"Merck concealed risks of Vioxx, GSK of Paxil, J&J of the Ortho Evra patch"

All three of these statements are false.

But I'm very pleased to see you endorse the idea of moral hazard. I look forward to your post arguing for the need for a loser-pays rule because of the problem of moral hazard of plaintiffs bringing litigation that imposes costs on defendants who are eventually exonerated. Such as, for example, Merck.

Good job for trying to shift attention to plaintiffs' lawyers, but that doesn't add anything to the topic at hand. It's also not really a true moral hazard since when the defendants are exonerated, the plaintiffs pay their own costs.

I won't argue Vioxx with you because you were on the Vioxx defense team and aren't likely to ever admit Merck did anything less than angelic with regard to Vioxx.

Check out http://www.pharmalot.com/2008/06/washout-or-whiteout-paxil-and-placebo-suicides/ for evidence of what GSK did with Paxil.

But back to the topic at hand: As you yourself pointed out, all painkillers have side effects. Most if not all drugs do, actually. Shouldn't the manufacturer bear the cost of those side effects? If not, who should? Certainly not the taxpayers, I hope you'll agree.

Add "moral hazard" to the list of terms Justinian uses without understanding.

Which is stunning, really, since you correctly state the definition in your original post. You must have cut and paste, because your 4:57 PM comment shows you don't know what "moral hazard" means.

Anytime I make a point you can't rebut, or expose corporate wrongdoing, you accuse me of ignorance. Nice debate tactic. A large case in which the plaintiffs' attorney has to put up a large sum of money isn't a pure moral hazard.

Would you care to address the substance of my post, or just continue sidestepping the issue and bashing plaintiffs attorneys?

"Anytime I make a point you can't rebut, or expose corporate wrongdoing, you accuse me of ignorance."

I only accuse you of ignorance when you say ignorant things like "It's also not really a true moral hazard since when the defendants are exonerated, the plaintiffs pay their own costs" that demonstrate you use words like "moral hazard" without understanding them. Take a look at the definition of moral hazard in your own post. Notice the part about "others will pay the cost for"? Of course you don't -- because you're just using words without understanding them.

And experience has shown that you never ever ever admit that you're wrong, so it becomes a waste of time to point out that you're wrong, as any debate will now devolve into you insisting that moral hazard means something other than moral hazard. I don't feel like wasting time when you keep changing your argument without admitting that's what you're doing. Anyone who knows what "moral hazard" means recognizes that I'm right and you're wrong. Either you do, in which case you're being dishonest; or you don't, in which case there's no point in this discussion until you acknowledge that your 4:57 statement is incorrect.

NB the statement "Mr. Lotfield's isn't a 'true moral hazard' because he's paying for his own Vioxx tablets" is both incorrect and logically identical to your bogus 4:57 comment.

Mr. Loftfield is 87 and thus eligible for Medicare...So the question becomes “Why should Mr. Loftfield be able to shift the cost of his decision to take Vioxx to the taxpayers?”

Justinian,

This is an interesting point. But query why the moral hazard is presented as only an argument against Vioxx waivers. Medicare (along with all health insurance) creates a moral hazard across all health-jeopardizing activities carte blanche. Thus, the question "why should [Citizen] get to shift the burden of risk involved in [Activiy X]?" could be asked for any activity, from skydiving to lawn darts. This doesn't seem so much as an argument against Vioxx waivers so much as it is an indictment of the entire Medicare/Medicaid system, not to mention health insurance to the extent that a policyholder's inclination for risky behavior can't be separated through underwriting.

I think the reason we put up with moral hazards in health insurance (as opposed to the insurable interest laws in place re: taking life insurance on another person) is because, at the margin, knowing you're insured won't substantially affect your risk-tolerance for a life-altering peril. Men such as Loftfield above aren't usually saying to themselves, "I usually wouldn't take this drug, because I don't want to pay for my heart attack, but since I know that I'm insured, I really don't mind cardiac arrest." Since having a heart attack is already such an undesirable event, the fact that a he wouldn't have to pay for it would have little effect on his risk-calculus.

"And experience has shown that you never ever ever admit that you're wrong..." You and others gave me a serious tar-and-feathering about my post about the Ford Pinto. I corrected it. When I'm wrong, I admit it. Now why don't you quit wasting space arguing about what is or is not a moral hazard and how ignorant I am or am not, and address the point of the entire post?

