> The California governor, a Democrat, said earlier this year that the state would soon start making its own brand of insulin. California has a $50m contract with the non-profit pharmaceutical company Civica Rx to manufacture the insulin under the brand CalRx. The state would sell a 10-milliliter vial of insulin for $30.
> “With CalRx, we are getting at the underlying cost, which is the true sustainable solution to high-cost pharmaceuticals,” Newsom wrote in a message explaining why he vetoed the bill on Saturday. “With co-pay caps however, the long-term costs are still passed down to consumers through higher premiums from health plans.”
Cheap insulin already exists right over the border and it's government that is in the way. I wonder why they don't start there instead of elaborate government manufactured insulin plans or price controls.
There is an excuse. Political capital. It's not an excuse that is compelling, but this is Newsom. He's a Democrat that is trying to hold on to power for as long as he can, however he can.
Your comment makes no sense to me. It just doesn't track. Either he can parlay with pharma and point to how he kicked the bill, or he has to make excuses for not kicking the bill (regardless if he runs 2028 or not). It's political capital. It's power.
The point is that in the run up to the 2028 presidential campaign, Newsom isn't going to take any major actions which might alienate large swing voting blocs or major campaign donors (such as pharmaceutical companies). Unfortunately, low-income insulin dependant diabetics aren't a major political factor so regardless of what Newsom says in public, their needs aren't a priority for him.
Perhaps not solving the problem simply by allowing mexican medication, like New York doesn't simply solve pharmaceutical prices by importing Canadian drugs and keeping drug prices high in the present with promises of future fixes is a form of parlaying with Pharmaceutical companies
Sorry am I missing something here. If the cheap insulin across the border got the full brunt of American demand, it would obviously not remain abundant for that country. Even if this country (canada?) had price controls in place that would be no use to factories with a set supply.
Seems like the right solution is to increase supply right here.
Crazy that people who can't survive without insulin, food, and rent money see the risk of dying from violence as less than the risk of dying from poverty.
Arbitrarily? To how much? When building the factories do we know if Canada had accounted for servicing the American market (just the California market would be a 100% increase)
What would most likely happen is that insulin factories would scale up production and price would go down in the long term (economies of scale and increased competition). That's what free trade pretty much always does to prices.
What does that have to do with living in California? And you know they have no track record yet right? They didn’t even exist until 2018!
The perennial issue is big promises, total shit delivery, way over budget and late - if ever. Regardless of where the subcontractor lives. They’ve already been talking about the insulin plan for several years.
But hey, maybe 2024 is the new promise.
Have you heard about our ‘high speed rail’ project, for instance? It isn’t even high speed anymore!
You didn't say living in California, you said "California non-profits". But sure, keep moving the goalposts if it makes you happy. Why are you even still living there?
Oh, I see, I assumed you were the OP continuing a conversation. But no, you’re not the OP, you’re someone else that came into the thread to ask a question you yourself admit has nothing to do with the thread.
Could you provide any information on that, rather than just vague remarks? Or more helpfully, information regarding CalRx specifically?
If you provided a link showing that some of its leadership had a history of corruption, that would be one thing, but instead we got an unsourced quip about "California nonprofits."
I had a hard time even thinking of stuff the government manufactures. Best I came up with is physical currency, passports and other ID, and license plates. All of those are of quite good quality and reasonably priced, so I'd have to disagree.
The US government has a surprisingly good track record when it manufactures stuff internally. Outsourcing that to private contractors is more troubled, but nonprofits tend to work out reasonably well.
Comparing to the cost paid per dose of COVID vaccines 30$ insulin is easily achievable.
Recently it’s a small list, but physical currency is one example. They do outsource the paper etc, but if you compare costs and results to private companies doing similar work there’s no incentive to outsource the full process.
The rocket was not. Of course you will have components built by industry. You can't expect government to mine the iron and mill the steel for every bolt.
Except it kind of was. Car companies don’t manufacture the most complex components in house either.
Those things were custom, but NASA saved a great deal of money going with an existing supplier of giant rocket engines who had already been working in scaling up their designs.
Most car companies do indeed produce their own engines. It's why many of them are named "XYZ Motor Company".
Of course, they don't produce their own microchips for all the electronic stuff in cars these days, and I suppose you could say those are more complex, but back in the 60s when the Saturn V was made, the engines were probably the most complex things in cars.
