Emergency. California to force pharmacies to buy California Generics

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MrBonita

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Brothers we must unite. If California is to make its own generic, prices will start to go up. Pharmacies will be forced to use california generics which will cause pharmacies to close. I demand we march down to the board of pharmacy and off with the head of the fool who dares to stop us from using generics from China and India.


 
What is wrong with this idea? Good for the public
 
From WSJ:

“The plan, which the Democrat said will be part of his new budget proposal, would allow California to contract with generic-drug manufacturers to make the medicines available for sale to all Californians, according to a summary released by his administration.”


I don’t see how this is a problem, aside from the philosophical idea that government shouldn’t enter/subsidize private business.

Maybe they can make cheap drugs no one wants to make (like dextrose and bicarbonate) so we don’t have stupid shortages from having a single manufacturer.


Also, correct me if I’m wrong as it’s been a while since I’ve taken high school economics...but when supply goes up, prices go down, yah?


Also, title misleading. But that was obvious.

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nothing says you have to use them -but ya - more competition, especially if this is considered "non-profit" seems like a good idea
 
I'm with you guys, I fail to see how drug prices will increase as a result. I am, however, curious about what PBMs will do with this.
 
People need to realize that buying drugs from China and India is the only way to get cheap drugs. Making drugs in California will cause us to use American tax dollars. This is wrong in terms of globalization. I’m surprised no one is as outraged as me. The world will come to an end if the state starts supplying hamburgers and toilet paper too. We want independence. Viva la California.
 
People need to realize that buying drugs from China and India is the only way to get cheap drugs. Making drugs in California will cause us to use American tax dollars. This is wrong in terms of globalization. I’m surprised no one is as outraged as me. The world will come to an end if the state starts supplying hamburgers and toilet paper too. We want independence. Viva la California.
take off your tin foil hat

PS- I am guessing I would rather have the meds made here and more oversight by the FDA and have less of chance of lead and carcinogens being added to the mes.
 
California "might" be a rich enough state to force the so called Pharmacy Board to put the screws to these giant chains and their non-sense...
 
People need to realize that buying drugs from China and India is the only way to get cheap drugs. Making drugs in California will cause us to use American tax dollars..

Do you not know how to read? Do you have comprehension issues? Good lord.


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Ok. I see it as a cost vs safety issue and we all know which one wins. With tighter margins on generics, the industry loses. Look at the market for some life saving meds of epi and heparin. A coalition of hospitals have created a drug company just so they continue a stable drug supply. Drug companies have started producing other meds with better margins and the patient is the ultimate loser. The FDA cannot look at all these facilities on global scale and I am all for bringing drugs under better compliance so matter who is making them is the US.

This was a report from the FDA on the issue.

Until passage of the Food and Drug Administration Safety and Innovation Act (FDASIA) in 2012 (P.L.112-144), the Agency was legally required to inspect manufacturing facilities in the United States every two years but had no similar mandate for the inspection frequency of foreign facilities. This resulted in more frequent inspections for domestic facilities and created an unequal playing field that was exacerbated by resource constraints.
 
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Many drug companies make rediculous net profit margins that you can't find anywhere else consistently in the world (about 6x more than retail pharmacy according to a quick Google search). California might even make money off this idea if done well. It would put a stop to all the shady price-fixing deals and "shortages" that keep driving up prices. Insulin for $200 which the company manufactures for $10? Now you can buy insulin for $20 that California bought for $10! The conservatives on this forum that have responded forget that a free market is not free in the presence of lawlessness, monopolies and price-fixing. The government exists to prevent that.
You are ignoring the govt added costs to bring a drug to market if you only compare the per unit manufacturing cost to the per unit retail price. That’s not how economics works.
 
