[Trinidad]

barmar, on 2014-June-02, 08:59, said:

Conversely, put 10 of the smartest scientists there, and you won't come up with anything, either.


But it's a prerequisite to get anything done.

I think you are grossly underestimating scientists. Look at the scientists in most countries. Look at their accomplishments, their efforts (starting with sacrificing the first 10 years of their adult life in relative poverty, compared to their fellow countrymen with a regular job), and their salaries when they are recognized scientists (compared to the salaries of recognized entrepreneurs).

These people are not driven by money. They are driven primarily by fascination, and secondarily by a desire to improve the world.

If you put 100 scientists together for 10 years under one roof and give them a bed and 3 meals a day, they will get out after 10 years with innovative ideas, of which some can be used to improve the world.

If you put the 100 wealthiest entrepreneurs with their money together for 10 years under one roof and give them a bed and and 3 meals a day, they will come out after a month. 1 will be filthy rich, 49 of them will be poor and 50 will have died of starvation.



Of course, to make scientists function well, they need to be facilitated with - simply said - money. (Or, if you want to see it differently: entrepreneurs need to be facilitated with scientists.) But, in principle, it is irrelevant where that money comes from: a private company or a government.

There are, however, good reasons to put medical research more into the hands of governments (or government organisations): It takes a very long time (10-30 years) to develop new medication or new medical treatments. This time scale fits much better with the time scale of governments (e.g. the EU with a budget period of 7 years) than with a private company that needs to show the results of the last quarter to its shareholders. Many companies don't even last 20 years, let alone that they can afford to put large amounts of money into an R&D project for 20 years before they might (i.e. not "will") see a return. Compare that to the development of a new car model, which takes a few years. That fits private enterprise quite well.

Rik

[StevenG]

Trinidad, on 2014-June-02, 09:49, said:

These people are not driven by money. They are driven primarily by fascination, and secondarily by a desire to improve the world.

You're talking about scientists. The rest of the contributors to this thread are talking about American scientists. There is a difference.

[Trinidad]

I wasn't talking about a scientist of a specific nationality. But I think that my post above is even more valid for American scientists than e.g. European scientists. I got an MSc from the Netherlands and a PhD from a US university, so I think I can compare.

US grad students live in poverty. It is hard to get on a tenure track in the US... and the track is long (with many a winding turn). You need to love science a lot to go that road. It is better for corporate scientists, but their salaries are small, no tiny, compared to the managers.

In Europe scientists are better off. PhD students get a small, but decent pay and the difference in salary between scientists and managers is smaller.

Rik

[mike777]

edit

[helene_t]

Trinidad, on 2014-June-02, 14:57, said:

US grad students live in poverty.

I thought Barmar's point was that pharmaceutical research needs money for all the other costs (lab equipment, reembursement of healthy volunteers in phase I trials, etc) rather than that the scientists themselves necesarily need big carrots. But maybe I misunderstood.

From my experience, working with largely govenment-funded medical research (but sometimes in colaboration with pharma or charities) in UK, NL and DK, I would say that the resource waste is enormous, and that it stands in sheer contrast to the very efficient patient care which paradoxaly often takes place in the same institutions. Read "The truth in small doses" to see why. While a small for-profit company has a clear objective (to make money) and the care departments at a hospital have a clear objective (to make the patients healthy), it is really hard to identify the raison-d'etre of a goverment-run medical research facility. Something like obtaining grants for doing more research, and to publish papers so that we can get more grants, and to breed PhDs so that they can apply for grants as well when they grow up? It sounds a bit circular. It is rare that I get involved in a project that, even with some imagination, has the potential to advance science and/or patient care. And even when it does happen, the slow pace of the apply-for-grants-get-rejected-reapply-do-research-submit-paper-get-rejected-resubmit-apply-for-new-funding cycle means that we always run out of momentum before we deliver anything: the technology we work with gets out of date, key workers get children, key workers move abroad to advance their carrere, key workers reach retirement age.

I am not sure what the solution is. The pharmaceutical industry isn't necesarilly better at serving society than we are - while they occasionally invent drugs that actually help patients, their business model is largely parasitic: to invent new diseases that require costly treatments (ADHD, post-menopausal complaints), and to make (at best) marginal improvements of old drugs when the patents expire so that new patents can be obtained.

Anyway, patient care seems to work most effectively in countries that have socialised medicine. So I think that one is easy.

[mike777]

To be fair can we agree that all of these countries have a major free market?


The problem is the free market is stifled to use Winston term

"Anyway, patient care seems to work most effectively in countries that have socialised medicine. So I think that one is easy."


At the very least we need a debate over

One huge issue is 99.99 mericans don't underatand uk...Canada health care


50% simply don't care

[mike777]

Again to say that competition is not the key is just silly....


Look at the posts that confirm competition is so important.


the issue is govt inhibits competition


often in the name of VA or NHS is sacred and holy.

[mike777]

concerning patient care there are stories about VA patient care


1) Acute patient care

2) VA based infection rates.

[helene_t]

mike777, on 2014-June-04, 04:00, said:

Again to say that competition is not the key is just silly....

I wouldn't take it for granted that competition is good in health care.

