[pessimizer]

> People mostly aren't dying because they can't afford life-saving medicine.

No, people are definitely dying because they can't afford medicine. They're not taking things they need, they're cutting pills in half, they're diluting injections. When they finally die from some acute episode, what got them there is never recorded.

The amount of bullshit I have gone through to get albuterol inhalers (which cost $5 in civilized countries, but used to cost $20 in the US until a consortium of pharma lobbyists churned the patent and got the price up to $80.) I've met people in parking lots to buy out of date medicine in a crumpled brown paper bag. I guarantee that more than one person dies from this every single day, and none of them are recorded any differently than any other asthma death. Not being able to obtain this absurdly cheap to produce medicine that has been available for half a century has put me into intensive care for a week, causing years of medical debt when I was young. I wouldn't have been there if I hadn't been trying to manage without an inhaler.

Daraprim and emergency epinephrine seem like the same type of thing. To be honest, though, I prefer to Meet the Criminals Smuggling Their Own Medicine. For Albuterol, ordering inhalers from India was the real answer.

[kragen]

It's also worth mentioning that albuterol and similar inhalers used to be an exception to the prohibitions on CFCs (these inhalers an't used in large enough volume to do significant ozone damage), but due to lobbying from the companies that made them, they no longer are.

Why would a company lobby to outlaw its current product? Well, they had patents on "improved" CFC-free versions, allowing them to exclude new entrants from the market.

[kragen]

*aren't used in large enough

[chillingeffect]

That's what I call Metacapitalism.

[jdkee]

It is "evergreen" with respect to patented pharmaceuticals.

See https://en.wikipedia.org/wiki/Evergreening

[Tenoke]

Seems odd to call it that as there's little 'capitalism' in it. It's abuse of state regulations rather than market forces.

[kragen]

Agreed, regulators granting your company a monopoly is definitely the opposite of capitalism in a significant sense, even if the company does use wage-labor to produce products whose ownership rests with the owners of the means of production rather than the laborers.

[PicassoCTs]

State regulations which are exploitable due to lobbyism which is capital transferred into law generating power. Neo-Feudalism is the final form of unregulated capitalism and has always been it.

Why not just step forward into the Acceptance-Stage of Ideology-Death, instead of being caught with the intellectual trousers down half a century later by ones googling grandkids on a witch hunt?

[Nasrudith]

Any characterization of corporations as neofeudal shows a fundamental complete and utter ignorance to what feudalism actually is, in a way that only communists could manage to get so wrong.

Feudalism is a system of rule by networks of oaths and obligations, with military service as the top links. Its practicioners also historically depised merchants and traders from the top and bottom of the hierarchy. It aims for lifetime oaths.

And it is capitalism which cannot accept its ideological death, not communism? The one who proclaimed its inevitability loudly only to die in a single human lifetime, and is preoccupied with 19th century writings and works from unquestioned imperatives rather than experimentation? I think there is some major projection going on here.

[cloudfifty]

Why wouldn't a capitalist corporation choose to lobby the government to bend the rules in their favor if they think that that would give the best ROI? In what version of Capitalism would this not happen? What would remove this incentive structure?

[kragen]

In almost any version of Democracy, an authoritarian politician can choose to run for office on a platform of establishing a dictatorship; in most of them, they can even succeed. That doesn't make the would-be dictator a democrat, and it doesn't make their platform a democratic platform. Similarly, free-market incentives to lobby for government monopolies don't make monopolies capitalistic, because capitalism requires a free market, and monopolies and monopsonies are the opposite of a free market.

Marx called this sort of thing "the internal contradictions of capitalism"; he argued that capitalism was an inherently unstable structure, just as many writers have argued that democracy was inherently unstable. They might be right. But in either case, the possible fact that one system inevitably gives rise to its opposite doesn't make it the same as its opposite.

[pessimizer]

If the premise is that being elected dictator in a free and fair election is undemocratic, it's an authoritarian premise. It presumes that elections are only democratic to the extent that the results agree with some "democratic values" that are separate from the process of having elections.

I agree that the outcomes of democracy can be bad. But I don't believe that bad and undemocratic are synonymous.

[cloudfifty]

You're missing the forest for the trees. This is what Capitalism has always been and always will be due to its incentive structure. If you accept wealth and thus power concentration, you accept market manipulation. The corps won't skip this due to some overarching ideological free-market reason. That's just naive.

I mean, just look at the jungle of regulations and the vast inefficient bureaucracy of the US healthcare system. Those 15k layers of shite can only happen with just as many corps doing everything to either save their profits or trying to get as large a piece of the cake as possible. Public good be damned.

Say if the US gov planned to add $100 per patient in some grant for whatever reason. How much do you think would actually trickle down to the patient? I'd be like nervously donating $100 to a dodgy charity in a corrupt developing nation in the 1960s.

[dekhn]

Thgis is roughly my opionion. I expect companies to get right up against the legal line of what is permitted (to make more profit than their competitors, and be motivated to make the best products) while I expect government to regulate them when their actions would harm the public good.

[salmonfamine]

Only the most naive understanding of capitalism holds those two things as opposites, or mutually exclusive.

[pasquinelli]

lobbying is just utilizing accumulated capital to create favorable conditions. that capital was accumulated by a capitalist firm. that firm's competitive strategy might be aesthetically unappealing to you, but the firm exists in the first place because it can more efficiently utilize resources than any individual could.

capitalism is a way of organizing production with workers being paid a flat rate and owners keeping all additional value added by the workers in exchange. is that not how pharmaceutical companies are arranged?

[nyolfen]

of course, true capitalism has never been tried, but this is what you might call 'actually existing capitalism'

[refurb]

Exactly. This woman in Canada had to sell her house to get a drug that insurance readily pays for in the US. Criminal.

https://www.cbc.ca/news/canada/british-columbia/a-tale-of-2-...

”"It's crazy that I live in Canada, but now I'm looking at having to sell my house for coverage of my medication."

Earlier this week, McLaren walked to her local Shopper's Drug Mart and paid nearly $8,000 for a 21-day supply. On Tuesday she swallowed her first pill, worth $262.40 for just one day of treatment.”

[woofyman]

Generic albuterol inhaler is $20 using GoodRx.

[dekhn]

Yeah, I don't get the $80 comment (that's the list rate, which people don't pay normally), or the brown bags of expired inhalers.

[mrxd]

I said mostly. Some die without medicine, but I'd argue that the number is small in comparison with people who are affected economically. By focusing on deaths, you're effectively minimizing the problem.

It's similar to issues like homelessness: 0.15% of the population are on the street, but the number of people affected by housing costs is much larger.

Or police shootings of unarmed black men: 100-200 per year, which pales in comparison with millions of incarcerated black men.

We hear so much about these tiny problems is because political activists have chosen media-centric strategies to influence policy makers. The idea is to use outrage to get on the news, and then bring up the bigger issues. But in practice, policy makers just solve the outrageous problem: body cams for police; more shelters. Then the media goes away.