I don't know where the costs would come from? California would go to a manufacturer in India/China and buy the generics from the source and then sell them to wholesalers at the cost of the drug, shipping etc. A quick google search shows that it costs less than $6 to manufacture a vial of insulin. You're telling me it costs $100+ in administrative and transportation costs to get a vial of insulin to the consumer? There's plenty of room for a nonprofit entity to cover their costs and it would bust up the price-fixing and monopolies that have been going on in the drug pricing game for decades. I do agree that there are places where this could go wrong. Retail pharmacy margins would skyrocket which would be great for us 🙂
Cheap generic insulin is already ~25 at walmart with us manufacturing standards

The expensive stuff is partially so because the cost has to cover r/d, liability, other researched drugs that didn’t make it to market, etc. It’s dishonest math to just say it takes pennies to make and they are charging thousands. That’s not how it works
 
You cherry-picked one example of one medication at one pharmacy.

So then why does insulin in Canada cost on average 1/10 of what it does in the US? Are you really defending the monopolization and price-fixing that has been going on in the US drug market for decades? It's called extortion. Actually look at the linked articles.

Chapter 1 in an economics textbook is how the free market creates healthy competition. Chapter 2 is how a lawless free market allows for monopolies and many other issues to arise. For-profit companies care about making money, nothing else. They don't care about the wellbeing of their workers, the sustainability of their operations, damaging natural resources that others need, the affordability of their products, etc. We have laws to prevent these problems. In reality, the free market can allow entities to cause more harm than good by acting only out of selfish interests.

We live in a world where we allowed tobacco companies and opioid manufacturers to sell addictive products that kill people. If you want an example of where the "free market" can go wrong there you go. A lawless market is not a free market. It never ceases to amaze me the number of conservatives in this country that claim to be economists and completely ignore and cherry-pick economic principles. Knowing what free-market competition is does not make you an expert. Allowing for a natural supply and demand balance is good. Having no laws and allowing companies to artificially skew supply and demand to extort money out of people who will die without their medications is bad.

There are certain industries where for-profit free markets don't make sense and healthcare is one of them. The objective of an industry needs to line up with the incentive the industry has. It makes sense that video game production would be a for-profit industry. If a company makes great games they sell more copies and make more money and the workers and shareholders earn more money. In healthcare, the objective is not to sell as much as possible at the highest possible price. The objective is to help people live healthy lives. That is why much of the healthcare industry has trended naturally towards being non-profit. Sadly, in the US we continue to incentivize companies not for outcomes, but for pushing expensive services and medications no one needs. There's a reason most of the industrialized world has made healthcare a public system and there's a reason why US healthcare costs much more with worse outcomes.
You put a lot of stuff in there so I’ll number some responses:

1. At the end you repeated the untruth that we have “much worse outcomes”, no we don’t. We’re expensive here but if you can afford it we are freaking good at medicine.

2. The walmart article was crap. Despite you not being happy that I used generic insulin from walmart as my example of cheap meds, they used a clearly name brand version of insulin a their example and kept referring to it generically as “insulin” thus implying this lady’s kid died if she didn’t spend hundreds of dollars per vial....at walmart. That’s not true, walmart sells generics for ~30. It doesn’t take thousands per month to keep the avg diabetic alive.

3. The hbr article doesn’t mean govt intervention is the answer, it’s an article about how a bunch of govt rules created a longer monopoly time due to manipulation of govt rules. The answer there would be to eliminate some of those govt rules

4. You really misunderstand the tax status “non-profit” as being benevolent and disinterested in making more and more money
 
1. The US has worse outcomes compared to other countries with nationalized healthcare systems and spends way, way more. I'm shocked you're even debating this. There's no shortage of evidence.

Not entirely, no.

So first we have this: The Myth of Americans' Poor Life Expectancy

Second, let's look at this study: US vs. Europe: Life Expectancy and Cancer Survival | American Enterprise Institute - AEI

The preventative measures were easy - we rocked those:

Talked with provider about things in life that cause worry or stress in the past two years, among those with a history of mental illness - 4th place but only 10% behind first place which was 74%
Talked with provider about healthy diet, exercise and physical activity in the past two years - 1st place by a lot, we hit 59%, next best was 41%.
Talked with provider about health risks of smoking and ways to quit in the past two years, among smokers - 1st place
Talked with provider about alcohol use in the past two years - 1st place at 33%, next best was 25%
Women age 50-69 with mammography screening in the past year - 1st place
Older adults (age 65 plus) with influenza vaccination in the past year - 4th place, 1st place was 75%, we were 68% so very close

-30 day in-hospital mortality rate following acute myocardial infarction, deaths per 100 patients - 3rd place, I'll take that

-30 day in-hospital mortality rate following ischemic stroke, deaths per 100 patients - 1st place

-Breast cancer five-year relative survival rate - 1st place

-Colon cancer five-year relative survival rate - 3rd place, likely due to our lower rates of screening and thus more advanced cancer.