Setting aside the entire concept of moral hazard: Who should pay for the medical costs when someone suffers a heart attack (or other serious medical problem) because of a prescription medication?

I argue that the manufacturer should. Do you agree? If you disagree, then who should pay them and why?

Please stop giving Ted Frank attention. I'm interested in reading about the issues, but when this party-pooper blow-hard gas-bag shows up, it's time to grab my coat and go home.

Justinian: Vioxx does not cause heart damage. There is no special cost other than its ordinary side effects. It's a hoax for lawyer rent seeking. The FDA demanded its return to market. Fear of litigation is the sole moral cost in this situation. In the case of SSRI's, lawyer rent seeking and plundering deterred their use, and 1000's of untreated teens committed suicide. Thank the lawyer for this mass murder.

Why don't you address the moral cost of lawyer rent seeking, in crime rates, in anemic growth, in depriving people of products and services? Why not? Because you have been made a moral imbecile by your criminal cult indoctrination.

Lawyers who find loving criticism unpleasant may leave. You haven't been sued and ruined as you do everyday to others.

As part of the effort to avoid significant CV info on Vioxx label, Merck perpetratred the knowing lie that naproxyn (Aleve) was cardioprotective almost up to the point of withdrawing the drug. Their own scientists knew it was horse manure, and some of them have said so.

FDA "ordered" nothing re: Vioxx. By a narrow vote, they opened the possibility of its return to the market if that could be done for the right people. Merck has not offered any such plan.

Just today we learned more about the "reporting maneuvers" (FDA's term) that GSK perpetrated to avoid revealing the truth about Paxil. Meanwhile, there is _no_ reliable data that the SSRI warning have been associated with increased teen suicide. The numbers we do have suggest the opposite.

I, by the way, am not a lawyer, but a healthcare provider, including treatment of depressed adolescents.

HolyCow: All that is trial lawyer propaganda. Vioxx was the best drug ever. Just ask Ted.

And if I recall, didn't Paxil data show that it was negative for efficacy and safety on adolescents?

It's interesting that Justinian is unable to respond to my actual well-documented position and instead has to make up false claims about what I say about Vioxx.

Much like his lengthy diatribe criticizing my accurate quote of a book that he has never read.

Not nearly as interesting as your inability to contribute anything of substance to this post. Much better to divert attention to me in hopes that no one will discuss the financial cost of preemption, eh?

I contributed a comment that caused you to prove that you don't know what "moral hazard" means.

You still haven't answered my question or Lawyer's question why we should be concerned about moral hazard in this instance, and not in the other instances we discussed. It's almost as if you're being hypocritical.

I'll take Justinian's 9:59 comment as evidence that he has no defense for his lie in his 9:21 comment.

As for contributing substance, I contributed a comment that caused you to prove that you don't know what "moral hazard" means.

You still haven't answered my question (4:49) or Lawyer's question (5:40) why we should be concerned about moral hazard in this instance, and not in the other instances we discussed. It's almost as if you're being hypocritical. The only one changing the topic is you.

Vioxx is given to old people with bad tickers. They have a baseline death rate. In order to show the prevention of cancer, the subjects were taken off aspirin which prevent heart attacks. When the difference between the rates of heart events (no deaths) in the placebo and in the Vioxx groups is corrected for the inflation of statistical significance by the large sample sizes, it loses its statistical significance. This is taught in 11th grade statistics class. Because of this error prompted by the terror of litigation, the care of millions of pain patients was disrupted. The moral cost of the plaintiff bar terrorism deserves total self-help from these patients in pain.

The sole reliable prevention of suicide is adequate treatment of the disorder, such as depression. The family doctors got scared off by the irresponsible black box warning. Millions went untreated, thousands died. Stop your appalling collaboration with the lawyer caused mass murder of these young people around the world. Here is why the bogus black box warning went up. The Psychopharmacology Committee was bullied and threatened by screaming, left wing ideologues with violent tendencies, and their vicious lawyers. They caved in to left wing threats and bullying.

The Committee will face accountability for its cowardice before Congressional investigations. They and the Commissioner must resign for their cowardice in the face of anti-scientific bullying.

