"Big Pharma" in the eyes of the public is two related but separate issues; 1) the weird employment-insurance-hospital loop that has developed in the US, and the terrible second-order-consequences of all the open-high/settle-low insurer<->carer system it led to, and 2) the medicine advertisements, and all the terrible consequences thereof.

The second one seems like a much easier thing to get rid of using hard government power, and should be the low-hanging fruit.

The first will require a decade of masterful leadership, co-operation from competing interests, and delicate undoing over time that I don't think any country in the west has right now.

Big pharma is significantly less of a problem than the physician and hospital cartels.

I have no idea why these groups have survived scrutiny for their literal multi-hundred million dollar lobbying/bribery of politicians.

My closest guess is that we all know "My" physician or a well paid nurse that benefits from the bribery.

Direct link to the executive order (it's in the article, but might as well put here):

https://www.whitehouse.gov/briefing-room/presidential-action...

> hospital price transparency,

Wasn't this already put in place by the previous administration?

Well, I hope this does some good, but I'm a bit skeptical. I think we need more focus on how to help freelancers, gig workers and microbusiness actually succeed as a counterpart to preventing big business from preying upon small business.

It's something I personally try to promote but I feel I have little in the way of success. I still struggle to make it through the month myself and my various projects intended to help others seem to mostly kind of languish, with one exception and I have no hard data on how much good that is doing.

I think my efforts aren't pointless or fruitless, but it never seems to be enough to actually resolve my chronic poverty and I don't get enough feedback affirming that the lives of others suck less thanks to me.

That kind of thing is maybe part of what helps drive a concentration of money and power.

I think we overregulate small business. You need to know a lot of laws and regulations to operate at all and if you are one or a few people, that's a big burden. It's less of a burden for big business to play that game because they make enough money and have enough people that it's a relatively small part of what they do and I think that regulatory burden is one of the things hampering small business, just like it tends to impede the development of affordable housing.

I don't know the answers. I just am skeptical that focusing exclusively on breaking up monopolies and putting a break on big business actually breathes life into small business. It's perhaps a necessary but insufficient precondition.

Sort of good, but we'll see how it plays out without other policies supporting it. Frankly, many consolidations are not malicious but necessary for survival. Economies of scale and verticle integration are required to complete with foreign companies with lower costs. Look at domestic steel production. No way the market can support numerous domestic options that can compete with the low cost of foreign imports.

Then there's vertical integration. I don't know if this will effect vertical integration. If it does, I wonder how domestic companies will compete without it.

As a beekeeper, it's vastly cheaper foreign imports (some of it fake) that are more damaging than large domestic producers (although there's a healthy variety). The low prices have been forcing consolidation, or for some people to switch from producing domestically to packing imported honey. It's tough to market local honey for even $12/lb when walmart sells honey for less than $5/lb.

How about Big Telecom and Big Fintech and Banking? Or is it simply because the rest did not pay enough to the lobbyists?

Worth noting that the Pharma industry, as well as Big Tech and Wall Street, supported Biden. As a Biden supporter I’d like to believe that this is because he’s an old school Democrat and not afraid of biting the hand that feeds him. More cynically, this could be seen as posturing to keep together what is a very weird coalition (Occupy Wall Street and Wall Street under the same tent).

Also maybe relevant: https://ksr.hkspublications.org/2021/05/18/can-conservatism-...

> The best answer, in my view, is that the Republican Party’s remaining connection to the dominant sectors of the American economy occurs through its usefulness as a tool to selectively balance and discipline the members of the Democratic coalition. Big Pharma, for instance, will throw money at the Heritage Foundation to rant against “socialized medicine” whenever talk of the government negotiating drug prices surfaces, but pharma is hardly interested in repealing Obamacare, much less dismantling Medicare. Financial lobbies will rent the Republican Party to ward off troublesome regulations or taxes, but are hardly interested in “sound money” policies or big spending cuts that would derail financial markets, never mind social conservatism. Big Tech will team up with Americans for Prosperity to oppose legislation limiting app store developer fees, all while more aggressively controlling conservative speech online, and so on.

