Hacker News new | past | comments | ask | show | jobs | submit | braink's comments login

Bottom line: pharma sells pills to make money; they don't make money off of healthy people who don't take their pills. So long as we link the health industry to making profit, we are prioritizing profits over health.


Making a profit on pills is just one motivation in a very complex system of competing motivations, incentives and regulations that shape what "we" prioritise.

I think drawing conclusions from one specific motivation in isolation is too simplistic. Many other profit interests benefit greatly from a healthy population that doesn't spend all its money on useless pills.

And motivations other than profit, both personal and political, are very powerful as well.

I don't think there is much evidence that eliminating the profit motivation leads to better results in general -- on the contrary. But there is a lot of evidence from Europe that health systems with public buyer cartels can achieve the same or better health outcomes far cheaper than in the US.

Although some say that sky high US drug prices effectively subsidise those European outcomes.


> pharma sells pills to make money; they don't make money off of healthy people who don't take their pills

But insurance companies do.

American healthcare is a complex system of highly-incentivized agents. Zooming in on a single component as a synecdoche is like trying to reason how a car works by extrapolating from a fuel injector.


That's not entirely true, a lot of the research comes from passionate students trying to make the world a better place with no intention of keeping you sick.

Additionally almost every industry is profit motivated, we wouldn't have the brightest people going into medicine unless it paid well. Ironically it doesn't actually pay well enough


It’s a very limited view on any industry to think that profits and greater good cannot coexist. You say the pharma industry just makes pills so they can extract profits. The researchers at those companies who dedicate their lives in persuit of treatments for the benefits of patient would say we only make money so we can make new treatments.

That’s just semantics in the end. But it’s foolish to think that just because some endeavor is profitable is must be immoral.


> we are prioritizing profits over health.

A cure for Hepatitis C was developed by profit-seeking companies. Be careful what you're willing to throw away.


Profits are what drives innovation in pharmaceuticals.


That is a truism, right? Currently in the US we have private pharmaceutical companies driven by a profit motive, so profits are what drives their innovation.

Setup a different system, and other motivations will drive their innovation, right?

Unless your claim is that innovation can only EVER be driven by profit?


I thing the argument is more along the lines of:

1. Observed value drives innovation.

2. Profit / profit-motive is one of the most straightforward / most efficient means we have to observe value.


You’re probably right and my counter argument would be:

1. Human [curiosity, desire, necessity] drives innovation.

2. Profit mandate suppresses most of those innovations by promoting the few money making ideas (however beneficial or harmful they may be).


I think the issue with that response is that [curiosity, desire, necessity] are all just specific versions of "observed value" which you are then applying to oneself. Sure, you'll have a lot of innovation if everyone is trying to satisfy their own curiosity, desire, or necessity. But you'll drive far more innovation if you have individuals who are also concerned with satisfying those needs for other people. And the easiest proxy for "someone else desires or needs this" is pricing mechanisms. Luckily, the internet / better communication methods are making it much easier to determine what is valuable to others without pricing mechanisms, but I would argue that profit motive is still the most effective method.


Yeah, I mostly agree. Profit motive is not a terrible method on average. I just get a bit worked up when I encounter any variant of “a corporations only duty is to create shareholder value”. :)


Curiosity does not provide funding in the quantities needed. Nor does it allocate resources towards maximizing the benefit to the maximum number of people.


But neither does profit motive. Is facebook maximizing the benefit of their users? It’s more like maximizing benefits to the minimum amount of people at the expense of the maximum number of people.


> But neither does profit motive.

Sure it does. Developing a cure for 100 people will generated far less profits than a cure for 100,000 people.

It's why you see cars get better every year and constant attempts to appeal to the widest customer base possible. (That didn't happen with Soviet built cars, which tended to never improve.)

As for advertising platforms, the customers are the advertisers.


I don’t dispute that.

But in the first paragraph, the side effect is that developing a not-quite-cure treatment for 50,000 people is more profitable than both the others.

As for the last paragraph, this is perhaps the essence of the problem. The motive is profit, so we only care about the advertisers. But the users are real people too, and they are getting screwed.


> the side effect is that developing a not-quite-cure treatment for 50,000 people is more profitable than both the others.

Until someone else develops a cure and takes all your business away.

Recall that a company blinded by greed developed a cure for Hepatitis C, not a treatment.


The US leads the world in pharmaceutical innovation. Hepatitis C cure, for example. Treatment for rheumatoid arthritis (Enbrel), for another.

Socialist funded research is driven by politics, not maximizing the benefit to the maximum number of people.

Note that a lot of university research is funded by corporations.

I await your list of medical advances from the USSR.