It could be. Maybe the problem with the US health care is lack of competition. Maybe socialized medicine is rubish and just seems OK because nobody has ever implemented a sensible alternative.

Who knows. In the absence of evidence I don't believe that competition is the solution. I know from my own experience, both as a patient and as an employee in health care institutions, that the British/Scandinavian socialized system works much better than the Dutch private insurance system. Of course that doesn't prove anything. Just saying: I don't find it plausible that a competition works in health care, and I don't see any evidence for it either.

[hrothgar]

mike777, on 2014-June-04, 04:10, said:

concerning patient care there are stories about VA patient care

1) Acute patient care

2) VA based infection rates.

There are also stories about the Loch Ness monster.

FWIW< here's a good article sketching out some of the issues surrounding the VA scandal and why Phoenix seems to be ground zero.

http://www.washingto...re_an050598.php

[cherdano]

How dare the government get involved in health care for its former soldiers?

[Winstonm]

mike777, on 2014-June-04, 04:00, said:

Again to say that competition is not the key is just silly....


Look at the posts that confirm competition is so important.


the issue is govt inhibits competition


often in the name of VA or NHS is sacred and holy.

Asserting it so does not make it so. In fact, closing one's eyes and believing really hard does not even make it so. Like Helene said below: maybe it is so, but it doesn't sound plausible and there is no evidence that it is.

[hrothgar]

Winstonm, on 2014-June-04, 06:10, said:

Asserting it so does not make it so. In fact, closing one's eyes and believing really hard does not even make it so. Like Helene said below: maybe it is so, but it doesn't sound plausible and there is no evidence that it is.

Don't bother trying to use logic on a LaRouchie...

Mocking them is fine and dandy, however, they don't engage in intelligent discourse.

[kenberg]

cherdano, on 2014-June-04, 05:27, said:

How dare the government get involved in health care for its former soldiers?

Details I don't know, but it is what we do.

We have friends who are retired military. They get substantial access to medical care through Andrews Air Force base. Actually some of that is changing, I don't know the details.

You might or might not agree, but the idea, as far back as I can recall, is that part of the agreement for military service is a commitment to lifetime medical care. Fort Snelliong, near where I grew up, is now, I think, a rest home for aged soldiers.

I may say more later, but I am still traveling and just took a quick glance here.

[Winstonm]

One more time into the fray, although likely rendered nugatory by the opposing ideology. Even if competition is the key, competition is not reliant on profit incentives. Profit-driven incentive is only one type of competition. Incentives of pride, curiosity, intellect, good will, and others all play a part in human activities.

I feel like I'm playing with a "real" Scotsman.

[barmar]

helene_t, on 2014-June-04, 03:06, said:

I thought Barmar's point was that pharmaceutical research needs money for all the other costs (lab equipment, reembursement of healthy volunteers in phase I trials, etc) rather than that the scientists themselves necesarily need big carrots. But maybe I misunderstood.

That is exactly my point. You put those 100 scientists in a room for 10 years, keeping them fed and clothed, you'll get lots of good ideas, but not a single drug. They won't even know if any of their ideas actually work.

Einstein came up with his Theory of Relativity in his spare time while working for the Patent Office, so obviously financial incentives aren't necessary for the thought work that goes into innovation. But turning E=mC^2 into a working nuclear power plant required more innovation and creative work than anyone could do on their own.

[akwoo]

Despite the fact that we tend to lump it in with science, medical research generally looks a lot more like engineering research than science research.

[helene_t]

akwoo, on 2014-June-04, 12:21, said:

Despite the fact that we tend to lump it in with science, medical research generally looks a lot more like engineering research than science research.

Oops I upvoted this because I somehow took it as "medical research needs more engineering ...".

Medical research would be a lot more productive if it was done by engineers instead of physicians, IMO. But maybe I should write this from an anonymous account .....

[cherdano]

kenberg, on 2014-June-04, 06:25, said:

Details I don't know, but it is what we do.

We have friends who are retired military. They get substantial access to medical care through Andrews Air Force base. Actually some of that is changing, I don't know the details.

You might or might not agree, but the idea, as far back as I can recall, is that part of the agreement for military service is a commitment to lifetime medical care. Fort Snelliong, near where I grew up, is now, I think, a rest home for aged soldiers.

I may say more later, but I am still traveling and just took a quick glance here.

I guess my sarcasm has gotten a bit too subtle these days...

[Winstonm]

barmar, on 2014-June-04, 11:21, said:

That is exactly my point. You put those 100 scientists in a room for 10 years, keeping them fed and clothed, you'll get lots of good ideas, but not a single drug. They won't even know if any of their ideas actually work.

Einstein came up with his Theory of Relativity in his spare time while working for the Patent Office, so obviously financial incentives aren't necessary for the thought work that goes into innovation. But turning E=mC^2 into a working nuclear power plant required more innovation and creative work than anyone could do on their own.

Yes, but that is not what Mike777 claims, and it was his point to which I objected. His point is that competition and monetary incentives are the driving force of innovation and that government stifles incentive.

You and I are in agreement - it takes money to get things done. That is not the same as saying it requires free markets to get things done.