"Hearing aids cost thousands of dollars apiece, for no other reason than there is a cartel established by government that prevents firms from selling hearing aids without a prescription."

An example of how many (most?) monopolies are able to exist because of some sort of legal authorization or protection. Regulatory capture.

There are dozens of companies who would no doubt start making inexpensive hearing aids tomorrow. Absent government regulation, they already would be.

No it can't.

Top 10 spenders on lobbying in 2021:

    "Lobbying Client","Total Spent"
    "US Chamber of Commerce","$17590000"
    "Pharmaceutical Research & Manufacturers of America","$8664000"
    "National Assn of Realtors","$7985521"
    "American Medical Assn","$6520000"
    "American Hospital Assn","$5852623"
    "Blue Cross/Blue Shield","$5774300"
    "Raytheon Technologies","$5360000"
    "Amazon.com","$5060000"
    "Facebook Inc","$4790000"
    "Northrop Grumman","$4610000"

Plus, Biden is the last person to be trusted with this. The overall lockdowns in the US are basically a joke. Your government let big pharma abuse the entire society for more than a year and people are still so discombobulated by what happened that they've started to develop a stockholm syndrome.

If the whole country gets a California-style ban on noncompetes, will Silicon Valley start to lose it's hold on tech?

A lot more people support action than support any given outcome. I worry that the majority will be disappointed by the outcome because of this.

Take the big tech action: some people support it because they want less censorship (that's me), others because they want more. The same applies in other aspects of peoples' issues with big tech (fake news, hate groups, grooming and CP, privacy, foreign election meddling etc). We can't all be happy with whatever the FTC does to social media sites can we, given we mostly want different things.

"The most interesting pushback was by Google, Facebook, and Amazon, as well as Chinese giants DJI and Alibaba. All of these firms speak though the trade association Netchoice, which has them as key members. Netchoice didn't bother to try and convince Democrats. Instead, the big tech trade association used the order to lobby Republicans, making the case that Biden's actions against monopoly are opening the door to a larger more powerful government. Here's the key part of Netchoice's statement:

"Sen. Lee and Rep. Jordan's warnings were right - when Republicans back progressive antitrust proposals because of concerns about tech, they open the door to progressive antitrust activism... By backing hard-left proposals, like nominating Lina Khan to the FTC and Rep. Cicilline's antitrust legislation, anti-tech Republicans bear responsibility for the damage that will result from importing a European-style antitrust framework to all sections of the American economy."

Netchoice represents mostly American giants, but also Chinese dominant players. So it's interesting is to see the Chinese tech giants through their lobbying proxy coming out against Biden's anti-monopoly actions, and praising conservative Republicans Jim Jordan and Mike Lee in the process. It's clear that both big tech, and China's own tech giants, do not want to see anti-monopolists like Lina Khan succeed. But conservative Trump-supportive ranchers, by contrast, do."

It is almost as if these "tech" companies are trying to sow divisiveness. Divide and conquer.

So why do we a accept that VC's invest in software tech but we don't expect them to do the same in biotech (obviously some do I am generalizing) but instead expect Americans (mostly, I live in Canada though) to subsidize Big Pharma through taxes and, in many many many cases outrageous costs for decades old drugs?

Perhaps we would look at the donations to see if this is likely or not?

I can understand them going after Ag and Pharma in a big way, but I'm skeptical about the Tech part. There is just too much to lose in political support from that industry for any politician to attack them too aggressively.

I hope they take a look at VeriSign's monopoly power over .com/.net. We saw how dangerously close .ORG got to being turned into a rent seeking tax on non profits. .COM/.NET are a licensed rent seeking monopoly with increasing prices and decreasing costs to serve and no contract competition. Those contracts need to be made competitive, there are plenty of registry providers who can do it cheaper and VeriSign as a company exists because of those no-compete contracts.

The reason we can afford universal health care in my country is because there are hard caps to the prices health professionals can legally ask, be it for fees or medication prices. If the prices are kept closer to their real value, and not inflated prices, then it's already much more affordable to consider paying for universal health care.

