The Holtonian

I would make a joke, but you seem pretty pissed.

Who says chivalry is dead? Pull out your sord and kill the guy! Okay don’t go that far,
just pray for him that will get’em.

as a former waiter I know that there is no easier way to get wacked than not tipping.

I wish all waiters and waitresses were as nice to me as I am to them...not that I'm insinuating anything about wifey. I am sure she is the best and did not deserve this. My point (and I'm sure it's happened to everyone) is that I've had servers with the same attitude as this Grant...as if they're the shiz. Makes you long for everyone, regardless of their position, to have more of a Matt. 20:28 attitude.

Grant the drug rep eh? will have the boys look into it...

this dude gives drug dealers a bad name. I hold drug companies and their pushers at least partly (if not mostly) responsible for the healthcare mess in our society.

Bob, nice digression...much more stimulating to the senses than rage killing (just kidding Chris).

I work for a healthcare insurer and I am sure that a lot of people would lay the blame on us as much as the drug companies. However, I personally think that the "mess" is more a matter of mindset. Americans are getting to have such an entitlement mentality--and the government has promoted that perspective via the Welfare State. Many would have you believe that healthcare is a basic human right, but I disagree. Someone has got to pay for healthcare services, and wealth redistribution is not the right answer.

I think that more deregulation in the drug and healthcare industries would make healthcare much more affordable for Americans than getting the government more involved. I'm not talking about no regulation at all...with witch doctors roaming the halls of hospitals...but making more use of nurse practitioners, making it easier for drug companies to get started rather than limiting competition, etc.

I shudder to think what our healthcare system will look like in four years if Kerry gets elected. You want to start talking about messes, look at Canada. Dying because you are on a waiting list for surgery is not an uncommon occurance.

Scott

"Long live the invisible hand!" ~some Adam Smith fanatic.

"You can agree to disagree, just remember that two opposing statements cannot both be true at the same time." ~me.

I agree, good job scott, way to take the post into the realm of sanity! Oh and for those wondering I have no plans to kill anyone, but if I do ever meet this Grant fellow, he will get a swift kick in the crotch from yours truly, I think its the least I can do to repay him for my wife's misery. And there's much more to the story that I left out, he was a complete 100% a hole and was basically looking for tortilla factory to pay for his meal.

Call me and I'll come up. We could kick his ass together. It could be a brotherly bonding thing.

OOOh, I like brother bonding, especially when violence is involved.

Bob, you know I love ya, but I couldn't disagree with you more. I agree with Scott that the "healthcare mess" in our society is due to the sense of entitlement that people seem to have these days, but in somewhat of a digression from my generally conservative views, I believe government regulation is not the problem. Consumers want drug companies to GIVE drugs away. On the one hand, they praise them for contributing to their health and wellbeing, while cursing them for the price. Drugs -- and research to create new ones -- cost money, and people don't seem to get that.

If I sound like I'm taking this personally, it's cuz my dad works for a drug company, and that money was the reason I had a roof over my head, food to eat, and a quality education to get me out on my own someday. Not taking offense, just thought I'd defend "Big Pharmaceuticals" since "Big Healthcare" was defended by Scott.

yeah even as I wrote that I was thinking we've probably got the best healthcare system in human history, despite the problems. but still I'm disgusted by the arrogance, narrow-mindedness, and greed that seems to be ingrained in much of the healthcare and satelite industries. I dont want canada, but it'll suck when our system falls in on it's own weight. but I've already said more than I really know about.

so where's the line between profits and greed? if I was poor, would I die on a surgery waiting list around here? I think it would at least be more likely, and that creeps me out.

looks like we somewhat cross-posted there ute. I can see why you're passionate about drug companies, but when profit is elevated above human life, I start to get squeamish. I dont advocate more government, and I agree that our enititlement attitude is a huge problem. but to see companies pour millions (if not more) into pills that'll give folks everlasting erections, and not give a shite about a certain fibromyalgia medicine b/c it's so freakin cheap they'll never make money, I tend to get pissed off. and now you know why I care a little about this...

All I can say is that capitalism...the pursuit of profits...is what makes companies develop all of the wonderful technology that we enjoy today. Under an oppressive economic system like communism, there is little innovation. While capitalism is not "the biblical economic system", I do think it's the closest thing to it. I could go on for pages on various scripture references that I studied in my economics ethics class under Cal Beisner, but it is late...and really the topic would be done better service with us all sitting on my back deck, sipping on some scotch and smoking Dominican cigars or puffing on a briar pipe.

Holton- Check out this song it is for you and Wifey!

"Tip that Waitress" by Loudon Wainwright III
you can find it here

Scott, here's a problem with consumer-driven pharmaceuticals:

its not just an issue of some broad sense of "demand" that drives the pharmaceutical companies innovation and research, its a matter of demand + the ability to spend money.

