Count me as another who endorses complete legalization of drugs. There will still be a clusterf**k of problems associated with this decriminalization, but the way the war on drugs is going, we need to see if they're going to outweigh the positives. We'll also in one fell swoop hugely defund organized crime and the latin american narco gangs. Legalize and tax - the drugs will still be available at a fraction of the current prices and crimes due to turf protection and theft/burglary to support a habit will drop significantly IMO.
Count me also as one who finds The Wire manipulative and contrived, but still better than most TV shows. This is coming from someone who was familair with the Crips and Bloods (and the Piru) as far back as 1971.

oh megan, you're oh so easy on the eyes. But you do rant a bit.....And I know you and a few others on bhtv love getting your little libertarian kicks in. But Libertarianism is SOOOO bourgeois! Money, markets, and "personal liberty." Don't you see how pedestrian that all is? Don't you see what liberalism has done to "theater" and art. Ever read Tocqueville...even Nietzsche? Yes megan, libertarianism is bourgeois....admit it. AND you know so little about the "civil rights movement." And yes, Megan, who voted for Bush in 2004, the PIRgs are "giganitic money machines" as well. Ha! Can your resentment of the left be just a little more subtlety? I'm still trying to get over your fabulous argument on a previous bhtv that economic inequality is "irrelevent." Oh Megan....come out of that plush iron cage you live in.....

Who is this Megan McArdle chick? She can't even pronounce Ayn Rand! And what's the deal with ramping up the rhetoric against a fat tax? Is the market price of Pringles sacred? Last I checked, we don't make our choices in a vacuum; the companies peddling these products are engaged in massive propaganda campaigns, especially pernicious because of their direct appeals to children. Moreover, these advertisements are not intended to appeal to our more rational, enlightened sensibilities. Health care markets do differ from other markets and not just because of adverse selection. Yes, if we move to a single-payer model some people will consume more health-care because it's "free." But there's also the slight, slight, slight, niggling little problem that they were not consuming enough before, you know, when they were uninsured. Then there's the whole life-time issue and preventive care vs. emergency room care. So-called "libertarians" would have us believe that people will be running to the doctor's office given the slightest scratch. Is that how rich people behave? Is that how the more civilized world behaves? I mean, "free" or not, people do not generally enjoy going to the doctor's office. It arouses fear (and irrational superstitions are another reason

Libertarians would be wise to never mention Ayn Rand. It makes the entire ideological project seem incredibly sophomoric and superficial. Oh, wait a minute...

Exactly right, Eric. Clealy, the mileu that Megan is coming out of is one with merely recreational drug use. It's telling that her anecdotes are all about cocaine - the 'safest' of the 'hard' drugs. She seems to be unaware of the toll that drugs like Crystal Meth and Heroin take on people. (Again, this might be her New York provinicialism coming out; Meth has exacted a terrible price here in the Pacific Northwest.) Megan may be right that people that are prone to dangerous drug use are already troubled; that said, why should the government sell people the weapons with which they may end up killing themselves, or at least further destroy their lives? I can't believe this shallowness of analysis passes muster at The Atlantic. Then again, Andrew Sullivan works there now, so why should this surprise me?

Quoting nikkibong: Exactly right, Eric. Clealy, the mileu that Megan is coming out of is one with merely recreational drug use. It's telling that her anecdotes are all about cocaine - the 'safest' of the 'hard' drugs. She seems to be unaware of the toll that drugs like Crystal Meth and Heroin take on people. (Again, this might be her New York provinicialism coming out; Meth has exacted a terrible price here in the Pacific Northwest.)

Every person I know or have read who has had any sort of association with people on meth -- even those who generally have libertarian views -- says that it should never, ever be legalized. Way too addictive, way too dangerous.

Quoting nikkibong: ...the toll that drugs like Crystal Meth and Heroin take on people.

When access to a drug is made extremely difficult, a newer, more potent version of the drug ends up taking its place. For example, Crack cocaine for cocaine and crystal meth for amphetamines (diet pills). Making the originals illegal seemed only to exasperate the problem, IMO.

I think I'm only going to listen to diavlogs with experts talking about their expertise. I just listened to the Clay Shirky one the other day, and it was the best diavlog I've ever heard.

I would like someone who extolls the virtues of the market for health care to address the fact that most countries with universal health care get better results (on metrics like life span, infant mortality, etc.) at lower per capita cost, lower administrative costs, and higher patient satisfaction than here in the U.S. See, for example, this Malcolm Gladwell article from the New Yorker

Megan on P.J. O'Rourke Ms. McCardle, you are no P.J. O'Rourke

Megan's take on healthcare is exactly why I'm not a libertarian. It's for those who can't see the difference between markets for triscuits and health-care that the term market fundamentalist is reserved. Or, euphemistically, libertarian.

Every person I know or have read who has had any sort of association with people on meth -- even those who generally have libertarian views -- says that it should never, ever be legalized. Way too addictive, way too dangerous.

I haven't listened to this dialogue, but "legalization" can mean a lot of things. I think the libertarian are on the right side of the human rights/civil rights issue by calling for decriminalization of drugs. That is, NO ONE should be incarcerated for using them. Period. As for production, distribution, marketing and sales, we can certainly develop a far better policy than WAR ON DRUGS. We need to reduce consumption (demand) through education and treatment and by addressing the social conditions that breed use and addiction. Meth is already readily available for anyone who makes the slightest effort to find it. Why would legalization dramatically change that? We should look to other countries for more humane and less repressive policies. Spain, for example, has no penalties for drug consumption. They do not have a significantly higher addiction rate than comparable countries that criminalize use.

Eric wrote:

Megan goes over her reasoning to legalize drugs, and it's all based on her experience with her friends. Perhaps her friends are not a representative sample of the US? If you are going to talk about policy, you need more than anecdotes.