Over half all heavy duty trucks in the 1960’s used Cummins engines. Their engines made their way into Doge RAM trucks etc. Aircraft manufacturers also tend to outsource engines as do shipyards building boats.
Most major car companies did and do manufacture engines in house, but it’s common to find some outsourced engines and various joint ventures used by automotive manufacturers.
Well of course a bunch of ultra-tiny car manufacturers are going to use outsourced engines. The major automakers never have, outside of a few odd projects (like the Ford Taurus SHO with the Yamaha engine) and joint ventures.
Heavy-duty trucks and aircraft are very different situations.
Many people here probably already know this, but there are many types of insulin formulations with varying half lives. It seems that CalRx will be producing several popular ones including a Lantus-like insulin:
Gov. Newsom, as of late, has found his veto pen and hasn't stopped using it. He vetoed one insane law which would have taken parental rights away (AB 957 would have updated California law to clarify that, for the purposes of child custody and visitation decisions, a parent's affirmation of a child's gender identity or gender expression is an essential factor that must be considered in determining the best interest of the child) he also vetoed a bill which would have added caste as a protected class to California’s current anti-discrimination laws, as well as ones to decriminalize psychedelics, and one to require humans in self-driving trucks.
I just can't figure this guy out, but he's such a political animal I can't believe any of these have anything to do with any sort of principles on his side.
It's not about "ownership", it's about parents having a right to raise their children how they see best. No one argues against parents naming their baby (well, some on the insane far-left do, going as far as to call gender assignments at birth being wrong).
A parent's job is to raise their child well, to keep them safe, healthy and morally grounded so they can develop into good human adults. Their job isn't to sit on the sidelines and let the state make decisions in these arbitrary situations. Otherwise the only "child ownership" will be the State owning our children, in the long run.
Hardly any politician wins an election only considering their personal beliefs and ignoring that of their electorate.
It's pretty obvious he wants to run for President, so moving a bit to the right as opposed to what he'd do for a purely California political position makes sense.
As a centrist type thank you Gov Newsom for vetoing that crazy gender identity bill.
I remember as a kid being into feminine things and I couldn't imagine today the pressures on kids to start identifying as a different gender that would come from teachers and other "care givers" in our school system.
I'm also against the people who say that parents shouldn't be notified if a kid is talking to a counselor about identifying as a different gender. I suspect said counselor would push the child in the different direction in order to be a "hero" - it's such a shame that we're doing this to our children while other similar countries (in Europe where they aren't doing crazy stuff) are clearly looking on at us with pity.
Recently I've watched as Bill Maher has taken up the mantle of rejecting this idea as liberalism and I've been happy to see a prominent(-ish) face doing so without fear of "cancellation" or being called bigoted or risking getting fired.
They're talking about children. They're denied autonomy all the time. It's absolutely normal and fine usually, they're not mentally developed. Next thing you know I'll be hearing five year olds should be able to sign apartment leases drive cars or smoke cigarettes or work a full time job. After all we wouldn't want to deny autonomy.
I cannot rightly comprehend the ignorance of history that would engender such an utterance.
I do not think that this statement is sufficiently genuine to require refutation. Reflection would be more appropriate: perhaps this should be sought in the replacement of the word “children” with any subjugated group, from “women” to “black people” to “Sicilians” to “Irish” to “<any First Nations people> to…
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People deserve the support of their families and communities in their self-actualization, and while of course that looks different for children, if you’re the kind of person that doesn’t look at kids as people then I wouldn’t be surprised to find you’re the kind of parent that finds themselves cut out of the lives of their kids as soon as they’re able.
I'm not saying you shouldn't support people in their self-actualization, but the argument that they should be highly autonomous is absurd. We don't let kids drive for a reason, right? We assume they shouldn't be able to buy alcohol or cigarettes right? Or do you disagree with these ideas? After all you're equating not letting kids buy cigarettes as the subjugation of black people in the US.
Sure, I give my kid some autonomy. I let him choose what he wants for breakfast in the morning, for example. But the deck was stacked against him. If he had actual autonomy the pantry would be nothing but candy and cookies. But I've already decided, and removed that autonomic choices from him. I guess I'm a bad parent for not letting him have free reign at the grocery store, letting him fully choose what he'll have every meal.
> perhaps this should be sought in the replacement of the word “children” with any subjugated group, from “women” to “black people” to “Sicilians” to “Irish” to “<any First Nations people> to…
Ok let me try your logic.
Children should not be allowed to work. Women should not be allowed to work. Oof, not good. Well I guess child labor is back.
