinical research used to develop Truvada as PrEP. Yet the price stays out of reach for millions, and will for at least several more years.

[russell]

welcome to the land of the golden calf

[Countme-a-Demon]

"Healthcare for those who can't afford it is an unknown unknown in the land of it's free to die, and we plan to keep it that way."

Donald Rumsfeld, former Chairman of Gilead Sciences

[Nigel]

I think Trump might now be done.

‘I misspoke’ is so absurd, and, more significantly, weak, I think he might just have lost whatever bizarre hold he has on half of America.
The one thing would be autocrats can’t be is weak.

Much as I despise the word, I think the term here is ‘cuck’.

[Countme-a-Demon]

https://www.mediamatters.org/blog/2018/07/17/after-trump-s-disastrous-press-conference-putin-three-news-anchors-report-republicans-won-t-appear/220709

They'll spend Fourth of July in Moscow and speak to Russian state Limbaughs, Hannitys, Buchanans,and Joneses, while freezing out American media, but over here, Martin Luther King was a Soviet agent.

[Countme-a-Demon]

His favorable polling among Republicans will rise shortly from 87% to over 90%, especially once patients with pre-existing conditions start croaking without insurance.

I spotted a Soviet tank rolling down I-25 to Colorado Springs yesterday.

[Pro Bono]

I think Trump just claimed that he's so mentally impaired that he can't construct a double negative.

Well, I have to acknowledge that that's better than being a traitor.

[Girl from the North Country]

I think Trump might now be done.

From your lips to God's ear.

But I fear this may be wishful thinking...I saw some R campaign hacks interviewed somewhere in flyover country who were just laughing and saying "It's the swamp creatures getting hysterical, Trump's people love him and all they care about and should care about is their jobs, and the economy, and the wonderful job figures" Trump/Fox talking points, yadda yadda yadda. When the C4 News interviewer asked about Russian interference and the joint press conference etc, they were blythe and uncaring, and I bet they're right that his base will be too.

Unless the politicians from his own party comprehensively turn against him in a much more convincing way than they have, and than refusing to appear on interviews (and if I'm right about his base they probably won't) this will just be another outrage that disappears down the plughole until the next one. The Republican Party and politicians have sold their tattered souls to the devil, and unless the Dems really manage to get it together for 2018 and 2020 it's hard to see how this can be salvaged.

[wj]

"Trump's people love him and all they care about and should care about is their jobs, and the economy, and the wonderful job figures."

Hold that thought while the tariff wars trash their jobs and the economy. The only question is, will the pain hit significantly before November...?

[Girl from the North Country]

Hold that thought while the tariff wars trash their jobs and the economy. The only question is, will the pain hit significantly before November...?

Or will they make the fucking connection once it does hit? They seem to ignore the ever upward trend under Obama which has merely been continued, and attribute it all to Trump, so presumably when the economy crashes that will be Obama's fault too.

[Nigel]

No, he’s done.

Of course millions will continue voting for him. Just not enough of them.

[Girl from the North Country]

I really hope you're right, Nigel.

And on that comforting thought, I'm off to bed. We'll see what tomorrow brings....

[Countme-a-Demon]

What tomorrow since November 9, 2016 has NOT been more full of republican/mp dog shit than the previous day?

Every republican/mp tomorrow is a horror sequel with bigger jaws and new ways to fucking kill America.

Fuck elections.

[Countme-a-Demon]

This:

https://www.washingtonpost.com/video/politics/house-republican-says-rising-sea-levels-caused-by-dirt-rocks/2018/05/17/42c3871a-5a05-11e8-9889-07bcc1327f4b_video.html?utm_term=.9a7992bc8e9e

Notice how timid, how polite, the fucking scientist is.

It's time to merge the First and Second Amendments.

We need more guns available to witnesses called before congressional republican vermin.

Gunfire should be permitted as part of their opening statements.

But if republican dog puke want to go in this direction, let me help.

As the Chinese become more affluent because they fuck Americans on trade, they tend to take more beach vacations each year. All of those millions of chinks, as republican filth in the White House and Congress and Moscow refer to them, to mimic their political base, wading into the ocean at the same time cause ocean surges and coastal inundations as far away as Palm Beach, Florida.

The Chinese are gaining weight too as they feast on shit American cheeseburgers and Papa Adolph's Pizza, and Kentucky Fried Lynched Slaves.

Therefore, they displace more ocean water while doing the sidestroke, resulting in beachfront property sold by lying shithead bucketshop Americans in Boca Raton being underwater most of the year, rather than only half the year outta town American suckers have been complaining about for decades.

[Countme-a-Demon]

Some ask "Is this where we are now?'

Yeah, we are there:

https://talkingpointsmemo.com/news/mgm-lawsuit-against-las-vegas-victims

Blow up America

[cleek]

"It's the swamp creatures getting hysterical...."

Breitbart's take has been "The Deep State is furious at Trump!"

and the Derp State will buy it.

they bought Trump, after all. they aren't very bright.

[McKinneyTexas]

oh, McTx...?

I presume this is a reference to my position on capitalism. Fine, I'll bite. First, take a look at this link:

https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv/459/cost-considerations-and-antiretroviral-therapy

As it happens, there is a generic alternative, courtesy of capitalism, i.e. competition. It is Emtricitabine and Tenofovir Disoproxil Fumarate Tablets. See: https://www.raps.org/regulatory-focus%E2%84%A2/news-articles/2017/6/fda-approves-first-generic-version-of-gilead-s-hiv-drug-truvada

The first link reflects the high cost of HIV treatment generally. Truvada runs about 1K a month more than the generic (you have to tease the pricing out of the first link).

