Libertarian introspection: Where the market fails

SeanEdwards

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I thought it would be interesting to discuss situations where the actions of the free market do not work well at meeting the needs of consumers.

One area where I think the market is not so good is in medicine, and in particular in the development of cures for illness/disease. Just today, I sat through a presentation by a researcher from Amgen, where he discussed the drug discovery/development process. The current process requires these drug companies to spend anywhere from 7-15 years, identifying, testing, and getting FDA approval before they can bring a drug to market. It can cost up to $1.5 billion in this development process before a single dollar can be earned form sales.

These financial pressures tend to make drugs that treat and control symptoms vastly more attactive to drug companies than drugs that cure an underlying disease. The holy grail for these researchers is a drug that must be taken daily for the rest of the patients life. I can imagine a circumstance where one of these companies would actually bury a drug that cured or prevented cancer, in favor of drugs that just check the growth of a tumor. The market simply does not reward them for developing cures. In fact it penalizes them, by eliminating the disease that they could otherwise get rich from by making drugs that treat symptoms.

This situation is very noticeable in the development of vaccines. Relatively few drug companies are searching for vaccines, even though vaccines are some of the most effective products ever discovered for preventing illness.

More generally, these market pressures are at work in medicine as well. Doctors are treated for "fixing" problems. They don't get paid if you stay healthy. This seems like a perverse outcome that is not in the interest of consumers. A pill that could prevent heart disease for a lifetime with one dose sounds pretty damn good to me, but to the medical industry it would be a disaster.

This is not a plea for socialized medicine, so all you anarcho-capitalist zealots can just enjoy a big steaming cup of STFU before even getting started. This thread is meant to spark a discussion about ways that these flaws in the market system can be mitigated.

One possibility that occured to me, was perhaps creating a new type of patent law that grants the inventor of a cure an extra-long patent on their discovery. This would be an incentive to encourage drug developers to spend the money researching vaccines and other medications that permanently cure illness. Right now, the patent law gives a company 22 years of patent rights (I think). And usually these drug companies patent their drug molecule long before it's ever approved by the FDA as a way to protect their intellectual property. Then of course they burn up a bunch of their protected patent period trying to get the drug approved for use. This in turn tends to drive up the price of the drugs when they hit the marketplace, because companies have less patent protection time to recoup their investment and start profitting.
 
That sounds like a good idea with the patent extensions.

Another idea is to have some sort of system where companies can pay for part of the research/development, and then charities can kick in and pay for the rest. Also, you can pay into a charity for each disease and the charity could then give the money in a lump sum to the people who cure the disease first to give them an incentive to get the money that they lost in R&D back quickly and then they'd be able to sell the drug to the public to make profit.
 
Well, if comapnies can get their stuff into the market faster, they'll be able to make extra profits as compared to a company that has to be restrained in it's release dates. That could mean, potentially, tens of millions of dollars. Not to mention, the prices would be easier for the consumers :)
 
Well, if comapnies can get their stuff into the market faster, they'll be able to make extra profits as compared to a company that has to be restrained in it's release dates. That could mean, potentially, tens of millions of dollars. Not to mention, the prices would be easier for the consumers :)

I think this in addition to the reward from a charity would go a very long way to solve this problem.
 
Eliminating the FDA seems like a good idea to me. However, that should go hand in hand with getting rid of limited liability protections for the drug companies. Let the drug developers bear the full risk/reward of their products. If they face the potential of being destroyed as a business for releasing an unsafe product, then they will have the incentive to make sure it's safe.

And it's not as if the FDA beauracracy does a perfect job of keeping dangerous drugs out of the marketplace. Drugs get recalled all the time after being approved by the FDA. At the same time, the FDA prevents a lot of seriously ill people from using unapproved drugs that may offer them their only hope of survival.
 
I believe in the UK (socialized medicine) they have a program where government doctors get paid more salary if they keep their patient returns low. I think this means that because they keep patient #s low (by administering preventative treatment), they save tax dollars spent on frequent patient visits.

I'm no fan of socialism, but I'm starting to think that medicine and capitalism defeat the purpose of curing ailments. Lots of other things thrive under a capitalistic system, however.
 
I wish there was a capitalist society left in the world so I could see it thrive.
 
chris rock said it best
"There ain't no money in the cure, every drug dealer know that. They get you on the comeback"
 
2nd thought (more on topic)

I don't think the original premise is always true.
True free market, the value of a cure should equal the value of a lifetime supply pills that treated the symptoms.
If you gave me the choice of a $20,000 pill that cured my fatal disease or $1 pills that kept it bay, I'd choose the cure.

I think its just current consumer perception that the price of the pill is a function of the manufacturing costs, instead of a function of development costs. I believe $50,000 cures for cancers would sell very well :-)

Think about the software world, orgs pay $20,000+ for a piece of software that is delivered on a CD that cost less than $1 to manufacture.
 
