You aren't entirely wrong to have questioned the source(s)/motivations behind these numbers. There are lots of competing interests afoot. And not everyone who is calling this issue a "crisis" or who is expressing "concern" is doing so altruistically. I know that having spoken to them personally.
Your question is valid, not entirely sure why you were down-voted.
someone has to raise their kids, support their families? Also there's a loss on taxes. BUT, on the "positive" side, they die early, no SS or medical expenses. An overdose and all is settled.
> someone has to raise their kids, support their families?
Not asking rhetorically, but do you think that this is a pressing concern for many addicts?
>on the "positive" side, they die early, no SS or medical expenses...
It's funny that you raise this point. Last year I had a conversation w/a big name researcher who has been "studying" the Opioid 'crisis' as part of a broader matter.
He agreed that the prospects (social and financial mobility, etc...) of many of those who are affected wouldn't likely improve much even if Opioids were taken out of the equation.
He stated, yes actually said, that alcohol would be a preferred vice because "One can live a pretty good life as an alcoholic."
I don't have any experience as an alcoholic, so I can't say, but I think the comment and the ease with which the researcher made it are telling of a greater issue.
The costs of the opiate epidemic aren't limited to deaths. E.g. when people get HIV or Hep C through needle sharing, that costs millions of dollars per person to treat.
A lot of states are providing treatment to those with liver damage (which in the context of the thread means that they are likely reducing costs vs treating the chronic disease).
I guess $33 billion is too expensive to get popular support, but it really isn't that much money, especially if the reduction in future infections is taken into account.
To take an automotive analogy it is a bit like a major big manufacturer and how that as well as the headline jobs there are also jobs in suppliers and other local companies down to corner shop level. The opioid epidemic is like that in reverse.
It takes a while to overdose, before that there is a long journey of addiction, albeit not that long a period of time, more akin to the amount of time needed to do a university degree.
So the 'fun' starts at a party somewhere and soon the unlucky addict to be is buying and not just trying. This leads to a period of health problems leading to dismissal at work. During the last year of this 'work' they will not have added value to the company and may have cost many sales or other opportunities.
Soon there will be a draw down of funds from concerned friends and relatives, so the savings of others will also go to this, 'enabling' by paying rent checks and such like.
During this decline there will be a lot of medical things going on - nasty infections and horrors that only go with the disease of addiction.
Soon a circle of a dozen or so people will be affected, even if the addict did not have many friends.
Eventually these friends are cut off and only the drug scene exists. Sources of revenue then become stealing and prostitution. There is also supply of drugs, dealing.
Initially this may be for the party friends but then that is even more of a drain on the local economy as those party friends also have to come up with money.
Along the way there will be car crashes, so those cars don't go back on the road like company cars do, these people are no longer buying gas.
There will be police time with these car crashes, plus insurance and a whole lot of court misery.
With no vehicle but still needing to travel the addict then becomes likely to have things like bike crashes and strange things happen to them on public transport.
There may be prison or community service for some of this, perhaps some rehab that does not get adhered to.
They may get lucky and get another job, to give things a fresh clean start. However, the addiction gets the better of them. By the time the company has expelled them on some health dismissal thing that had to be tip-toed around, they will have wasted a year on getting anyone useful in that role.
There can also be some temping work done, but really it is very difficult for an addict to hold down a job.
The inevitable end can be spared with a miracle birth of a baby and the mother going serious about rehab. Some people are able to move away to another country or somewhere and rebuild their lives, this does not mean they will be adding to the $$$ of the local community.
Although death is inevitable, there is no way the headline figures reflect on the reality. For instance, an addict may be self medicating for some genuine physical pain that is only getting worse as they get older. So on their death certificate it mentions the other disease and not the addiction disease. They die of a heart attack, not smoking. Or in a car crash from a smashed brain, not because they had smashed their brain on heroin causing them to smash their brain around an A pillar.
At any one time there are many addicts going through the phases of doing things they said they would never do. In a given year, for the 881 folks dying officially, there are so many more, all of them directly costing their employers, their friends, their families, health services and so on. These are the fluffy costs. Imagine the addicts that have moved on to stealing or selling their bodies. Once quiet neighbourhoods then become involved in an arms race of security upgrades yet still that person that is now an addict finds opportunity in the area every time they need a fix. If people have had their cars broken into and all their hobby toys stolen then they find that stuff wasn't insured and don't buy it again. It's gone.
Then there are those children in single parent families where the parent is an addict. Other inlaws that could b...