I infer your premise is that, in a non-capitalist system, Truvada would be much cheaper. Ok, how much cheaper? Second, which non-capitalist country/system is producing high quality and effective new medicines?

Innovation and competition demonstrably drive down costs over time on a macro basis. Outlier, seemingly bad behavior is part of it.

I'm open to a solution that rewards continued R&D in the pharma field.

Back to you.

[russell]

Second, which non-capitalist country/system is producing high quality and effective new medicines?

FWIW, Cuba.

Some people do stuff to make a lot of money, other people do stuff for other reasons.

[cleek]

I presume this is a reference to my position on capitalism.

rather, to your repeated incorrect assertion that R&D of useful drugs only happens at private companies.

I'm open to a solution that rewards continued R&D in the pharma field.

pharma routinely has the highest profit margin of any industry.

[Pro Bono]

Competition has very little to do with the pharmaceuticals market, which operates through the granting of monopolies by the patent system.

This gives us the harmful situation where a patient will often not receive a drug which would help them, despite being willing and able to pay many times the marginal cost of producing it.

Because almost all of the sale price is to recover sunk development costs. Or in some cases is simply profiteering.

It would be much more efficient and better for humanity to abolish drug patents altogether, and instead have a reward system for drug development, funded by governments globally and administered by an independent panel.

[Nigel]

pharma routinely has the highest profit margin of any industry.

Gross profit margin on individual products, sure. Overall, not so much.
ROCA is pretty low these days.

It would be much more efficient and better for humanity to abolish drug patents altogether, and instead have a reward system for drug development, funded by governments globally and administered by an independent panel.

Would certainly be a sensible idea for antibiotics, where the incentives are particularly perverse.

Abolishing patents wouldn't help so much for biologicals (which tend to be the most expensive drugs, too).

[CharlesWT]

One of the most effective breast cancer drugs was developed by neither government or corporate funded research. But by donations and fundraising done by Revlon Cosmetics.

[Snarki, child of Loki]

Second, which non-capitalist country/system is producing high quality and effective new medicines?

Since one can count the number of "non-captialist contry/system(s)" on two thumbs, it seems unlikely. russell suggested Cuba, but does Cuba even count as "non-captalist" any more?

IMO, it's not "capitalist vs. non-capitalist", but rather "robber-baron capitalism vs. constrained-greed capitalism".

After Trump and his GOP enablers gut the NIH, and declare war on triple-digit IQs, the resulting exodus of bio talent will show us whether the USA can still compete. IIRC, there was an exodus after Dubya restricted stem-cell research, but the effect was temporary.

[Tony P.]

Let me play McKinney for a moment:

A business that can not "recover sunk development costs" out of its "profit margin" will go bankrupt pretty quick. Doesn't matter whether it "develops" medicines, videogames, or mousetraps.

Products that go un-developed can't help anybody. If you had to choose between
1) No drug to treat a particular fatal disease, or
2) A very expensive drug to treat that disease,
you'd effectively have to choose between
1) More people die, or
2) More people go broke.
The people who die because they can't afford the drug while it enjoys monopoly pricing would have died just as dead if nobody could afford to "develop" the drug without some period of monopoly pricing.

That's my best shot at understanding McKinney's POV.

Naturally, I don't share McKinney's POV because I am aware of the many ways to finance drug "development" besides the doctrinaire "free market" model -- which of course relies on government intervention anyway; the USPTO is as much a government agency as the Pentagon is.

Speaking of which, a nation is a population, not just a territory. Protecting the US population from microbes and pathogens is "national defense". Tax-funded "development" of pharmaceuticals to fight against those enemies ought not be anathema to even the hardest of hard-core capitalists.

--TP

[Nigel]

This is interesting about Wisconsin;
https://slate.com/news-and-politics/2018/07/wisconsin-used-to-be-progressive-dan-kaufman-on-what-happened.html

[Donald]

As often happens with the Just Foreign Policy organization, I get emails with material I can’t find on their website. So I can’t post a link. This is annoying. I can cut and paste the email. Here it is —
——————————————————————————

North Carolina Republican Walter Jones and Hawaii Democrat Tulsi Gabbard have introduced H.Res. 922, a bipartisan resolution which states explicitly that initiating wars without explicit prior congressional authorization constitutes impeachable “high crimes and misdemeanors” within the meaning of Article II, section 4 of the Constitution.

Unconstitutional war is already an impeachable offense; an impeachable offense is whatever the House says it is, just as an unauthorized “war” constitutes "hostilities" under the War Powers Resolution if Members of Congress say it does. But the Jones-Gabbard resolution would make explicit that unconstitutional war is an impeachable offense, improving the prospects for calling the question in the House on unconstitutional war in the future.

The bill explicitly states that unauthorized co-belligerency in a war, such as the ongoing, unauthorized U.S. co-belligerency in the famine-producing Saudi war in Yemen, is prohibited. The bill explicitly states that the U.S. becomes a co-belligerent if it "systematically or substantially supplies war materials" to a belligerent.

The bill states: “This resolution shall be interpreted to prohibit the President from making the United States a co-belligerent in an ongoing war without a congressional declaration under the Declare War Clause. For purposes of this section, the United States becomes a co-belligerent if it systematically or substantially supplies war materials, military troops, trainers, or advisers, military intelligence, financial support or their equivalent in association, cooperation, assistance, or common cause with another belligerent.”