You should stop the misleading statements about Paxil. It is well known for 50 years. Even the most sedative of all anti-depressants agitates someone. If that happens, even the uninformed patient should have the ordinary common sense to stop the medicine causing such a reaction after the first day. There is no cover-up, except for the pretextual plunder of a productive entity by a cult criminal, now facing his own legal problems.

If I were a patient on these meds, after the unwarranted, and total disruption of my care, I would be seeking out the cult criminal AG to throw a pie in his face. These left wing, rent seeking cult criminals will face total accountability. Their doctor running dogs get to join them in their fate.

My 9:21 comment was sardonic, not dishonest. I hoped that bold and italic text would indicate that. Apparently not.

Your 4:49 question is irrelevant to the discussion. This isn't a post about loser pays, it's about who should pay for the medical bills of those injured by prescription drugs. If you'd like to discuss moral hazards & loser pays, why not post about it at Overlawyered and I'll be happy to respond there - if my posting ban is lifted, anyway.

As for Lawyer's comment: Regardless of what thoughts a hypothetical citizen has when choosing to take a medication with high risks, the fact remains that if that citizen suffers an injury because of the drug, someone has to pay for those bills. I submit that the party who should pay for those bills is the manufacturer of the drug that caused the injury.

Justinian: But for the Big Bang, the injury would not have taken place. The maker of the Big Bang should pay the costs.

What about the plaintiff bar that loses most of its cases, who should pay for the moral cost of that land piracy plunder? Nor do I differentiate between the defense and plaintiff bars, nor the corporate apologists, nor the criminal lovers. All are self-dealing hypocrites, including you until your support allowing legal malpractice claims against the adverse lawyer and against the judge. You want to hold everyone else accountable for the slightest pretextual mishap. You refuse to hold the lawyer accountable for the massive damage to the economy and safety of the public. You are a criminal cult indoctrination victim. It is so good, you do not even realize how much damage they have done to you. Anytime you want to sue the hierarchy of the lawyer profession for this crime against humanity, as lead plaintiff in a class of law students, let me know.

Doctor: Here is the story on the order to return Vioxx to market. It is in an appalling left wing propaganda organ, so it should have credibility with you.

http://www.washingtonpost.com/wp-dyn/articles/A34803-2005Feb18.html

Did you read your post, Justinian? It's titled "The Vioxx Moral Hazard." Your post is about moral hazard. My 4:49 question is thus relevant: when should moral hazard dictate policy? Right now, you seem to use "moral hazard" as reasoning when you agree with the results, and ignore it when you disagree with the results, and I'm curious whether you have any principled reason for raising the issue of moral hazard at all. (Of course, as your 4:57 PM comment shows, you don't understand what moral hazard means, so your post was really just word soup. But I'm humoring you for a moment.)

Or, it's possible that you really are so befuddled that you don't understand why my 4:49 comment refutes your post. Fair enough.

Justinian: The corporation is a fictional entity. You will learn about that later. It serves as a pretextual pipeline from the wallets of working class people to the wallets of highly paid lawyers, pondering the decor for their third business jet.

There is no moral cost, but one paid by the public. If the corporation cannot pass on its costs to the public, like an unauthorized tax to fund the lavish lifestyles of the land pirate it cuts back on public access to products and services. So the fees that go to the cult criminal do not go to research the next advance in drugs.

As an alternative to the land pirate bunco operation would people who care consider, Medicaid for all victims of injury? That would be quick. It would eliminate the fee of the lawyer. It would openly declare the source of all moral costs, and stop the lawyer hiding of these costs.

This is the test of sincerity for those claiming torts make people whole. I know even corporatist apologists will oppose that because it cuts out the huge lawyer fee.

If the "Doctor" post from SC was meant for me, the WashPost story says exactly what I said - that, by a narrow vote (which we now know had potential COIs all over the place), Vioxx _could_ be marketed again, so long as it was full of warnings and titrated in a particular way.

You don't get blockbusters that way. So, understandably, Merck passed.

This pretty much confirms that they couldn't care less about those folks whom the med actually helped and had relatively few risk factors.

HAZARD ISSUE ASIDE - informed consent would not have been possible anyway - Merck made sure no-one was informed...