Eric, go back and watch any of Megan's old diavlogs. I have no idea if this is the way she is in her writing as well, since I am simply not a strong enough person to put up with that sort of self-inflicted torture, but when she speaks here, the vast majority of her opinions appear to be based entirely on anecdotes from her own life, usually involving her mother, high-quality food markets, and her 20's-to-30's group of blogger friends in New York and then D.C. The absolute worst was her first vlog with Yglesias - it turned completely into a autobiographical exercise in narcissism of the highest caliber, as their stories about how amazing D.C. and New York are simply spiraled into a positive feedback loop of interactive cowanking. Ugh. Mostly, I think I listen to McArdle to make myself feel better about the vast majority of ways in which

I've had intimate experience with meth and I can tell you the people who you have to hang out with in order to do the drug are worse than the drug.

I always wonder if there would be more drug addicts but less alcoholics. Would drugs eat into alcohol use or would it add to it. It would be an interesting empirical study. On the other hand, the problem with drug decriminalization is that people talk about some sort of government regulation scheme as if that can be invoked out of thin air with no unintended consequences. Decriminalization does not immediately or necessarily lead to a problem free distribution regime. Edit: although thinking this through suggests the market would probably work it out and reliable online vendors would quickly get the lions share of the market.

the problem with drug decriminalization is that people talk about some sort of government regulation scheme as if that can be invoked out of thin air with no unintended consequences. Decriminalization does not immediately or necessarily lead to a problem free distribution regime.

True. Which is why it's a good idea to study other countries that have liberalized. States that have decriminalized marijuana can also be instructive. But the notion that it's ok for the state to put you in prison for changing your mood is barbaric. It's just a tremendous insult to personal freedom. And it's outrageously hypocritical in a society that celebrates alcohol consumption. You can get drunk, but you can't get high??? What kind of sense does that make?

I enjoyed this diavlog. Megan is always fun when she stays away from economics. And Tah-Nehsi is an interesting conversationalist.
To the dissenters, statistics can manipulated any which way. Anecdotal evidence and life's lessons are as useful as statistics.
I am for decriminalization and I agree with some of the com mentors on this thread.

samuelsd, thank you for the expert opinion

Of course the idea of legalizing all drugs sounds attractive, but the fact is, it's a nutty idea when applied to the real world and would result in the destruction of far more lives than one might otherwise imagine. (No, it's not just the cohort of losers one notices on the fringes of one's ninth-grade class, Megan.) Perhaps decriminalization or de-emphasis of heavy-handed treatment of folks playing with THC and psychedelics might make sense, but the negative downstream effects of even that wouldn't be pretty, especially given the message sent to the young and impressionable. (And believe me, I've got enough personal history in that world to know of which I speak. Having blown it off as a life-drag early on after moderately extensive involvement, I've also worked on the treatment side with drug dependent profiles. Even otherwise very straight-up folks have a strange way of getting completely ruined by first toying with, and then ultimately majoring in drugs of one kind or another. A huge percentage of these people did not have to turn out to be such irreversible losers.) There have to be other ways to eliminate

-Countries with mandatory medical plans benefit from monopsony power when negotiating with drug and medical equipment suppliers, whereas individuals in market economies do not (unless they go to canuckpharma.com or whatever). Of course if all countries did this, goodbye R&D investment! -Costs in the U.S. are also driven up by the moral hazard Gladwell refers to. Besides prices being driven up by insured patients with minimal copays, there is the fact that (for some reason) emergency rooms must treat patients whether they can pay or not. So uninsured patients are incentivized to wait until their ailment gets good and expensive. -"satisfied users" may be judging their care relative to that of their neighbors'. If their neighbor is forced into the same system they are, you're keeping up with the Joneses! yay.

Mr. Acid Glee: Re your first point: This fact does not address than much higher administrative costs in the U.S. Also, if true, it makes us suckers who pay all the R&D costs while the rest of the world reaps the benefits on the cheap. I say better to join their system, and if R&D dries up, all will be forced to renegotiate. Re your second point: I would not say that the fact emergency rooms must treat patients incentivizes them to wait; it's the fact that they can't afford health care that makes them wait until their condition is so bad they must go to the emergency room. Also, I'm not sure I want to live in a country where people are turned away from the emergency room because they can't afford it. Re your third point: I just don't buy it. A quick google found this study from 2004 which doesn't sound like the issue is that people in other countries are satisfied because they know nothing else.

It's funny that the comments here cover both disagreements over the value of drug decriminalization and the value of universal healthcare: my challenge to liberal friends is to square a desire for drug decriminalization with advocacy of universal health care as a cheaper, politically popular policy. Do people on the left think that drug decriminalization is more likely with universal health care? If your average voter sees directly that she's paying the cost for the (generally frowned-upon) lifestyle choice of her local heroin addict, how long do you think political support for both these things will endure? It seems obvious to me that you'd have to choose between the two, that you couldn't sustain support for both simultaneously. Of course we "pay for" the choices of others now, but in a much less direct method.

Wait, so Megan berates liberals for wanting to "do something now!", even though that "something" may not be completely thought-through or be the most rational thing to do. And yet she supported the Iraq war because she felt like "we had to do something!". Come again?

Opium, cocaine and derivatives like morphine weren't "controlled substances" until 1914. Marijuana wasn't prohibited (via a "tax act") until 1937. Was the country going to hell in a handbasket because of drugs prior to those prohibitions ? I don't buy arguments like EastWests UNLESS they're willing to include alcohol prohibition in their mix of enforced rectitude. Alcohol is devastating to those addicted to it. I don't have a solution to that problem. Although I know that attempting prohibition in response to the human devastation due to alcoholism is pretty much nuts.

Yes and if yo go back to the a little further one of the proper medical responses to the problem of habitual drinking was to get the drinker strung out on opium because a maintenance dose left them functional.