Under House rules and precedents, impeachment resolutions raise a question of the House’s constitutional privileges, and that makes them eligible for expedited floor consideration. Thus, the Jones-Gabbard bill would improve the ability of House members to force floor votes on unconstitutional wars such as unauthorized U.S. co-belligerency in the famine-producing Saudi war in Yemen.

Urge your Representative to co-sponsor the Jones-Gabbard bill by signing our petition.

—————————————-

[Donald]

I guess I can link the petition.

https://www.change.org/p/u-s-house-of-representatives-define-unconstitutional-yemen-war-as-impeachable-offense

[McKinneyTexas]

I googled the Cuban pharmaceutical industry. Didn't come up with much. I won't get into the debate about patents. I disagree with the premise that protecting IP is the equivalent of granting a monopoly. TP misses my point again. That's ok. I'm not changing any minds there.

I will say this: if we had to depend on publicly developed drugs for our well-being, we'd all be much worse off. I take three prescription drugs everyday. I need all three. I'm glad they are there. All three have competitive products on the market, which makes the cost competitive.

[wj]

Maybe I'm just an innocent here. But it appears to me that the resolution has a gaping hole in it. That is, it doesn't define what constitutes "war".

Consider.
- Was sending Seal Team 6 in to take out bin Laden an act of war against Pakistan? (Which would require a Congressional action before it could happen.) Why or why not?
- Does a cyber attack constitute "war"? Which ones -- hacking in to gather information vs hacking in to cause something to fail to work (see the Stuxnet worm). How about hacking into voting systems?

The world just isn't as simple as it was when "war" only consisted of an actual military force shooting guns.

[Ugh]

It’s an interesting experiment where the US subsidizes drug development for the entire world. I guess we do other things in that veIn.

It’s also probably not better than the alternative because the alternative is tax cuts.

[bobbyp]

Profit Margins

Somebody explain to me the auto and components numbers.

Thanks.

[Tony P.]

McTX: I disagree with the premise that protecting IP is the equivalent of granting a monopoly. TP misses my point again.

Who is missing whose point here?

You can "protect IP" in many ways; just ask Coca Cola. You can establish a monopoly in many ways; just ask Standard Oil. The concepts are somewhat orthogonal, so yes: not "equivalent".

But when the government grants you the right to exclude others from making, using, or selling your invention, in what possible sense is it NOT granting you a monopoly?

Is it the time limit on the grant that makes it not a monopoly, McKinney?

Note that to get a patent, you have to publish your IP: your patent must explain to the world exactly how to "practice the invention". How does that "protect" your "intellectual" property?

--TP

[bobbyp]

I disagree with the premise that protecting IP is the equivalent of granting a monopoly.

In economics terms a patent or copyright is a monopoly for analytical purposes as the effect on prices and production are the same. Patents and copyrights artificially raise prices higher than the 'competitive market' price and restrict supply.

I'm not changing any minds there.

Haha...you bring a series of weak assertions and are not surprised to not change anybody's mind? Funny stuff, McTex.

if we had to depend on publicly developed drugs for our well-being, we'd all be much worse off.

Actually, no, we would not. But perhaps a citation from you would bolster your otherwise absurd claims.

As for other countries doing it different, how about India?

Also check out this AM's NPR report on the marketing of drugs to the US medical community.

Molinari wins the Open.

[bobbyp]

So, just who funds pharma research?

[Nigel]

That profit margin figure is from 2012; returns have fallen quite a bit since then, though as you can see from the figures for the top 25 pharmaceutical companies, vary greatly from company to company (and indeed over time)
http://client.globaldata.com/static/PR1298.jpg

Of course patents effectively grant temporary monopolies - though for many biopharmaceuticals, the effective monopoly remains after patent expiration as producing biosimilars and demonstrating bioequivalence is far more complicated (and expensive) than copying simple chemical drugs. Though techniques are improving.

About 14% of US healthcare spend is on prescription drugs, so even if they were made for nothing, you’d still have the most expensive healthcare system in the world...

I don’t think the answer is abolishing patents - rather, I think the system could be improved by government intervening/competing in various ways.

Vaccines are the area which could be improved most (and would make the most significance improvement to healthcare worldwide).
The patent system is utterly inadequate to properly incentivise their development and production.
Similar considerations apply to antibiotics - which ideally ought to be used as little as possible to,prevent the development of resistance, which means most novel antibiotics will never earn back their R&D costs.

Government might also usefully fund research into existing off patent drugs for other indications than they were developed for. These will usually not have much value for manufacturers, as they can be produced and sold so cheaply, so expensive clinical,trials don’t get done by private industry, but can have great value for the customer and/or patient.

[russell]

Didn't come up with much.

From here:

Cuba has also produced innovations in medical research. In 1985 the country pioneered the first and only vaccine against meningitis B. The country’s scientists developed new treatments for hepatitis B, diabetic foot, vitiligo and psoriasis. They also developed a lung cancer vaccine that is currently being tested in the United States. Cuba was also the first country on earth to eliminate the transmission of HIV and syphilis from mother to child, a feat recognized by the WHO in 2015.

The health care system in Cuba is actually under some stress now, because the economy is getting stratified, because money. But for a small-ish, poor country, they have a really good track record in medical innovation.

I'm fine with patents and IP, and I recognize that the profit motive plays a part in making stuff available to us. I'm not a communist, and I'm not against people making a living.

To reiterate my point:

Some people do stuff to make a lot of money, other people do stuff for other reasons.

[Nigel]

Incidentally, patents on three of the world’s top ten drugs by revenue have already expired, and four more do so over the next twelve months:
https://www.igeahub.com/2017/08/08/top-20-drugs-in-the-world-2017

[Nigel]

so who funds pharmacy research ?