TO: Vioxx Helped Me Live a Lot Better and I'd like It Back - June 14, 2008; Page A10

…

NO – I am not in the “settlement”, but I feel for those souls that are really getting shafted, and I feel so big time…the first crime against morality is the litigants, and beyond that, you are not aware, but your civil rights are being eroded (again) as well as the litigants….shall the Vioxx settlement deal “work” for Merck – it has become a proxy in a battle of poorly and mean spirited conceived MASS LITIGATION REFORM, then it becomes a lynchpin for future atrocities.
….

What Merck SHOULD have done is practice what some other dangerous medicines (or known to have the potential to be so) do – INFORMED CONSENT; and have been honest with the doctors – and this goes for Heart – Stroke – Bone & Spine healing – and the other problems that they damn well knew about and that have much scientific evidence. Merck made a conscious decision NOT ONLY to market this very powerful and unknown (how it affects the body as a whole) but in about as arrogant as you can get – they (allegedly) decided NOT TO EVEN WARN OF THE POSSIBILITIES.

Merck’s cost/benefit was:
…

NOT – is it worth it to market this drug? – We do need to warn and run some models to see how it will affect sales…

…

IT was: - is it worth it to market this drug; let’s try it this way… IF WE DO NOT even warn, or provide some education to physicians, surgeons, and consumers is it worth it to market this drug? - The answer apparently was yes.

Sure they could have marketed it with proper education, warnings, etc. – but they chose NOT TO EVEN do that. RESULT arrogantly marketing it with a GREAT safety profile, stampeding the market AND begin planning on how to beat back the future litigation yet make a profit… – further result… thousands and thousands of deceased, life expectancies impacted, loved ones shattered, bones and spines that did not heal…

…

That is going a step beyond… Merck just basically let the clock run (ignoring FDA warnings, ignoring Independent Research, waiting until the statute of limitations was mostly effectively over, precisely timing it before the TRIAL PACKAGE was available (and was just about to be released…); avoiding the 250+ cases in 2008 which would have exposed much more truths with the trial package and individual testimonies; “settling” before the other high profile settlements with states, Medicare, etc which would have impacted opinion, “settling” before the increasingly apparent patterns of alleged deceit by concealment, fraudulently marketing, neglect,… ignoring their own people while they made LOTS of $ - AND EVEN after/IF the “settlement deal” goes through as is they STILL profit $3B from this poisonous drug.

….

“I pray that Merck will again allow us to purchase its wonderful product; I would gladly sign a release paper….”
….

Richard Loftfield
Jacksonville, Fla.

YUP – too bad INFORMED CONSENT AND being honest with physicians, surgeons, and consumers – let alone the pro-act, effective, and calculated “feel good about VIOXX” infomercials was not practiced by Merck, when it darn well should have been!

…

Merck spent I believe it was over $500M on advertising… Merck knew the party would end, and they drank as much as possible. Waking up with a bad hangover, they then reached for some relief, with what they had been counting on – PRIVATE SETTLEMENT (also called “GLOBAL SETTLEMENT”). Private means blocking and perverting legal representation; “global” is a “nice” way of saying it so as to have the public continue their feel good about Merck attitude that Merck so skillfully imbedded in that same public who would then become jurors… Sure, pump the heck out of sales with what is the Merck strategy of funding long term litigation with short term profits form shoddy drugs, one right after the other (and keeping the difference)…..it’s an obvious corporate strategy. THIS WILD WEST PRIVATE SETTLEMENT nonsense has to stop at Merck/Vioxx – NOW. Not after Merck and other drug companies are REALLY incented to place long term safety DEAD LAST in their priorities. Look, there are several things going on, and one of them is using PRIVATE SETTLEMENT deals to move the rats from the laboratories into the public domain…- it’s so obvious….
…
OH, let’s not forget the Independent Research, and the SCIENCE OF VIOXX which is more than just a bit compelling that you better not have had a bone or spine trying to heal while on Vioxx….Merck so skillfully put that one under the radar, even with so much published, as Merck just continues to feign ignorance. They must have had a moment of awareness, however, when they took their very correct description of how bones and spines heal out of their Merck Manual after 2001. I just do not see a coincidence there – and didn’t they do the same thing around 1999 with prostglandalins? ….now they are working the cost side of the profit equation more by looking for cheap private settlements – hey, virtually anyone knowing the corporate world would understand Merck has consciously undertaken it as their strategy.