Cut sugar industry subsidies and promote real food. Covid pandemic is nothing to the obesity one.

Why don't they allow insurance companies to operate in all states so people can shop around more? Currently they have regional rackets.

My health insurance is buying hospital company stocks.

Finally, they've started attacking big tech on the privacy front. The whole "monopoly" and "anti-trust" thing was going nowhere. But privacy orders like this are a step in the right direction.

And to put the nail in big tech's coffin, congress should pass a law forbidding the sharing of any personal information on any resident of the US for any commercial reason whatsoever. With draconian penalties assessed per user infraction. That would stop these tech companies in their tracks.

I'm generally skeptical about all such news but a few things make me cautiously optimistic:

- Lina Khan: I had heard about her a long time ago before she even got into politics. She is known for her academic work on antitrust and big tech so she definitely understands how monopolies work and how they are unfair.

- Biden saying "Capitalism without Competition is Exploitation"; simply the acknowledgment by a sitting president that what we have today doesn't look like capitalism anymore is in itself a huge achievement and lays the groundwork for real improvement. Now, everyone knows that something needs to be done and everyone knows that everyone else knows that!

- Biden is getting old and probably doesn't care about a second term in office. It's possible that he decided to make as many powerful enemies as necessary to secure a great legacy for himself.

That said, I think that people have such low trust in government and media nowadays that I don't expect anyone from the right to warm to Biden until we see actual results.

here [1] they say that Kamala Harris is seen as a friend of big tech and silicon valley, that would imply she is a friend of big tech corporations. Does this step signify a rift between Biden and Harris, or is that not the case?

[1] http://web.archive.org/web/20210206212101/https://www.nytime...

He misspells Tyler Cowen as Tyler Cowan.

Would “Small Pharma” have gotten us our COVID vaccines faster?

I get the complaints, but so much of these actions feel like they don’t start with an understanding of the benefits large can bring.

The sentence "Capitalism without Competition is Exploitation" immediately makes me think about the many monopolies held by the government. Will he do something about those too?

Is he really in a position to keep doing this? Biden recorder the most votes in history, while winning the fewest counties. That's a head scratcher. The fact remains most of the geographic area of the country voted red. If he keeps this up, states are going to start ignoring his executive orders. That's not how democracy is supposed to work. Laws get passed by legislature, not by dictate of the King.

Yeah, like the democrats will bite the hands that feed. This is democrat posturing for 2022, that is all.

It's not actually real. The lobbying firm behind most of the fact sheet is made up of people on the boards of different tech firms.

Around 2005, I asked Kevin Phillips:

Me: According to your book, America's political parties have flipped every ~70 years. It should have happened around the time of Ross Perot, so I guess we're overdue. Do you think another realignment is emminent?

Phillips: No. It won't happen while Wall St. and finance remains in control of our political discourse.

--

It'll be amazing if Biden Admin is able to uncork the next cycle. But I'm not holding my breath.

Wealth and Democracy: A Political History of the American Rich [2003] https://www.amazon.com/Wealth-Democracy-Political-History-Am...

Here's a more recent account:

Lobbying America: The Politics of Business from Nixon to NAFTA [2015] https://www.amazon.com/Lobbying-America-Politics-Business-So...

Edit: I changed "Last decade" to "Around 2005". Time flies. My bad.

It's about control. These "Big" companies are in a position to collect plenty of data about the market - companies and individuals. They are now able to do what previously was exclusive (read: monopoly) to the government.

I'm not defending "Big *", simply noting that historical context is mostly irrelevant. The game is different now. The rules also different. It's not about markets and dominance. It's not about economic monopolies. It's about control. Control of the future. Control of the narrative.

Executive orders were a constant theme of the previous administration. It was the first time that I’ve really heard about them consistently as a presidential technique and similarly as much in the media.

The lower executive order numbers from the previous 2 administrations before made me think that these were tools used for media attention when I kept hearing about them.

Now the current administration is using them (for causes that I hope will benefit) and I’m wondering are these going to hold weight or is this another media ploy?