US Politics: Spicey Onion Indigestion in the Age of Trump

[Mudguard]

44 minutes ago, OldGimletEye said:

You know it's not like healthcare companies are the only types of companies that have invest in capital and take some risk. All businesses have to do that. Also, again, there is some evidence out there that what really happens is that: Its dying companies that accumulate patents and then use them to prevent innovation from competitors. I'm pretty sure TI did this for awhile.

And lets remember what the definition of rents are. It's more payment than what is necessary to bring a factor of production into use. Now surely, there would still be big profits to be made for a company that would be first to deliver a new drug? Maybe not the kinds of returns that pharma is used to, but still substantial enough for innovation.

 

Then maybe we should shorten patents for software companies too. You, I have to look this up, but if I recall correctly software patents didn't actually become a thing until the mid or late 1990s. There was was a case out there that I think allowed it. Now it seems to me, there was pretty robust growth in software before that case.

Oh yeah, I think I remember it. It was called In Re Alappat

Are they? I'm not really sure there is a robust empirical case for patents in promoting technological innovation. And why isn't the potential profits from being the first to deliver a new drug not sufficient? What you are basically asserting here is that there isn't sufficient returns without patents or strong patent protecton. That maybe true for some drugs. But, surely that isn't true for drugs that people would find truly useful.

Is it a fair exchange? Why? If you're a startup it would seem you would have to worry a lot about some big company crushing you with their patent.

Also trolls seem to leach off more productive companies, rather developing their own stuff. That is a waste.

And I'm not suggesting we completely nationalize all R & D. Private companies should be expected to invest in R & D ,if they want the profits.And I don't know why it's a "massive undertaking". Simply give them more resources.

Well fuck, then in that case let's get rid of the CDC, NASA, the EPA, and any other government that conducts research.

Virtually all companies that innovate file for and obtain patents unless they can keep their technology a trade secret.  And yes, the entire point of having a patent is for its ability to exclude others from making, using, or selling the patented invention.  A large company can use their patents to block or restrict what a startup can do, but at the same time, a startup can do the same and prevent a big company from doing ripping off their product if they have a patent.

Pharmaceuticals are different because it takes years to get a drug approved, and the drug compounds themselves are easily copied and manufactured.  Without patent rights, it would be trivial for a generics drug company to copy and have the drug ready for sale as soon as FDA approval was granted.  Nobody would be first by themselves anymore.  Since the copycat company doesn't have to spend on R&D, they can massively undercut the innovating drug company.  In this environment, why would anyone bother to invest capital to develop a new drug?  Same thing for biotech and medical devices which face similar regulatory barriers.

You need some length of patent protection.  There's certainly nothing magical about the 20 year term, but it's what been settled on by essentially the entire world.  Could a 19 or 18 year term also work?  Probably, but shortening the patent term would almost certainly have negative consequences.  It would be very strange for the USA to have the weakest patent system in the world, and I don't think that would be a good thing.

Software patents were allowed before Alappat.  Alappat just set forth a new test to determine whether a particular software patent was patent eligible or not.

I agree with you on trolls.  

Private companies do invest in R&D, in the expectations of making a profit.  If we make the expected profit smaller, then we likely push some investments off the table.  I'm all for spending more on public research, but that doesn't address the problem on making the expected profit smaller by shortening patent term.

The rest of the world has 20 year patent terms, but most don't have the same problems with drug pricing as we do.  I don't think the solution is to mess with patent terms.  I'd rather more pressure be put on drug companies through public transparency (and outrage) about pricing, like what happened with the epipen, or even better, enacting a universal health care system, which I think is more likely to happen than reducing the patent term for pharmaceuticals.  As far as I'm aware, both parties support a strong patent system.

[Martell Spy]

Quote

 

The Trump administration is considering a plan to weed out would-be immigrants who are likely to require public assistance, as well as to deport — when possible — immigrants already living in the United States who depend on taxpayer help, according to a draft executive order obtained by The Washington Post.

A second draft order under consideration calls for a substantial shake-up in the system through which the United States administers immigrant and nonimmigrant visas, with the aim of tightly controlling who enters the country and who can enter the workforce, and reducing the social services burden on U.S. taxpayers.

