I used to be persuaded by arguments from “big Pharma” that the enormous costs of research and development justified the sometimes staggering prices of new drugs.
That justification seemed eminently reasonable, until I learned some inconvenient facts. For example, the amounts drug companies spend on television advertising (“ask your doctor for the purple pill”) exceeds the amounts they spend on research and development. And for another example, significant percentages of those front-end R and D costs are paid for by citizens’ tax dollars, through government research and grants.
Those discoveries left me disgusted, but unsurprised, by recent reporting from Pro Publica.
Five years ago, the U.S. Department of Health and Human Services tried to plug a crucial hole in its preparations for a global pandemic, signing a $13.8 million contract with a Pennsylvania manufacturer to create a low-cost, portable, easy-to-use ventilator that could be stockpiled for emergencies.
This past September, with the design of the new Trilogy Evo Universal finally cleared by the Food and Drug Administration, HHS ordered 10,000 of the ventilators for the Strategic National Stockpile at a cost of $3,280 each.
But as the pandemic continues to spread across the globe, there is still not a single Trilogy Evo Universal in the stockpile.
Instead last summer, soon after the FDA’s approval, the Pennsylvania company that designed the device — a subsidiary of the Dutch appliance and technology giant Royal Philips N.V. — began selling two higher-priced commercial versions of the same ventilator around the world
When Trump belatedly invoked the Defense Production Act, forcing General Motors to begin mass-producing a different company’s ventilator (for which taxpayers will also pay), no one even mentioned the Trilogy Evo Universal.
Nor did HHS officials explain why they did not force Philips to accelerate delivery of these ventilators earlier this year, when it became clear that the virus was overwhelming medical facilities around the world.
An HHS spokeswoman told ProPublica that Philips had agreed to make the Trilogy Evo Universal ventilator “as soon as possible.” However, a Philips spokesman said the company has no plan to even begin production anytime this year.
Instead, Philips is negotiating with a White House team led by Trump’s son-in-law, Jared Kushner, to build 43,000 more complex and expensive hospital ventilators for Americans stricken by the virus.
It’s despicably corrupt to use a pandemic to–excuse my phrasing here–suck even more deeply at the public tit. But it is the foreseeable result of America’s thoughtless, decades-long embrace of “privatization” and “public-private partnerships,” which have all too often simply been a more sophisticated form of patronage. Old-style patronage–whatever its flaws– mostly benefitted working people; you helped to get out the vote and if your candidate won, you got a (usually low-level) job with the city. Now, you write a nice fat check to the candidate and your company gets a lucrative contract with the city. (And no one gets out the vote, which is a different problem..)
As Pro Publica reported,
The story of the Trilogy Evo Universal, described here for the first time, also raises questions about the government’s reliance on public-private partnerships that public health officials have used to piece together important parts of their disaster safety net.
“That’s the problem of leaving any kind of disaster preparedness up to the market and market forces — it will never work,” said Dr. John Hick, an emergency medicine specialist in Minnesota who has advised HHS on pandemic preparedness since 2002. “The market is not going to give priority to a relatively no-frills but dependable ventilator that’s not expensive.”
Reagan began what has since become a concerted attack on the very idea of government–an attack that has benefitted corporations and businesses in a position to profit, but has eroded (“hollowed out” in the words of one scholar) the capacity of government to act on behalf of the common good.
We are about to see what happens–and how many people needlessly die–when what is left of our hollowed-out governing institutions is incompetent and corrupt.