I could go on and on. Maybe this rule doesn't make nearly as much sense as you think it does.
> I cannot rightly comprehend the ignorance of history that would engender such an utterance.
Yeah, I can't comprehend you suggesting the above logic as the right way to determine if a child should have autonomy or not.
I feel like you’re valuing hypothetical kids who would get tricked by nefarious school counselors over real kids who are abused by their parents and kicked out onto the streets for being queer.
It assumes that what is in the best interest of the child is to affirm their feelings of gender dysphoria with a name change, and that the court can consider this and grant a name change over the parent's objections.
Why am I against this? It is against parental rights. It takes away the rights of a parent to name their child and raise them as they see fit, and hands it to the state.
I won't even get into what happens with children experiencing gender dysphoria and how the mental health profession is (mis)handling the vast majority of these by affirming the child's dysphoria, and the pressure parents receive that if they do not affirm their child's desire to transition they are putting them at mortal risk.
I don't agree with any of this for children who cannot consent to any other things, legally, until they reach the age of majority. Once they do, it's up to them how to live their lives (with, or without, their parents' support). Nor is this to say I do not believe children have rights, but I see what these family courts do and in a lot of cases how biased they are, I do not think anything good would come of this law pure and simple.
It’s poorly drafted, and family law isn’t an appropriate place for the state to take positions on emerging medical issues. Imagine if such a bill enshrined a parent’s affirmation of the violent psychiatric treatments of the 1930s and 1940s. Wiser to let the courts figure out this issue using their current tools.
The courts will continue to have substantial leeway and the bill makes no mention of medical care:
“Democratic California lawmakers have approved a bill that would instruct courts to consider, among many other factors, whether a parent affirms a child’s gender identity when making custody and visitation decisions.”
The bill caps the price of the co-pay, but the actual cost is still passed on to the consumer through insurance premiums. Meanwhile, the California government has contracted out with a nonprofit pharmaceutical company to manufacture insulin and sell it at cost, which comes out to $30.
This is—in theory at least—more effective, since it forces pharmaceutical companies to compete on price. And if they don't, Californians still have access to a source of cheap insulin.
If the bill capped the total cost to 30 dollars he would not have vetoed it. The reason he vetoed it is because it would ultimately just trigger insurance companies to raise prices to cover it across the state. That goes against trying to keep healthcare affordable.
Except the insurance companies would have strong incentive to make sure that their clients take the $30 one instead of another one that force them to raise their prices.
Patients/doctors have much less incentive to pick the cheaper brand if the insurance company is forced to provide the expensive insulin for a low copay.
If a patient can get California-produced insulin for $30 or insulin produced by a for-profit pharmaceutical company for $35, many people won't bother to opt for the former. This, despite the latter containing significant hidden costs which are reflected in insurance premiums.
A 20% difference in cost ought to be enough of an incentive to make the consumer chose the nonprofit one especially since there shouldn't be any “bothering” involved.
Also, insurers would have incentives to mandate the $30 version since it means lower cost on their side and they don't even have to reflect that in insurance premiums (which they don't since they're competing with each other).
> the California governor, a Democrat, said earlier this year that the state would soon start making its own brand of insulin. California has a $50m contract with the non-profit pharmaceutical company Civica Rx to manufacture the insulin under the brand CalRx. The state would sell a 10-milliliter vial of insulin for $30.
Costs over that are passed on to the consumer via higher premiums.
The CalRx is $30 total.
I think insulin specifically and medicines/drugs in general might be another area that CA leads the country in modeling how to manage prices and overall cost.
Why put another law on the books when you believe it will be obviated by other measures?
One reason I can think of is that a law might be more politically "durable" than a contract with a third party to produce insulin. But on the whole I think I'd rather one less law.
It's a bill created by big pharma to whitewash their image while changing nothing about their profiteering. We should not have these sort of laws on the books.
I think steelmanning is good, depending on how much time you have for the debate. Obviously if you're going to be working on something for days with this person they should understand your position in detail and vice versa, but if you only have a couple hours or less for a debate it saves time without devolving into a point scoring war.
These are not arguments against steelmanning -- these are arguments against doing something else and calling it steelmanning. In other words, this is strawmanning steelmanning.
The obvious one is that price controls feel good but will cause shortages if they are below the price at which a company can profitably bring a product to market.
Because somehow medicine shortage don't exist yet because fortunately there's no price cap…
Also, there's no practical difference between an actual shortage and a price rising so high that many people can't afford it, like it's already the case with insulin[1].