There's way more at play than the loss of productivity of one person. Entire families are impacted, not just the addict. $375k in impact per addict? That could even be a conservative estimate from what I've seen with the impact growing up in the 80s. Everyone who comes into contact with the addict is losing so imagine 10 people per addict losing at east $37.5k and that's how you get that number.
I suck at math but with the help of google it says west virginia's gdp is 57 million, and 12% of that is around 6 not 8, so i stopped reading the article as I am positive more unreal facts are presented, but im an asshole so maybe it's just me.
I was in the US recently and watched some TV in my hotel room. I noticed that half the commercials seem to be for prescription drugs, trying to convince people to "talk to their doctor" about using some drug to fix some vague inconvenience.
I am happy it is illegal to advertise prescription drugs to the general public in the EU, it seems pretty clear this does not lead to good things.
“TV ad spending by pharmaceutical companies has more than doubled in the past four years, making it the second-fastest-growing category on television during that time,”
“The drug companies aren’t generally marketing to people in their 30s; they’re marketing to the 65-plus, and that’s the population that tends to still be watching television,”
Why don't you look and see what the FDA says about it? I'll let you Google the study from the early 2000's.
Most people who ask their doctor about a drug they saw on TV have the disease. Of those, a small percentage were undiagnosed, thus the TV commercial helped them with self-diagnosis.
I'd say that's a good thing, no?
Plus, opioids have never been advertised on TV, so you point isn't relevant.
The underlying issue you've described there would be better treated by educating people to talk to their doctors about their actual problems, not around marketed solutions <sic> to perceived symptoms.
Which is what happens in most other western societies (UK, EU, AU, NZ, etc).
The fact that absent that kind of direct marketing, there isn't the same kind of opioid crisis may be merely correlative ... but I'll let you google around for studies that indicate causative effects in play there.
Look at my other post. I'm sourcing actual data that shows benefits and drawbacks. Care to source something to back up your claims?
You realize that a decent amount of DTC in the US is around disease awareness and not a specific product, right? It's those commercials that say "Disease X has new treatments that can help you, ask your doctor." Products are not mentioned.
> Look at my other post. I'm sourcing actual data that shows benefits and drawbacks. Care to source something to back up your claims?
My reply to your comment came before your 'other posts' .. consequently they were not taken into account during my reply. I note that your 'other post' points to a link at the US FDA that includes this caveat:
"It has come to our attention that readers may be projecting these results beyond the surveyed samples. We remind readers that this was designed to be an exporatory look at this issue. We caution readers that these analyses were not weighted back to the population."
> You realize that a decent amount of DTC in the US is around disease awareness and not a specific product, right?
I am not, and I would welcome a breakdown of the ratio of public-service non-sponsored content vs 'specific product' advertisement ... if indeed such a separation could be determined.
This is of course allowing for a large leeway of 'disease awareness' versus 'drug marketing' differentiation.
> BTW - NZ allows for DTC the last I heard.
"Such industry funded ‘health information’ campaigns have been banned in almost all industrialised countries since the 1940s. New Zealand and the United States are lonely exceptions.
"To what does New Zealand owe this dubious honour? While most other developed countries enacted legislation prohibiting this practice approximately three quarters of a century ago, the New Zaland Medicines Act 1981 failed to address DTCA, seemingly more by accident than design."
I Googled, and found that (1) research into it was financed by the media and pharmaceutical industries, (2) the FDA lifted the moratorium/ban on it around 1999, after heavy lobbying, (3) regulations around it center on truthfulness of the product claims and complete risk disclosures (free and cheap alternative treatments will never get advertised, of course), (4) since then ad spending is up exponentially, as are drug use and drug prices, (5) after advertising was allowed, research into this stopped, I found nothing recent, just rehashing old research.
To me it is pretty clear what is going on here (and no, it's not a good thing)
You're looking at the wrong study. It was a survey financed by the FDA, not by the media or manufacturers.[1]
Findings:
- Most physicians agreed that because their patient saw a DTC ad, he or she asked thoughtful questions during the visit.
- Many physicians thought that DTC ads made their patients more involved in their health care.
- The study demonstrated that when a patient asked about a specific drug, 88 percent of the time they had the condition that the drug treated. And 80 percent of physicians believed their patients understood what condition the advertised drug treats.
Not all positive though:
- Physicians thought the ads did not convey information about risks and benefits equally well.
So if you had said DTC has pluses and minuses I would have agreed with you. Blanket "it's terrible" just demonstrates that person's lack of knowledge of the data that's out there.
> Most people who ask their doctor about a drug they saw on TV have the disease. Of those, a small percentage were undiagnosed, thus the TV commercial helped them with self-diagnosis.