There exists a huge demand in America for drugs the deal with erectile dysfunction & increase the ability to function sexually way into the later years of life.

There also exists a huge demand for drugs in Sub-Saharan Africa to combat malaria and hundreds of other diseases.

But what we get is Cialis, Levitra, and Viagra. Why? Because Americans not only have the demand, they've got the *bling* to pay for said drugs.

I'm not making a moral assertion here, I'm just stating the case. Our wallets & needs drive pharmeceutical innovation. Right or wrong, that's just the case.

But here's where it gets a little wierd to me: Pharmeceutical companies on average spend 4 to 5 times as much on marketing their products than they do on research.

So what we end up with is huge pharmeceutical companies spending hundreds of millions of dollars a year in marketing, doing what marketing does best, creating a perceived (real or no) *need* for a given product. So no longer are the pharmeceutical companies responding merely to the demand & money of Americans, its also influencing that demand!

In my mind, its an ugly conflict of interests. It out to be against the law for Pharmeceutical companies to market their products. That's billions of dollars a year that SHOULD be going into research. If you're a pharmacy, and you put out a new product, your sell should be to the doctors who will be prescribing your product. They're the gatekeepers, the people we should be trusting in this situation.

But again, this is why I hate all the damn lawsuit happy folks sueing the pants of their doctors. Sure, sometimes it might be necessary, but damn if it isn't causing healthcare costs to go through the roof.

So in my mind, we need to kill frivolent lawsuits against doctors, ban pharmeceutical companies from advertising, and then provide healthcare plans to the public that they pay for. By that point it'd be so cheap that even the poorest in america could afford the $20 a month to get generic healthcare.

Well, this may take a little while, but there is just as much bad big media PR going on with some of your opinions about pharmaceutical companies. In full disclosure, I do early drug discovery for Pfizer. I work in a histopathology lab doing the nuts and bolts of new drug discovery, and I don’t get paid like the reps (and at times, complete jack-asses). But Josiah’s contention that drug companies shouldn’t market their products is absolutely ridiculous. Given, the ED (erectile dysfunction) drugs are something that created its own market (but not totally), but those weren’t developed for that purpose. They were actually a result of a cardiovascular drug Pfizer was working on and I’ll be damned, but all the rats on the study were always very happy to say the least. This byproduct being recognized, there was a large group of individuals that had this problem, young and old. Pfizer didn’t “create a perceived need,” the need was already there.

With your point about advertising vs. research, a little research on the subject is good before going with presupposed facts. In actuality, pharmaceutical companies put more money back into research as a percentage of their profits than any other major industry and their profit margin is not as high as people believe. Pharmaceutical companies are not the most profitable companies in the world. With a recent average profitability of 14.3% (profits as percentage of revenues), research-based pharmaceutical companies are significantly below both the commercial banking and the mining / crude oil product sectors. The industry is comparable to the publishing / printing sector, which has 14.2% profitability. No other industry in the world comes even close to investing 17% of revenues in research and development. The next highest is the computer and software services area with 10.5%. Now, I don’t know if you feel that the auto, software, textiles or manufacturing industries should be investing more, but to hold an industry that actually develops products that not only saves lives, but also increases livelihood (think of someone with arthritis that is able to function because of Celebrex or Bextra, instead of living their life in pain) is part of the bigger problem.

Let’s be honest. Pharmaceutical companies are companies, not charities. That doesn’t mean that they “create a perceived need” in the form of creating new diseases.

The president of Pfizer recently made the comment that no new drugs had been developed out of Canada in the last 50 years due to the lack of incentive. The govt’s Health Dept. spokesman, promptly replied that that was an outright lie...they have developed 2...2...oh, my bad, your system really is great. This is an industry that saves lives and makes lives better, and more and more people are drinking the Kool-Aid that makes you think they are the evil in the world. By the way, over half of the marketing costs are free drugs that are given to doctors, so that patients can try the drug and see if it works for them, before they spend their money on a prescription.

Good discussion though, and I’m glad people are actually having it. Thanks for letting me play.

"I apologize for any nurses I spit on that don't work for Grant the Drug Rep."

Brilliant. Pure poetry. That should be the title of somebody's blog.

Haze, I'm more than willing to consent my own ridiculousness, but I'd at least like to know why?

I mean, I think its a conflict of interests for pharmeceutical companies to market their products like they do in the middle of wheel of fortune, playing to the sentiments of old folks who wanna get some action. Not that its wrong for old folks to get some action, but there's something a little bizarre about using playing up peoples medical problems to make a buck.

I'm not saying don't work with doctors, I'm saying the money spent making catchy allergy commercials, which is millions dump that back into research on a cure for malaria.