Justinian Lane - KEEP it up; someone needs to give these rogue, radical TORT "REFORM" individuals some back. I have always been, am, and will always be for capitalism and profit - via education and experience...but businesses run amuck, just corrupting and influencing in a manner that is becoming a very, very shameful part of American History. We all know that PRIVATE SETTLEMENTS is merely so that the rats can move out of the laboratory and into the public domain so the drug companies can continue reckless, just absolutely reckless, their own version of Sherman's March to the SEA. We all know what is going on; and it needs to be STOPPED!
….

HAZARD ISSUE ASIDE - informed consent would not have been possible anyway - Merck made sure no-one was informed...

TO: Vioxx Helped Me Live a Lot Better and I'd like It Back - June 14, 2008; Page A10

…

NO – I am not in the “settlement”, but I feel for those souls that are really getting shafted, and I feel so big time…the first crime against morality is the litigants, and beyond that, you are not aware, but your civil rights are being eroded (again) as well as the litigants….shall the Vioxx settlement deal “work” for Merck – it has become a proxy in a battle of poorly and mean spirited conceived MASS LITIGATION REFORM, then it becomes a lynchpin for future atrocities.
….

What Merck SHOULD have done is practice what some other dangerous medicines (or known to have the potential to be so) do – INFORMED CONSENT; and have been honest with the doctors – and this goes for Heart – Stroke – Bone & Spine healing – and the other problems that they damn well knew about and that have much scientific evidence. Merck made a conscious decision NOT ONLY to market this very powerful and unknown (how it affects the body as a whole) but in about as arrogant as you can get – they (allegedly) decided NOT TO EVEN WARN OF THE POSSIBILITIES.

Merck’s cost/benefit was:
…

NOT – is it worth it to market this drug? – We do need to warn and run some models to see how it will affect sales…

…

IT was: - is it worth it to market this drug; let’s try it this way… IF WE DO NOT even warn, or provide some education to physicians, surgeons, and consumers is it worth it to market this drug? - The answer apparently was yes.

Sure they could have marketed it with proper education, warnings, etc. – but they chose NOT TO EVEN do that. RESULT arrogantly marketing it with a GREAT safety profile, stampeding the market AND begin planning on how to beat back the future litigation yet make a profit… – further result… thousands and thousands of deceased, life expectancies impacted, loved ones shattered, bones and spines that did not heal…

…

That is going a step beyond… Merck just basically let the clock run (ignoring FDA warnings, ignoring Independent Research, waiting until the statute of limitations was mostly effectively over, precisely timing it before the TRIAL PACKAGE was available (and was just about to be released…); avoiding the 250+ cases in 2008 which would have exposed much more truths with the trial package and individual testimonies; “settling” before the other high profile settlements with states, Medicare, etc which would have impacted opinion, “settling” before the increasingly apparent patterns of alleged deceit by concealment, fraudulently marketing, neglect,… ignoring their own people while they made LOTS of $ - AND EVEN after/IF the “settlement deal” goes through as is they STILL profit $3B from this poisonous drug.

….

“I pray that Merck will again allow us to purchase its wonderful product; I would gladly sign a release paper….”
….

Richard Loftfield
Jacksonville, Fla.

YUP – too bad INFORMED CONSENT AND being honest with physicians, surgeons, and consumers – let alone the pro-act, effective, and calculated “feel good about VIOXX” infomercials was not practiced by Merck, when it darn well should have been!

…

Merck spent I believe it was over $500M on advertising… Merck knew the party would end, and they drank as much as possible. Waking up with a bad hangover, they then reached for some relief, with what they had been counting on – PRIVATE SETTLEMENT (also called “GLOBAL SETTLEMENT”). Private means blocking and perverting legal representation; “global” is a “nice” way of saying it so as to have the public continue their feel good about Merck attitude that Merck so skillfully imbedded in that same public who would then become jurors… Sure, pump the heck out of sales with what is the Merck strategy of funding long term litigation with short term profits form shoddy drugs, one right after the other (and keeping the difference)…..it’s an obvious corporate strategy. THIS WILD WEST PRIVATE SETTLEMENT nonsense has to stop at Merck/Vioxx – NOW. Not after Merck and other drug companies are REALLY incented to place long term safety DEAD LAST in their priorities. Look, there are several things going on, and one of them is using PRIVATE SETTLEMENT deals to move the rats from the laboratories into the public domain…- it’s so obvious….
…
OH, let’s not forget the Independent Research, and the SCIENCE OF VIOXX which is more than just a bit compelling that you better not have had a bone or spine trying to heal while on Vioxx….Merck so skillfully put that one under the radar, even with so much published, as Merck just continues to feign ignorance. They must have had a moment of awareness, however, when they took their very correct description of how bones and spines heal out of their Merck Manual after 2001. I just do not see a coincidence there – and didn’t they do the same thing around 1999 with prostglandalins? ….now they are working the cost side of the profit equation more by looking for cheap private settlements – hey, virtually anyone knowing the corporate world would understand Merck has consciously undertaken it as their strategy.