We fail both Mortality Amenable to Health Care and decline in that same number.

-Infant mortality, deaths per 1,000 live births - Last place, but that's almost entirely due to how these things are reported. Our birth-30 day mortality is right in the middle of the pack. What gets us is that infant mortality is defined in this study as birth to 1 year. Our SIDS rate and abuse rates are much higher than most of OECD countries.

-Adults age 18 to 64 with at least two of five common chronic conditions - Last, see diabetes and obesity rates in this country compared to everyone else

-Life expectancy at age 60 in years - Middle of the pack.
 
1. The US has worse outcomes compared to other countries with nationalized healthcare systems and spends way, way more. I'm shocked you're even debating this. There's no shortage of evidence.

2. Medication prices in the US are higher than anywhere else in the world by a wide margin. There is also no shortage of evidence. You seem to use denial as your main defense mechanism (which is considered one of the lowest levels of defense mechanisms). There's not much that can be said to a denier.

3. You think having no laws would allow companies to start caring about other stakeholders and not just profit? We allow companies to patent medications for a reason. That's a good idea and provides an incentive for innovation and research. Allowing them to divvy up the market to allow monopolies and price-fixing for medications that have already gone generic is not a good idea.

4. I am aware that a non-profit organization still seeks to make money and that there are still issues with the non-profit system. It is still better than the corporate, publicly-traded nonsense that seeks to extort money out of employees and customers combined with aggressive accounting practices to pay off shareholders in the short term while ignoring everything else that matters. Go on Glassdoor and compare the company ratings of some for-profit and some non-profit companies and you will see a significant difference. A non-profit theoretically serves stakeholders, a for-profit serves only shareholders.

If we can't even agree that the United States spends more money and has worse outcomes (the fundamental issue) then there's not much more to be said.

For Christ's sake, life expectancy in the US has started to decline over the past 3 years according to the CDC mainly due to an increase in suicides, alcohol and drug overdoses in young adults. What do you get when you screw over the next generation by extorting all their money in order to pay for basic education, housing and healthcare (all incredibly bloated) on top of handing them a bankrupt social security system and $23 trillion in debt? Plus an economic system designed to funnel individuals into a toilet bowl of depression working themselves to death for horrible companies to make the wealthy money in the stock market By basic measures, there is more wealth inequality now than there was during the guilded age. It is insane that three individuals in the US have as much money as the bottoms 50%. Most of the country struggles to survive working to make the country function while the investor class cracks the whip complaining about having to pay their employees. Economies don't flourish with massive amounts of wealth inequality spurred on by asset inflation. Just ask investors from the 1920's. If the average person doesn't have money, the average person can't sustainably buy things in the economy which is what actual economic growth is--not this asset inflation spurred on by exponential investment into housing and stocks that no one can actually afford. High drug prices resulting from "free market" monopolization and price-fixing is just one factor contributing to this broader issue. And when you get down to it, it all stems from the fact that the world stopped caring about everything other than "growth" and pandering to corporate interests. It turns out "growth" is a horrible measure of societal advancement. The United States was supposed to have been founded with the goal of the "pusuit of happiness," not the pursuit of corporate profit. Destroy nonrenewable resources? Who cares as long as we make a profit. 80% of people hate their jobs and their mental health is suffering as a result? Who cares as long as we're profiting off it. There will be a significant crash/depression at the end of this. It's just a question of how long all this nonsense can go on with the Fed pouring gasoline on the fire until the house burns down. The direction the world is heading in is sadly not sustainable.

This is my last post on the topic. I'll be bumping this thread in however many years it takes down the road before all of this becomes apparent and it's written in the history books.
VA already handled your outcomes misrepresentation.