This is one of the things driving the US rates of over testing, over diagnosis, and over treatment. Some people are helped, but many are harmed. See, for example, prostate cancer. Many men die with, not of, prostate cancer. The treatment for prostate cancer can be aggressive and can seriously degrade quality of life.
If your doctor can't diagnose you without you asking for medicine you saw on TV, either your doctor is an idiot, or you suffer from a huge communication problem.
Your self-diagnosis isn't the failure of doctors, it's the failure of people (especially in the US) to go see a doctor, most often due to the cost.
Sure, trying to scare the general public into questioning whether or not they have diseases is one way to go about things, but I shouldn't have to explain why this is not ideal and why the rest of the developed world takes a different approach.
Regarding your last point, I would say it is relevant. I mean have you ever stopped to question the reasons why America leads the world in opioid abuse?
You're right. My girlfriend watches the news first thing in the mornings, like Good Morning America, and yes, easily half the commercials are for prescription drugs towards non-emergency issues including weight loss that have horrendous side effects. Scary actually. Directly targeting middle of America. The casualness of "seeing a doctor" and putting X,Y in your body is astounding. It's usually relief at best..
At least now it’s legal for the advertisement to say what the drug is for. Used to be you’d see people running through fields, and I’d be thinking “WTF does this drug do”? Turns out it was an allergy drug.
West Virginia voted 70% for Trump in the election (and 70% for Bernie in the primary). Just in case anyone still thinks Trump was elected based on racism, or Russia, or whatever the media obsession this week, the truth is that life is a damn mess for a large part of the country that's been forgotten by the coastal elitists
And such a result it just goes to show how brainwashed they are. Nothing's more appealing than a scapegoat (liberals, "coastal elites", the EPA, Mexicans), when the biggest problem is yourself.
In this heavily divided, partisan atmosphere, no amount of propaganda (Russian or otherwise) is going to make someone living in the rust belt vote for someone like Clinton. Likewise, no amount of propaganda (Russian or otherwise) is going to convince some hipster startup founder in the SF bay area to vote for someone like Trump.
Where does this 70% figure come from? A cursory search I just did turns up 51% for Bernie [1]. At any rate, it's unclear to me what you take this to show.
I missed the part of history where white people / middle America / anyone really rallied to treat the drug crises in inner cities. Other than to go as far as labeling African Americans as criminals in the best case, or as genetically inferior and predisposed in the worst case.
As for how democrats and the coasts are to blame, well, this is revisionist history. The reps from the coasts were not the ones sent to Washington to bust unions. The republicans sent from middle America were. There’s a movement by middle America that wants to blame others without accepting responsibility. And I think it’s foolish for democrats to engage at that level, because we have to build a coalition that lasts here. We can’t begin that without proper understanding of past mistakes or else we will move 8 years down the road and do the same stupid thing over again.
I sympathize greatly with problems faced from middle America. But there’s a lot of blame to be shared and even now middle America wants to denigrate causes important to the coasts, while also begging for the coasts to bail them out. This is unreasonable.
> democrats ... can’t begin that without proper understanding of past mistakes or else we will move 8 years down the road and do the same stupid thing over again
Indeed. So who is the best candidate for 2020?
> middle america ... labeling African Americans as criminals in the best case, or as genetically inferior and predisposed in the worst case
You might want to check your stereotypes of middle america. Those are really ugly accusations.
> how democrats and the coasts are to blame, well, this is revisionist history
I didn't suggest anyone is to blame, I just said they've been forgotten
I will never understand the voter who is frustrated with a lack of support from their government and thinks the party most likely to help them is the one that advocates for dismantling the social safety net.
I believe it's because people don't want handouts, they want an honest day's work for an honest day's pay. Not an unreasonable demand. I would say based on US Puritan cultural roots, and how our capitalistic system works, it would be a necessity.
what are the definitions for an honest day's work and pay? do you think that the definitions would be the same between a 6th generation american white male and a 1st generation american latino male?
Well it's such a broad question. I tried to answer it a few times, but it ended up being very long winded and only covered a few edge cases.
The first one is easy - enough to pay the bills and live a decent life, including the ability to raise a family while having basic needs and some occasional extravagances met.
The second one depends on time, location and circumstance and changes from time, location and circumstance depending on which of the millions of people you are comparing. It's more of a macroeconomic / socioeconomic / philosophic question rather than a microeconomic one. The best I can answer is sometimes they would be the same, some times group A would take less than group B, sometimes group B would take less than group A. I would guess given the same location and cost of living, they would be similar.