Quoting Mr. Acid Glee: -Countries with mandatory medical plans benefit from monopsony power when negotiating with drug and medical equipment suppliers, whereas individuals in market economies do not (unless they go to canuckpharma.com or whatever). Of course if all countries did this, goodbye R&D investment!

I think that assertion is a canard. There's plenty of money to be made on pharmaceuticals. The R&D costs for most of them, by the way, are nearly nil, because the vast majority are minor changes of already existing molecules. You don't need to charge a cancer patient thousands of dollars weekly to make a profit. Likewise AIDS patients are being extorted. The prices being charged for the relevant drugs aren't determined by R&D needs, but by the fact that mortality is at stake, and the drug producers factor that uncomfortable datum into their pricing schemes. A fair amount of basic R&D occurs outside based on public subsidy, as well. The argument that R&D would dry up in a regime that didn't price exploitively is self-serving BS cooked up by the people with something to lose.

"The R&D costs for most of them, by the way, are nearly nil, because the vast majority are minor changes of already existing molecules" says AemJeff. That's good to know; I definitely want AemJeff making decisions regarding medical resources on a nationwide scale.

Quoting Exeus99: It's funny that the comments here cover both disagreements over the value of drug decriminalization and the value of universal healthcare: my challenge to liberal friends is to square a desire for drug decriminalization with advocacy of universal health care as a cheaper, politically popular policy. Do people on the left think that drug decriminalization is more likely with universal health care? If your average voter sees directly that she's paying the cost for the (generally frowned-upon) lifestyle choice of her local heroin addict, how long do you think political support for both these things will endure? It seems obvious to me that you'd have to choose between the two, that you couldn't sustain support for both simultaneously. Of course we "pay for" the choices of others now, but in a much less direct method.

Why do you think there's any value in asserting a linkage between them? My opposition to drug laws is simply that I don't think a government has the moral authority to control what individuals do to themselves, including ingesting or injecting a substance. It's a simple libertarian argument and reflects my

Quoting Exeus99: "The R&D costs for most of them, by the way, are nearly nil, because the vast majority are minor changes of already existing molecules" says AemJeff. That's good to know; I definitely want AemJeff making decisions regarding medical resources on a nationwide scale.

Ok you know how to press the "Quote" button. What exactly is the argument you're making here?

Here is a quick survey from Wikipedia of several distinct, but common, classes of drug and some of the variants of each. Note, there's a good reason for the existence of many of these drugs, the point here is that, despite the multi-billion dollar cost of developing a brand new class of drug, most pharmaceutical R&D is on a much smaller scale, and is mostly derivative. The cost of developing the first Statin drug will have been orders of magnitude greater than that of developing the nth variant of the same molecule. COX-2 inhibitors
valdecoxib Bextra
celecoxib Celebrex
rofecoxib Vioxx Opioid (Semisynthetic derivatives) Diacetylmorphine (heroin)
Dihydrocodeine
Hydrocodone
Hydromorphone
Nicomorphine
Oxycodone
Oxymorphone Opioid (Synthetic) Anilidopiperidines Fentanyl
Alphamethylfentanyl
Alfentanil
Sufentanil
Remifentanil
Carfentanyl
Ohmefentanyl Phenylpiperidines Pethidine (meperidine)
Ketobemidone
MPPP
Allylprodine
Prodine
PEPAP Diphenylpropylamine derivatives Propoxyphene
Dextropropoxyphene
Dextromoramide
Bezitramide
Piritramide
Methadone
Dipipanone
Levomethadyl Acetate (LAAM)
Loperamide
Diphenoxylate Benzomorphan derivatives Dezocine
Pentazocine
Phenazocine Oripavine derivatives Buprenorphine
Dihydroetorphine
Etorphine Morphinan derivatives Butorphanol
Nalbuphine
Levorphanol
Levomethorphan Others Lefetamine
Meptazinol
Tilidine
Tramadol
Tapentadol Statin Atorvastatin Lipitor, Torvast
Cerivastatin Lipobay, Baycol
Fluvastatin Lescol, Lescol XL
Lovastatin Mevacor, Altocor
Pitavastatin Livalo, Pitava
Pravastatin Pravachol, Selektine, Lipostat
Rosuvastatin Crestor
Simvastatin Zocor, Lipex
Simvastatin+Ezetimibe Vytorin
Lovastatin+Niacin extended-release Advicor
Atorvastatin+Amlodipine Besylate Caduet ACE inhibitors Enalapril (Vasotec/Renitec)
Ramipril (Altace/Tritace/Ramace/Ramiwin)
Quinapril (Accupril)
Perindopril (Coversyl/Aceon)
Lisinopril (Lisodur/Lopril/Novatec/Prinivil/Zestril)
Benazepril (Lotensin) Beta blockers Non-selective agents Alprenolol
Carteolol
Levobunolol
Mepindolol
Metipranolol
Nadolol
Oxprenolol
Penbutolol
Pindolol
Propranolol
Sotalol
Timolol ß1-Selective agents Acebutolol
Atenolol
Betaxolol
Bisoprolol[16]
Esmolol
Metoprolol
Nebivolol Mixed a1/ß-adrenergic antagonists Arotinolol
Carvedilol
Celiprolol
Labetalol ß2-Selective agents Butaxamine Proton pump inhibitors Omeprazole (brand names: Losec, Prilosec, Zegerid)
Lansoprazole (brand names: Prevacid, Zoton, Inhibitol)
Esomeprazole (brand names: Nexium)
Pantoprazole (brand names: Protonix, Somac, Pantoloc, Pantozol, Zurcal)
Rabeprazole (brand names: Rabecid, Aciphex, Pariet)

If your average voter sees directly that she's paying the cost for the (generally frowned-upon) lifestyle choice of her local heroin addict, how long do you think political support for both these things will endure? It seems obvious to me that you'd have to choose between the two, that you couldn't sustain support for both simultaneously. Of course we "pay for" the choices of others now, but in a much less direct method.