I’ll add on that there isn’t anything immoral about income inequality. If you want as much income as the next guy/girl, you need to bring talent, time, or capital to the marketplace that the economy values as much as what the next guy/girl brought

We both just said the same things about govt with drug prices, patents are good and a ton of govt loopholes extending monopoly isn’t
 
Nothing immoral about income inequality? Let's do a thought experiment. We have $1,000,000 to spend. We can either buy a yacht and give it to someone who already has a net worth of $100 million or feed the 25,000 people who are statistically going to starve to death today for a month. Which use of the money produces more value? It doesn't matter if stocks increase in value if all the profits go to those who see no benefit whatsoever from such a gain. The world benefits very little from the rich buying yachts and mansions and benefits greatly from feeding the hungry, housing the homeless and educating the impoverished. Next you're going to tell me that we need rich people so that poor people are inspired to work hard just like them and make it big someday. Newsflash, the vast majority of people work very, very hard just to survive. The hungry and the homeless don't need billionaries to be incentivized to house and feed themselves. We can reward innovation in the economy without completely stripping 90% of the population of everything. Creating a global company should be rewarded with a net worth of $20 million, not $100 billion. $20 million is more than enough by a wide margin for you and all your heirs to live happily never having to work in perpetuity. That should be the ceiling. Everything else is a waste that should be utilized elsewhere.

You're argument about needing to bring "talent or capital" to the marketplace on a level playing field else is flawed in a world of income inequality and scare resources. As the decades have gone on, the number of opportunities to enter the middle/upper class have declined. The economy has turned into a lottery where most fail so that a few succeed. If I were to tell you that you were starting your career over right now with $200k in debt and your application was one of 200 residency applications would you think it was "fair" that everyone had a level playing field? Boy, how fair it is to lose out to 199 other individuals because the director didn't like how you signed your name. It's not like there wasn't anything wrong with the system to begin with.
The problem here is you have no respect for property rights. “We” collectively don’t own the money. The money is owned by whoever owns it. You and I don’t have any claim to it just because we think it might be used better elsewhere, that’s not how rights work

And you’re wrong about class mobility, it’s pretty dang good generationally in the US
 
And you’re wrong about class mobility, it’s pretty dang good generationally in the US

Compared with who, exactly? Would it surprise you to know we aren’t even in the top ten?
 
Compared with who, exactly? Would it surprise you to know we aren’t even in the top ten?
Haven’t seen and don’t care about the rankings by country. When a parent in the lowest quintile of earning here has a >50% chance their kid will move up at least a quintile it’s fine.

And even if it wasn’t, it wouldn’t mean the rest if us have the right to start seizing money from the wealthy
 
Haven’t seen and don’t care about the rankings by country. When a parent in the lowest quintile of earning here has a >50% chance their kid will move up at least a quintile it’s fine.

And even if it wasn’t, it wouldn’t mean the rest if us have the right to start seizing money from the wealthy

Where does that statistic come from?

Will you at least admit to moving the goal post?
 
I can't resist the urge to respond. I'll make it short. Either side could cherry-pick whatever statistics they want to make an argument. I could quote ten more well researched articles from reliable sources that contradict your opinion. The United States objectively spends way more on healthcare per capita than any other country and at best other countries still manage to do a lot of things in healthcare better. The US has A LOT of room to do more with less. I can assure you from my personal experiences in pharmacy both in the US and in the UK that the NHS does a much better job using funds efficiently than the "free market" in the US.
I don't disagree with any of that. The US can definitely improve and we do spend more per capita for at best slightly better results in some areas.

I just disagree that more government is necessarily the best way to do it.
 
Your arbitrary following of "rights" above what is logically best for everyone overall is not logical or rational. Many starve to death every day in this world and you're telling me that's how it has to be because the world's wealthy elite have a "right" to have everything while watching the world burn. Ask King Louis XVI how much the people of France cared about his "rights" when they established modern democracy. The United States is no longer a democracy. It is trending toward plutocracy. The wealthy do not have a "right" to whatever they can get their hands on by whatever means. The government exists to ensure everyone plays by the rules so that we may maximize the benefit for everyone. If that means raising taxes on corporations and putting the money in the pockets of people who actually work then so be it. If that means creating a non-profit drug label to undercut the extortion that has been going on in the market for decades than so be it. Jeff Bezos will be fine with a net worth of $20 million instead of $100 billion. And I promise Jeff Bezos will continue to work at Amazon and innovate for the price of $20 million.
The french king wasn’t wealthy through voluntary market interactions, he impoverished the people via taxes. That’s not the same.
 