The answer is complicated.
“ended up helping the development of 84 first-in-class drugs....” is not the same thing at all as saying developed 84 first in class drugs.

The world’s best selling drug was developed in the UK by a company called Cambridge Antibody Technology, based on research originally funded by the Medical Research Council.
They could’t afford the very expensive clinical trials, so it was licensed to a US company. CAT got a 3% royalty on sales (of which they have to pay a proportion to the MRC) - and anyway they are now owned by Astra Zeneca...

[wj]

Trump in Helsinki, according to Russian state TV:
https://mobile.twitter.com/juliadavisnews/status/1019389905020051456?s=11
Money quote:

"When Trump says our relations are bad because of American foolishness and stupidity, he really smells like an agent of the Kremlin."

Apparently we get more honesty from Moscow than from some of our Senators.

[Pro Bono]

Reasons to abolish drug patents, #1.

When a drug patent is held by a corporate, its aim will be to maximise revenue from the drug. The price point it will choose will be the one which maximises price*volume. Unless all potential customers have (almost exactly) the same money available to pay for the drug, that 'optimum' price point will price some of them out of the market.

So the effect of the patent is inevitably that some patients who would benefit from the drug don't get it.

[Donald]

“But it appears to me that the resolution has a gaping hole in it. That is, it doesn't define what constitutes "war".”

Bin Laden was an assassination. I think at one point during the 70’s we outlawed assassinations because of what it turned out the CIA had been doing, but that prohibition went away during the war on terror. But yes, obviously Congress should have ultimate authority over whether a President can wage assassination programs. In the case of drone strikes they are pretty much small scale wars anyway.

If election interference is war, then the US has been warring on other countries dozens of times. I don’t think the current uproar about our 2016 election suddenly makes this kind of thing “ war” just because we don’t like it when it is done to us.

Cyberwar is new. If it kills people it would be war or terrorism or something like that. I am sure we would call it terrorism if people destroyed our secret military programs and assassinated our scientists. Congress should be able to put a stop to such programs. I assume that at least in theory there is secret Congressional oversight, but in the case of Iran I don’t know if there was or if Congress could have stopped it if they had wanted to.

Yemen is straightforwardly war. Our wonderful democracy should vote on it if we want to help the Saudis make war on children.

[wj]

Bin Laden was an assassination.

But was it? Bin Ladin was the leader of a group which had attacked the US. Which attack was the proximate cause of our massive military effort (a war beyond question) in Afghanistan. A sniper with a rifle, or an introduction of poison would be an assassination. But a military team, collecting intelligence as well? I would say that, at minimum, muddies the water.

Hence my desire for a definition in the bill. You appear have a clear idea of what is and is not "war." Others also have clear ideas on the subject. However, they are different ideas. Better to get that sorted out up front, rather than have an enormously frustrating fight over terms when there has been an actual, arguable (and it would be) instance.

[Nigel]

Reasons to abolish drug patents, #1.

A simpler and less disruptive approach might be for the government to negotiate drug prices - as they do in the UK, and quite a few other places ?

[Nigel]

After all, the US government is a pretty massive customer (via Medicare/Obamacare) of the drug companies - and it doesn’t do so.

[Nigel]

This was quite amusing.
https://www.theguardian.com/fashion/2018/jul/18/was-the-queen-sending-coded-messages-to-donald-trump-via-her-brooches-absolutely
Twitter user @SamuraiKnitter has pointed out that on the first day of the Trump visit, the Queen wore a simple green brooch that was given to her by the Obamas to signify their friendship. On the second day, she wore a brooch given to her by Canada, a country with which Trump is less than pleased at the moment (also, it was in the shape of a snowflake, a classic Trump term for people who disagree with him.) And, for the last day, she chose a brooch the Queen Mother wore to the funeral of King George VI, so not one associated with happiness and joy. Queen’s brooches: 3. Trump: 0.

[wj]

One thing you can be sure of with Trump. Subtle messages will go right by him. Leaving the rest of the world laughing, and him clueless . . . until someone explains to him later, in simple words, what happened.

[Nigel]

In Trump's view, it didn't happen.

[Pro Bono]

A simpler and less disruptive approach might be for the government to negotiate drug prices - as they do in the UK, and quite a few other places ?

The UK does not negotiate prices as such. The manufacturer sets a price, and NICE either approves the use of the drug at that price, or it doesn't. There's also an overall limit on how much profit a manufacturer can make from the NHS. And if NICE says a drug is not worth the money, there's some wiggle room for the manufacturer to offer sweeteners to change its mind.

Several other countries base their pricing on what NICE agrees for the UK. There's a lot at stake.

This is certainly better than what happens in the US. But it's built into the system that some beneficial drugs will be priced too high. Because the manufacturers need to push prices up, and NICE needs to hold them down. So it's still the case that some patients don't get drugs which would help them.

[Jeff]

In the early 60’s my father teamed up with a hydraulic engineering professor and developed a heart valve. The work was funded by the hospital and the college. Cutter Labrotory manufactured the device for a good profit. My father and the professor donated their royalties to the hospital lab and the college. Sometime people are modivatex by something other than making money.

[Nigel]

Because the manufacturers need to push prices up, and NICE needs to hold them down. So it's still the case that some patients don't get drugs which would help them....

That still sounds like a negotiation to me; it's certainly very different to what happens in the US.

[Nigel]

Defending misogyny:
https://www.washingtonpost.com/news/powerpost/wp/2018/07/18/you-cant-call-her-a-slut-gop-congressman-complains-about-political-correctness-in-newly-unearthed-audio/
“This has all been litigated before, and as Congressman Lewis has said time and time again, it was his job to be provocative while on the radio,” campaign spokeswoman Becky Alery said in a statement....