Seems dubious to me. Many countries provide universal health care and treatment for heroin addicts. If fact, health insurers provide treatment for addicts rather generously today, since it is far cheaper than paying for the expenses of drug-related illnesses long term. If we invested in prevention and treatment, we'd get a lot better at it. Also, we currently pay -- as you suggest -- for the choices of others who smoke tobacco and drink alcohol. Heroin is a less dangerous drug than alcohol. Heroin use rarely results in violence, for example, whereas alcohol is implicated in a very large number of violent crimes, especially murder, rape and felony spousal abuse.

...so in your mind, then, "orders of magnitude less than developing a new class of drug"=nil? Do you think all the R&D cost of a drug is in creating the new molecule itself? The statment that "The R&D costs for most [pharmaceuticals] are nearly nil" is obvious nonesense.
The claim that much of the R&D cost of a drug is borne by public sources, btw, in no way means the "cost is nearly nil," just because a cost is paid by someone else does NOT mean that something is free!

But note that many here are talking about not just decriminalization but legalization; I should have made the distinction. My money's on a politician being able to point to some millions of dollars in universal health care spending going to essentially subsidize some disfavored drug using class and effectively arguing "non-drug using Americans, look where your money's going! Look what your taxes are paying for, look what universal health care dollar is supporting!"
Politically that seems like a tough sentiment to overcome in the minds of people who are already predisposed to dislike certain classes of drugs and/or the class of people who use certain drugs.

Quote button, hell, that was plain ol' cut and paste! I think the argument you want to make is that once R&D has been factored in, the marginal cost of producing every additional pill or dose is essentially nil. That is a defensible position, and could be used to argue against a standard market model of pharm. production...but arguing that most R&D costs "are nearly nil" for any new drugs is very wrong.

Quoting Exeus99: ...so in your mind, then, "orders of magnitude less than developing a new class of drug"=nil? Do you think all the R&D cost of a drug is in creating the new molecule itself? The statment that "The R&D costs for most [pharmaceuticals] are nearly nil" is obvious nonesense.

The R&D cost for more than ninety-nine percent of all drugs brought to market is trivial. That is definitely not an unsupportable claim.

Quoting Exeus99: The claim that much of the R&D cost of a drug is borne by public sources, btw, in no way means the "cost is nearly nil," just because a cost is paid by someone else does NOT mean that something is free!

The point is it's been paid out of the public sector. In other words I (along with you) have born that cost already. i.e. it should have nothing to do with an argument about pricing.

Quoting Exeus99: Quote button, hell, that was plain ol' cut and paste!

I think the argument you want to make is that once R&D has been factored in, the marginal cost of producing every additional pill or dose is essentially nil. That is a defensible position, and could be used to argue against a standard market model of pharm. production...but arguing that most R&D costs "are nearly nil" for any new drugs is very wrong.

I'm not making an argument about marginal costs. I'm arguing that the stated relationship between development costs and pricing is exaggerated.

I wonder if the R&D costs of drugs that fail to get to market are trivial to the costs. Can you answer what percentage of drug concepts actually make it to market?

So you've gone from "nearly nil" to "trivial." But not so fast...trivial compared to what? The cost of a single Shuttle mission is trivial compared to the cost of the Apollo program, but that has nothing to do with the impact a Shuttle mission will have on NASA's budget in a single year. The cost of R&D for a new drug within an already-discovered class may be "trivial" compared to the cost of creating an entirely new class of drugs, but this has nothing to do with that R&D costs' impact on the corp. bottom line or the drug's price, and it most certainly does not mean that the R&D cost is "nearly nil."

"The Autobiography of a Twit" Some people say that libertarianism is dead. I say it just smells funny.

Wow, is it just me, or does Megan excite unusually high negatives among the BHTV commentariat? Not that this level of invective is misplaced, but it sure makes this whole "liberaltarian" project look like fun. See, they've got the basement all decked out for you, complete with coal scuttle and chintz curtains!

Quoting Exeus99: So you've gone from "nearly nil" to "trivial." But not so fast...trivial compared to what? The cost of a single Shuttle mission is trivial compared to the cost of the Apollo program, but that has nothing to do with the impact a Shuttle mission will have on NASA's budget in a single year. The cost of R&D for a new drug within an already-discovered class may be "trivial" compared to the cost of creating an entirely new class of drugs, but this has nothing to do with that R&D costs' impact on the corp. bottom line or the drug's price, and it most certainly does not mean that the R&D cost is "nearly nil."

Nil, trivial, take your pick. The R&D costs for the vast majority of drugs brought to market are negligible. That that isn't the case in a proportion of instances does not prove that the R&D burden endured by pharma is so staggeringly large that the price charged for key drugs is reasonable. There's plenty of room for profits without extorting tens of thousands of dollars and sometimes more annually from the ill and dying.

Quoting piscivorous: I wonder if the R&D costs of drugs that fail to get to market are trivial to the costs. Can you answer what percentage of drug concepts actually make it to market?

Actually, I don't think that's exactly the right question. There's a ladder, if you will. More money gets spent on a particular idea when that idea shows greater promise. The largest expenditures are, by definition, the least risky. Which isn't to say there isn't any risk. And certainly not to say that development money isn't lost. Trials are expensive. FDA approval is extraordinarily burdensome, and if you don't get it, how do you recoup? But the fact is, new drug development is not what drives the industry. Most of the development is incremental, based on pre-existing drugs, and carries minimal risk.

So 0 and "some amount that's small compared to some other, probably large amount" mean the same thing, then...interesting.
And poorly-defined terms are growing at an alarming rate here, we've got "negligible," "reasonable," and "extorti[onary]." What's a reasonable profit, in percentage terms? More seriously, is it your contention that 1. R&D costs are very low for most drugs brought to market AND 2. drugs brought to market are mostly very profitable (low risk, high relative price)? If the cost is so low, and the profits so high, and the risk so tiny, where are all the mom & pop pharmas? If all you've got to do for most new drugs (within known drug classes) is "simply" modify some molecules, couldn't a small company do this, patent the molecule, license it, and print money? Wouldn't the rush to get in the business, doing exactly this, create huge numbers of new drugs, and huge numbers of pharm. companies, driving down the price of pharms? Does this sound anything at all like the pharm. market as it now exists? If not, aren't your assertions about the costs, risk, and profitability involved empirically dubious?