Justinian Lane - KEEP it up; someone needs to give these rogue, radical TORT "REFORM" individuals some back. I have always been, am, and will always be for capitalism and profit - via education and experience...but businesses run amuck, just corrupting and influencing in a manner that is becoming a very, very shameful part of American History. We all know that PRIVATE SETTLEMENTS is merely so that the rats can move out of the laboratory and into the public domain so the drug companies can continue reckless, just absolutely reckless, their own version of Sherman's March to the SEA. We all know what is going on; and it needs to be STOPPED!
….

"Regardless of what thoughts a hypothetical citizen has when choosing to take a medication with high risks, the fact remains that if that citizen suffers an injury because of the drug, someone has to pay for those bills. I submit that the party who should pay for those bills is the manufacturer of the drug that caused the injury."

Justinian:

Fair enough, but you do realize that in the event the manufacturer has to pay for any damage caused by the drug *you still have a moral hazard.*

Initially, it seemed like preventing moral hazards was the whole point of this post:

"It seems that in order for any kind of a waiver to be fair, it would have to shift any cost of medical care entirely to the patient."

But from the consumer's perspective, the degree of moral hazard is the same whether the manufacturer pays for the damage or medicare/aid does. (Let's hope the consumer doesn't factor-in the possibility of jackpot consumer damages!)

The difference with placing the costs on the manufacturer is that the manufacturer has a choice not to sell the drug to a specific consumer due to that consumer's risk factors. If Merck (relying upon its own internal data) told Mr. Loftfield that it felt he was too high-risk to sell the drug to, then there's no moral hazard. And if Merck decided to sell the drug to him after evaluating his health, any moral hazard is minimized because Merck was the one who let the sale happen.

"If Merck...felt [Mr. Loftfield] was too high-risk to sell the drug to, then there's no moral hazard."

I agree there's no moral hazard if Merck doesn't sell any drugs: implicit in the very concept is that a consumer can choose their behavior. We can very much remove any moral hazard by locking Mr. Loftfield in a closet, but that's not the point of your post. Your original point involved consumers choosing drug waivers.

"And if Merck decided to sell the drug to him after evaluating his health, any moral hazard is minimized because Merck was the one who let the sale happen."

This doesn't make any sense. The very question you presented -- the effect of moral hazards upon consumers choosing to sign drug waivers -- presumes that the drug company is going to "let the sale happen."

Either a consumer bears the risk of loss for a particular activity, and behaves accordingly, or they don't. A drug company can test and poke and prod until the cows come home, and "let the sale happen," but unless the consumer bears some cost associated with the risk of the activity there will always be a moral hazard.

I personaly feel it is a Hazzard to sell any drug that affects anyone's well being, and I also feel the Vioxx was pushed on me in the time it was, and no I didn't know of and of the effects that it would have on me later on. So yes I feel like Merck should be fully resoppseible for it and I will hold them to it and that goes for any drug company that forsed any unsafe drugs to the marrket. Our FDA is so unbeleiveable that I just do not trust any of the new druds put out so I guess I will go back to the stone age Have a Great 4 of July

Lawyer, I don't see any situation in which we truly will allow a consumer to sign such a waiver because it would result in some people literally dying in the street for lack of medical care. Maybe I'm missing something here, and if I am, do explain. But as I see it, if we allow Mr. Loftfield to take Vioxx and he has a stroke that he can't pay for, there are two choices: First, let him die. Second, make medical professionals give him medical care that he can't pay for. The former is socially unacceptable, and the latter still causes a moral hazard because Loftfield knows he'll be taken care of by SOMEONE if he has a stroke. (Unless of course, Loftfield has enough money to pay for his $100k+ hospital stay. If he does, pretend we're talking about Mr. Smith, who does not.)

