You know when you hear something so mindblogglingly stupid..Follow

My counter was that I'm just as legitimate in claiming that fear of the NSA wiretapping program has been used to oppose it, as fear of terrorist attack has been used to promote it.

This isn't the case, at all. The argument against any wiretapping program is that it infringes on rights of privacy, BECAUSE THEY DO. The argument that this particular program might stop a terrorist attack is PURELY SPECULATIVE. See the distinction?

One is arguing the impact based on known unavoidable actions, one is presenting a theoretical dramatized scenario to appeal to emotion.

I wish you'd develop a consistent political philosophy. Either you're against government encroaching on your personal rights or you aren't. You'd agree this wouldn't be ok if it wiretapped CEOs to monitor insider trading, right?

Pick a side. This completely mindless parroting of whatever the up to the second GOP line is wastes everyone's time. I don't and Nexa and Flea and Joph don't come anywhere near doing this with the DEM line of the moment. We have actual clearly defined political philosophies and OFTEN comment that we'd prefer something else but that the DEMs are closer to what we want than the GOP.

Why is that so hard for you? There's nothing in your previously stated philosophy that supports this type of thing. You don't want a police state. You're parroting an inane argument that the trade off is worth it because the imaginary consequences are so dire. This is the same case radicals make for nationalizing anything. Oil, healthcare, energy, whatever. That the potential consequence is worth government control. You can't hold with one and not the other.

Wrong on both counts. Assuming the NSA is doing what they're legally required to do (under FISA and the new modified legislation), a US citizen living in the US's odds of having a phone conversation listened to by the government has not increased at all.

If we assume the NSA is breaking the law, then you weren't protected before. Get it? Nothing is changed here.


The second count is wrong because while we can speculate about whether the program is or has protected us, we do know that terrorist attacks can occur. They do exist. We have suffered them. So the "harm" being protected against (or claimed to be protected against) isn't speculative. It is real. It exists.

But the "harm" you're talking about is speculative. You're speculating that for some reason the NSA will be more likely to violate the law today then it was 10 years ago. That's pure speculation Smash.


You couldn't be more backwards on this.




One is domestic. The other is foreign. There is no violation of my rights (or any US citizens rights) if our government conducts wiretaps on foreign soil.

We've had this argument before. Do I really have to go through the steps of explaining the difference between domestic and foreign surveillance to you again?



No. It's a consistent understanding of what my rights are, and what things *actually* infringe them, and what things don't.

Democrat program to tax me and spend it on free trips to the hair saloon for poor people: Violation of my rights.

Republican program to conduct foreign surveillance program: Not a violation of my rights.

See how easy that is?


You're one of those people who has the rare memory condition that causes you to forget everything everyday, right? Cause that's the only explanation for why I have to explain this exact same thing to you every time we have this or a similar debate.

Edited, Apr 29th 2008 5:06pm by gbaji

Which is strange, given that I justify my positions by using the exact same criteria every single time.

You're the one who changes his mind based on party affiliation, not me.




Way to prove my point. If, as you're implying here, the medical drug benefit is in opposition to my ideas, why do you not support it? Because it came from Bush? Or maybe you oppose it specifically because it's supply side in nature?

IIRC, I didn't say that this plan was "the best thing for capitalism". I did say that if we're going to pay for medicine for people with taxpayer money, I'd rather the money be spent in a way that spurred on the pharma industry and rewarded them for bringing new drugs to the table, then in a way that competed with them and reduced their ability to do so going forward.


I'd certainly rather we not spend the money at all. But I certainly would not want what you seemed to think was the ideal solution, which IIRC was that the government provide generic alternatives only to their patients. This would certainly reduce the total cost, but would essentially reward businesses that did nothing but wait for patents to expire and then make profit on the government market, while punishing companies who spent the R&D to develop new drugs (by shrinking their market due to government only paying for generics). It would also mean that many medicines would not be available to those in the program, reducing the quality of the program itself.