But, why look for a cure for malaria? There's incredible DEMAND for a cure for malaria, but no money to back it up, hence little to no research put into discovering said cure. While this is understandable, one might be hard pressed (at least I'd be) to call it a good thing.

As the richest, wealthiest country on the plent, I think it'd be a good thing for us to consider focusing our signifecant wealth & resources towards some good stuff. This of course, rarely occurs on a systematic level; it'd take the hearts & minds of the heads of pharmeceutical companies changing to instead of being purely bottom line driven for there suddenly to be an odd, charitable dump of time and resources into helping out folks who wouldn't make them a dime.

All we can do is act differently. If we start thinking about charity as an end goal of our financial success, and if enough of us start thinking that way together, then there's no reason why the million dollar law firms and pharmeceutical companies or software development companies can't act that way also.

Also, Haze, just 'cause most pharmeceutical companies spend more on R&D; than other industries, it doesn't mean that they shouldn't spend more. I mean heck, its their JOB to come up with new cures for diseases! I mean ya, they get props, but c'mon, its like a bunchof doctors doing research at some university getting called out for only spending 17% of their time doing actual research and them crying "well, we do more research than lumberjacks!" Its' apples and oranges. My question is should they be doing more?

Josiah, I’m sorry if I wasn’t clear. What I thought was ridiculous was that you were claming that pharmaceutical companies were creating a demand for certain products, while at the same time IGNORING need in other areas. It seems that most of your argument is based on the ED drugs, which although popular now, do not even make up a fraction of drugs being prescribed. Targeting old people that are watching wheel of fortune is making the assumption that only the elderly are using these drugs. I don’t have hard numbers off hand, but from reports that I have read, a large percentage of patients being prescribed these drugs are under 50. Many people suffer from dysfunction that are your age (but I’m sure your fine).

As for the issue of allergy medications, I don’t know how well you know your family physician, but I’ll bet you don’t have long conversations when you are in the office. This is anecdotal, but I have had the same family physician since I was about 10, and I am still amazed by how little interaction that there is. This isn’t because he isn’t caring, (he is one of the more personable people I’ve met in the medical community) but he has 10 other people in the waiting room and you can’t talk about every problem you are having. When I was having neck soreness, I had to bring up taking Bextra (a Pfizer drug to treat these types of symptoms), to which he gladly replied, “Oh, yeah, that would work great, we could try that.” Sometimes it takes patients bringing up issues like, “Doc, I saw this commercial for a new allergy med, would it work for me?” I don’t know a doctor that wouldn’t tell you that a doctor patient relationship is a two way street (and I work with a lot of doctors). Maybe that still isn’t acceptable to you, but this is still a business, and the doctor decides what is best for his/her patient.

As to the comparing apples and oranges, or pharmaceutical companies to lumberjacks, please reread my post. I compared the “profits” of pharmaceutical companies to other non-research industries (which I would think you would accept, since profits are profits), but I compared R&D; budgets specifically with another R&D; based industry, software services. There isn’t much that would be apples to apples for your liking, but this is about as close as I can get. Both industries turn over very fast and need new products to keep moving forward, and if that wasn’t the case, my old 386 would still be going strong.

Oh, and it seems that you are very concerned about out malaria, so you will be happy to know that a French Research Center has a drug that is still in development that they are calling the cure to Malaria almost two years ago. Here's the link to the original story:

http://news.bbc.co.uk/1/hi/health/1821686.stm

They predicted that two more years of testing would hopefully have it on the market by 2004 or 2005. I don’t know where it is at, but I haven’t read any devastating news about a total let down. It may not be a total cure, since parasites adapt very quickly, but the issue isn’t being ignored. We do have vaccinations and preventative measure that can be taken. Also, when the drug comes out, there won’t be any problems with the cost, since most 3rd world nations with these problems are exempt from patent laws as dictated by the U.N. But the company is French, so they might quit before the job is done. Also, this presupposes that as soon as we want to fix something, it is fixed. I do this every day, and that couldn’t be further from the truth. Micro and Molucular Biological systems are still just being understood. Although some scientists and doctors think so, we are not God. God made an incredible and complex system of life, and it is very hard to figure out. Hell, we’ve been working on the common cold forever…and no cure is not due to lack of need in the West.

And finally, of course we should be working to always make thing better, and we are. Only big tobacco has a worse rep than pharmaceutical companies, and you don’t think the CEO’s know that. It is why I have conversations with intelligent people like yourself, to shed some light on a lot of assumptions and misconceptions.

You may not think that 17% on R&D; is big, but I think you are forgetting that we also manufacture all of the drugs we have developed. Out of 130,000 employees, only about 20-30,000 are R&D.; Anyway, thanks for the response and I look forward to the next.

Man I need to threaten more people's lives, I get great posts this way!