> people don't want handouts, they want an honest day's work for an honest day's pay
But why? People do seem to want this, but I cannot for the life of me figure out why. I was unemployed one summer and got about $400 every other week from the state. It wasn’t a lot of money, but factoring in transportation costs it was a better deal than going out and getting a low paying job. It was literally the best summer of my life since I was a kid.
If I was working a $12/hr factory job or mining or some other labor type job and someone came along and said they’d pay me the same to stay home, I’d take that deal before they could finish the sentence.
I’ve worked a factory job and I’ve worked outdoors. While I enjoyed the work, I enjoyed not working 1000 times more.
I don’t particularly like working in an office either, but since I can generally set my own hours and the pay is good, it’s not so bad. Punching a clock is hell; why anyone would prefer that over unemployment, welfare or UBI is beyond me.
I've been unemployed (due to illness) for the last few years. Not having the resources to truly take advantage of unlimited free time, whilst also lacking the structure etc. that employment provides, can get _really_ tedious after a while.
I can understand not wanting handouts, it's the combination that i don't get: "i don't want handouts, but the coastal elites don't give me enough handouts, so i'm going to vote for the guy who's going to take away all my handouts"
No, I believe it's, "I don't want handouts, I want jobs back."
The GOP convinced people that removing regulations and cutting taxes will make US companies more "competitive," globally. I assume that was interpreted as bringing back jobs.
Of course that won't compete with countries willing to pollute their land, sea and air for a buck, has no worker protections, and/or heavily subsidizes it's industry.
Both parties are for open trade, which has the downside of extremely cheap labor for US companies at the expense of domestic labor. US companies send materials to foreign countries, where they are assembled for nearly nothing, under bad conditions, and don't have to worry about industrial waste. The assembled product is then shipped it back to the US, or to it's ultimate desination.
Also, something that isn't talked about much anymore is what was called the "Walmartization" of America. Before Walmart, small towns were fairly autonomous. They had their locally or regionally owned hardware stores, clothing stores, grocery stores, banks, etc. Whenever a Walmart was built (and this applies to most conglomerate companies like banks and farming), it leveraged it's logistics might and shut everyone else out of business. Local politicians didn't do anything about it, probably because they were corrupt, incompetent, powerless or all three. State and federal politicians didn't do anything about it either. Coupled with globalization, these once healthy towns shriveled to nothing. Your options mostly became limited to working at Walmart, working at a fast food joint, or be a public servant.
All this affected the vast majority of land mass in the entire US. Think about that. What other country sits by and lets that happen?
If you can logically analyze (meaning take emotion out of it) the related issues Trump was campaigning on, it was to renegotiate trade deals to improve the US job market and prevent illegal immigration to improve the US job market. Of course both of these were politicized by the establishment (who both love free trade). And of course he didn't do himself any favors, but I think that was the main draw in middle America. Having a honest job with honest pay is so important to a lot of people (for obvious reasons), that everything else that comes with Trump is secondary or ignorable. It's been bad for middle America for decades, starting in the 70s and has gotten worse (and ignored by the parties). Trump is the result of 50 years of not merely frustration but absolute despiration. Remember, not only did he beat the Democratic candidate, he handily beat all of the 20 or so establishment GOP candidates. I think if any other candidate campaigned on the same jobs platform as Trump (regardless of party), Trump would never have gotten elected. Trump is a symptom of the above economic problem, and people offering the same solutions will be elected again.
Here's the Gore/Perot debate on NAFTA in 1992. I'm not convinced open trade isn't just another form of corporate giveaway at the expense of domestic workers.
I get the impression that most commenters negatively reacting to these comments (where they bear on the frustrated blue collar ethic of 'interior' America) are not terribly interested in deliberate and honest analysis or motivations of unpopular personalities.
My own memory of pre-corporate businesses from the 70s and 80s aligns closely with your points.
The rationale of many commenters on HN is simple defense of their best bottom line and/or pushing the social agenda.
Rarely do I find honest analysis or, at least, historically conscious analysis.
An honest day's pay for honest day's work, but without the willingness to get education / skills required for that work, to move to parts of the country where the existing skills are in demand, or to use collective bargaining to get a larger share of the results of productivity.
The fantasy that coal mining jobs with wages that allow high school dropouts to support a single-income family living a middle class existence are coming back en masse to back country West Virginia is just that.
Take those ideas a few steps further and see if they still sound reasonable. Start with you live in a trailer or small home with your family (parents, uncles, aunts, brothers) in a small town that died 30 years ago, and you live on whatever assistance the state gives. Also, you may share an unreliable car between everybody, you might not even have that.