My position on that was (and is) perfectly consistent with my historical positions on issues like this. Ideally government shouldn't interfere with the market at all. If it has to get involved, it should do so in a way that rewards innovation and discovery rather then simply reward those who tailor their business models to the shape of the public trough...

If, as you're implying here, the medical drug benefit is in opposition to my ideas, why do you not support it?

You know why, the reason no one should support it, it guarantees profits to drug companies REMOVING THE MARKET FORCES THAT ENCOURAGE them to research more effective drugs.

You agree competition for profit is what motivates new drug research, right?

It allows the physician to prescribe the drug, which may be a named brand or a generic, and pays for the drugs. While we can certainly imagine some conspiracy involving every doctor in the country deliberately prescribing only named brand drugs in order to pump extra money into the pharma industry, that's another fear based argument, with no evidence (or logic) to back it up.

Woah woah woah, that's absolutely not the case. By pure coincidence, as I mentioned in an earlier thread so it's clear that I'm not spontaneously creating this fact, my last few consulting contracts have been for medical device companies. While that's not pharma, the discussions I've had with people in the industry have all been with the assumption that it's much more prevalent in pharma than in devices.

This is anecdotal, and just my own experience, so discount it accordingly, but all other research I've ever examined will show the same thing.

Medical devices are aggressively SOLD to physicians. Because of NDAs I have to be somewhat vague, but here's what I've seen in the last few weeks:

Got a contract to build sales tracking software for a multi-billion dollar maker of devices, the contract encompassed all of their shoulder and knee replacement kits. These are basically synthetic screws/pins/sutures etc used to hold ligament grafts in place. The large company had recently acquired a much smaller company that held the patents on said devices and was having problems integrating them into their SAP implementation. I wrote code to do that and in the process had to ask various questions about business practices for obvious reasons. Here's how it works.

Sales reps take kits with literature about the devices to some amicable location, a resort frequently, and invite area doctors to come for a demonstration. When I say "invite" I mean they fly them first class, put them up in 5 star hotels and *literally pay them* to attend a lecture then do a surgical technique procedure on a cadaver. I used a real dataset from a demo in Henderson NV (which is about 10 minutes from Vegas) to test. Expense allocation was a maximum of $10,000 per surgeon (including airfare food, etc), with anything beyond that requiring special authorization. Surgeons were paid in the area of $1000 per day. This is all, I'm sure, completely above board. Physicians who had *bought* certain quantities of the kits were invited to be special "guest lecturers" and were paid considerably more. 5 figures in many cases. When I asked offhand if it mattered how many procedures they'd actually carried out with them, I was told it wasn't tracked.

This small company had 50ish employees, some research engineers, some staff, a few doctors, who worked there full time. They had 319 consulting surgeons being paid yearly in various forms, research grants, lump sum allocations for consulting, weekly allocations for various things. Again, completely above board. I saw no evidence of outright bribery or payola or any of that.

The implication was clear, though. The efficacy of these particular devices was about the same as several other, and possibly lower than another option. When I asked about this I was given a speech about differing studies and data and a bunch of medical terminology I didn't understand completely. This device scored higher on a 3 point flexibility scale even though another scored higher on a 6 point scale, etc. I don't doubt it was a viable option in knee reconstruction, it just didn't seem to my untrained opinion to be better than an alternate *much less expensive* option. I was told off the record by two separate surgeons that was pretty much the case when I asked them about it. Not worse, but not better in any meaningful way. It was overtaking market share though. There was pretty much universal agreement that this was because of how it was sold.

Current gig I'll be starting Friday is a return to a company I consulted for last year that does medical imaging. They were in FDA trial then and they are in another round now, so I really do have to be careful about disclosure, so without specifics, I'll say I was there for the entire first trial which consisted of physicians using these imaging machines and recording a score on a scale used to measure the severity of a disease based on the image.

