The Conservative Case for Drug Price Controls?

Reading a book called Rise of the Robots about the increasing role of automation in our lives. The author takes a bit of a detour in the chapter on health care to discuss how the markets are broken. I’m not sure how related to automation this is, but he makes this interesting point:

…every other national government negotiates prices with the drug companies. The result is that Americans, in effect, subsidize the lower drop prices in the rest of the world.

[...] It’s something of a mystery to me why this is not more disturbing to Americans, and to grassroots conservatives in particular. The Tea Party, after all, got started after a famous rant by CNBC personality Rock Santelli, who decried the fact that people with mortgages they couldn’t afford might be subsidized by taxpayers. Why aren’t average Americans more upset that they are paying pharmaceutical freight for the right of the world — including a number of countries that have significantly higher per capita incomes than the United States?

Drug companies are price-limited in other parts of the world, so they charge higher prices in the United States to make up for it. The rest of the world gets a free(er) ride off the backs of U.S. patients.

The U.S. effectively ships billions of dollars overseas by paying the drug companies to provide drugs at lower costs to other countries.  We pay more, so they pay less.

Now, I’m  not blanket condemning this. The are some countries so poor that this might be a unintended humanitarian effort than needs to happen.  But it’s quite interesting to look at from a politically conservative standpoint.  Could this be a rare situation where a political conservative should support price controls in the U.S. so drug companies would have no choice but charge other countries more to level prices?

New Word: “idiopathic”

Basically, a disease that just happens for no reason:

Relating to or denoting any disease or condition that arises spontaneously or for which the cause is unknown.

From an article about Natalie Cole:

The family told the Associated Press the singer died of idiopathic pulmonary arterial hypertension, which led to heart failure. [...] Because Cole’s case was idiopathic, the exact cause is unknown.

I think that last sentence is superfluous. It was idiopathic because it was unknown, not the other way around.  And even then, you’re just confirming the definition there, really.

New Word: “Carapace”

This is a physical word that was used in an emotional context.  Technically a carapace is:

A carapace is a dorsal (upper) section of the exoskeleton or shell in a number of animal groups, including arthropods such as crustaceans and arachnids, as well as vertebrates such as turtles and tortoises. In turtles and tortoises…

Basically, it’s a shell.  I encountered the word in a marvelous book called The Emperor of All Maladies, which is a history of cancer.  In it, the author describes a cancer patient descending into the hell of chemotherapy, and shutting herself off emotionally from the people around her:

Her melancholy hardened into something impenetrable, a carapace, and she pulled into it instinctually, shutting everything out.

“Pulled into it” is clearly a reference to the shell of a turtle, of which the word seems to most often refer (though, technically it refers to the shell of lots of different things).

Feeding Children in Mali

I read a book recently called Triggers: Creating Behavior That Lasts–Becoming the Person You Want to Be.  The book was just okay, but it contained a chilling story that I don’t want to forget.

The book was written by a motivational speaker, and a master of the story and anecdote.  We apparently volunteered in the Third World, and relayed this story about his time in Mali, and of a picture he keeps in his office to remind himself of what he has.

The picture shows the 35-year-old me kneeling next to a Red Cross professional in the Sahara Desert. Behind her is a line of children between the ages of two and sixteen.

The food supply in Mali was extremely limited, so the Red Cross was introducing triage. Any available food would be handed out to children between the ages of two and sixteen on the chilling assumption that children under two would almost certainly die and those over sixteen might survive on their own.

The woman from the Red Cross was measuring children’s arms to determine who ate, who didn’t. If their arms were too large, they were “not hungry enough” and given no food. If their arms were too small, they were beyond saving and also given no food. If their arms were in the midrange, they were given a small portion of the available food.

Id’ need a sociopath’s personality to be unmoved by the experience. But as I returned home to my “normal” life, there was a good chance the memory, no matter how searing, would gradually recede in power. Except I have this photo.

The picture triggers gratitude, as if the 1984 me is coaching today’s me.