 

Trump administration circulates more draft immigration restrictions, focusing on protecting U.S. jobs

https://www.washingtonpost.com/world/national-security/trump-administration-circulates-more-draft-immigration-restrictions-focusing-on-protecting-us-jobs/2017/01/31/38529236-e741-11e6-80c2-30e57e57e05d_story.html?postshare=2611485889175975&tid=ss_tw&utm_term=.6fe07a4c8947

 

Two theories about why Steve Bannon midwifed such a bad executive order
The immigration executive order has been an unmitigated disaster. So why would Bannon have pushed it?

https://www.washingtonpost.com/posteverything/wp/2017/01/30/two-theories-about-

[Altherion]

55 minutes ago, Kalbear said:

What might work best is for the Democrats to be really, really annoying. Super slow play the hearings, super delay things. Make it take a really long time.

This appears to be their strategy so far with Trump's cabinet nominees: they've delayed the committee votes of the Treasury pick by boycotting the hearing altogether and exploiting some rule that requires at least one of them to be present. The drawback of this strategy is that it only works as long as the Republicans tolerate it: there are no Senate rules which cannot be changed with 51 votes and all of these tricks don't even have the popular cachet of the filibuster.

[Swordfish]

11 minutes ago, OldGimletEye said:

But, surely, according to your original logic, it would make sense to say cut funding for the CDC, right?

 

I don't recall mentioning the CDC at all, and I'm not familiar enough with their work or their funding to answer that question one way or the other. 

And stop calling me Shirley.

 

Quote

Should we cut funding cause its wasteful? Or should be do it simply because Trump is in office?

I am in favor of cutting funding that is being wasted, yes.  Whether funding should be cut because Trump i in office is really a case by case discussion.

[Swordfish]

9 minutes ago, Altherion said:

This appears to be their strategy so far with Trump's cabinet nominees: they've delayed the committee votes of the Treasury pick by boycotting the hearing altogether and exploiting some rule that requires at least one of them to be present. The drawback of this strategy is that it only works as long as the Republicans tolerate it: there are no Senate rules which cannot be changed with 51 votes and all of these tricks don't even have the popular cachet of the filibuster.

It also runs the risk of further alienating swing voters. 

it seems to me, based on my limited knowlege about how these things work, that they are a little bit stuck between pansdering to their base, and re engaging a lot of those voters that didn't bother showing up this time around. The two things may be mutually exclusive.

 

[OldGimletEye]

Just now, Mudguard said:

Virtually all companies that innovate file for and obtain patents unless they can keep their technology a trade secret.  And yes, the entire point of having a patent is for its ability to exclude others from making, using, or selling the patented invention.  A large company can use their patents to block or restrict what a startup can do, but at the same time, a startup can do the same and prevent a big company from doing ripping off their product if they have a patent.

But, a large company is more like to have the resources to put into their legal departments to play games. So I don't see this being an equal fight.

Just now, Mudguard said:

Pharmaceuticals are different because it takes years to get a drug approved, and the drug compounds themselves are easily copied and manufactured.  Without patent rights, it would be trivial for a generics drug company to copy and have the drug ready for sale as soon as FDA approval was granted.  Nobody would be first by themselves anymore.  Since the copycat company doesn't have to spend on R&D, they can massively undercut the innovating drug company.  In this environment, why would anyone bother to invest capital to develop a new drug?  Same thing for biotech and medical devices which face similar regulatory barriers.

Lets say your right. Lets say a competitor can quickly reverse engineer a new drug and have it ready for production the day the inventing company is ready to sell a new drug. Then maybe some length of protection would be necessary, after the drug gets approved. But, I don't think it follows it has to be 20 years.

Just now, Mudguard said:

You need some length of patent protection.  There's certainly nothing magical about the 20 year term, but it's what been settled on by essentially the entire world.  Could a 19 or 18 year term also work?  Probably, but shortening the patent term would almost certainly have negative consequences.  It would be very strange for the USA to have the weakest patent system in the world, and I don't think that would be a good thing.

As are as I know there is no strong empirical case that there is anything magical about 20 years. The fact that many countries have 20 year patent systems could just be a case of countries copying each other. I don't buy it that shortening the 20 year period would have negative consequences.

Just now, Mudguard said:

Software patents were allowed before Alappat.  Alappat just set forth a new test to determine whether a particular software patent was patent eligible or not.