That's probably a pretty decent scenario. Add a few drug addictions and a police record for drugs, and it gets significantly worse. Add a long term medical ailment. Add the inability to get any credit. Add some relatively massive debt. I don't want this to sound like it does, but I don't think you understand the reality of the situation that affects the vast majority of US land mass.
Nobody said anything about coal, except Trump. Coal is economically dead, even the coal miner's know that. It's that since coal is gone, there is nothing else to turn to. It's all the other jobs and factories that have long since gone.
/Relatable/ is a good word for the democrats to consider in candidates for 2020. Trump and Bernie are certainly coastal, but there's nothing elite about them.
And I didn't say "elite". I said ELITISTS, which are electoral kryptonite.
Bernie was definitely in a good position for this prior to the 2016 election, but, the revelations of his collusion with and acquiescence to the DNC in the 2016 election cycle poisoned him to many voters, myself included.
Thing that saddens me is this article goes to great lengths to talk about the economic impact on the state, without so much as try and pinpoint the REASON they have such a huge problem with opioids.
This is the only paragraph on one of the probable causes:
In 2012, then-state Attorney General Darrell McGraw filed lawsuits against more than a dozen drug wholesalers, accusing the companies of fueling West Virginia’s drug problem by shipping an excessive number of pain pills to the state. The lawsuit alleged that the drug problem cost the state $430 million a year, and projected that those costs would rise to $695 million by 2017.
So they're suing drug companies not because an excessive amount of people are dying, it's because it's costing the state $600+ million?
- How about pumping a few billion into treatment centers so people have a way out instead of jumping from pain pills to heroin to fentanyl and then ODing on fentanyl?
- How about pumping a few billion dollars into finding and developing new methods to combat chronic pain? This would include alternative methods and such things like CBD oils or making medicinal marijuana legal in all 50 states?
- How about imposing stricter limits on what doctors can prescribe or just banning the drugs all together?
- How about making billions of federal money available to states to try give them additional resources to combat the root problem instead of just adding more police officers to put non-violent addicts in jail?
There's so many things we could be doing and yet, nobody is really doing anything about it. As soon as you start talking about this as an economic issue, you totally lose me. This is about real people and you shouldn't be concerned about the economic impact to your state, since that's not the root of the cause. Fix the root causes (there are many) and those economic issues will fix themselves.
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[ 2.3 ms ] story [ 151 ms ] threadThat's like $375k per person or something.
There's a bunch of write ups of the talk the article is based on:
https://academicmediaday.wvu.edu/media-coverage
This is the best one I looked at:
http://www.timeswv.com/news/opioid-use-hurts-state-s-economy...
Not asking rhetorically, but do you think that this is a pressing concern for many addicts?
>on the "positive" side, they die early, no SS or medical expenses...
It's funny that you raise this point. Last year I had a conversation w/a big name researcher who has been "studying" the Opioid 'crisis' as part of a broader matter.
He agreed that the prospects (social and financial mobility, etc...) of many of those who are affected wouldn't likely improve much even if Opioids were taken out of the equation. He stated, yes actually said, that alcohol would be a preferred vice because "One can live a pretty good life as an alcoholic."
I don't have any experience as an alcoholic, so I can't say, but I think the comment and the ease with which the researcher made it are telling of a greater issue.
So that's changed in the last few years.
And yet what percentage of the prison population has it? Last time I checked, treating everyone would be so expensive that it isn’t even on the table.
https://fivethirtyeight.com/features/prisoners-with-hep-c-ge...
A lot of states are providing treatment to those with liver damage (which in the context of the thread means that they are likely reducing costs vs treating the chronic disease).
I guess $33 billion is too expensive to get popular support, but it really isn't that much money, especially if the reduction in future infections is taken into account.
Especially when even a small bridge costs a billion dollars these days, e.g.:
https://ctviewpoints.org/2016/11/08/the-billion-dollar-bridg...
It takes a while to overdose, before that there is a long journey of addiction, albeit not that long a period of time, more akin to the amount of time needed to do a university degree.
So the 'fun' starts at a party somewhere and soon the unlucky addict to be is buying and not just trying. This leads to a period of health problems leading to dismissal at work. During the last year of this 'work' they will not have added value to the company and may have cost many sales or other opportunities.
Soon there will be a draw down of funds from concerned friends and relatives, so the savings of others will also go to this, 'enabling' by paying rent checks and such like.
During this decline there will be a lot of medical things going on - nasty infections and horrors that only go with the disease of addiction.
Soon a circle of a dozen or so people will be affected, even if the addict did not have many friends.
Eventually these friends are cut off and only the drug scene exists. Sources of revenue then become stealing and prostitution. There is also supply of drugs, dealing.