Quoting Exeus99: So 0 and "some amount that's small compared to some other, probably large amount" mean the same thing, then...interesting.
And poorly-defined terms are growing at an alarming rate here, we've got "negligible," "reasonable," and "extorti[onary]." What's a reasonable profit, in percentage terms?

More seriously, is it your contention that 1. R&D costs are very low for most drugs brought to market AND 2. drugs brought to market are mostly very profitable (low risk, high relative price)? If the cost is so low, and the profits so high, and the risk so tiny, where are all the mom & pop pharmas? If all you've got to do for most new drugs (within known drug classes) is "simply" modify some molecules, couldn't a small company do this, patent the molecule, license it, and print money? Wouldn't the rush to get in the business, doing exactly this, create huge numbers of new drugs, and huge numbers of pharm. companies, driving down the price of pharms? Does this sound anything at all like the pharm. market as it now exists? If not, aren't your assertions about the costs, risk, and profitability involved empirically dubious?

I don't assert that there are no costs involved in the development of drugs.

The R&D costs for most of them, by the way, are nearly nil, because

Again, we haven't really defined "exorbitant, extortionate cost," is this some percentage of some amount we can all agree upon? Do you just know it when you see it? You say that "The R&D budgeting is proportional to the expected returns times the perceived risk," but of course it is--in what business is that not true? Your assertion is that "most" R&D costs for "most" drugs are "nearly nil." My question is that, given this, why don't we see more small cap., mom & pop pharm. manufacturers? If large amounts of money are not necessary to successfully (and repeatedly) bring profitable drugs to market, it shouldn't take a large pool of money to get started doing so, thus the barrier to entry into the pharm. market must be low compared to other industries, and we should see many pharm. producers offering competing drugs (within already-discovered classes) driving down prices generally. This doesn't seem to be the case, though, making your claim empirically dubious.

I guess you could look at it from a libertarian perspective, in that I don't care what you do to yourself as long as you don't infringe on my rights, so that if you want to use any drug I don't have a valid reason to object, so long as I don't have to bear the consequences. With universal healthcare, though, I do directly pay for the consequences of your choices--if you decide to become a heavy drug user I will have to pay more money to cover your medical bills. If I'm on the hook for your choices, I will expect to have some say over them, and then I can see a valid reason to make certain behaviors that would otherwise only affect you personally illegal--if I have to pay for your actions, I expect some say in them that I wouldn't otherwise have if I didn't have to pay. In a world where you don't have any claim against me for your actions so long as they don't harm me, I don't have much legitimacy in desiring to prevent you from engaging in behavior that might be harmful only to yourself. In a

Quoting Exeus99: Again, we haven't really defined "exorbitant, extortionate cost," is this some percentage of some amount we can all agree upon? Do you just know it when you see it?

Pick a number. $50,000/yr is extortionate. $120/yr isn't. I'm not complaining about merely high costs. I'm complaining about costs greater than what many people earn. In the case of anti-retrovirals there are millions of people in need of the drugs. Does a company really need to earn tens of thousands of dollars per patient? That's extortionate. Where exactly you draw the line isn't really the point when the prices are set that extravagantly. Which isn't to say it's not an interesting question, but it's a battle for another day, I think.

Quoting Exeus99: You say that "The R&D budgeting is proportional to the expected returns times the perceived risk," but of course it is--in what business is that not true?

The point is that the risks are built into the funding model, just like any business. The costs aren't extravagant.

Quoting Exeus99: Your assertion is that "most" R&D costs for "most" drugs are "nearly nil." My question is that, given this, why don't we see more small cap., mom & pop pharm. manufacturers? If large amounts of money are

Do you think there is any tension between your statement that

Quoting AemJeff: Pharma has every right to expect a profit - I shouldn't have to explicitly assert that

and your statement that

Quoting AemJeff: Does a company really need to earn tens of thousands of dollars per patient? That's extortionate.

? Within certain undefined bounds, then, it's ok for pharms. to make a profit, subject to some moral rule we can't quite pin down. Very well. I'm still not clear, though, on how, if R&D is low cost (relative to the profits a drug will make), small companies devoted just to creating slightly modified drugs don't rule the market. If you assert that the pharm. business is high cost, yet R&D is low cost, where are these expenses coming from? We've already eliminated marginal production costs, and advertising/distributing costs need not be borne by the inventing company--they could all outsource those functions. If it's relatively cheap to create the (successful) drugs (even counting the failures), why is it expensive to bring them to market?

Quoting Exeus99: Do you think there is any tension between your statement that

and your statement that

?

Within certain undefined bounds, then, it's ok for pharms. to make a profit, subject to some moral rule we can't quite pin down. Very well.

I'm still not clear, though, on how, if R&D is low cost (relative to the profits a drug will make), small companies devoted just to creating slightly modified drugs don't rule the market. If you assert that the pharm. business is high cost, yet R&D is low cost, where are these expenses coming from? We've already eliminated marginal production costs, and advertising/distributing costs need not be borne by the inventing company--they could all outsource those functions. If it's relatively cheap to create the (successful) drugs (even counting the failures), why is it expensive to bring them to market?