I try to comprehend the idea of denying a starving two-year-old food because they will die anyway, and I simply can’t. While I do not second-guess the people on the ground in that situation, and I just can’t wrap my head around a choice like that.

Much like the author kept a picture of the event to remember it, I took a photo of this page in the book, and transcribed it here so that I might too remember.

New Word: “Piscene”

I knew that “piscis” was a astrological sign, but it didn’t occur to me that the word was simply Latin for “fish” and would be the root of other words.

Of or relating to fishes. Having the appearance or characteristics of a fish.

From a passage where the author expresses “piscine ignorance” of how fishes breathe underwater.

(My Chrome browser spellcheck, for the record, has flagged the word as misspelled with the squiggly red underline.)

New Word: “Variegated” and In-Group/Out-Group Bias

An adjective which seems to related originally to colors:

Varied in appearance or color; marked with patches or spots of different colors; varied; diversified; diverse.

It seems to just be another way to state “varied,” perhaps with more emphasis on a series of discrete states or gradients.

Found in the book The Organized Mind in a discussion of “In-Group/Out-Group” bias, which is the concept where we find numerous variations of those people in our “in-group,” but we tend to view the “out-group” as a single, monolithic block.  The example from the book:

Oh Democrats are a very diverse group — we come from all walks of life. Oh those Republicans — all they care about is lower taxes. They’re all alike.

And the usage of the word…

In cases on in-group/out-group bias, each group thinks of the other as homogeneous and monolithic, and each group views itself as variegated and complex.

New Word: “Affordance”

Actually not a new word — I had encountered this once before in a book about why we would never completely rid ourselves of paper. The reason being that it offered “affordances” that digital screens never could.

A noun:

…a relation between an object or an environment and an organism that, through a collection of stimuli, affords the opportunity for that organism to perform an action.

For instance, paper has the affordance of being able to be easily passed around a room of people. Digital text does not currently have that (clearly, however, digital text has affordances of its own).

Found in The Organized Mind:

…[some stores] have made a business model out of [...] products which function as affordances for keeping wayward objects in their respective homes.

New Word: “Abeyance”

A noun:

A state of temporary disuse or suspension.

When discussing a notecard system for remembering things:

You don’t need to carry all the cards with you everywhere of course — the abeyance or future-oriented ones can stay in a stack on your desk.

Something is “in abeyance” or “held in abeyance” when there is no current assignment of ownership.  A noble title is “in abeyance” when there is no one of the bloodline to claim it, for instance. By the same token, I suppose that consciousness is “in abeyance” while you’re asleep.

New Word: “Salutary”

An adjective:

(especially with reference to something unwelcome or unpleasant) producing good effects; beneficial.

So, something is not objectively pleasant, but that provides good benefits overall.  Found in a sabbatical application:

Rubbing shoulders with [discipline] scholars again with be salutary.

In this case, the use was more generic — rubbing shoulders with other scholars wasn’t viewed as negative; “salutary” just meaning “good” more generally.

New Word: “Dialectical”

An adjective which means:

  • relating to the logical discussion of ideas and opinions.
  • concerned with or acting through opposing forces.

I found this in a review of Bridges of Spies, in the New York Times, which described the move as “insistently dialectical.”  Wikipedia describes the root form — dialectic – this way:

The dialectical method is discourse between two or more people holding different points of view about a subject, who wish to establish the truth of the matter guided by reasoned arguments.

And this is a fair way to describe Bridge of Spies. The movement is a constant examination of the opposing forces during the Cold War.  It presents both sides, and careens back and forth between them, never particularly choosing a side as correct.

The term dialectics is not synonymous with the term debate. While in theory debaters are not necessarily emotionally invested in their point of view, in practice debaters frequently display an emotional commitment that may cloud rational judgement. Debates are won through a combination of persuading the opponent; proving one’s argument correct; or proving the opponent’s argument incorrect.

And this is an accurate description of the movie.  Bridge is very detached from the subject.  It’s more of a a neutral observation of a situation that took place during the Cold War.  The movie invites the viewer to make their own decision, while at the same time, subtly making the point that nothing has really changed, and standoffs between superpowers continue today and will forevermore.