Recently Turing Pharmaceuticals, led by CEO Martin Shkreli, acquired the AIDS/HIV drug Daraprim. He raised the price by 5,500%, from $13 a pill to $750. Unsurprisingly, there's been a lot of outrage directed at Shkreli on my Twitter timeline regarding this action. Given that we're in the midst of an epic unveiling of Johnson and Johnson conducting business in the pharmaceutical industry in the most egregiously offensive manner imaginable, it's no doubt that people are calling for Shkreli's blood. I find this topic interesting enough to warrant writing down my thoughts but not so controversial that I need to spend days crafting a well-edited post.
Let me quickly address the very question I had myself upon first hearing of this. The reason a generic simply doesn't spring up at 1/10th the price is an issue of economic scale. Vox does a reasonable enough job explaining it; check there if you're curious.
What makes this a compelling topic of discussion is the fervor of the protest against Shkreli's actions given that what he did, is not in the strictest of terms, wrong. In fact, what he did may even be "right." In the purest ideologies and philosophies of capitalism, he would in fact have a moral imperative to do what he did. The idea being that under pure capitalism, ruthless pursuit of profit by all agents eventually finds a balance as the best society possible. Shkreli then is one of those most adherent to our beloved system of capitalism, touted constantly and from the highest soapbox by those on the campaign trail. A more glowing condemnation of capitalism I've never seen.
The vitrol over Shkreli is of course that his actions are reprehensible. A drug that helps those with an incurable disease is now about 5,000 times more difficult to acquire, and people will undoubtedly suffer because of it. (I can't help but wonder if this public outcry would be so loud if it were for a designer or luxury drug, such as Viagra or something related to plastic surgery. Would people care about a major price hike that makes it tougher for wrinkly enlarged-prostate-ridden geriatrics to bone their mistress?) To claim that Shrkeli shouldn't have done what he did is inherently flawed though. That's an argument of what he should or should not have done, which is not a reliable, meaningful, or helpful way to discuss matters of public policy.
Under many, many systems of morals are Shkreli's actions offensive. I don't disagree with the public that what he did is, in a word, shitty. Morals are not the direct system by which we govern though, a fact evident in our nation's defense of the first amendment so vigorous that at times the Viagra is hardly necessary. Rather, we use the law to govern, and the law is black and white. Here is what you can do, and here is what you can not do. To make a case for what lies in between is simply arguing shades of grey, and that will ultimately be fruitless. After all, what one person considers entirely acceptable another will assuredly find distasteful. Attempting to draw a line between can and cannot that the public should be beholden to will only leave you disappointed, and it will do so repeatedly. Even if you manage to shame Shkreli out of the business, a fool's endeavor I'm sure, there will be no shortage of those willing to take his place. And quite frankly, there (hah) shouldn't be.
A component of game theory, and other doctrines as well, is similar to that of capitalism. Not only does it encourage agents within a system to maximize their expected value, it is essentially required of them. To do any less is immoral or unethical. Shkreli's actions, and anyone that would follow the same path, is merely seeking the most value they can within the system they operate.
Following that arises the ultimate point: Shkreli isn't to blame. We can publicly lynch him for his choices, unscrupulous as they may seem, but scruples are relative to their framework, and he's merely operating at a more "pure" framework than the rest of us. I'm reminded of the Patriots having employed people to steal discarded playbook pages from hotel trash cans after an opposing team has left them behind. Does it leave a bad taste in your mouth? Possibly. Is what they did technically legal? Yep. So does that make Belichick a filthy cheater, or the NFL's coach most committed to his convictions? Yes.
Instead of directing your anger towards Shkreli, an act akin to tilting at windmills, focus it on where it more appropriately belongs: the system. The pharmaceutical industry and regulatory environment, to more specific.
It is within this system that Shkreli, and every one of us, is compelled to do exactly what has happened. They are playing by the rules. If that upsets you, don't change the player. Change the rules. Only then will people be forced to behave within our agreed set of moral guidelines. Deciding what is legal is deciding the question of when should not becomes can not, a far more industrial behavior. Instead of ultimately condemning a single individual, only to rehash the argument the next time someone steps up to the plate, we can instead draw the lines where we as a society are comfortable with them. Then there's no need for moral outrage at Shkreli's actions, because we have something even better - legal recourse.
Of course, legal recourse is only as effective as the system that enforces it.
If it can be summed up in a Kermit meme, I don't know that it's particularly insightful to point out a system that permits this activity is somehow broken. http://www.livememe.com/e9jr0f5
ReplyDeleteAnyone who cares to look can see that just about everything about the the way health care is distributed, from research to retail, is pretty much busted. And worse than just about any other developed country by any meaningful measure.
Wealth accumulates wealth, which leads to wealth influencing policy that tends to support accumulation of more wealth.
Finally, while it is understood and accepted that Corporations have a mandate to essentially be sociopaths in their pursuit of capital, individuals still have the option to not be monsters. While someone would have snatched this low hanging fruit from the mouths of the dying eventually, this jagoff decided to be that monster, and doesn't get the option to avoid our ire with a simple recital of "but capitalism made me do it". Consider the outrage a non-market force, and take your medicine with your millions. While the harm is simple to understand, a useful policy solution to the problem is far more difficult to achieve, and far less conducive to popular facebook posts.
It looks like your argument hinges on a relativistic framework, that an individual is compelled to act in a certain way because there is something to gain from their actions and they are acceptable within the legal context in which they are operating.
ReplyDeleteIf there is no objective truth, if everything is contextual, then things such as slavery and racism can be acceptable and should be pursued as just, given the correct context.
I reject this argument. There is objective truth. For example, treating people with fairness, respect and compassion is objectively better than not doing so. It doesn't need to be enshrined in law, but we can live with this ideal as we strive to strike down laws that impede it. Doing what is right and just exists outside of any relativistic framework.