I guess that's OK, then ?

[Nigel]

Sometime people are modivated by something other than making money...

Absolutely - and any well functioning system should recognise and facilitate that.
(Note that the UK's biggest medical charity was endowed with proceeds from the sale of pharmaceutical company Wellcome to what was then Glaxo.)

Some people aren't, though.

In the end the human genome project benefitted from the competition (and collaboration) between the commercial and the government funded academic projects.

Surely the aim should be to design a system which gets the best out of both ?

[Nigel]

The party of Trump.

Republican Senators doing nothing about Trump's betrayal of the country, as they hope it will "blow over soon", or fade in the news as he does something else objectionable...
https://www.politico.com/story/2018/07/18/trump-russia-republicans-spin-putin-731976

[Donald]

WJ—

I think there are always going to be gray areas. In a way I would welcome a debate about all the various cases, because Presidents have the powers of an absolute monarch when it comes to killing and sabotage. So if the proposal is ambiguous, it gives us an opportunity for challenging excessive Presidential power in other cases.

But cases like Yemen are clearly in the war category.

[cleek]

Republican Senators doing nothing about Trump's betrayal of the country

they're doing what representatives are elected to do: they're representing their voters.

it's not a Senator's fault if his voters are treasonous idiots who have no principles beyond "Stick It To Teh Libz!" right ? he has to do what they want.

the GOP is a cult.

[Nigel]

the GOP is a cult.

On that theme, Republican women candidates talk about being "often forced to answer for Trump — a reality they find unfair...."
https://www.politico.com/story/2018/07/19/republicans-women-trump-midterms-731615

Which basically requires the extraordinary, willed unseeing of the President their party is in thrall to.

[Girl from the North Country]

Sometime people are modivatex by something other than making money

Not about drugs, but I believe it was Janie who previously referred to the shining example of Tim Berners-Lee and the Worldwide Web....

[wj]

Indeed, there are a host of people (in IETF and ICANN) who are continuing to volunteer to work out how the Internet will function. None of them are getting rich off their work. But the work keeps getting done.

[cleek]

also, the bulk of the software that runs the bulk of the internet is free.

[cleek]

79% of Republicans approve of how Trump handled the Putin meeting.

the GOP is a cult.

[JanieM]

79% of Republicans approve of how Trump handled the Putin meeting.

the GOP is a cult.

I know there's no logic to it, but I keep marveling (not in a good way) that this is the party of St. Ronnie the Destroyer of Communism.

[Michael Cain]

Indeed, there are a host of people (in IETF and ICANN) who are continuing to volunteer to work out how the Internet will function.

It's been a very long time since I was involved in IETF work, but even then most of the people doing the work were getting paid by an employer. Certainly I was. Perhaps, "Companies who depend on the Internet functioning properly pay engineers to work out the details in a cooperative open-rather-than-proprietary fashion."

[Tony P.]

What's to marvel at, Janie? Putin is not a communist, he's a kleptocrat. He's exactly the sort of guy for whom the "white working class" would demand tax cuts, just like Saint Ronnie taught them.

--TP

[JanieM]

TP, do you actually think the "communists" were actual communists, and not kleptocrats? Putin was a KGB officer. The break in continuity from the former to the current regime, in terms of how power is wielded and in terms of ambitions on the world stage, isn't more than skin deep.

[Tony P.]

Janie, we both know the Soviets were not actual communists. But tell that to the "white working class" who learned at Saint Ronnie's knee to talk about "communism's death toll".

--TP

[bobbyp]

do you actually think the "communists" were actual communists, and not kleptocrats?

Yes, I would wager that most of them (those who wielded actual power) were, at worst, rather jaded communists who nonetheless wholeheartedly believed in the tenets of dialectical materialism.* We tend to overlook and discount the idealism embodied in the Marxist canon. That's because we observe the rather dismal/horrifying results.

Putin strikes me as an authoritarian nationalist trying to restore the lost power and prestige of 19th century Czarist Russia or the post WW2 Soviet Union.

*They might have lived a bit high on the hog in relation to a typical citizen, but they did not stuff $billions in foreign banks...like true kleptocrats.

[hairshirthedonist]

Yeah, well, remember when Uranium One was such a horror when the other party was in charge?

I actually saw a meme a RWNJ friend of mine posted a couple days ago listing all the great things Putin has done and asking how it was he "suddenly" became the enemy.

[russell]

Where this is all going to land, is this:

The connections between Trump and/or his campaign and Russian nationals aligned with Putin, quite likely including Putin, will be demonstrated.

Trump will say, "Yes, that's all true. So what?"

Trump's base will be more than good with all of it. If that's what it took to get their guy in, they're fine with it. Everybody does it, what's the big deal.

And then we'll see what happens from there.

Depending on the makeup up the House and the Senate at that point, articles of impeachment may or may not be brought, and if brought, may or may not be sustained.

Some of the issues involved may end up before the SCOTUS, and they either will or won't be favorable toward Trump.

And we'll end up on one side of the looking glass, or the other.

The alternative is to burn it the hell down, because our form of government doesn't really give us too many more options than what I've outlined.

The fact that the man has not yet been impeached on grounds of violating the emoluments clause makes me skeptical that anything of consequence will come of out of all of this. Which is to say, it's completely likely that Trump will skate, on all of it. He quite well may be POTUS until 2025.

Tough shit for Manafort, Flynn, Papadopoulos, et al. Shoulda watched their backs. It ain't show friends, it's show business.