Yeah, but didn't that make getting software patents easier?

Just now, Mudguard said:

Private companies do invest in R&D, in the expectations of making a profit.  If we make the expected profit smaller, then we likely push some investments off the table.  I'm all for spending more on public research, but that doesn't address the problem on making the expected profit smaller by shortening patent term.

Well of course monopolies are more profitable. However, usually, monopolies are associated with welfare losses and not welfare gains for the public.

Just now, Mudguard said:

The rest of the world has 20 year patent terms, but most don't have the same problems with drug pricing as we do.  I don't think the solution is to mess with patent terms.  I'd rather more pressure be put on drug companies through public transparency (and outrage) about pricing, like what happened with the epipen, or even better, enacting a universal health care system, which I think is more likely to happen than reducing the patent term for pharmaceuticals.  As far as I'm aware, both parties support a strong patent system.

I think the government should negotiate over drug prices, particularly if patent terms are not cut down. In my view, governments can get away with this, without causing decreases in the quantity of drugs supplied because, since the companies are largely monopolies, they still can supply the drugs, at the government negotiated prices, and be profitable. They are still selling the drugs above their marginal cost of production.

[Mudguard]

55 minutes ago, Aemon Stark said:

As an aside, why are "startups" the answer? Medical devices are not generally trivial to produce, and most products come from the likes of GE, Dräger, Stryker, Medtronic, etc. What's more, "smaller" pharmaceutical companies like Alexion absolutely rake in revenue from orphan drugs for rare diseases. It helps that (currently) it has no competition for something like Soliris, for which it can charge pretty much anything, and especially because its indications are only for very uncommon conditions. 

Of course, it's not patents that are necessarily the problem, but price regulation more broadly. 

We have lots of cures for "cancer" and even more treatments, be it surgery, radiation, chemotherapy, hormone/targeted receptor therapy... it goes on. We can also prevent HIV transmission and treat it more effectively than many other things. We might get a good vaccine one day, but you're not going to be able to "cure" it. 

Back to Trump...

Medical devices run the gamut.  Some medical devices, like stents, sutures, and pedicle screws are trivial to make, while others like complex imaging systems are much more complex.  A lot of the products sold by large medical device companies like GE, Medtronic, Boston Scientific, Edwards Lifesciences, etc. were developed by startups that were eventually acquired by these giants.  These startups are able to take risks that many larger companies are not willing to accept.

With respect to orphan drugs, part of how we encourage their development is to provide additional patent term extension for orphan drugs.  In the US, you can get up to 7 extra years of patent term for orphan drugs.  Again, stronger patent laws are encouraging this development that you otherwise wouldn't see.

Yes, I agree that price regulation is the main problem.  The US needs to move to a universal healthcare system.  I think that's the only reasonable way to get prices under control at this point.

We have a lot of effective treatments for many cancer types, but no overall cure for all cancers.  Some cancers, like glioblastoma, still have no effective treatment, even after many decades of research.  Billions and billions and decades have been spent on trying to develop a vaccine for HIV, but still nothing.  The point is that simply throwing money at a problem is no guarantee that you'll develop a cure or treatment for that particular problem.  The post I was responding to suggested that if we just spent more money on public research, a laudable thing, we would have an antibiotic to treat multi-drug resistant bacteria.  Sure, more money is helpful, but I don't think that's the limiting factor is this case.

[OldGimletEye]

Just now, Swordfish said:

I don't recall mentioning the CDC at all, and I'm not familiar enough with their work or their funding to answer that question one way or the other. 

But, since Trump is in office, we should just cut their funding without looking at the merits of cutting their funding right?

Just now, Swordfish said:

I am in favor of cutting funding that is being wasted, yes.  Whether funding should be cut because Trump i in office is really a case by case discussion.

So in other words, you think spending decisions should be based on the merits of the underlying policy goals of the spending decision. Strangely enough, I don't disagree.

[Impmk2]

5 minutes ago, Mudguard said:

The post I was responding to suggested that if we just spent more money on public research, a laudable thing, we would have an antibiotic to treat multi-drug resistant bacteria.  Sure, more money is helpful, but I don't think that's the limiting factor is this case.

I worked in research microbiology for several years. There is very little funding in antibiotic development. That's from either public or private money. Big pharma isn't really interested, as any new drug developed will immediately be put as a drug of last resort and be extremely sparingly used. Plus resistance tends to arise very quickly.

