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> has been shown to be effective at controlling costs

That has never happened. What does happen is the cost is borne by the taxpayer rather than the user of the service.

The "warping" of the profit motive in the insulin case is entirely caused by government interference and regulation (by making it nearly impossible for competitors to spin up and make insulin).



Not really. The internet is an example of what happens when you suck margin out of high margin businesses like content creators. India is an example for pharmaceuticals.

If the state takes a commodity and sells it on a cost plus or cost basis, it’s going to kill investment in the spaces and collapse the margin.

At this point, we’re killing people and bankrupting states and employees with out of control costs. Making an example out of insulin would fix that and constrain some of the players in the market.


> Making an example out of insulin would fix that

No it won't. It will just shift the cost to the taxpayers.


Who do you think is paying now? States are spending billions on it through Medicaid cost share.

A state like California with a contract manufacturer would probably break even on the insulin and save billions for reduced complications. Poor people with diabetes are frequent fliers for ER admissions. The cost of one ER visit is probably close to annual insulin cost.


> Who do you think is paying now?

It'll cost even more when the government takes it over. There's a reason why central economic planning results in poverty.

Instead, reduce the regulation and laws and interference by the government so that competitors can sprout.


Why make the jump directly to central economic planning? I mean what it sounds like you're saying is communism is when the government buys things? So not a big fan of like, roads?

Are you arguing in favor for no government regulations whatsoever? Are you arguing for cartel state?


> Why make the jump directly to central economic planning?

That's what government running things is.

> communism is when the government buys things?

No, communism is from each according to his ability and to each according to his need. You can form a commune with such a structure, it's not illegal.

> Are you arguing in favor for no government regulations whatsoever?

No.


Earlier you said the warping of insulin cost is caused by government regulation. It sounds like you're not differentiating between central economic planning, the government "running things," and regulation.

I'm confused by this because it seems a purposefully black and white take.

I don't use "central economic planning" unless I'm talking about a State that has implemented, well, central economic planning. It doesn't make sense to me to point to a country with nationalized transit and nothing else nationalized, and say "they do centralized economic planning." How are you differentiating between these two kinds of states? Because otherwise I don't know how to communicate the difference between the Soviet Union and, idk, Spain or whatever.

I'm also confused by the conflation of that with "the government running things." The government runs the military, is that central economic planning? The government "runs" elections, is that central economic planning? The government sends soldiers to break strikes, is that central economic planning? FEMA sends food and medicine to hurricane disaster zones, is that central economic planning? Is a firetruck central economic planning? Where does it end lol?

Finally the most confusing thing to me is where you stand on any form of government regulation. Happily it sounds like you aren't Full Libertarian and think Amazon should be building our roads, but when you say "the government running things" is the same as the government regulating things like how medicines can be produced and tested, I get totally confused. So a law that says "no murcury in medicine" is the same as... Central economic planning? It's equivalent to a nationalized healthcare system? That's weird because people have been arguing for the usa to socialize its healthcare system for decades but apparently it's already socialized, cause it has regulation?

I only am pinning you down so hard on this because I completely disagree that whatever people mean by "free market" is a means to greater material conditions for people, but I genuinely can't even figure out if that's what you're arguing for, I'm just working off my understanding of your world view from the other thread where you dropped a simple "this would be better if the free market did it."


> the cost is borne by the taxpayer rather than the user of the service

If the service is "not dying preventably" that's fine.


There are far better ways of doing that. For example, government agriculture, because feeding people prevents them from dying, is still a bad idea, because every time the government took over agriculture, people died of starvation. Free markets produce a food surplus.


Where is there a free market for agriculture? The usa subsidizes farmers to control volume and prevent surplus overrun. Prices of food are thus artificially high.


In this case the regulation is certainly being pushed by the pharma companies themselves as they wish to use regulation as a means of eliminating their competition so they can charge monopoly prices. So less regulation is not going to help, rather, the political influence of the corporations is the problem. Doing an end run around the whole mess by simply producing your own insulin will rapidly cause collapse in prices as those companies will suddenly have competition, even if from a state run agency. It's happened many times before.


> So less regulation is not going to help

Yes it will. The government is far, far more powerful than the corporations.


Remember this - the California insulin manufacturing program is going to turn out to be very expensive.


There are many cases where the government can produce things at cost and bankrupt for profit companies. It's not always effective but the situation is quite dire at this point


> There are many cases where the government can produce things at cost

Yes, and the costs are always higher than that of a for profit company.

> the situation is quite dire at this point

Right. The solution is to remove the regulatory and legal barriers that add $190 in cost to a dose.




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