I see very little tension between the two statements you highlighted. One strictly asserts a right to exist, the other implies a boundary. On the rest, you're still making characterizations of my words that don't accurately reflect my argument. I've never said R&D is low cost (relative to the profits a drug will make), I've said R&D costs are exaggerated by claims that

The better Libertarians on Bloggingheads have been a relief. I listen to Brink Lindsay with careful attention because nothing but good sense flows from his mouth. And Megan at her best offers arguments that liberals ought to engage with. But I'll always remember the 70s Libertarians of my youth fondly. They reacted to Jimmy Carter's "midnight in the oasis" fiasco by saying that the US embassy hostages deserved what they were getting because they were leeches on the government tit. By the 90s, when I came back to the US from Britain, I found most Libertarians I met largely unchanged, only wider: gun-licking, chair-endangering, denizens of the double-wide. Megan . . . well, you can't help getting the impression that she's much less fact-based than she believes herself to be. I can see why she got entirely put out with the cosseted liberals of New York, not known for being overly-supplied with pragmatism, but you can't help thinking that when she voted for Bush in 2004, and when she autonomically supported the Iraq war, she was as purely an ideological creature as any of the drooling liberals she'd come to feel superior to.

The two sentiments, then, for universal healthcare and for the liberty to do whatever drugs (or engage in other behaviors which might be costly to oneself) one wishes seem opposed.

Society has already resolved the issue regarding alcohol and tobacco abuse. We don't deny seniors Medicare, for example, because of prior tobacco or alcohol addiction, nor do we criminalize beer. On the contrary, we glorify and glamorize alcohol consumption. In addition, addressing addiction through universal healthcare is likely to decrease costs to you rather than increase them. Addiction is both preventable and treatable. Education, poverty reduction and early intervention are crucial to success. Legalization -- in the context of investment in prevention and treatment -- might have many benefits to society. Just one example: violent crime might decrease dramatically (no more drug wars, no more junkies trying to earn a few hundred dollars a day). Again, we need to decriminalize the use of all drugs NOW and proceed slowly and cautiously with legalization of highly addictive substances like heroin, cocaine and methedrine.

You are correct with respect to tobacco and alcohol, but I think you miss how much of a growing trend the anti-libertarian legal tendencies run with respect to personal behavior. Moves like banning trans-fats, calling for taxes or outright bans on fattening foods, etc. seem to be justified by public-health cost arguments. If legalization did lower the society-wide cost in a way that was easily seen by all, you are correct that there wouldn't be any tension--it would clearly be the correct thing to do from a cost-benefit perspective. If the outcome was muddier, though, with legalization leading to more users (but more casual users) and increased visible costs--even just in the short run--I think there would be tremendous political pressure against such legalization. The important feature of society-borne costs of drug laws and other such laws currently is that those costs are largely hidden; I pay more in taxes generally, but it's difficult to say exactly how much of my taxes go to pay for drug treatment, or care for the morbidly obese, etc. With universal health care, however, I will be able to see exactly how much more I'm paying (increased

Really? When I did consulting work for TAP Pharmaceuticals they had one drug. It was the only one available, in it's class, to fight prostrate cancer. They seemed to make a pretty good living on it with no competition available for the life of the patent. When I consulted for Abbott Laboratories (7 years) they went through 3 block buster break through drugs that made it almost all the way through stage 3 testing only to prove ineffective or too many adverse side effects.

Quoting piscivorous: Really? When I did consulting work for TAP Pharmaceuticals they had one drug. It was the only one available, in it's class, to fight prostrate cancer. They seemed to make a pretty good living on it with no competition available for the life of the patent. When I consulted for Abbott Laboratories (7 years) they went through 3 block buster break through drugs that made it almost all the way through stage 3 testing only to prove ineffective or too many adverse side effects.

I'm sure that's true. It doesn't invalidate the premise that investment is scaled to risk. Looking up TAP I note that they're a pretty forward leaning firm, with only four products, at least one of which (Ramelteon) is a genre definer. They also produce Prevacid, a proton-pump inhibitor - a class of drugs that includes several blockbusters such as Prilosec. So while it's an interesting example of a really good pharma firm, I wouldn't look at it as a counterexample of what I'm talking about.

It may have left that impression as I forgot to add that while I was consulting at TAP they had a new break through drug that went bust in stage 2 testing. With all the money the company was making, and believe me they were making serious sums of money, off of Lupron this had many ripple effects on the company. There were large layoffs, comparatively speaking, both Abbott and Takeda Pharmaceutical had to inject considerable amounts of capital into the partnership just to keep the R&D wing alive and kicking and I wound up consulting at Abbot which was a much better fit for me as I didn't really care for the Japanese style of management that was at the time prevalent at TAP.

Quoting January: But I'll always remember the 70s Libertarians of my youth fondly. They reacted to Jimmy Carter's "midnight in the oasis" fiasco by saying that the US embassy hostages deserved what they were getting because they were leeches on the government tit.

Hmmm. How stunningly tone-deaf!
I'll admit, I read Reason magazine on occasion, and I listen to Cato events every now and then. But this has always been the thing that bugs me most about the libertarians I meet, that there is precious little about being a libertarian to informs one's outlook on America's place in the world. It's like the philosophy ends at the water's edge for so many libertarians. With all due respect to Amity Shlaes, it seems that there's not much to motivate the libertarian history of America other than a distaste for Woodrow Wilson and FDR.

Quoting Bobby G: I think I'm only going to listen to diavlogs with experts talking about their expertise.

I completely agree. MM has no business getting into this debate as anything other than a casual observer. Anyone of our opinions on and/or experiences with drugs are as relevant to the coversation as anything MM said here. But of course she's a "libertarian" so she takes the experiences she's had watching her yuppy friends do blow and tries to ram it into her precious idealogical framework. Whatever.... there is so much hackdom out there. It's sad.

Drug Addiction is a genetic disease says NIDA: http://powerandcontrol.blogspot.com/...c-disease.html http://powerandcontrol.blogspot.com/...und-holes.html It is triggered by trauma: http://powerandcontrol.blogspot.com/...id-system.html This can not be fixed by law. And in fact no one is benefited by the drug war because you can not fix a genetic problem by law. The real crime? This information is out there and very few know it.