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Where does that statistic come from?

Will you at least admit to moving the goal post?

I don’t have the study handy but we spent pages and pages discussing it in the spf at some point

I didn’t move the goal post. I was both refuting the other poster’s claim and attempting to be very clear that either way it didn’t justify the response proposed by them (redistribution)
 
The old "if it's broke, why fix it?" argument.

If there's room for improvement, you should improve. What you just said doesn't make sense. It's fine so no need to make it better?

It’s not a “problem” because it doesn’t matter morally. It is inappropriate to suspend property rights over that metric
 
I don’t have the study handy but we spent pages and pages discussing it in the spf at some point

I didn’t move the goal post. I was both refuting the other poster’s claim and attempting to be very clear that either way it didn’t justify the response proposed by them (redistribution)

Well at first you claim the US has good upward mobility then you say you don’t know how we rank and double down on claiming it doesn’t matter anyway. I would call that goal post moving. If it doesn’t matter anyway and you don’t actually know if the US has good upward mobility why even make the claim?
 
Well at first you claim the US has good upward mobility then you say you don’t know how we rank and double down on claiming it doesn’t matter anyway. I would call that goal post moving. If it doesn’t matter anyway and you don’t actually know if the US has good upward mobility why even make the claim?
I was clear that i consider the actual numbers discussed in the prior thread to be good. I also find it irrelevant to the horrible goal of suspending property rights
 
I was clear that i consider the actual numbers discussed in the prior thread to be good. I also find it irrelevant to the horrible goal of suspending property rights

Don’t you just hate autocorrect errors? They are horrible.
 
A very conservative viewpoint is to have certain "rights" or "morals" to defend your opinions instead of logic or evidence. Saying something is a "right" does not make it a good idea. Labeling is a classic logical fallacy. There is no shortage of examples in history of labeling things and then just using the word as an argument. I could say not starving to death is a right or living indoors is a right, but I argued with reason instead for a reason. Saying something is a right isn't an argument, it's circular logic. You're basically saying the wealthy should be allowed to limitlessly extort money out of the economy because they should be able to do it.

Corporations and the wealthy elite are impoverishing the American people by paying as little as possible and then forcing them to work horrible, depressing jobs just to pay basic bills while marketing addictive junk to them to take even more money. The entire economic system has been designed to keep the poor as poor and desperate as possible and distribute their earnings to their masters.

Did you know that American congressman spend about half their workday in cubicle-based based call centers soliciting funds from the 1% in exchange for political favors? We've literally legalized bribery in the political system. The founding fathers would not be proud.
You’re all over the place, again.

Of course not violating rights is more important than what you think works economically. It’s the reason that if you pitched slavery was good for economics, I don’t have to argue that with you using math....I just point out that it’s a violation of rights and we don’t get to do that.

I don’t think rich people get to “extort money” from the economy. I think they get to keep what they make via voluntary transactions. You point out some violent extortion and I’ll agree with arresting that person but you don’t get to steal money because you don’t like how much they have.

Regarding govt...that’s the type of corruption you want to have the power to steal from people. That’s a dumb idea. Of course they are corrupt, so their power should be curtailed
 
I’m happy there’s robust discussion about the French monarchy in here, but I’m annoyed the misleading thread title (the result of a gross misinterpretation) keeps getting bumped to the top.


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It's not voluntary to grow up in poverty, inherit $23 trillion in debt from your parents, be forced to pay a ridiculous amount of money to go to school just to have a chance at a decent job, work for a horrible corporation just so that you can pay basic bills to stay alive or pay hundreds of dollars for your life-saving insulin. Again, a lawless "free market' is not free. These are not voluntary transactions.