Good luck to all.

[cleek]

this is the party of St. Ronnie the Destroyer of Communism.

my favorite is still how they pretended to be the party of family values.

LOLSTFU

[cleek]

and i wrote that before i saw this.

[Countme-a-Demon]

"The alternative is to burn it the hell down, because our form of government doesn't really give us too many more options than what I've outlined."

They will take it all. For it is written.

Aside from everything else, the Federalist Society's ultimate goals are to declare Social Security and Medicare unconstitutional, which will follow on quickly after all abortion, insurance for pre-existing conditions, including pregnancy, all union political activity, all immigration (including removing citizenship from U.S.-born citizens*), all LGBT rights, all regulation that protects the civil rights of blacks, women, and the environment, are dead.

What we will learn about traitorous republicans and conservatives, the entire malign anti-American movement, in this country .... is that many dozens of millions of them, possible 100 million, are the "queers and commies" .. in so many of THEIR words for the past 65-plus years, so let's use their fucking words and their fucking bullets against them for a change ... their beloved Joe McCarthy fingered as the mortal enemies of America.

There will be much gnashing of teeth regarding our friends and family members who will be destroyed among these internal enemies of America, but let's learn a lesson from Abraham Lincoln, who didn't flinch at personal loss in executing his duties to the country.

https://chch.oncell.com/en/benjamin-helm-119305.html

Helm was killed in battle, leading Confederate enemy troops, in 1863.

Lincoln continued to butcher the Confederate enemy for two more years, despite his personal grief.

If Lincoln was living today, he would be shot dead by a contemporary conservative movement bullet.

Probably some fuck who kinda likes the tax cuts AND the Russian hookers run out of Mar-a-Lago.

Trust no one. No conservative or republican. Not one. All of them are under our beds.

And when we are done killing these ratfuckers on U.S. soil, we'll provide massive foreign aid to movements who butcher the fascist vermin elsewhere as well.**

*https://www.washingtonpost.com/opinions/citizenship-shouldnt-be-a-birthright/2018/07/18/7d0e2998-8912-11e8-85ae-511bc1146b0b_story.html?utm_term=.83bdf815d6

** https://www.motherjones.com/kevin-drum/2018/07/austria-wants-to-register-anyone-who-buys-kosher-or-halal-meat

If they were a cult, mere amateurs, we could count on them committing mass suicide.

No. They are something else.

These are professional, sadistic motherfuckers. And they want everyone but themselves dead:

https://www.youtube.com/watch?v=eRBI1VSO7hc

[Countme-a-Demon]

https://www.nytimes.com/aponline/2018/07/19/us/politics/ap-us-congress-election-security.html

2018 and 2020 elections are already stolen. Savage violence is the only viable response.

http://www.lawyersgunsmoneyblog.com/2018/07/republican-war-public-sector-unions-won-2020-elections

Just as the cuck c*nts will make it possible for workers to sue unions for back dues, in addition to disallowing any dues-paying going forward, thus bankrupting unions, once they declare affirmative action unconstitutional, they want to make it possible for those who feel they were adversely affected by affirmative action any time in the past 30 years to sue for damages, thus bankrupting much of higher education in America.

All aimed at one-party fascist government.

I hope mp successfully does this, so we can begin necklacing republicans with burning tires in the streets.

https://www.balloon-juice.com/2018/07/18/the-white-house-needs-to-knock-back-putins-offer-of-assistance-in-exchange-for-interviewing-investigating-ambassador-mcfaul-several-other-us-officials-and-bill-browder/

[wj]

Sometimes, you win one:
https://www.washingtonpost.com/powerpost/senate-gop-withdraws-judicial-nominee-ryan-bounds-delivering-a-blow-to-trumps-court-plans/2018/07/19/0d81ff50-8b83-11e8-8aea-86e88ae760d8_story.html

[Tony P.]

The Deep State might yet save us.

He, Trump and his KGB handlers, NRA co-conspirators, and MAGA-hat-wearing dupes all seem to think that their boy can do their bidding by dint of his own mighty arms. This is of course not true. Even absolute monarchs can only operate through agents willing to follow their orders.

Imagine for instance that He, Trump decided to ship Mike McFaul to Russia. Could He tackle and handcuff McFaul all by Himself? No: He would have to issue orders to people who issue orders to people who issue orders to lower-level people who work for a living.

I don't know how many levels "Deep" the "State" is, but Putin's Little Bitch needs to count on an unbroken chain of loyalty between Himself and the FBI field agent who physically handcuffs McFaul -- not to mention the prosecutors, judges, and so forth, who would be involved.

In principle, we want everyone in The Government to obey orders from a "democratically" elected POTUS like automatons who are not programmed to care whether the POTUS is a Republican, a foreign agent, a crook, or a nutjob. In principle. In our current situation, we have to hope that some of them are actual American human beings and not brainless stooges of the Kremlin.

I'm not betting on that, mind you. I fully recognize that the Deep State may already be in Putin's pocket -- in which case we are all fucked.

--TP

[Countme-a-Demon]

The Deep State is retiring:

https://www.marketwatch.com/story/three-of-the-top-fbi-cybersecurity-officials-are-retiring-2018-07-19?siteid=bigcharts&dist=bigcharts

The Russian karaoke disc jockeys at mp Resorts who graduated from Ratfuck U with a major in Loose Lips will replace them.

[Countme-a-Demon]

Bounds was nominated precisely BECAUSE he is a fag-hating, racist republican.

Find no comfort in his withdrawal.

They have a deep bench.