Cheap and easy controlled substances are a manufacturer’s dream. It’s expensive because we have a captive healthcare system and they can do whatever they want.
The cheap old varieties of insulin are still available and still cheap. What's expensive are the newer analogues which make it much easier for diabetics to manage their insulin levels.
Supply and demand. If you're going to die without insulin then your demand is fairly inelastic to price changes. If the producer doubles the price, then you'll pay it.
Some might think that this is a bad thing, but in the bigger picture this demonstration of common-sense governing could endear Newsom to voters on the national stage should he run for president — a position he could use to veto insulin price caps for all Americans.
Newsom's running for President. Biden's continuing to deteriorate before our eyes, but no one with any power is willing to say so in public. So Newsom is positioning himself for the big event.
What will be interesting is if another Democrat starts running/not-running. Then you'll know it's on.
I feel like Harris isn't exactly going to inspire people to vote. She's a little better than Hillary, maybe, but that's not saying much.
It's too bad Democrats have such a terrible time finding candidates with some charisma and likability; Obama's election should have taught them a lesson here, but it seems they never learned it.
Setting price caps is a flashing alert that the government has lost anyone with authority that appreciates basic economics. Very common to see this before a slide into collapse (Venezuela, Cuba, etc.).
When the government also gives de jure monopolies on production and distribution, they can reasonably call for price caps as well. You're thinking of the way economics work in a free market.
Insulin is not a single drug. Discounters such as Walmart already offer low prices for generic insulin. The expensive branded forms have different release profiles which are more effective at controlling blood sugar in some patients.
While we should do more to improve insulin affordability, the pricing is a bit of a distraction from the core issue. While type-1 diabetics will always need some exogenous insulin, the majority of diabetics are type-2. And research has shown that the majority of those patients can put the disease into remission with lifestyle changes. That is where governments should be focusing.
Many companies manufacture insulin. There's also not just one kind. Two pervasive types are fast acting and slow acting, the latter typically used to provide a low level continuous boost throughout a day. Manufacturing high quality product in volume isn't particularly easy because it's a biologic drug requiring genetically modified organisms to create the protein, typically E Coli, and purification to human injectable standard is costly, requiring removal of the pieces of cells that were used to make it, including endotoxins in the case of E Coli.
Beyond that, there's an easy way to guide analysis of what appear to be excessive costs in any market: find out where government force has screwed it up. It will always be the cause.
I’m seeing the price per vial of generic insulin lispro (Humalog) for roughly $20 a vial. I’m not sure how many vials a person needs but that’s not completely nuts.
Yeah they’ve invented newer more expensive types of insulin that better control blood sugar, and they are continuing to invent newer types that are even better. Which I think is great and allowing there to be a financial incentive to create new and better insulins.
Passing this bill gives the drug companies the same amount of money as today. It only capped copays. Doing that still just passes on increased insurance costs to individuals. Drug companies would still make a ton.They need to wait for their in house insulin so they are not just giving a ton of money to the drug companies through the VA/Medicaid.
This was proposed by republicans to help save their pharma buddies from losing a ton of business in california to the state contracted insulin. If the cap went into effect there is no reason for people to switch to the state funded insulin.
Plenty of countries do it. It's a misnomer to call it capitalism. It's fascism: nominal private ownership with defacto government control in different potential ways (e.g. force backed barriers to competition, regulation boosting costs, etc.)
I think that's why Crony Capitalism has a very specific meaning different from Capitalism. Modifiers make a difference. For example, National Socialism and Socialism are very dissimilar.
National Socialism is a type of socialism and the National Socialist party platform is overtly socialist in every way if you want to look it up in historical documents. The ludicrous idea that they were "right" was a crude smear from the communists who were merely trying to undercut a competing gang. A smear even more ludicrously carried forward to the present day by the staggeringly ignorant.
> The California governor, a Democrat, said earlier this year that the state would soon start making its own brand of insulin. California has a $50m contract with the non-profit pharmaceutical company Civica Rx to manufacture the insulin under the brand CalRx. The state would sell a 10-milliliter vial of insulin for $30.
> “With CalRx, we are getting at the underlying cost, which is the true sustainable solution to high-cost pharmaceuticals,” Newsom wrote in a message explaining why he vetoed the bill on Saturday. “With co-pay caps however, the long-term costs are still passed down to consumers through higher premiums from health plans.”