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by nickik 3146 days ago
You argument that nobody decides to have cancer is true but it applies to tons of stuff. You don't decide that your car breaks down. You don't decide that a storm is coming. You don't decide the change in import controls for goods from China. There are literally millions of things that you don't decide.

The very reason we have capitalism is that we have dynamic system that reacts to feedback and finds or at least moves the system towards a new optimal point given the new circumstances.

If there is a operation that exists free market would make that operation as cheap as possible and weather it is your decision to need the operation or not, you will still get a very cheap operation. For the market is irrelevant why the demand exists, but it will attempt to satisfy that demand and we are all better for it.

So the problem with opioids is about demand.

People should trust doctors to give sound advice regarding their opioid consumption, as they do with many other things. The majority of people don't want to be addicted and are happy to comply with measures.

There are a couple problems, first, the doctors primary earn money by selling stuff thanks to the perverse system of intensives that the modern american health care system produces.

Second, there was a actual problem where doctors in the US, by themselves started to over-issue these drugs, and they still do. That is as much a cultural problem as it is anything else. This has to change.

Third, I think its pretty clear that the distribution and demographics about this issue tell a story that is hard to explain by a general 'evil capitalist' pushing pills on people. It is clear that some communities are dis-proportionally effected and that is a more deterministic factor then the price of the pills.

Fourth, if there were actually free markets people would buy high quality product that does not kill you. People who take it might be addicts but you can be high functioning and your chances of recovery are much better then with this disgusting stuff people are forced to consume because of government regulation.

3 comments

A car analogies, the best ones!

If your car breaks down there are other means of transportation like getting a Uber, renting a car, carpooling, riding a bicycle or even walking. This is the typical "infinite" possibilities situation where capitalism really blossoms. I personally don't own a car because exactly all of those reasons, so I chose to never have a car that I need to repair. I hate things to maintain.

Now imagine a situation where you are only allowed to go to your work in a car, nothing else. If you don't go to your work you will be fired and you will never find another job again (i.e. dead). And the spare part you need for it to get it working again is only available through one source that for some reason charges about 100 times more than it takes to manufacture the part itself. You are not allowed to have any other car than the one you currently own, not even the same one new.

Now that's how having cancer works in the field of choice.

People choose to live near volcanoes, mountains, oceans. Places where tornadoes are frequent. There's a good reason most people on Earth never saw one.

Though I agree somewhat on most of your points. Actually one of the biggest problems is that nor the legal opioids nor heroin are freely available towards consumers. A lot of people are killed because impurities or more unhealthy alternatives. Again, mixing pure capitalism without the real choice makes things really ugly.

But there's a huge incentive to make money not on the best solution for the patient but based on the largest kickback for the doctor and the biggest profit margins for the industry.

Except this is an actual known "evil capitalist" scenario, where pharma execs literally bribed doctors to over-prescribe opioids. RICO conspiracy charges are generally reserved for the likes of the mafia, and even then are rare due to the overwhelming burden of proof required. I'm honestly not sure who I consider worse in this case: the pharma execs handing out bribes, or the doctors who accepted them.

Reference: https://www.justice.gov/usao-ma/pr/pharmaceutical-executives...

I believe this exists, but I don't think that is the majority of cases.

There was genuine movement among doctors in the US, with serious people writing about how pain was not necessary. It is also the case that legally in the US you can be accessed of not addressing peoples pain enough.

Also again, if doctors had an intensive to care for their patient they would have to be more careful about what they give to them.

I’d encourage you to read a book called Drug Dealer, MD. It details how pain was made “the fifth vital sign” and doctors could lose their board certification and license if patients filed complaints alleging that their pain was not adequately treated by their provider. Even today, surveys that are sent out following hospital encounters ask people if their pain was addressed to their satisfaction. It’s difficult to withhold opioids when your livelihood is on the line.
Yes. That is very much a problem.

But its not a problem with capitalism, it just depends on what your legal rights are. Any institutional setup could have the same problem.

'Dreamlands' addressed the same problem.