Public money is up and down. But infectious diseases in general aren't particularly sexy. And the healthcare burden isn't high enough (yet) in the western world when compared to the more common cancers, or say, smoking related illness (which I'm currently working on). 

A large sustained injection of cash into antimicrobial drug development could absolutely make a big difference.

 

[Swordfish]

16 minutes ago, OldGimletEye said:

But, since Trump is in office, we should just cut their funding without looking at the merits of cutting their funding right?

 

You're going to have to explain to me what I've said that led you to the conclusion that this is my opinion.  

Because I have literally no idea, and it seems only tangentially related (being generous) to anything I've said.  

[OldGimletEye]

Just now, Swordfish said:

You're going to have to explain to me what I've said that led you to the conclusion that this is my opinion.  

Because I have literally no idea, and it seems only tangentially related (being generous) to anything I've said.  

 

Quote

yeah.  It's surprising to me that people are advocating this now, of all times.

Do we really want Trump anywhere near the purse strings that dictate what kind of drugs get researched?  That's crazy to me.

 

seems to me the only thing worse that profit driven research of new drugs is politically driven research of new drugs.

 

[Mudguard]

13 minutes ago, OldGimletEye said:

But, a large company is more like to have the resources to put into their legal departments to play games. So I don't see this being an equal fight.

Lets say your right. Lets say a competitor can quickly reverse engineer a new drug and have it ready for production the day the inventing company is ready to sell a new drug. Then maybe some length of protection would be necessary, after the drug gets approved. But, I don't think it follows it has to be 20 years.

As are as I know there is no strong empirical case that there is anything magical about 20 years. The fact that many countries have 20 year patent systems could just be a case of countries copying each other. I don't buy it that shortening the 20 year period would have negative consequences.

Yeah, but didn't that make getting software patents easier?

Well of course monopolies are more profitable. However, usually, monopolies are associated with welfare losses and not welfare gains for the public.

I think the government should negotiate over drug prices, particularly if patent terms are not cut down. In my view, governments can get away with this, without causing decreases in the quantity of drugs supplied because, since the companies are largely monopolies, they still can supply the drugs, at the government negotiated prices, and be profitable. They are still selling the drugs above their marginal cost of production.

Large companies with aggressive patent strategies can definitely make life difficult for their competitors.  But to get those patents, the company has to disclose all those inventions to the public.  That's part of the costs and benefits of our patent system.

The USA has been slowly harmonizing it's patent laws with the rest of the world.  I just don't see a patent term reduction as a serious possibility at this time, especially if it would lead to the US having a weaker patent system than the rest of the world.  It's also too esoteric a subject to get people excited about it, especially when compared to stories like the unconscionable price gouging by drug companies.

I agree with your last paragraph about the government negotiating over drug prices.  Some of the pricing is completely out of control and needs to be reigned in.

[OldGimletEye]

Just now, Mudguard said:

Large companies with aggressive patent strategies can definitely make life difficult for their competitors.  

And for this reason, patents may not offer the growth in innovation, some of its proponents claim. It may actually harm innovation.

Just now, Mudguard said:

But to get those patents, the company has to disclose all those inventions to the public.  That's part of the costs and benefits of our patent system.

Which they have to wait 20 years to use.

Just now, Mudguard said:

The USA has been slowly harmonizing it's patent laws with the rest of the world.  I just don't see a patent term reduction as a serious possibility at this time, especially if it would lead to the US having a weaker patent system than the rest of the world.  It's also too esoteric a subject to get people excited about it, especially when compared to stories like the unconscionable price gouging by drug companies.

I agree for many folks it is probably a subject that is about exciting as watching paint dry. Still, it's still a very important policy issue that has serious implications for many, if not most people.

The fact that it is a technical, arcane, and boring subject probably has worked in favor of big pharma.

[Mudguard]

16 minutes ago, Impmk2 said:

I worked in research microbiology for several years. There is very little funding in antibiotic development. That's from either public or private money. Big pharma isn't really interested, as any new drug developed will immediately be put as a drug of last resort and be extremely sparingly used. Plus resistance tends to arise very quickly.