Quoting Exeus99: ...with legalization leading to more users (but more casual users)...

First of all you assume legalization will lead to increased drug use. It is absurd to assume that a person who had no interest in using a particular drug today, would all of a sudden have a change of heart tomorrow, and suddenly decide to become a drug user just because it's legal. It's even more absurd to assume that mass amounts of people will do this just because the law changes. Keep in mind that there is still plenty of motivation for most people not to use drugs, and this motivation won't change just because the law changes. Also, if money that was formerly being spent on the criminalization of drugs can now be spent on more education and treatment, this could actually help to lower the number of users and harm done by drug use. Second, prior to prohibition, drug use in the U.S. was roughly about the same as it is now. If you look at the numbers, prohibition has had little effect on the number of drug users and addiction rates. However prohibition

Quoting Exeus99: if you want to use any drug I don't have a valid reason to object, so long as I don't have to bear the consequences. With universal healthcare, though, I do directly pay for the consequences of your choices--if you decide to become a heavy drug user I will have to pay more money to cover your medical bills.

One more thing Exus99: Following your logic, basically what you are saying is that we should make being overweight illegal too. Drinking, smoking, & having high blood pressure should all be illegal because they lead to high health care costs. We could also make driving a car illegal because many people get hurt in accidents. Do you see the poor logic in your argument? Not only that, you are assuming that the legalization of drugs would lead to more people using drugs equaling higher health costs. Not true, there is no evidence to support this claim. (See my last post) Current drug use is about the same as is was when drugs were legal, prohibition has done nothing to decrease the rates of drug use. Adopting a new drug policy and eliminating prohibition will in fact

Quoting meeneecat:

Originally Posted by Exeus99
...with legalization leading to more users (but more casual users)...

First of all you assume legalization will lead to increased drug use. It is absurd to assume that a person who had no interest in using a particular drug today, would all of a sudden have a change of heart tomorrow, and suddenly decide to become a drug user just because it's legal.

True that. I might expect a short-term blip, but that'd be about it. Speaking for myself, were all drugs to be legalized tomorrow, I would indulge in almost none of my past favorites. Those days are over, independent of the legal status of the substances. The only possible exception would be a return to smoking a little pot from time to time, and a related effect would no doubt be a further decrease in my consumption of alcohol. I also think that there might be a decrease in drug usage among a certain type of people -- those who are attracted to the forbidden fruit aspect. I mean, if you're a rebellious teen and you see your 'rents and other grups smoking weed, you're going to be

Quoting meeneecat: First of all you assume legalization will lead to increased drug use. It is absurd to assume that a person who had no interest in using a particular drug today, would all of a sudden have a change of heart tomorrow, and suddenly decide to become a drug user just because it's legal. It's even more absurd to assume that mass amounts of people will do this just because the law changes.

I'm on-board with the drug legalization movement. But, I'm not so sure that your second assertion above ("It is absurd to assume...") is as solid as you'd have it. I'm not sure how we measure the deterrence effect of current laws. I'm sure I know personally more than a few folks that take the laws seriously enough that their behavior is affected. I can also name plenty of people for whom the secondary prohibitions - e.g. workplace testing is a significant deterrent. Change the law, and the workplace prohibitions lose their best platform. Public health would have to become the primary argument there, and while it's not nothing, and plenty of nannies and actuaries would love to enhance

Quoting AemJeff: I can also name plenty of people for whom the secondary prohibitions - e.g. workplace testing is a significant deterrent. Change the law, and the workplace prohibitions lose their best platform. Public health would have to become the primary argument there ...

I don't see why this should be have to be the case. Why couldn't threat of job loss remain an effective deterrent? And isn't that what it really is, right now, anyway? I don't think even the most wild-eyed NORMLs among us would be against restrictions as to time and place. For example, alcohol is legal, but it's pretty much universally agreed that drunk driving laws are a good thing.

Most "experts" in drug addiction favor legalization of, at least, some of the drugs. Cocaine and crystal meth have such deleterious effects on health or safety of others that they create a lot of controversy.
The examples of alcohol and prescription drugs: sedatives, narcotic pain killers are good models to look at as a general reference. Looking at other countries where drugs are "legal" may not be an accurate reference because the psychosocial conditions in this country are very different. If drugs were legalized, I would speculate that initially there would be an increase in use, sort of an initial spree, and then a significant decrease. Also, when you talk about legalization, you also have to say how the availability of these drugs would be regulated. Legal doesn't mean they would be sold in the grocery store.
The mortality associated to drug use is the most compelling argument for legalization. Most deaths are due to trafficking and not to direct use. I personally prefer chocolate, dark, legal...

Quoting bjkeefe: I don't see why this should be have to be the case. Why couldn't threat of job loss remain an effective deterrent? And isn't that what it really is, right now, anyway?

I don't think even the most wild-eyed NORMLs among us would be against restrictions as to time and place. For example, alcohol is legal, but it's pretty much universally agreed that drunk driving laws are a good thing.

Xuan, 100% in agreement. These are two points I didn't include in my comment. Tell me, what is wild-eyed NORMLs?

Quoting Ocean: Xuan,

100% in agreement. These are two points I didn't include in my comment.

Tell me, what is wild-eyed NORMLs?

NORML stands for the National Organization for the Reform of Marijuana Laws. Maybe not the best noun choice for the current conversation, given that we're currently talking about legalizing all (or at least, most) drugs, but once the adjective popped into my head, I couldn't resist.

Quoting Ocean: I personally prefer chocolate, dark, legal...

Whoa. What a buzz kill. (I'm all about the milk chocolate, myself.)

Quoting bjkeefe: I don't see why this should be have to be the case. Why couldn't threat of job loss remain an effective deterrent? And isn't that what it really is, right now, anyway?

I don't think even the most wild-eyed NORMLs among us would be against restrictions as to time and place. For example, alcohol is legal, but it's pretty much universally agreed that drunk driving laws are a good thing.

