I'm going to follow Nisha with a premature, pre-Coachella blog post!
Pogge advocates for his full-pull plan since it
“fits better with the private enterprise/free market spirit that increasingly
pervades economic life worldwide” (20). I found his solution so compelling
precisely because his realignment of incentives fits so well into how our markets are set up; to
summarize: (1) GDB patent holders will try to encourage generic producers to
make their drugs (2) GDB patent holders have incentives to make their drugs
readily available to the people that need them (3) GDB patent holders will market
their product to people who actually need them (4) GDB patent holders will
focus on making medicines that reduce the GBD in the most cost effective way,
(5) inventor firms are incentivized to make sure the drug users know how to
properly administer the drug, (6) inventor firms would be incentivized to work
together to make a system that would enhance their impact in poorer countries
(23-24). All of these market-based incentives seem that they would succeed in
realigning the drug market to make and provide “essential” drugs for the poorer people
who actually need them. However, while I was reading all of this economic
argument, I felt a certain cognitive dissonance when putting humanitarian aid
in the framework of strictly narrowly self-interested incentives.
At the end of
the piece, Pogge starts to introduce the idea of how being moral makes us feel
good as people, but discusses this concept as an afterthought, or externality
of the realigned incentives. He writes: “in light of the extent of avoidable
mortality and morbidity in the poorer countries, the case for including the
interests of the poor is morally compelling” (36); he also offers: “Finally,
there is the important moral and social benefit of working with others,
nationally and internationally, towards overcoming the morally preeminent problem
of our age” (37). While I agree with Pogge that finding market-based solutions
will probably be the most sustainable and reliable means to reach the
humanitarian aid end (36), it seems that he could incorporate some of Robert
Frank into his analysis. Doesn’t the desire to be moral deserve a price within this
model? We do make trade-offs between
money and morality, and we do it all the time, as Frank’s What Price the Moral High Ground? demonstrates. Shouldn’t Pogge
take Frank’s argument seriously by accounting for it within his economic model?
Hi Becca! Wonderful post! I definitely agree that incentives are a driving factor for Pogge's plan. I also thought of Frank too, but more in regards to his discussion about a strategic arms race. The patent accounts for the undersupply of medical innovation by providing pharmaceutical companies with monopoly power, but also creates a problem of deadweight loss in the process. Thomas Pogge offers two solutions to eliminate deadweight loss, differential pricing and public good strategy. The concept of differential pricing is not a new concept as he states, “It is common to find products being sold at different prices to different groups of consumers” (17). Airlines apply differential pricing on a daily basis. American Airlines sells a ticket for the same seat at a higher price for a business man and a lower price for that relaxed vacationer. However, when it comes to medicine, Pogge points out that the large price differentials for the same medical treatment “create strong incentives to divert to rich countries medicines intended for the poor” (17). After acknowledging the substantial problems with this strategy, Pogge leads us to an alternate strategy. In the public good strategy, Pogge uses incentives to work to his advantage by proposing a reform plan with “open access, alternative incentives, and funding” (18).
ReplyDeleteTo provide alternative incentives to pharmaceutical companies, Pogge presents the push and pull programs. While a push program sponsors one firm with adequate funding to create pharmaceuticals, a pull program targets “all potential innovators promising to reward whoever is the first to achieve a valued innovation” (19). Although he seems rather ambivalent about what program the public-good strategy should use, Pogge favors the pull program over the push program because the pull program aligns with “the private enterprise/free market spirit” and are “politically more sustainable” (20). His discussion of pull programs reminded me about Frank’s positional arms race. Based on Pogge’s definition, I would argue that the pull programs would lead to a positional arms race with each company striving to invent the newest and most effective drug. Each move for a relative advantage in the medical industry would not be a waste of effort and time like prepping for the SAT, but a valuable contribution as it would provide higher quality medical care to more people. Would Pogge, or even Frank, approve of this strategic arms race in the pharmaceutical industry?
Tierra, I think you're right to point out that Pogge is creating a positional arms race here, and it seems to me that this is exactly his goal. He wants to realign incentives such that private companies efficiently allocate capital in pursuit of profits, profits which are now realised by ensuring better health care outcomes for the global poor. He sides with the pull plan for precisely this reason, because it embraces the market more so than the push plan, and thereby legitimates itself in the eyes of the global elite, in addition to ensuring efficiency and side-stepping some political issues faced otherwise.
ReplyDeleteFor me the issue with Pogge lies more generally with the philosophical underpinnings of his proposals. It appears that at different points he makes various appeals to constituencies that rely different arguments. For example, when appealing to affluent consumers who need to pay for all this, he argues that his plan will eventually lead to higher investment in 'rich people diseases' such as heart disease. This argument seems fallacious to me, as eventually surely new urgent serious health emergencies must emerge. His argument would only hold true if we were able to eradicate the initial classification of essential causes and then focused on less immediate threats, like heart disease. Given the rate with which new threats to humankind emerge, this is exceptionally unlikely to occur.
Instead, it seems to me that Pogge would be better served by focusing his argument on global good. He argues that the current system is inhumane and leads to millions of deaths globally that could and should be avoided, which is correct. However, he fails to apply this logic consistently, and therein partially relies on weaker reasoning. By positing that there exists a universal right to quality health, and that we are all obligated to ensure this is achieved, he can effectively (or so it seems to me) mandate global participation. As a practical matter all sorts of pandering would likely be necessary to actually implement such a plan, but the true moral basis for his reasoning need not be obscured.
Hi Tierra, Thomas, and Becca!
ReplyDeleteI also definitely saw connections with Frank in many ways, including positional arms races. Yet, I think that Pogge shows that there exists a positional arms race in the current system as well. Pogge explains that in the current system "companies compete against one another, and any company acting 'nicely' in more than marginal ways would lose ground against the others and ultimately be driven out of the market" (31). He further explains that "it is then not an evil lust for blood-stained profits that causes tens of millions of premature deaths and unimaginable human misery. The cause is rather a collective action problem that harms the pharmaceutical companies, too, in terms of their reputation and profits" (31). Thus, under the current system, Pogge shows that these positional arms races are inefficient. If the positional arms race is to gain the greatest position, then in this current system, we are being inefficient because we are allocating our resources and catering to only those who are able to pay. As Pogge explains, this ends up beginning mutually disadvantageous as our GBD increases and these pharmaceutical companies' reputations deteriorate. Thus, while the pull system may encourage competition, the competition is well-aimed at a more efficient and better goal.