Public money is up and down. But infectious diseases in general aren't particularly sexy. And the healthcare burden isn't high enough (yet) in the western world when compared to the more common cancers, or say, smoking related illness (which I'm currently working on). 

A large sustained injection of cash into antimicrobial drug development could absolutely make a big difference.

 

Very interesting points.  It's strange to me that more research isn't done because blockbuster antibiotics, like Zithromax for example, had sales of $2 billion at their peak.  That was about 10 years ago, so maybe doctors have become much more conservative with handing out their antibiotic prescriptions since then to combat drug-resistance development.  I also suspect that research in this area is just very difficult.  Tweaking an existing antibiotic is easy to do, but finding a new class of antibiotics is a huge challenge.

If there isn't much incentive for big pharma to get involved, then incentives for private companies, whether it's big pharma or a startup, need to be created because basic research labs aren't going to be able to take a drug through clinical trials and to market.

[Mudguard]

23 minutes ago, OldGimletEye said:

Which they have to wait 20 years to use.

Only if they are able to actually obtain a patent, which is generally getting harder and harder to do nowadays.  In the good old days, maybe around 20 years ago, patent examiners had to hand search through paper records to find prior art to reject the claims in a patent application. As you can imagine, that wasn't a particularly efficient or effective method.  Now, examiners can search electronic databases which make them much more effective at their jobs.  

And even if they get a patent, it's often possible to design around the patent.  The tradeoffs seems fair to me.

I'm OK with where the patent system is at right now.  I'd rather the government take a stab at directly trying to regulate drug prices, preferably through some sort of universal healthcare system.  If that still isn't enough to control drug prices, then I'd be willing to look at revising patent terms.

[Rippounet]

7 hours ago, Tywin et al. said:

Thanks @Rippounet. Frankly that sounds pretty bleak to me. Is it all but guaranteed that France will pull out of the EU if Le Pen wins?

No. According to the National Front's program they want to end the Euro and renegotiate the European treaties. Technically they are not running on the idea of pulling out of the EU. If they were elected and negotiations proved difficult, they would likely organize a referendum on pulling out, which would have no guarantee of succeeding (like Brexit, it would be close to 50-50 and could go either way).
Ending the Euro however is almost certain to trigger an economic crisis and cripple the EU. To be fair, the NF actually has a point when it criticizes the EU's monetary policy.

7 hours ago, Ormond said:

I have to disagree. Even though I am a gay man (and so part of the one group whose rights might be even more in danger under Pence than Trump), I would really prefer Pence as President. I don't see any indication that Pence would be controlled by Steve Bannon or his ilk as President, or that he would be issuing executive orders without at least running them by affected agencies first. I would much rather be opposing a rational evil than a completely irrational one who is largely controlled by someone who may well think that starting World War III is a good thing. 

I'm always wary of Evangelicals since they tend to believe that the end time is near... At a glance, Pence would appear more reasonable than Trump... But couldn't his religious beliefs lead him to some even crazier stuff than Trump?

1 hour ago, Swordfish said:

It also runs the risk of further alienating swing voters. 

it seems to me, based on my limited knowlege about how these things work, that they are a little bit stuck between pansdering to their base, and re engaging a lot of those voters that didn't bother showing up this time around. The two things may be mutually exclusive.

I really doubt that. Very few people pay close attention to the details of confirmations. And even among those who do, mere delaying tactics are unlikely to be alienating.

[aeu]

3 hours ago, Jaxom 1974 said:

This.  If he's to go through, not a single inch should be given without making things as uncomfortable as possible.  Any and all tricks. Nothing is off the table.  Republicans didn't have to vote for Garland, but by refusing to even meet with him, let alone have a vote, they have abrogated any chance of just getting what they want without a fight.  

A fight to what end, though?  They cannot block the nomination.  Republicans were able to do what they did to Garland because there was nothing Obama or the Dems could do to counter.  This supposed retaliation by the dems will just be a temper tantrum.

There is no tangible benefit in sight, maybe other than appeasing certain parts of their "base." Maybe they will think that it is worth it...(Though I find it ironic that, after going through all that, some non-negligible portion of that base will inevitably find something to nitpick about the next democratic candidate and decide that both parties are the same, so why vote?  Even more will not turn up for midterms...)

Of all the things to get upset about, I cannot get worked up about this SCOTUS nomination.  Elections do have consequences.  Say whatever you want about Trump, he earned this one. (And by all accounts, did a decent job).