Initially this may be for the party friends but then that is even more of a drain on the local economy as those party friends also have to come up with money.
Along the way there will be car crashes, so those cars don't go back on the road like company cars do, these people are no longer buying gas.
There will be police time with these car crashes, plus insurance and a whole lot of court misery.
With no vehicle but still needing to travel the addict then becomes likely to have things like bike crashes and strange things happen to them on public transport.
There may be prison or community service for some of this, perhaps some rehab that does not get adhered to.
They may get lucky and get another job, to give things a fresh clean start. However, the addiction gets the better of them. By the time the company has expelled them on some health dismissal thing that had to be tip-toed around, they will have wasted a year on getting anyone useful in that role.
There can also be some temping work done, but really it is very difficult for an addict to hold down a job.
The inevitable end can be spared with a miracle birth of a baby and the mother going serious about rehab. Some people are able to move away to another country or somewhere and rebuild their lives, this does not mean they will be adding to the $$$ of the local community.
Although death is inevitable, there is no way the headline figures reflect on the reality. For instance, an addict may be self medicating for some genuine physical pain that is only getting worse as they get older. So on their death certificate it mentions the other disease and not the addiction disease. They die of a heart attack, not smoking. Or in a car crash from a smashed brain, not because they had smashed their brain on heroin causing them to smash their brain around an A pillar.
At any one time there are many addicts going through the phases of doing things they said they would never do. In a given year, for the 881 folks dying officially, there are so many more, all of them directly costing their employers, their friends, their families, health services and so on. These are the fluffy costs. Imagine the addicts that have moved on to stealing or selling their bodies. Once quiet neighbourhoods then become involved in an arms race of security upgrades yet still that person that is now an addict finds opportunity in the area every time they need a fix. If people have had their cars broken into and all their hobby toys stolen then they find that stuff wasn't insured and don't buy it again. It's gone.
Then there are those children in single parent families where the parent is an addict. Other inlaws that could b...
https://news.ycombinator.com/newsguidelines.html
I am happy it is illegal to advertise prescription drugs to the general public in the EU, it seems pretty clear this does not lead to good things.
“TV ad spending by pharmaceutical companies has more than doubled in the past four years, making it the second-fastest-growing category on television during that time,”
“The drug companies aren’t generally marketing to people in their 30s; they’re marketing to the 65-plus, and that’s the population that tends to still be watching television,”
Most people who ask their doctor about a drug they saw on TV have the disease. Of those, a small percentage were undiagnosed, thus the TV commercial helped them with self-diagnosis.
I'd say that's a good thing, no?
Plus, opioids have never been advertised on TV, so you point isn't relevant.
Yes, but products related to them have. https://en.wikipedia.org/wiki/Naloxegol
I would argue opioid constipation is more important to the patient than the doctor.
No.
The underlying issue you've described there would be better treated by educating people to talk to their doctors about their actual problems, not around marketed solutions <sic> to perceived symptoms.
Which is what happens in most other western societies (UK, EU, AU, NZ, etc).
The fact that absent that kind of direct marketing, there isn't the same kind of opioid crisis may be merely correlative ... but I'll let you google around for studies that indicate causative effects in play there.
Look at my other post. I'm sourcing actual data that shows benefits and drawbacks. Care to source something to back up your claims?
You realize that a decent amount of DTC in the US is around disease awareness and not a specific product, right? It's those commercials that say "Disease X has new treatments that can help you, ask your doctor." Products are not mentioned.
BTW - NZ allows for DTC the last I heard.
My reply to your comment came before your 'other posts' .. consequently they were not taken into account during my reply. I note that your 'other post' points to a link at the US FDA that includes this caveat:
"It has come to our attention that readers may be projecting these results beyond the surveyed samples. We remind readers that this was designed to be an exporatory look at this issue. We caution readers that these analyses were not weighted back to the population."
> You realize that a decent amount of DTC in the US is around disease awareness and not a specific product, right?
I am not, and I would welcome a breakdown of the ratio of public-service non-sponsored content vs 'specific product' advertisement ... if indeed such a separation could be determined.
This is of course allowing for a large leeway of 'disease awareness' versus 'drug marketing' differentiation.
> BTW - NZ allows for DTC the last I heard.
"Such industry funded ‘health information’ campaigns have been banned in almost all industrialised countries since the 1940s. New Zealand and the United States are lonely exceptions.
"To what does New Zealand owe this dubious honour? While most other developed countries enacted legislation prohibiting this practice approximately three quarters of a century ago, the New Zaland Medicines Act 1981 failed to address DTCA, seemingly more by accident than design."
