Archives for category: moral hazard
https://www.snopes.com/fact-check/hepatitis-c-drug-prices/

https://www.azquotes.com/quote/1133913

Then, if ‘greed is THAT good’, why blame Big Pharma for ‘buying’ politicians in order to extract as much profit as possible from their work?

Specially when it does work as advertised?

We priced the product at exactly the same as the existing standard of care, which worked about 50% of the time, and are providing a benefit that, based on real world experience, works about 98% of the time. From our perspective, it was a very good value.

I think our failure, if I have to take a step backwards, we were unable to have a good enough conversation with the payers. Perhaps we were a little conservative about what we could have or should have said to them to allow them to prepare for the number of patients that came forward. Honestly, it was far more than we thought. We did not think the system could or would try to handle as many patients as it did. We essentially quadrupled the number of patients treated in a year. That surge really created a lot of pain.

Ooops… so it’s the ‘payers’ who are hurting, not the patients themselves…

Gilead’s CEO Admits To ‘Failures’ In Setting Price of $1,000-A-Pill Breakthrough

Hepatitis C Treatment Highlights Disparity in Worldwide Drug Prices

Recent developments connected with some people having used Facebook to manipulate the public opinion have led me to understand something absolutely trivial.

Almost everything can be used as a resource.
And it’s us, all of us, who are ultimately responsible for how these resources are being used.

For no other reason than it is us who will eventually bear the consequences.

Having said this, I’m now wondering about the wisdom of our ancestors…
And the nearsightedness of some of our contemporaries!
the golden rule

trump on corker

 

corker on WH

OK, let me wrap my head around this.

So Corker doesn’t have enough guts to run for re-election without Trump’s blessing but has enough to openly tweet his mind about what’s going on in the White House?!?
A reality show run by the supposedly most powerful man on Earth?
Who’s about to transform the “Great” America into the biggest laughing stock of the world?

Am I the only one wondering whether any of these can be described as “adult” behavior?

There’s a glimmer of hope though.

401K is way bigger than 65K. And big enough to rise above 65K+57K+62K… I know, adding this numbers up doesn’t make much sense – there is a strong possibility that many individual readers may have liked more than one of these tweets, but still…

For some people the fog may have started to rise.

The fog generated by the fake news manipulated by the ‘Great Deal Maker’, that is.
Compare the comments which accompany those tweets.

 

 

donald-trump-grab-them-by-the-pussy-cartoon

Or is it the (unforeseen?) consequence of some very ‘intelligent design‘?

Until not so long ago it was possible to buy unlimited coverage against the risks that scared you.
After things became too complicated and fraud a too widespread occurrence even the Lloyd’s gave up and started to introduce caps on insurance policies.
In fact Lloyd’s of London was the only place – that I knew of – where risk was understood, at least in part, in a ‘functionalist’ manner.
Risk is something that can be seen in two ways.
As yet another opportunity for making profit or something that has to be mitigated for the profit of the entire community.
Let me deal with the latter ‘option’ first.
Somehow I don’t buy it that Bismarck was primarily motivated by the well-being of the workers.
But what the German industrial barons of the day needed in order to catch up with the British ones – the Albion was the industrial power house of that time, o tempora…- was more and more people willing to leave the relative safety of the country-side and come to the city to work in the newly built factories.
In order to appreciate the huge difference between these two situations we must remember that in those times families were a lot larger than they are now and that their members used to help each other in times of need. But this could happen only if the members of the same family remained in close vicinity and worked on very flexible schedules – agriculture or family owned shops. You cannot go help your ailing mother if you work in shifts and live two hundred miles away from her.
So, in order to ‘lure’ more and more people out of the fields, and in a very short time, Bismarck had to offer them a ‘safety net’.
OK, let’s accept the idea that, maybe, there are some risks that the society, as a whole, should concern itself with.
But how to fulfill this ‘social need’?
How to identify which risks should be dealt with in a collective manner and which should be left alone. Then how to manage the whole process?
‘State-wide’ or through privately owned/operated initiatives?
Does it really matter?
I don’t think there is a universally valid recipe here.
The Bismarck’s social insurance system worked in Germany.
Lloyd’s has functioned almost seamlessly for 3 centuries. In England.
Both systems, one centered mostly on profit and the other on the safety of those who took part in it, worked because they spread out both the risks and the profits.
Current systems, where only the risks are being mutualized while the benefits tend to become more and more centralized – by ‘design‘, by corruption or both – are no longer functioning properly.
Take ‘Obama Care’, for instance. Most people, including Donald Trump, agree that something has to be done about ‘public health’ but the whole thing isn’t yet working properly.
Instead of fighting among ourselves on whether the state/government should have anything to do with risk management how about considering for a moment where our current infatuation with ‘profit‘ has brought us?

gambit noun [C] (CLEVER ACTION)

– a clever action in a game or other situation that is intended to achieve an advantage and usually involves taking a risk:

 Рspecialized games a way of beginning a game of chess, in which you intentionally lose a pawn (= game piece) in order to win some other form of advantage later

I borrowed this definition from Cambridge Dictionary, the on-line version.
You have already noticed, I’m sure, the accent on cleverness, the ‘intent to achieve an advantage’ and the relative downplay of the risk that is only ‘usually’ involved.

A more nuanced definition of the concept would mention that the person who uses this tactical maneuver has to get out of their psychological  comfort zone in order to perform it properly.
The whole thing involves offering a valuable bait which, once taken, might produce consequences favorable to the party that is ‘spending’ it.
Since the favorable consequences are not sure – otherwise it would have been a bribe, not a gambit – but the expenditure is certain the guy who initiates this has to thread very carefully. Hence the need for the bait to be really valuable. Valuable enough for the taker to take it and valuable enough so the giver would be really careful when performing the maneuver.

We have witnessed three gambits in close succession.

Britain’s David Cameron promised a Brexit referendum in an attempt to win the 2015 general election. He won the election but lost the referendum.

Quite a large number of Americans, fed up with what has been going on in their country, have pinched their noses and elected Trump into the Oval Office. The deal is not going exactly as they have planned it – Clinton is not going to be charged, the ‘swamp’ is more likely being repopulated rather than drained in earnest – but the jury is still out on this one.

Italy’s Matteo Renzi tried to cash in on his popularity and stream-line the constitution – a move which would have given more powers to the central administration. He has just lost the referendum, is about to resign – as promised and his losing the gambit has opened a wide venue for the opposition 5 Stars Movement led by a comedian – Beppe Grillo.

Need a moral to this?
Gambit works fine when playing chess. That’s a special kind of game where all the pertinent information is out there on the table and the sole variable is the opponent’s mind/will.

Real life, a.k.a. politics, is a completely different game. There are lots of stakeholders, instead of the two chess players, while most of the pertinent information is jealously guarded by each of the stake-holders – along with most of their real intentions.

If we add here the ‘detachment’ of the players – Trump and Cameron are both independently wealthy while Renzi is rather inexperienced – we’ll soon arrive at the conclusion that we’d be better off with some unadventurous, bland even, politicians.

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