I made like $500 at work today at a horrible job. I made $1,500 in the stock market today owning parts of other companies many of which treat their employees like disposable garbage. I don't deserve to quadruple my salary simply because I grew up in a somewhat affluent, financially literate family and have been fortunate to be able to wring some money out of the economy in the short term. Many of my classmates are intelligent, hardworking people who are unemployed under a mountain of debt. Most people do not get to participate in the current asset inflation bubble. Most people don't see wage growth above inflation and work full time just to see all of it go toward rent and groceries and student loans. So yeah, the rich have continued to tweak the system to allow them to extort it. Again, it's why we now have congressman in call centers soliciting bribes for hours a day from wealthy interests.

It's not stealing to tax corporations (and their profits and the money that eventually would flow to wealthy shareholders). It's insane that Amazon gets a refund and is subsidized by the government so that they buyback more shares and payoff Bezos and the bunch, but then Jo Schmo the worker pays 30% of their earnings away every year. It's not stealing to change the rules of the game. I'm not suggesting we sign a law that says Jeff Bezos must give half his wealth to the government. Just that we must change the rules of the game going forward to maximize the overall benefit for everyone.
more ranting, I'll try to address some points...

1. I said that unless you can prove theft, the wealthy got that way through voluntary transactions, that doesn't negate the poverty of others nor cause it.
2. The wealthy also live in that country with national debt, that's not just poor people and a lot of that debt was spent on the poor
3. No one has to pay "a ridiculous amount of money" to get a good job. Lots of trades are solid jobs that don't require school. And for someone pitching govt as a solution, it was govt intervention that ballooned tuition.
4. If you are qualified for a better job, go get it. If you don't want stock market returns, don't invest.
5. Your classmates debt and unemployment don't obligate anyone else to them. They need to show up with a skillset the market wants to pay for if they want money.
6. Again, corrupt politicians is an argument for less govt, not more
7. Jo shmo the worker does not pay 30% federal income tax, that's absurd as ~half the households pay none. I'm totally against corporate welfare as well as personal, let's trim the budget lower taxes and simplify the tax code. deal

The rules don't need to "benefit" everyone (which is you saying they get to control everyone), they should simply aim to leave everyone alone
 
...the wealthy got that way through voluntary transactions, that doesn't negate the poverty of others nor cause it.
...

I don't think I understand your point here and I would like to. If "voluntary transactions" do not cause poverty (which I think is what you are saying), what does?
 
I don't think I understand your point here and I would like to. If "voluntary transactions" do not cause poverty (which I think is what you are saying), what does?
Apologies for my phrasing being poor.

The other poster was stating wealthy folks got that way through exploitation implying that the gains were dishonest and therefore it wasn’t wrong to just use govt to take their stuff

I was trying to say that unless you have some proof about a specific person and are ready to press charges, most wealth is gained by someone providing services/goods/capital that a bunch of other people want and pay voluntarily for. I further tried to say that this doesn’t mean there aren’t poor people, only that it’s not an accurate thing to imply that poor people are poor BECAUSE of wealthy people.

Hope that helps
 
I further tried to say that this doesn’t mean there aren’t poor people, only that it’s not an accurate thing to imply that poor people are poor BECAUSE of wealthy people.

I can't decide if I agree with that statement or not. On the one hand, we know the first principle of economics is the scarcity of resources. So if one person is going to be rich, someone else has to be poor. Anyway someone has to be the servant after all. On the other hand, in life there will always be winners and losers; is it the winners fault that the other people/person lost?
 
Also is it unthinkable or immoral to suggest that people with wealth will use their position of power to keep their wealth and that will naturally limit the options of people without wealth from gaining it? Seems unavoidable to me. Tax laws that "level the playing field" do not seem immoral to me on the face of it.
 
Also is it unthinkable or immoral to suggest that people with wealth will use their position of power to keep their wealth and that will naturally limit the options of people without wealth from gaining it? Seems unavoidable to me. Tax laws that "level the playing field" do not seem immoral to me on the face of it.
If you fear the wealthy using govt against the poor, the answer is to weaken that tool or identify the bad law and repeal it. It isn’t appropriate for the poor to simply use the govt as a weapon first
 
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