What is the alternative to Friedman’s capitalism?

 Milton Friedman 50 Years Later

Angus Deaton says:

“Milton Friedman was one of the foremost thinkers who challenged the post-war Keynesian consensus. He was immensely successful in arguing the pro-market case, and questioning the ability of government to improve on market outcomes. Today, we need to reopen these questions, using new economic thinking and new evidence; is the market bringing the unalloyed benefits that Friedman thought it would? This book is an important contribution to that reevaluation,”

And this is the capitalism that Martin Wolf expects:

“in which companies would not promote junk science on climate and the environment; it is one in which companies would not kill hundreds of thousands of people, by promoting addiction to opiates; it is one in which companies would not lobby for tax systems that let them park vast proportions of their profits in tax havens; it is one in which the financial sector would not lobby for the inadequate capitalisation that causes huge crises; it is one in which copyright would not be extended and extended and extended; it is one in which companies would not seek to neuter an effective competition policy; it is one in which companies would not lobby hard against efforts to limit the adverse social consequences of precarious work; and so on and so forth.”   

 

The largest global public-health initiative

 The COVID-19 vaccines are here: What comes next?

From McKinsey:

As vaccine availability nears, communities and consumers will want answers to many questions, including:

• Is the vaccine effective and safe?
• Who will get vaccinated first?
• Which vaccine will we receive, especially if multiple vaccines are available?
• Where and when can we get vaccinated?
• Will we have to pay?
• Above all, what do we need to worry about?

Although the scale of the task may seem daunting, countries benefit by starting end-to-end planning immediately. Our 6A framework lays out a structured approach to ensure vaccines are available, administrable, accessible, acceptable, affordable, and accountable while taking into account strategic considerations associated with uncertainty (for example, vaccine clinical and technical profile) and building system capabilities (Exhibit 2). We have developed, in granular detail, the individual activities and considerations behind each component of the framework. Through the collective initial effort of the pharma industry, the scientific community, global health institutions, and governments, most elements of the “available” segment of the 6A journey are being addressed

 

Paul Strand

 

Platforms as essential services

Essential Platforms

Competition in Digital Markets 

Imagine you own a company, and you see millions of potential customers for a new product. But there is a problem: all these customers live on the other side of a river and the only way to reach them leads over a privately owned bridge. The owner of that sole bridge either prevents you from passing altogether or charges excessive fees. Long story short, if that is the case, this product line and, potentially, your entire business are doomed.

 Digital platforms can behave in that manner because they do not face serious competition. The platforms’ monopoly power mainly stems from network effects—that means the participation of additional users almost exponentially increases the utility of the network and creates enormous market entry barriers for potential competitors. The characteristics of data and algorithms further foreclose the markets.

 Google, Amazon, Facebook, Apple, and others behave just like the railroads did 100 years ago. Instead of physical infrastructure, like bridges and tunnels, the digital platforms leverage network effects that shield them from effective competition. 

To define the suitable remedies and to open the digital economy for competition, we can learn from the past. In the early twentieth century, the railroads controlled critical infrastructure and excluded competitors from crucial markets. The railroad monopolies rested on enormous investments in physical infrastructure that could not be replicated.

After all these years, a clear message, while the regulator is still on vacation. 

 

 

 

Rethinking technology evaluation

 Reviewing our methods for health technology evaluation: consultation

Access to effective medicines (in oncology)

Addressing Challenges in Access to Oncology Medicines Analytical Report

 Challenges in access to oncology medicines: Policies and practices across the OECD and the EU

From OECD report: 

The data clearly show that access to oncology medicines is unequal across the OECD and EU. Of the 109 product/indication pairs in the sample, the United States had the largest percentage of product/indications approved and covered (by Medicare), followed by Denmark and Germany (96%, 91%, and 88%,  respectively). Chile and Malta had the lowest percentage approved and covered (47% and 46% respectively). While access was more homogeneous for a subset of essential medicines (i.e. those included in the WHO 21st Model List of Essential Medicines [WHO-EML]), some of the 31 newer product/indication pairs were not yet approved (or launched) in some countries.

 Percentage of total sample of 109 product/indication pairs by approval and coverage status across OECD/EU countries

Note: Data for some countries were not included as many data were missing.
Source: Authors based on 2019 OECD survey on challenges in access to oncology medicines.

One of the countries with missing data is Spain. Nothing to add.

 

Fueling digital health

 Healthtech in the fast lane: What is fueling investor excitement?

From McKinsey brief:

As of 2019, digital health represented a global market of approximately $350 billion with many opportunities to compete across multiple subcategories; moreover, the markets for technologies in every value pool are expected to grow by at least 8 percent per annum (Exhibit 2). Understandably, the bulk of digital health players develop technologies that have a direct impact on patient care. About 49 percent of the digital health companies we studied fall into the care-delivery category (that is, offering more effective therapies, providing remote patient support, or supplying therapies to patients)—a $157 billion market (as of 2019) comprising 45 percent of the overall digital health market. Companies in this category either provide novel therapeutic solutions enabled by digital technologies—such as Livongo for diabetes—or use technology to broaden patient access to healthcare solutions, for example, telemedicine company Teladoc (offering remote patient support) or online pharmacy PillPack (supplying therapies to patients). Notably, every value pool in this category is expected to grow by at least 10 percent per annum through 2024.

The list of value pools.

Digital health’s platform wars are heating up. From Rock health

Few seats available

Long term care shame

 Spending on long-term care

The share of LTC spending in total health spending or as a share of GDP has gradually increased over the last 15 years in many OECD countries as demand for care grows with population ageing and the extension of publicly financed services. 

In some countries, spending on LTC has not grown much faster than the economy as a whole. In Slovenia and Spain, for example, the shares of LTC relative to GDP in 2018 were only 0.1-0.2 percentage points above those in 2005, at 1.2% and 0.9% of GDP, respectively.

In Spain, the share of LTC spending has been stagnating since 2009, with LTC spending tracking GDP growth.

Nothing to add.

PS. You'll not find such data in the spanish press. Somebody cares about it.