(from https://www.nzma.org.nz/journal/read-the-journal/all-issues/... )
So that's an accidental 2m pro-people for your argument.
To me it is pretty clear what is going on here (and no, it's not a good thing)
Findings:
- Most physicians agreed that because their patient saw a DTC ad, he or she asked thoughtful questions during the visit.
- Many physicians thought that DTC ads made their patients more involved in their health care.
- The study demonstrated that when a patient asked about a specific drug, 88 percent of the time they had the condition that the drug treated. And 80 percent of physicians believed their patients understood what condition the advertised drug treats.
Not all positive though:
- Physicians thought the ads did not convey information about risks and benefits equally well.
So if you had said DTC has pluses and minuses I would have agreed with you. Blanket "it's terrible" just demonstrates that person's lack of knowledge of the data that's out there.
[1]https://www.fda.gov/Drugs/ResourcesForYou/Consumers/ucm14356...
This is one of the things driving the US rates of over testing, over diagnosis, and over treatment. Some people are helped, but many are harmed. See, for example, prostate cancer. Many men die with, not of, prostate cancer. The treatment for prostate cancer can be aggressive and can seriously degrade quality of life.
Your self-diagnosis isn't the failure of doctors, it's the failure of people (especially in the US) to go see a doctor, most often due to the cost.
Sure, trying to scare the general public into questioning whether or not they have diseases is one way to go about things, but I shouldn't have to explain why this is not ideal and why the rest of the developed world takes a different approach.
Regarding your last point, I would say it is relevant. I mean have you ever stopped to question the reasons why America leads the world in opioid abuse?
http://www.bbc.com/news/world-us-canada-41701718
When I think commercials that do not lead to good things I think of the betting advertisements in Europe.
[1] https://www.fda.gov/Drugs/ResourcesForYou/Consumers/ucm14356...
In this heavily divided, partisan atmosphere, no amount of propaganda (Russian or otherwise) is going to make someone living in the rust belt vote for someone like Clinton. Likewise, no amount of propaganda (Russian or otherwise) is going to convince some hipster startup founder in the SF bay area to vote for someone like Trump.
Did you catch that they voted 70% for Bernie?
[1] https://en.wikipedia.org/wiki/West_Virginia_Democratic_prima...
As for how democrats and the coasts are to blame, well, this is revisionist history. The reps from the coasts were not the ones sent to Washington to bust unions. The republicans sent from middle America were. There’s a movement by middle America that wants to blame others without accepting responsibility. And I think it’s foolish for democrats to engage at that level, because we have to build a coalition that lasts here. We can’t begin that without proper understanding of past mistakes or else we will move 8 years down the road and do the same stupid thing over again.
I sympathize greatly with problems faced from middle America. But there’s a lot of blame to be shared and even now middle America wants to denigrate causes important to the coasts, while also begging for the coasts to bail them out. This is unreasonable.
Indeed. So who is the best candidate for 2020?
> middle america ... labeling African Americans as criminals in the best case, or as genetically inferior and predisposed in the worst case
You might want to check your stereotypes of middle america. Those are really ugly accusations.
> how democrats and the coasts are to blame, well, this is revisionist history
I didn't suggest anyone is to blame, I just said they've been forgotten
The first one is easy - enough to pay the bills and live a decent life, including the ability to raise a family while having basic needs and some occasional extravagances met.
The second one depends on time, location and circumstance and changes from time, location and circumstance depending on which of the millions of people you are comparing. It's more of a macroeconomic / socioeconomic / philosophic question rather than a microeconomic one. The best I can answer is sometimes they would be the same, some times group A would take less than group B, sometimes group B would take less than group A. I would guess given the same location and cost of living, they would be similar.
But why? People do seem to want this, but I cannot for the life of me figure out why. I was unemployed one summer and got about $400 every other week from the state. It wasn’t a lot of money, but factoring in transportation costs it was a better deal than going out and getting a low paying job. It was literally the best summer of my life since I was a kid.
If I was working a $12/hr factory job or mining or some other labor type job and someone came along and said they’d pay me the same to stay home, I’d take that deal before they could finish the sentence.
I’ve worked a factory job and I’ve worked outdoors. While I enjoyed the work, I enjoyed not working 1000 times more.
I don’t particularly like working in an office either, but since I can generally set my own hours and the pay is good, it’s not so bad. Punching a clock is hell; why anyone would prefer that over unemployment, welfare or UBI is beyond me.
The GOP convinced people that removing regulations and cutting taxes will make US companies more "competitive," globally. I assume that was interpreted as bringing back jobs.
