"Because We Can Bernie, Because We Can"

Senator Sanders always does claim the capitalists are greedy bastards, no?

It’s possible to think that Bernie Sanders, Senator that he is, is more than a little confused. Well, he’d not be the first elderly politician to suffer that fate. Nor the first socialist. It is necessary for me to be fair here though - one of his honeymoons he took in the Soviet Union. Which makes perfect sense to me - after all, there was bugger all else to do there other than your own wife.

However, here we’ve got him complaining about the cost of the new miracle drugs:

Bernie Sanders has urged Denmark to rein in its most valuable company, Novo Nordisk, and force it to slash prices on popular weight loss and diabetes treatments Ozempic and Wegovy, taking his fight to lower “outrageously high” drug prices in the United States to the company’s doorstep as its profits soar amid ongoing struggles to meet booming appetite for the revolutionary drugs.

Hmm, dunno how well that’s going to work with the Danes really. Yes, to some extent they’re milder than when they tried to rape and pillage the entirety of Europe but not wholly. My brother worked out in Afghanistan (feeding the troops) and he had a Danish unit rotate through. So he tells me their senior sergeant type carried a double bladed axe on his backpack - it didn’t come back clean from every patrol either. They’re not all equality and gender rights these days, you know?

So, we can imagine a certain portion at least of the Danish population celebrating this rapine of Medicare’s pockets by the simple expedient of selling a weight loss drug that actually works - which is, when we come to think of it, something of an innovation. Fen-Fen didn’t work after all. Hey, you know, Vinland failed but we’ll get ‘em this time? We’re charging high prices because we can?

A second pass at the argument would be that the drugs are in fact incredibly cheap. When it was shown that the same drug - semaglutide - works in stopping (that’s “stopping” as in ceased, stopped, dead, like Bernie’s career would if it were ever proven he had taken part in an act of voluntary capitalism) chronic kidney disease. So much so that the very day they announced the trials on the drug were being stopped a year early, so obvious was the success, the share prices of all the dialysis provision companies dropped 20 and 30%. That is, at near whatever price, this drug is a money saver. Which is, you know, good. J Foreigner turns up with this thing that saves America, Americans, lives and money and yet Bernie whines - so like a socialist, eh? Capitalism with markets makes us the humans who are living highest on the hog, ever, but they really never do stop whining about it, do they?

But Bernie’s real complaint is that Americans are paying more to burn off the cheeseburgers than everyone else has to. But from everything else Bernie says about anything at all this is at it should be - the rich should pay.

Back to our basics. The basic drug development problem is that the development of a drug is a public goods problem. It costs $2 billion to get a drug through the FDA and gain approval to actually sell it. Yes, of course we should slaughter much of the regulation that makes it cost that much (personally, against character type, I only recommend capture and humane release for the actual bureaucrats) but that’s another matter. It does. But if everyone can just copy the drug at that point then no one will spend $2 billion. So, OK, patents, so the developers have a decade (the patent is two decades, it takes a decade to gain approval) to make their $2 billion back then anyone can copy it. The price falls to manufacturing cost plus normal profit level and we’re about as good as we can get. This is not a perfect system but for mass market drugs it’s about as good as we’re going to get.

But it’s a public goods problem all the same even if we’ve an at least partial solution here. And a very basic idea of governance is that the richer among us should pay more for the provision of public goods, for solving public goods problems, than the poorer among us. This is something that Bernie would certainly sign up to - and Bernie rather more than anyone else possibly slightly better connected with reality too. The rich should pay and the poor should get - Bernie’s socialism is often a lot more to do with redistribution than it is with anything else.

OK, well, who are the rich in today’s world? The Americans. Sure, there are microstates - Singapore, Brunei, a few others - that are about as rich as Manhattan, or Santa Barbara, that sort of level. Same number of people too. But for a collection of hundreds of millions of humans richer than any other group have ever been we’ve really only got the US. The EU might have 450 million people but to get to that number we’ve got to include Spain, Portugal, Greece and so on and they’re really just not that rich. Look, Britain is poorer than Mississippi, the poorest of the American states.

The US is the rich bastard in the global economy. Therefore the US gets to pay for the public goods - like a drug to save us from cheeseburgers. Given that that is the basis of Bernie’s politics it’s amusing that he’s so against it. But then views always do change about rich bastards paying for dinner when you realise that you are that rich bastard at the table, right?

Bernie, Americans get to pay because Americans are the rich people here. You know, global socialism?