The FDA and Big Pharma are in a mutually symbiotic parasitic relationship. Think of Siamese twin vampires. Doesn't seem much like a failure of the "free market" to me.
 
the only area in which I honest believe the Free Market would fail is with currency--when you have competing currencies, I think that it'll work for a time, but, eventually things will just go back to the way they are now.

Ideally, the dollar would be fixed to 1/20th of an ounce of gold, and left at that, forever.

If I were President, I'd get some legislation passed to fix it at this forever, and no one, not the next President, not Congress, not the Supreme Court...no one would be able to change it.

that way, it would be out of the hands of government and out of the hands of the Free Market, so no one can screw with the value.
 
I believe in the UK (socialized medicine) they have a program where government doctors get paid more salary if they keep their patient returns low. I think this means that because they keep patient #s low (by administering preventative treatment), they save tax dollars spent on frequent patient visits.

I'm no fan of socialism, but I'm starting to think that medicine and capitalism defeat the purpose of curing ailments. Lots of other things thrive under a capitalistic system, however.


I have read though, that there's absolutely no proof that preventative treatment does absolutely anything to reduce the cost of medicine.

Even if the model were true, the MD would still have a huge incentive to refer sick patients to specialists, therefore maximizing his/her income simply by not treating sick people.

As for developing the cure - I'm not that cynical yet. The people that make drugs are humans, and there is a huge ego factor to be considered. People aren't stupid, nor are they entirely greedy. Many people would trade a Nobel prize for curing cancer for a steady income generated from curing cancer.
 
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i use 'Alternative Medicine', mainly 'Homeopathic Medicine'

you should try it...
 
As for developing the cure - I'm not that cynical yet. The people that make drugs are humans, and there is a huge ego factor to be considered. People aren't stupid, nor are they entirely greedy. Many people would trade a Nobel prize for curing cancer for a steady income generated from curing cancer.

Yeah, but if the marketplace doesn't reward them for developing a cure then there won't be the financial backing to do the necessary work to create the cure in the first place. A cure for cancer won't be found by some lone genius working in their garage. It will take a lot of people, working with expensive equipment for a long time.

That's what's going on with vaccines. The drug companies aren't interested in developing them. They want to find treatments for limp dick syndrome, or medications that keep cholesterol levels in check and other similar crap that they can make a buck off of.
 
Here's another where the free market kind of sucks:

Worker protection

There is no particular market penalty for building your products with slave labor. If you're China you can use the equivalent of slave labor to make your products so cheap that you drive ethical competitors out of business.

Now, sure some people will say, "the consumers don't have to buy goods produced by police states", but how do they know how a particular product was built?

This problem is not as hard to fix probably as the weird incentive the medical industry has for keeping us sick and hooked on drugs, but it is a problem. I think some kind of consumer information organization could probably be developed that would rate producers for their business practices, and then consumers could choose if they wanted to pay less for slave labor products, or pay more for products produced ethically.
 
A central idea in free market theory is that people are willing to pay more for things that they want more. If the market values prevention/cures more than an ongoing diet of pills, then by definition, they should be willing to reward the company that provides the cure over the extended treatment.

It's funny you mention vaccinations because it's a perfect example of the market being proactive with illness. If it were more profitable to feed us never-ending pills for these illnesses, then why do *any* vaccinations exist at all? What epidemics is the market failing to find a vaccination for right now? Many of the health problems we're facing on large scales, cancer for example, is not as simple as a vaccination fix (see http://www.biotext.co.uk/YVvqGcI.html).

Someone already mentioned this, but I think it's an important point because you seem to be assuming that a one-time cure is somehow inherently less profitable. If you had cancer and could pay $50,000 for an immediate cure, would you do it? If people are willing to pay that, can we agree that would be a cash cow for that company? I'd be willing to bet insurance companies would partially or completely pay for such a cure to the extent that it would save them money on your bills.

I think you're being a bit cynical in your view of big business here. I'm not saying everyone's an angel, but remember that people working at these places have family and friends of their own, and I don't think most would choose to have those people die for a few more bucks (even if we assume your profit motive is correct). And if a company was holding onto a cure, wouldn't that be a huge risk to continue investing in an alternative that could be made obsolete if another company actually put out the cure?
 
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the only area in which I honest believe the Free Market would fail is with currency--when you have competing currencies, I think that it'll work for a time, but, eventually things will just go back to the way they are now.

Ideally, the dollar would be fixed to 1/20th of an ounce of gold, and left at that, forever.

If I were President, I'd get some legislation passed to fix it at this forever, and no one, not the next President, not Congress, not the Supreme Court...no one would be able to change it.

that way, it would be out of the hands of government and out of the hands of the Free Market, so no one can screw with the value.

You can get your money backed by gold and if society trusts the banks that back their money with gold then it will become the standard. I believe even if we did have competing currencies, the people would not want money backed by gold.
 
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