Yes but it also skews the incentives. The cure for diabetes has little meaning to pharmas. They want to keep people alive but paying for rest of their lives. That's how money shape commercial research


> The cure for diabetes has little meaning to pharmas

1. ABC develops an effective treatment for diabetes, but you have to take it for life.

2. DEF develops a cure for diabetes.

Which one do you think is going to make more money? The only way ABC can make money is if a cure cannot be developed, or ABC somehow convinced the government to ban DEF's cure.

Your theory reminds me of the 1970s when everyone was sure that 100 mpg carburetors existed but the oil companies bought up all the patents for it so they could sell more gas.


> The cure for diabetes has little meaning to pharmas

Unless you're the first to cure. The income, grants, and knowledge drain in your favor? People will continue to get diabetes and a treatment will cure it.


Profit didn't get us vaccine against rabies or acetylsalicylic acid. Researchers did, and we have universities for that.

So there are alternatives, and probably others we didn't think about.


It was profit-seeking Bayer that found a way to make aspirin in an industrial process and put it in wide use.

"In 1897, scientists at the drug and dye firm Bayer began investigating acetylsalicylic acid as a less-irritating replacement for standard common salicylate medicines, and identified a new way to synthesize it.[2]:69–75 By 1899, Bayer had dubbed this drug Aspirin and was selling it around the world."

https://en.wikipedia.org/wiki/History_of_aspirin


I totally agree.

BTW, I'm having problems getting all the pictures rendered in my browser (Safari), but the ones I've been able to see are really inpirational.

I teach mostly (+95%) men in audio design studies at university level and women are painfully lacking in the field. It would certainly help make the field richer, more interesting, and more dynamic (not only for us men, but in general),if there was more gender diversity in tech in general and audio (this is where I see it the most because it's my domain) in particular.


I totally agree with Tim Bray's post. The bottom line is that the pestering that I get from AgileBits makes me, as a customer, really doubt their integrity after trusting them for years. Why are they trying to force me do to this? Obviously because they want more money (but are betraying their own oft-stated security attitudes) and maybe even for some other reason (the backdoor thing?).


I think they're doing it for 2 reasons:

1. Money, and

2. Significantly reducing complexity and maintenance burden. Supporting cloud-only vaults is a lot simpler than also supporting local vaults plus multiple different third-party sync mechanisms.


Generally speaking, when a vendor want more money to do less, it's time to get a new vendor.


In what way are they doing less?


Generally speaking, security solutions have (at least) two goals that are often at odds with each other: (a) Minimize the number of trusted third parties / components, (b) stay out of the way from a usability perspective.

Most negative comments here imply that 1password severely compromised (a), to the point of making it useless, in exchange for incremental-to-zero gains in (b). For most people here, using a third-party sync service is probably more convenient than avoiding whatever mass-market-cloud-thing 1password is trying to move everyone to.

(I haven't used 1password, but am planning to switch to some other password manager, and this article just knocked 1p off my list of candidates).


> For most people here, using a third-party sync service is probably more convenient than avoiding whatever mass-market-cloud-thing 1password is trying to move everyone to.

Using 1Password's service is actually far more convenient. It Just Works™, whereas other solutions like Dropbox are prone to creating conflicts.

TBH I don't know why anyone who was using a third-party sync service like Dropbox would dislike the 1Password sync service (beyond the fact that it's subscription pricing instead of a one-time license fee). It's only the small subset of users who used Wi-Fi sync that seem to have a legitimate complaint here.

> this article just knocked 1p off my list of candidates

Why? Unless you were planning on using Wi-Fi sync, then you shouldn't have a complaint. Tim Bray makes a lot of noise about web sites being insecure, but you don't need to use the web interface for 1Password (well, until today you needed to use it to create new vaults, but 1Password 6.8 can now create cloud vaults directly in the app). And his comment about if you use Dropbox all they have are the encrypted password file applies just as well to AgileBits, because you need the combination of your secret key + account password to decrypt anything, and at least the secret key (and maybe the account password too, not sure) is never sent to AgileBits.

If you're interested, they also have a white paper on their security, which you can find linked at the bottom of https://1password.com/security/.


They are deprecating local vaults.

Given that vaults contain secrets, and data shared with third parties is not secret in any legally compelling way, that effectively neuters the product.


> data shared with third parties

The data isn't shared with AgileBits. They only have the encrypted vaults, they don't have the keys to open them. So it's no more shared with a third party than using Dropbox to sync a local vault is shared with a third party.


But they haven’t stopped me from using my local vault so technically they’re doing more for more.


Are you certain about that first statement?


Consider applying for YC's Spring batch! Applications are open till Feb 11.

Guidelines | FAQ | Lists | API | Security | Legal | Apply to YC | Contact

Search: