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by vijayr02 1833 days ago
I don’t buy this explanation. There are enough publicly funded healthcare systems in the world for it to make economic sense for one of them to run a large scale trial. I don’t see an agency problem arising for such an existential threat as COVID-19. Do you see an issue with my argument?
2 comments

Your argument is sound. It is however, built on one glaring assumption: the people in charge of the publicly funded healthcare systems are primarily incentivized to find cheap and safe treatments for the illness.

I think when you look at the selective medicare payments, the ventilator contracts, and the price of the 'recommended' patent-drugs like Remdisivir... it quickly becomes apparent that our public incentive structure is profoundly broken.

Actually, they are incentivized! It keeps taxes down, which means voters are happier, and sometimes benefits people as well. It is a balancing act, since having bad care also makes folks unahappy or makes for bad outcomes and you wind up having to balance costs like paid time off and travel costs vs building more facilities (assuming you actually offer paid time off and travel costs for long travel, which any decent health care system should for better outcomes). I'll add that it isn't a fair comparison to use things like medicare to speak for publicly funded systems because things just don't work the same in other places.

You don't have to have recommended patent-drugs unless, of course, they are the best option. Sometimes the newer drugs really are better.

> Your argument is sound. It is however, built on one glaring assumption: the people in charge of the publicly funded healthcare systems are primarily incentivized to find cheap and safe treatments for the illness.

In many countries, they do. In some (like Brazil and India), they even rebelled and fought for their right to do so at some point (saving lives of people in other countries by the way).

I mean, in theory, all governments should care, but some are corrupted, and some have been designed to work against the best interests of the patient.

Well, no flaw in the argument I think, but for me it hints at those publicly funded healthcare systems being heavily influenced by the privately held Pharmas.