This guy needs a job:

https://nypost.com/2018/07/06/white-man-loses-job-after-calling-police-on-black-family-at-pool/

[wj]

The Deep State is retiring

Sometimes there is a job that needs doing, but your boss refuses to let you do it. In such circumstances someone with a sense of responsibility may decide to seek another situation, where he can do what is necessary.

[Countme-a-Demon]

You must be developing an ulcer, wj, keeping such a tight rein on everything. ;)

[Nigel]

wj, I think, might be in a similar position to the DNI (setting aside, of course, the latter’s self-proclaimed ‘good relationship’ with Trump).

The news appeared to shock Dan Coats, Trump’s director of national intelligence, who has underscored his assessment that Russia is continuing to target the United States, despite Trump publicly casting doubt on the idea.

“Say that again,” Coats said when informed of the White House’s invitation to Putin during a panel discussion at the Aspen Security Forum. “Did I hear you? Ok...that’s gonna be special.”

https://www.politico.com/story/2018/07/19/michael-mcfaul-trump-russia-question-732356

“Obviously, I wished he had made a different statement, but I think that now that has been clarified,” Coats said, referring to Trump in Helsinki.

“I don’t think I want to go any further than that,” Coats added.

[Pro Bono]

Reasons to abolish drug patents, #2.

Drug companies spend a huge amount of money, similar to what they spend on R&D, marketing their drugs in high-price markets. This spending is if anything harmful - it persuades physicians to prescribe drugs they wouldn't prescribe without it. And it feeds into drug prices.

Consider how this would change in a world where drugs were free of patent, and development were paid for by rewards. There would still be an incentive to get your drugs widely used, because that would increase the reward. But the reward for one additional user would be much smaller, because the high-price markets would be gone - an additional user anywhere would have the same value.

Furthermore, the reward system itself would publish the information behind its decisions about the effectiveness of drugs. So there would be an independent, well-evidenced source to guide prescribing.

The result of introducing such a system is that marketing spending would collapse. That in itself is a big reason why the change is not being discussed - the very well funded marketing people lobby against any such ideas dangerous to them.

[Nigel]

The result of introducing such a system is that marketing spending would collapse.

That's quite a large assumption.

Some indication of current spending by sector;
https://deloitte.wsj.com/cmo/2017/01/24/who-has-the-biggest-marketing-budgets/

[Nigel]

Here's a (slightly old) real world description of more or less that kind of drug market (India), which doesn't suggest that kind of collapse in marketing spend:
http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.377.67&rep=rep1&type=pdf

And note the world's biggest generic drugs company (Teva) spends around 15% of revenue on marketing.

[Nigel]

Consider how this would change in a world where drugs were free of patent, and development were paid for by rewards....

How would that system work ? If you think about the mechanics of it, setting up a complete replacement for the existing system would be incredibly complicated and fraught with difficulties.
(As a particular example, 'me too' drugs, even if second or third to market, are often improvements on the product that got there first - how do you incentivise that with a 'reward' system ?)

I am in complete accord with you that a 'prize' system could work in individual cases - tow sectors particularly suited to this approach which I mentioned above are antibiotics and vaccines (and indeed vaccine manufacturing systems - the egg based flu vaccine production is both inefficient and very slow, but there is a lack of incentive to develop a replacement).

Government could usefully complete with the commercial pharmaceutical companies in other ways - funding research into existing off patent drugs, for example, or the long term health benefits of diet and exercise; set up its own generic manufacturing for niche off patent drugs which are often massively overpriced etc.

[Pro Bono]

Comparisons of marketing spends with other industries are not to the point.

And the marketing of in-patent drugs should be understood differently from the marketing of generic drugs.

For generic drugs, in a healthy market (which doesn't always exist) your competition is other manufacturers producing the same molecule. Your marketing is aimed at building brand recognition which will persuade the consumer (or prescriber) to trust you over them. It's not much different to persuading me to buy your memory stick rather than someone else's.

In a rewards-based system, all drugs would be like this - there would be no legally enforced monopolies on manufacture and sale.

Marketing of in-patent drugs is different. It spends vast amounts of money persuading patients to demand unsuitable drugs, and persuading doctors to prescribe them. This is simply bad. Prescribing decisions should be evidenced-based, not marketing based.

Because manufacturing costs (separate from development costs) are usually a small part of the sales price, it's profitable to spend nearly all of the unit sales price to sell one more unit. In high-price markets (the USA) sales prices are very high, so marketing spends are correspondingly high. This incentive would simply cease to exist in a rewards-based scheme.

(The most striking thing for a Briton watching US television is the volume of drug adverts. This direct-to-patient advertising doesn't exist in the EU, as a matter of law.)

[Pro Bono]

How would that system work ? If you think about the mechanics of it, setting up a complete replacement for the existing system would be incredibly complicated and fraught with difficulties.

I don't claim it would be easy. But the patent-based system is intrinsically so inefficient and harmful that a new system needn't be perfect to be vastly better.

The biggest difficulty would be creating a system for bestowing awards which is (sufficiently) free from financial or political influence. It would need to be very strongly evidence based. Which is a good thing.

Me-too drugs? They'd be rewarded according to how much better they are for (some) patients compared with the drug they emulate. Since the rewards would be less, there would be fewer me-too drugs. That's a feature.

[wj]

Since the rewards would be less, there would be fewer me-too drugs. That's a feature.

Except that me-two drugs, like generics, are another form of competition. So reducing their number seems like a bug rather than a feature.

[Nigel]

For generic drugs, in a healthy market (which doesn't always exist) your competition is other manufacturers producing the same molecule.