I'll be blunt. They were blatantly coached. They were told the images contained x percentage of "5" on the scale, and x percentage of "1". They were told the machines should yield more "5"s than the current machines or the FDA wouldn't approve them because they had a higher risk of side effects, so there had to be a real improvement on current technology. They were told, quite literally "If you see what you think is a 4, it's probably a 5, there aren't many 4s in the sample set". They ate lunch together and discussed how they scored certain images. Some of them coached others of them saying "Oh, that was a 5 for sure."

This is how it goes in America. One of the physicians asked me about allergies I was having one of the days I was there and I told him I usually took generic Claritin which is OTC now. He responded that it was a great drug, and that he used to prescribe it in large amounts, but since it had gone OTC he now steered his patients to Clarinex, which is prescription. I asked him about Clarinex, because I had seen the commercials but wasn't that familiar with the drug. "Oh, it's Claritin. It's just pre-metabolized" I asked him if that made it more effective. He told me it was pretty much identical but "Schering isn't going to send me to Hawaii if people buy Claritin over the counter"

He was consulting too, he'd worked for the FDA for 10 years in the 90s.

That's capitalism, and sure, I'm part of it. My money doesn't come from nowhere, but let's not pretend that drugs are prescribed based on effectiveness by benevolent doctors. They're people. They like money. They make decisions accordingly.

Pigeons are natures answer to Gnomes.

They make good footballs but little else.

Also, if we're talking about the impact the .0001% of doctors who are "speakers" for one drug or another, and how many patients they actually see and prescribe medicines for, you'd also have a point.

Actually a recent study shows you're off by a factor of 80,000.

Good try, though.

Edit: Sorry, my bad, 250,000

http://www.eurekalert.org/pub_releases/2007-04/bc-ptt042507.php

Close, though. I find you to be a credible source for information on this subject.



Edited, May 1st 2008 10:16pm by Smasharoo

Edited, May 1st 2008 10:18pm by Smasharoo

Physicians were more likely to receive payments if less than 25 percent of their patients were uninsured or covered by Medicaid.

You missed the part of the drug benefit being part of MediCARE.

Two different programs.

Ok, I buy that.

But the parts you're finding problematic are the "socialized" parts. It's the very act of having a government agency provide some good or service to people from a broad fund that causes this problem. Once you separate the "cost" from the person paying for it, you're always going to have potential abuse. It's part and parcel for any such program.


Congratulations, you're an honorary Conservative, since you think this causes problems and inefficiencies. That's what many of us have been saying all along.


The point here (or at least my point) is that if we've already decided to have a system in which the payer is not actually footing the bill, I'd rather have on in which companies at least *can* be rewarded for bringing new/better products to market, then one that prevents any benefit for this. You're argument is basically that CompanyX is better off developing a minor knockoff of CompanyY's product and competing via "advertising", then it is in researching something truly new and groundbreaking. Ok. Granted. However, at least their version of the product has to compete in some way, even if it's just competing based on who can pump the right bene's to the doctors involved. And it certainly doesn't prevent the development of new drugs entirely. Profits gained by making "me too" versions of drugs can be spent on researching the next "big thing" as well.


What's the alternative though? Pay from a fund and structure it so that no company receiving payouts from the fund actually profit in anyway? Cause that's the only way you can prevent the abuse you're afraid of. Of course, that doesn't just limit the likelihood of new drugs appearing, it completely eliminates it.


If it's more profitable to make a "me too" variant instead of spending the money on R&D under the Bush plan, how much worse would it be under any alternative? There would be *zero* incentive for any company to ever research any new drug. If they already need to subsidize the R&D costs for "new" drugs with "me too" drugs today, then they'd certainly never be able to afford the R&D costs under any alternative I've seen proposed.


Your argument is the equivalent of saying that it's a bad idea to put tires on your car's wheels because if you hit something sharp, you might get a flat and lose performance and control. So we should drive around on bare rims instead. Hmmmm... Somehow that doesn't seem like a great idea...

And you don't think that'll be just as prone to special interests? You've just replaced doctors and pharma companies with politicians and research organizations.


Everything else being equal, at least the two organizations involved now are in some way related to the medical field...