 

 

[Altherion]

Here is a Vox article with more leaked orders on immigration. Obviously, until an order is issued by the White House, take it with a grain of salt as it could be anything ranging from outright lies to a draft that gets edited beyond recognition, but this seems broadly in line with Trump's campaign rhetoric so it could also be fairly close to the truth:

Quote

 

This executive action, though — according to the draft obtained by Vox, which seems consistent with the Post’s reporting — would ask the Department of Homeland Security to issue a rule saying that an immigrant can’t be admitted to the US if he’s likely to get any benefit “determined in any way on the basis of income, resources, or financial need.”

People who use any of those benefits and are in the US on visas would be subject to deportation. And the order would even require the person who sponsored an immigrant into the US to reimburse the federal government for any benefits the immigrant used (something that the government can theoretically ask for in individual cases now, but rarely does).

This is draconian. It seeks to punish not only legal immigrants in the US and their families, but also their US-citizen relatives. It’s a reflection of a worldview in which any benefit an immigrant gets from the government is, in some way, a theft of American tax money — and punishes immigrants as thieves accordingly.

...

One of the reports requested in the order would be a report on the cost of the entire Refugee Assistance Program — the program by which the US helps refugees get settled, obtain jobs, and learn English. Refugees are responsible for much of immigrant welfare use in the US because they’re not selected for their high earning potential — they’re selected because of their humanitarian need. But consistent with the forthcoming order restricting refugee admissions entirely, this memo sees refugees as a drain on the public coffers.

Unauthorized immigrants aren’t spared by the order: It would prevent families from getting the child tax credit if the parents are unauthorized (even if the children are US citizens), and it would prevent an unauthorized immigrant from being eligible for Social Security during the time he was unauthorized (even if he was paying into the system, as many do, using a fake Social Security number).

 

Vox is of course exaggerating somewhat. When you sponsor an immigrant, it is pretty clear that you're responsible for them and dishonest to foist them off on the government. Likewise, people who use fake Social Security numbers are lucky that they're not sent to prison for the obvious fraud that they're committing and deserve no sympathy for whatever losses they incur by their crime.

However... it's not obvious to me where the refugees are supposed to get any money if they come to the US speaking no English and not even Spanish or other commonly found languages, but something that fewer than a hundred thousand people speak in the whole country. There's a big fuss over the temporary seven country ban, but if there are significant restrictions on funding for refugees, this could actually be a bigger issue. I suspect they're only looking at how much the RAP costs rather than trimming it.

[mormont]

9 hours ago, Swordfish said:

What are the radical christian groups that these white men will belong to/be acting in the name of?

The alt-right?

I suppose you might deny that the alt-right is a radical Christian group, although they themselves talk frequently about Christianity, albeit as more of a cultural reference than a religious one. But OK, we can admit that and go on to call such people 'alt-right terrorists' or 'radical right-wing terrorists' if you prefer.

Personally, I prefer to avoid the labels as much as possible because the ideology is rarely the only reason why someone does something like this. But at the same time, it's beyond question at this point that the media coverage of these incidents is radically different according to the race of the shooter. That does no-one any good.

[James Arryn]

1 hour ago, Altherion said:

Here is a Vox article with more leaked orders on immigration. Obviously, until an order is issued by the White House, take it with a grain of salt as it could be anything ranging from outright lies to a draft that gets edited beyond recognition, but this seems broadly in line with Trump's campaign rhetoric so it could also be fairly close to the truth:

Vox is of course exaggerating somewhat. When you sponsor an immigrant, it is pretty clear that you're responsible for them and dishonest to foist them off on the government. Likewise, people who use fake Social Security numbers are lucky that they're not sent to prison for the obvious fraud that they're committing and deserve no sympathy for whatever losses they incur by their crime.

However... it's not obvious to me where the refugees are supposed to get any money if they come to the US speaking no English and not even Spanish or other commonly found languages, but something that fewer than a hundred thousand people speak in the whole country. There's a big fuss over the temporary seven country ban, but if there are significant restrictions on funding for refugees, this could actually be a bigger issue. I suspect they're only looking at how much the RAP costs rather than trimming it.

This conflation of refugee and immigrant is intentional, would you say? Or just ignorant?