Which is why marketing spend is a similar percentage of sales.

[Countme-a-Demon]

It's all about the blind justice and rule of law:

https://talkingpointsmemo.com/livewire/mcconnell-threatens-to-hold-kavanaugh-hearing-right-before-midterms.

Happily, Brett Bellmore wins another one, but not like he thinks. Downloading is fucking bipartisan.

https://www.thedailybeast.com/downloading-3-d-printed-guns-to-become-legal-next-month

Drugs:

https://other98.com/trumps-plan-to-lower-drug-prices-raise-them-for-everyone-else-on-earth/

Folks in other countries can download weapons too. A reminder to Americans who travel to countries where mp America wants to fuck their highly workable medical delivery systems.

"The biggest difficulty would be creating a system for bestowing awards which is (sufficiently) free from financial or political influence. It would need to be very strongly evidence based. Which is a good thing."

Up above, sapient, and me, probably on another thread, we posted a link detailing our republican psychopathic gummint's efforts to defund and halt the highly workable system in place to evaluate the relative efficacy of medical procedures and drugs.

As far as marketing goes, any attempt by government, including the provision of objective consumer information to curtail corporate superhuman four out of five dentists in marketing departments from lying and cheating about their producers will be stymied by the newly weaponized First Amendment, which provided rock solid constitutional penumbras for our freedom to lie, mislead, and yell "Viagra" in a movie theater full of terminal cancer patients.

You can't put a lid on lying in America.

It's tantamount to cutting out the tongues of the conservative minority of the population.

Also, downloadable pistols for the lied to.

Just in time.

[Countme-a-Demon]

mp and HIS thugs compromised the Kremlin source and the source is now fish food:

https://www.yahoo.com/news/cia-apos-had-source-close-201256557.html?.tsrc=daily_mail&uh_test=1_08

We're all Smiley's People now.

When does the killing start?

[Michael Cain]

Since the rewards would be less, there would be fewer me-too drugs. That's a feature.

I'm less concerned about the me-too drugs because of people who do not respond to the existing drugs, or have an adverse reaction to them. I have a friend who cycles through several cholesterol-lowering drugs because he develops a tolerance to any of them over the course of three to six months.

[Countme-a-Demon]

They'd kill us if they could. And they can. And will:

https://twitter.com/BFriedmanDC/status/1018852773448900609/photo/1?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1018852773448900609&ref_url=https%3A%2F%2Fdigbysblog.blogspot.com%2F

[Countme-a-Demon]

http://www.lawyersgunsmoneyblog.com/2018/07/fred-hiatt-commissions-white-nationalist-write-egregiously-dishonest-article-advocating-ethnic-cleansing

[Countme-a-Demon]

https://www.esquire.com/news-politics/politics/a22499568/brennan-center-report-voter-purgin

Fuck elections.

[Countme-a-Demon]

https://www.marketwatch.com/story/the-trump-tax-scam-had-a-very-bad-week-2018-07-19?siteid=bigcharts&dist=bigcharts

Fuck elections.

[Countme-a-Demon]

https://www.marketwatch.com/story/scott-pruitts-staff-at-epa-worried-about-exposure-to-formaldehyde-but-only-for-their-boss-2018-07-20?siteid=bigcharts&dist=bigcharts

Fuck elections.

[Pro Bono]

Except that me-two drugs, like generics, are another form of competition. So reducing their number seems like a bug rather than a feature.

You're the CEO of a pharmaceutical company. On your desk are two R&D proposals: one for a new gliflozin, which the proposal hopes will work similarly to existing gliflozins in managing type-2 diabetes, the other for a sleeping sickness cure. Resources being finite, you can commit to only one of the projects. So you look at the financial reports. They estimate that a successful gliflozin would net $1bn. And that a successful sleeping sickness cure would lose money. So you plump for the diabetes treatment.

In a rewards-based system however, saving the lives of many thousands of Africans is worth more than offering a slightly different treatment to millions of Americans. So you'd choose the sleeping-sickness cure. This is the world I want to live in.

In a world with unlimited R&D resources, the more me-too drugs we have the better. In the actual world, we should focus resources where they will do most good.

[wj]

Personally I would prefer a world where both projects could go forward. The problem of finite (corporate) resources being dealt with by readily available (and affordable, of course!) loans to fund things like the sleeping sickness cure. As long as we're laying out alternative castles in the air, that's the one I'd prefer.

[russell]

i'm sure there are many things that could be taken away from the pharma discussion on this thread.

what I take away from it is the idea that there are some things - some goods and services, tangible things - which we should not rely on purely market forces to provide.

there are always a million things for money to chase after, and most of them are probably more renumerative - certainly more reliably so - then developing medicines. for example. and, not just developing medicines, there are lots of things that are of profound social value, and which are going to have a lower ROI than, for instance, developing a ride sharing app. or, for that matter, a new and improved boner pill.

if we want those things to happen, we have to find other ways to make them happen. ways other than somebody somewhere getting stupid rich from them.

[Nigel]

In a rewards-based system however, saving the lives of many thousands of Africans is worth more than offering a slightly different treatment to millions of Americans. So you'd choose the sleeping-sickness cure. This is the world I want to live in....

And why could that not exist alongside the existing system, as I suggest ?
The example you give is precisely one of those suitable for a rewards based approach which could work alongside what we have.

And if you had a purely rewards based system as you advocate, who makes that choice ?
Why would an adminstration as the US currently has (or indeed the next Democrat administration) choose to spend its healthcare dollars on an overseas problem, rather than improving outcomes for one of the US’s biggest healthcare challenges ?