Well, the job-loss threat follows from the workplace prohibition. I'm arguing that the argument for the workplace prohibition would be weaker. Drunk driving laws are about specifically dangerous acts on public roads that are prohibited because of the immediate danger. Workplace prohibitions enforced by testing prohibit private acts outside the public or workplace spheres.

Quoting bjkeefe: Whoa. What a buzz kill.

(I'm all about the milk chocolate, myself.)

What do you know about the effects of dark chocolate on women?

Quoting Ocean: What do you know about the effects of dark chocolate on women?

Clearly, not nearly enough. Is it even more potent than milk chocolate?

Quoting bjkeefe: Clearly, not nearly enough. Is it even more potent than milk chocolate?

Milk chocolate? That's baby stuff...

Quoting Ocean: Milk chocolate? That's baby stuff...

Are you calling me a pedophile? I assure you, I have only given chocolate to grown women. Taking candy from babies ... well, okay. I do have to say that I think you're presuming to speak for too many in the sisterhood. Unless I've been being lied to lo these many years (no one thinks that conceivable, to be sure) by all those other women (okay, there weren't that many), I've always gotten an expressed preference for milk over dark when I asked. In fact, I remember the dismay emanating from nearby females when those health studies came out a short while ago, claiming a correlation between dark chocolate and (whatever good health thing it was) -- "Why couldn't it have been milk chocolate?" they wailed. I am willing to grant the possibility that my circle should be broadened, however.

Quoting bjkeefe: Are you calling me a pedophile?

I assure you, I have only given chocolate to grown women. Taking candy from babies ... well, okay.

I do have to say that I think you're presuming to speak for too many in the sisterhood. Unless I've been being lied to lo these many years (no one thinks that conceivable, to be sure) by all those other women (okay, there weren't that many), I've always gotten an expressed preference for milk over dark when I asked. In fact, I remember the dismay emanating from nearby females when those health studies came out a short while ago, claiming a correlation between dark chocolate and (whatever good health thing it was) -- "Why couldn't it have been milk chocolate?" they wailed.

I am willing to grant the possibility that my circle should be broadened, however.

No, not a pedophile. A baby... I make no claim my opinions or preferences represent the typical American sister. I'm neither American (born) nor typical. I celebrated with great joy the release of two breakthrough studies, one showing the goodness of dark chocolate (my favorite since childhood) and the goodness of coffee. With respect to "I am willing to grant the possibility that my circle should be broadened, however.", I'll tell you

Quoting meeneecat: ...
Also in countries that have adopted decriminalization policies, the use of drugs has actually decreased slightly, since you don't have drug pushers actively seeking out new users. (hopefully you understand that the reason dealers sell drugs is because prohibition enables them to make insane amounts of money on the black market...

While I fully support the legalization of all drug use, with the exception of antibiotics, the last data I've seen doesn't support this claim. I would be interested in seen your source for this claim.

From CNN today:

President Cristina Fernandez de Kirchner repeated her call this week to decriminalize personal drug use and crack down on traffickers and dealers.

.....the Argentine government is pushing Congress to pass the decriminalization legislation by the end of the year.

"Decriminalization of the consumer should include what are called second-generation human rights, but at the same time there should be a strong policy of prevention, so that no one falls in the situation of consuming any substance," said Anibal Fernandez, the minister of security and justice.

Ethan Nadelmann, founder and executive director of the New York-based Drug Policy Alliance, said such policies have been adopted throughout Europe and other parts of Latin America.

"The evidence generally shows that the decriminalization of possession is not clearly associated with any increase in illicit drug use," he said.

A few years ago, then-Mexican President Vicente Fox proposed decriminalizing possession of drugs combined with a crackdown on traffickers, but a harsh reaction from the Bush administration caused him to retreat, Nadelmann said.

Brazil and Colombia have passed laws decriminalizing drug use in an effort to combat the spread of HIV among injecting

Quoting Wonderment: From CNN today:

This country has been falling behind for the last eight years. A lot to catch up with...

A couple belated comments. Regarding the workplace - ultimately one's relationship with an employer is performance based. Regardless of the legal status of any consideration that might affect one's performance, the employer has the right to expect that the employee fulfill their side of the contract. Whether one is not performing due to drug use, boozing it up at luinch, basic laziness, general lack of relevant skills, the situation will be resolved. Regarding the cost-benefit question, a quote from John Stuart Mill: the only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others. His own good, either physical or moral, is not sufficient warrant. In any society that pays lip service to freedom, one must do more than hope some nominal benefit of a law or policy might exceed the cost. That may serve in deciding whether to fund some public work, but is not sufficient for a policy that restricts an exercise of individual liberty. Freedom includes the freedom to make poor choices, and for each individual to make their own value judgments regarding the valuation of those choices.

...of course, I wasn't arguing FOR universal healthcare, so the "poor logic" you're talking about isn't mine...and in fact, it's not irrational to think that someone who'll bear the cost of others' obesity might want to make such obesity illegal...I don't FAVOR that outcome, but it follows.

Sorry I didn't get back to you sooner, especially because parts of your post are wrong. I did make a few assumptions in claiming that legalizing a drug would lead to an increased number of users, but none of them are particularly absurd. The first assumption I made was that drugs are normal goods. From this it follows that they would therefore react to market changes in ways that comport with the law of demand. I additionally assumed that making drugs legal wouldn't cause very many current drug users to quit (since they use now, when it's illegal, making it legal shouldn't cause many to stop). Finally I assumed that there are a relatively large number of people who would use drugs now if the total price was low enough. From all of this I confidently assumed that legalizing drugs would lead to an increase in use. Which parts are absurd? As you seem to understand, the largest part of the price of drugs currently is not their nominal cost but the associated dangers-being arrested, being robbed, etc. Legalization would massively lower these costs, and thus dramatically lower the total price of drugs. Given