There's a difference between not saving someone's life and bribing an official to stop someone else from saving lives. This is no different than if I got a law passed saying that nobody was allowed to sell or give food to you. When you starve to death, would you say you weren't killed?
I agree with you about the specific example. But this thread is about the EpiPen, where no officials were bribed and where there was an FDA-approved alternative on the market until it was voluntarily withdrawn. The outrage is over Mylan taking advantage of transient market conditions to jack up the price on their product.
The overall thread was about the EpiPen, but you replied to a comment describing a pretty clear-cut case where bribery was getting people killed, and you wrote a completely general comment saying that greed in this industry wasn't killing people.
If you only meant that to apply to the EpiPen, and not to Russians being killed by their own government because of corruption related to cardiac stents, you chose a really weird way to go about it.
The comment I replied to led with a general point about greed in the medical industry getting people killed, and was in a thread about EpiPen. If it wasn't meant to be a comment on the medical industry generally, not just a specific case in Russia, that's pretty weird.
Except that "greed in the industry is killing people" is true even if it's rare. "Greed in the medical industry doesn't 'kill people.'" is false if there's just one instance to the contrary. So trying to reverse my argument, while witty, doesn't really work.
I do think that there was some bribery and game-riggery involved with the EpiPen. The Intercept had an article enumerating the various laws that the company had lobbied for or even had a hand in writing, almost all concentrated on either minimizing other manufacturers or encouraging the purchase of more EpiPens. The interesting bits are in the second half of the piece.
Nothing in that article says anything about bribery. Nothing says Mylan made any campaign contributions to anyone to keep competing products from being approved.
It gives three examples:
1) Lobbying to not let Medicare negotiate with drug manufacturers. Which is a perfectly reasonable policy to avoid a creating a monosopny buyer of drugs.
2) Lobbying for the Generic Drug User Fee Act. That law imposed fees on the industry to beef up FDA resources for reviewing applications of generics. It also imposed testing requirements on foreign production facilities equal to the testing requirements imposed on domestic facilities. Again, seems reasonable, and the Act was supported by public interest organizations.
3) Lobbying for federal funding to be used to purchase EpiPens for schools. Somewhat shady, but how does that kill anybody?
Actually I think point #1 reduces competition and encourages monosopnies, at least under our current situation where there are only a few major insurers. B2B market competition is probably even more important for prescription drugs than consumer market competition given the nature of medicine. That law effectively eliminates the government from engaging in competitive market practices (in other words, this gives pharmaceuticals a very large source of funds from a major purchaser of pharmaceuticals whose hands are effectively tied when it comes to both price and choice). IMHO this probably has done a lot to increase the price of prescriptions over the years. If private insurance was a highly competitive market, perhaps things would be different, but it's not.
The problem with #2 is that it creates artificial scarcity. In this case, there is plenty of justification as you don't want shady medicine on the market. The question is whether the FDA is being overcautious with generics and imports. As of now there's certainly plenty of people illegally importing prescription medicine from offshore pharmacies in an unregulated manner, because prescription prices are so inflated compared to most countries.
Lobbying does not produce some of the outright corruption that bribery does, but I've seen more than my fair share of lobbying encouraged laws in the US over the years where a subtext of the law was to eliminate competition. I'm not sure how much of current drug law is pharmaceutical industry influence (my gut feel is some but not all) but some of it definitely, for good reasons or not, blocks up the "invisible hand" of competitive forces.
At least the good thing about a system like the US (vs. the Russian example) is that there's some hope that public outrage over the most egregious examples (your Martin Shkrelis and whatnot) will cause some changes.
I agree that it doesn't specifically enumerate instances of bribery. It does, however, show Mylan engaged in the same sort of self-serving behavior that could, in my opinion, endanger lives.
I also agree that the case of Mylan is not as dramatic as that of the Russian heart stent company.
RE the killing vs. not saving, let's maybe put it more precisely - it's decisions that kill people vs. decisions that prevent someone else from saving people. Now in a way, the whole economy indeed runs on the second kind - as long as medical research and medical care aren't money-saturated (i.e. have more of it than know what to do with), all the money that flows somewhere else is preventing lives from being saved. One issue is, we can't just simply redirect all that money to medicine without the world (or at least the country trying) going straight to hell.
As for personal moral responsibility, I think it kind of depends on the "degrees of separation" from the issue. In the Russian stents case, I'd say that what happened is pretty close to mass murder. The separation between patients and the company is just one somewhat fixed legal system, that was about to save lives if it was not for the company. That's like if someone was jumping from a burning building, and last-second you pulled the life net away from where that person was landing. It's not you who killed them, it's the dv/dt...
Most of us, including Netflix, YouTube, et al. are much further separated from life-and-death issues. Like, if I work for a company automating some part of manufacturing in a factory, should I be responsible for a worker who got hit by downsizing? Don't know, I sometimes do feel that way. Should I be responsible for that worker not being able to pay his barberer, who had to start working overtime to compensate, and then didn't have time to go to the gym, and died of a heart condition? There's no way to do that in practice - there's too many variables in between me and that dying person to pin responsibility on one actor, or to even determine the casual chain.
Economy at large is kind of "causality laundering" - too many variables, too much things happening, for a single bad outcome to depend on a single actor if they're not directly connected. But the Russinan thing? Sounds as explicit and direct as one can get without pulling the trigger themselves.
> When you starve to death, would you say you weren't killed?
Being dead, he likely wouldn't.
Moral and logic (in the narrowest sense of the word) often don't go hand in hand. That having been said, your point is quite close to my own understanding.
