Power >>>>> money
How about letting the market work? Why not let the price of monoclonal antibodies rise until supply equals demand?
If we did so, a thousands medical ethicists would scream about how rationing by price favors the rich.
Suppose instead that we ration by political power—give it first to people with lots of clout:
The most immediate opportunity comes from antibody drugs that can be used both as treatment and prophylaxis. President Trump and former New Jersey Gov. Chris Christie both recovered after they received antibody combinations when their symptoms were worsening. These medications are likely to be most effective when used before or soon after symptoms begin. . . .
The federal government is working on a system to control distribution, essentially sending limited supplies to states in proportion to their expected eligible patients. Governors would allocate the drugs to hospitals, as happened with the antiviral drug remdesivir.
The response of ethicists? Crickets . . .
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20. October 2020 at 09:23
“How about letting the market work?” Such as eliminating patent protection for meds?
20. October 2020 at 10:06
Even if Bernie/Harris were President, I would favor they gets the best treatment available. I don’t think it is good if our President dies of a disease–even worse if it could have been avoided. Why? I think it would create potential global chaos and might encourage bad actors. Could be wrong—but its my belief.
What about the rest of us shmos? We know with certainty the very wealthy will get what they want—-because they can bypass the system.
I really find Zeke Emmanuel’s idea of death horrendous—-whatever his “75” year old rule is. I would like some attempt at treating the sickest first—there may be exceptions I suppose (like a President)–but lets hope IF we get a vaccine and more antibody medicines, enough will be produced.
20. October 2020 at 10:20
Worse than allowing the rich to buy monoclonal antibodies using their own money is allowing the politically powerful to buy monoclonal antibodies using Other People’s money. Of course, socialism is the allocation of resources using political, rather than economic, criteria.
20. October 2020 at 10:59
Foosion, IP laws should certainly be weakened.
BC, Yup.
20. October 2020 at 11:23
+1
Gilead voluntarily gave up market exclusivity for Remdesivir, so this isn’t even about IP laws. There’s a whole underlying regulatory drug manufacturing approval process that can take years. Even if whoever owns the monoclonal patent gave it up, it’s irrelevant.
20. October 2020 at 12:06
Regernon has a market cap of $60 billion; would nationalizing it for $120 billion save money overall? Probably… looking at the CARES act.
20. October 2020 at 12:54
Scott,
I think it’s quite normal that the head of government of a country gets the best therapy possible, if necessary also experimental.
What is probably not quite normal in the US is the immense cost of the US health system, combined with surprisingly bad results in some areas.
Especially the costs compared to GDP seem to be striking, so one has to ask if this is not, at least in part, due to relative free (and corrupt) market forces, which have a very strong bargaining position in the health sector: when it comes to health vs. serious illness, one can charge almost any price.
Many people want universal, quite inexpensive health care (on paper) that covers standard basic therapy. Unfortunately, this requires regulation and rationing, but still better than the system the US has now.
At the same time, this system could be expanded quite easily: those who want more luxury and freedom are allowed to buy additional private insurance.
20. October 2020 at 16:23
Christian, You missed the point.
20. October 2020 at 17:00
You are full of contradictions. If you believe in the free market, then why would you vote for Biden? How does that help you achieve anything resembling a free market? Biden epitomizes the apparatchik who places himself above the public. He’s done it for the last 47 years.
How can you support the fact that his son was working for the corrupt oil company Burisma which, by the way, was reported by the Washington Post, Wall Street Journal, BBC, the Guardian, Reuters, all calling it a “conflict of interest” upon hiring in 2014. Obama’s communication adviser was so flabbergasted by such a post that he simply told the media to “ask the vice presidents office”. The response from the vice presidents office was “no comment”.
Don’t you find it strange that these same newspapers that were “hysterical” about that appointment in 2014, are ignoring it now and rebranding it as simply a “son working innocently abroad?
How do you support a guy who just recently says the American people don’t deserve to hear his opinions on “packing the court”?
You might think these things have nothing to do with free markets, but they do. For free markets to work, you need a free press, free flow of information and ideas, and transparent policy. Corrupt politicians are a deadly virus for free markets.
Did it occur to you that draining the swamp might result in “fake news”. That draining the swamp might involve dealing with “corrupt politicians peddling disinformation about you”.
Trump is a playboy real estate developer who has banged more woman than he has read books; he does not historically have the characteristics of a US president: but neither does Biden.
Trump might be a lot of things. But he’s not corrupt. And he does care about the American people. Every egotistical maniac loves others, because he needs them to feel good about himself. Trump cherishes the people, and will do anything for them, because he needs their love. And that is not such a bad thing. It’s better than a sociopath who pretends he loves, but screws them at every turn.
20. October 2020 at 17:13
The allocation of vaccines and therapeutics is going to get wild I think.
I agree letting the market work this out is probably the least bad option but it’s gonna be a bit like the allocation life boats in the movie the titanic. The steerage are not going to be happy about being locked below deck while the rich are drinking scotch and comfortably escaping the sinking ship.
It’s times like these that lead to populists and nationalists…
21. October 2020 at 10:09
Xu, Let’s say Joe Biden really did do something corrupt in Ukraine (he didn’t, but lets say he did). I’m to vote for Trump on the corruption issue, even though there are new examples of Trump corruption almost every single day? A hundred Trump examples against one for Biden?
And Trump believes in free markets? LOL.
23. October 2020 at 18:21
Christian, heads of state would likely still get first dibs under a flexible price system. Their employer, ie the government, would just need to bid enough.
BC, letting the political powerful use other people’s money is still better than letting them use naked political power.
Christian, btw, the parts of the American health system that are closest to free markets, like cosmetic surgery and LASIK seem to work reasonably well.
There’s a bunch of regulations that the Americans should clean up, like the tax discrimination between privately bought insurance and employer provided insurance. And lots of other nitty gritties that normal people don’t normally think about.
If you want normal people to be covered, you can still let the market provide. Just give poor people money, so they can buy care or insurance, and sort out the regulations so that profit driven and competing suppliers can provide those low cost treatments you talk about. (Slatestarcodex covered some of these factors.)
Alas, sorting out the regulations can be quite tough with all the special interests and voters’ ideological preferences.
Also, as always in public policy, have a look at how Singapore solves the issue. Their healthcare system is only half as expensive in terms of proportion of GDP per capita as the much vaunted British NHS.
Michael, if you have a public distribution mechanism that doesn’t ration by willingness to pay, the next ‘obvious’ criterion is to go by QALY, ie quality adjusted life years saved.