Of course that won't compete with countries willing to pollute their land, sea and air for a buck, has no worker protections, and/or heavily subsidizes it's industry.
Both parties are for open trade, which has the downside of extremely cheap labor for US companies at the expense of domestic labor. US companies send materials to foreign countries, where they are assembled for nearly nothing, under bad conditions, and don't have to worry about industrial waste. The assembled product is then shipped it back to the US, or to it's ultimate desination.
Also, something that isn't talked about much anymore is what was called the "Walmartization" of America. Before Walmart, small towns were fairly autonomous. They had their locally or regionally owned hardware stores, clothing stores, grocery stores, banks, etc. Whenever a Walmart was built (and this applies to most conglomerate companies like banks and farming), it leveraged it's logistics might and shut everyone else out of business. Local politicians didn't do anything about it, probably because they were corrupt, incompetent, powerless or all three. State and federal politicians didn't do anything about it either. Coupled with globalization, these once healthy towns shriveled to nothing. Your options mostly became limited to working at Walmart, working at a fast food joint, or be a public servant.
http://www.nytimes.com/2003/11/15/opinion/the-wal-martizatio...
All this affected the vast majority of land mass in the entire US. Think about that. What other country sits by and lets that happen?
If you can logically analyze (meaning take emotion out of it) the related issues Trump was campaigning on, it was to renegotiate trade deals to improve the US job market and prevent illegal immigration to improve the US job market. Of course both of these were politicized by the establishment (who both love free trade). And of course he didn't do himself any favors, but I think that was the main draw in middle America. Having a honest job with honest pay is so important to a lot of people (for obvious reasons), that everything else that comes with Trump is secondary or ignorable. It's been bad for middle America for decades, starting in the 70s and has gotten worse (and ignored by the parties). Trump is the result of 50 years of not merely frustration but absolute despiration. Remember, not only did he beat the Democratic candidate, he handily beat all of the 20 or so establishment GOP candidates. I think if any other candidate campaigned on the same jobs platform as Trump (regardless of party), Trump would never have gotten elected. Trump is a symptom of the above economic problem, and people offering the same solutions will be elected again.
Here's the Gore/Perot debate on NAFTA in 1992. I'm not convinced open trade isn't just another form of corporate giveaway at the expense of domestic workers.
https://www.youtube.com/watch?v=0fi8OOAKuGQ
My own memory of pre-corporate businesses from the 70s and 80s aligns closely with your points.
The rationale of many commenters on HN is simple defense of their best bottom line and/or pushing the social agenda. Rarely do I find honest analysis or, at least, historically conscious analysis.
The fantasy that coal mining jobs with wages that allow high school dropouts to support a single-income family living a middle class existence are coming back en masse to back country West Virginia is just that.
That's probably a pretty decent scenario. Add a few drug addictions and a police record for drugs, and it gets significantly worse. Add a long term medical ailment. Add the inability to get any credit. Add some relatively massive debt. I don't want this to sound like it does, but I don't think you understand the reality of the situation that affects the vast majority of US land mass.
Nobody said anything about coal, except Trump. Coal is economically dead, even the coal miner's know that. It's that since coal is gone, there is nothing else to turn to. It's all the other jobs and factories that have long since gone.
And I didn't say "elite". I said ELITISTS, which are electoral kryptonite.
This is the only paragraph on one of the probable causes:
In 2012, then-state Attorney General Darrell McGraw filed lawsuits against more than a dozen drug wholesalers, accusing the companies of fueling West Virginia’s drug problem by shipping an excessive number of pain pills to the state. The lawsuit alleged that the drug problem cost the state $430 million a year, and projected that those costs would rise to $695 million by 2017.
So they're suing drug companies not because an excessive amount of people are dying, it's because it's costing the state $600+ million?
- How about pumping a few billion into treatment centers so people have a way out instead of jumping from pain pills to heroin to fentanyl and then ODing on fentanyl?
- How about pumping a few billion dollars into finding and developing new methods to combat chronic pain? This would include alternative methods and such things like CBD oils or making medicinal marijuana legal in all 50 states?
- How about imposing stricter limits on what doctors can prescribe or just banning the drugs all together?
- How about making billions of federal money available to states to try give them additional resources to combat the root problem instead of just adding more police officers to put non-violent addicts in jail?
There's so many things we could be doing and yet, nobody is really doing anything about it. As soon as you start talking about this as an economic issue, you totally lose me. This is about real people and you shouldn't be concerned about the economic impact to your state, since that's not the root of the cause. Fix the root causes (there are many) and those economic issues will fix themselves.