[nostrademons]

Some examples other than what people have already mentioned:

Prescription drugs. The FDA has a "no existing alternative first" policy - they work on approving drugs for conditions where no current treatment works before they even start considering competitors to existing drugs. This sounds quite logical, but the effect of it is that every new drug is granted a monopoly for a long period of time before any competitor can even legally sell their alternative, so the drug company can literally charge whatever they want.

Building codes. In my grandparents' day, it was still possible to construct your own house: you bought a plot of land, hired a concrete mixer to come pour the foundation, bought a lot of 2x4s, and spent a bunch of time hammering & sawing. Now, you have to conform to all of the local building codes (which in the Bay Area, I've heard, is an 800-page tome), and you need to get approval for every feature of the design from the city building inspector, who has the power to completely block your construction if you get on his shit list. As a result, the only people who can build housing are ones who have good relationships with the city and the know-how to adhere closely to all the building codes.

Zoning. Even if you have that know-how and relationships, there are some things you just can't do with housing. Own a 1/4 acre with a single family home and want to convert it to a 4-plex? Too bad, it's not zoned for that.

And you can see the economic impact of all of these by looking at situations where they're absent. Consider generic drugs: once a generic has been approved, the price of a drug can fall by 90% or more. Or compare housing in the Houston metro area, where you can get a 3BR2BA for under $200K, to the Bay Area, where the same house will set you back $2M.

[mcguire]

"In my grandparents' day, it was still possible to construct your own house: you bought a plot of land, hired a concrete mixer to come pour the foundation, bought a lot of 2x4s, and spent a bunch of time hammering & sawing."

It still is. And here in rural Alabama, I have the electrical wiring to show for it.

[flukus]

> Prescription drugs. The FDA has a "no existing alternative first" policy - they work on approving drugs for conditions where no current treatment works before they even start considering competitors to existing drugs. This sounds quite logical, but the effect of it is that every new drug is granted a monopoly for a long period of time before any competitor can even legally sell their alternative, so the drug company can literally charge whatever they want.

You think that's government control? Most countries have the government negotiating prices on behalf of it's citizens in a very "take it or leave it" manner. Pharmacists also have to offer a generic if it's available, regardless of what the doctor prescribes.

Those much stronger government controls produce better (cheaper and universal) outcomes.

[oconnor663]

Pharmaceuticals is a tricky example, because the marginal cost of producing them is extremely low. Having the government control negotiate the price of, say, automobiles, might have weirder results.

> Pharmacists also have to offer a generic if it's available, regardless of what the doctor prescribes.

I believe in the US it's actually illegal for a pharmacist to recommend a generic, if the doc didn't check the right box. Maybe just decriminalizing it would have a nice impact :p

[joe5150]

that's backwards. pharmacists are required by health plans or by law in some states to dispense generics (not "offer," dispense, i.e. if I bring in a script written for AMBIEN 10mg, I'm getting zolpidem 10mg without asking) unless the doctor insists on a name brand.

[oconnor663]

I feel like I heard my wrong version in an article about EpiPens. Is it different for devices maybe?

[joe5150]

the first generic EpiPens were just approved a month ago, I don't know if they're widely available yet. if for now some plan formularies only have name-brand injectors on them, some people with insurance could potentially pay less for the brand than the generic until that changes. otherwise, the same substitution allowances and requirements should apply.

EpiPens aren't really medical devices, it's just a drug with a specialized route of administration. it's not any different from an inhaler, a nasal spray bottle, an eyedrop bottle, etc., from a dispensing point of view.

EDIT: it's true that pharmacists aren't always allowed to tell patients when they could save money by buying a generic and paying out of pocket rather than buying a more expensive name brand and paying their share of the full price with insurance. that may be what you heard.

[AngryData]

You still can build a house that way, building to code is not hard, it only becomes any sort of problem once you start doing crazy shit like open spans 20 foot wide or vaulted ceilings, and even then, there are simple standards for most of that too, which is why the building codes are so extensive. With a couple months of work or training anybody could build a house to code by themselves without a problem. The only real consideration for not doing it yourself is your speed. Some guy that frames all day every day is going to get that job done multiple times faster from practice and have more than all the tools for anything they will encounter, but if you have the time and can swing a hammer then you can do it.