Justinian, you continue to miss Lawyer's point, which is that your "moral hazard" argument proves too much, since the only way to avoid moral hazard in healthcare is to "let people die in the streets." So whatever your argument for pharmaceutical liability, "moral hazard" isn't it, because you're perfectly content to have moral hazard apply in other healthcare situations where pharmaceutical liability isn't at issue.

Not to mention the fact that you're perfectly content to have moral hazard apply to plaintiffs' lawyers' meritless lawsuits, whereby they don't have to bear the full costs of the expense they impose on others.

Ted is getting a glimpse. The rate of weak cases and the absolute litigation privilege represent a regulatory taking. The absence of recourse for this injustice justifies a self-help response. No judge, no plaintiff lawyer, no plaintiff should live in peace while they destroy innocent people with zero accountability. Shun the cult criminals, including for essential services and products.

Enacting a constitutional amendment ending all self-dealt immunities of the cult criminal is for the welfare of the cult criminal. The alternative recourse is grim for them.

Ted, why don't you respond to what I write, rather than what you'd like to refute? The entire point of my post was that there is a moral hazard in allowing someone to take a dangerous drug like Vioxx when that person won't have to pay the costs.

Because we aren't willing to let people die in the street, the question then becomes one of who should pay the costs? You've yet to offer even one reason why the taxpayers should pay for the cost of Vioxx-induced heart attacks.

"[M]y [point] was that there is a moral hazard in allowing someone to take...Vioxx when that person won't have to pay the costs."

And it's a valid point. But again, the very existence of health insurance, medicare and medicaid, means, by nature, that third parties pay Americans' health care costs writ large. Thus, our entire health care system is permeated with moral hazards across all activities. This is why it's puzzling that Vioxx would be singled out. If we're charging Vioxx takers for their heart-attacks, why shouldn't the sexually reckless or needle-sharers bear the risk of their AIDS treatment? Should extreme sports enthusiasts have to fit the bill for their broken bones? Or chain-smokers internalize the cost of their cancer treatment? Should surfers pay for shark attacks? It seems to me that if we're jumping on the bandwagon of making people pay for their risky activities, there are many higher on the list than simply prescription pain-killers.

"[T]he question then becomes...who should pay the costs? You've yet to offer even one reason why the taxpayers should pay for the cost of Vioxx-induced heart attacks."

(Of course, we're assuming here that the person's health insurance won't cover their heart-attack, which in many cases it would.)

This is a valid question, but again proves too much. Why should taxpayers have to pay the cost of an *anything*-induced heart-attack? Why should they have to bear the cost of a sedentary-lifestyle induced heart attack? Why a high-fat diet heart-attack? A cocaine-induced heart-attack? A stress-induced heart attack? To ask this question for Vioxx is to indict our entire system that reimburses the cost for privately-caused heart-attacks.

So the reason Ted has "yet to offer even one reason why the taxpayers should pay for the cost of Vioxx-induced heart attacks" is because there isn't any reason why taxpayers should pay for *any* privately-caused heart-attacks, other than the fact that we as a society have collectively decided to pay for people's maladies.

I singled out Vioxx because it's a drug that's so dangerous the manufacturer won't sell it. The same thinking would apply to drugs the FDA hasn't approved.

With respect to drugs the FDA has approved - those drugs are sold for a profit, and I believe it makes sense for the seller to pay for the costs associated with that drug. At least, more sense than for taxpayers or private insurers.

All of the other risky activities you cite are not preempted. You can certainly sue a coke dealer. You can sue someone who shared a needle with you or had sex with you and gave you AIDS. Obviously you can sue big tobacco, and people have sued equipment manufacturers and hosts of extreme sports events. Some even tried suing fast food because of health problems brought about by their sedentary lifestyles. In all of those types of lawsuits, juries are free to decide who is at fault and apportion damages accordingly.

So why not also with prescription drugs? Because of their social utility? Then how about a sliding scale of utility for preemption purposes? Viagra has little or no social utility - it simply promotes recreational sex, so why not allow people to sue if they're injured over it? Vioxx was hardly a lifesaving drug, but merely another painkiller. It has more social utility than Viagra, but not by a large margin; come on, should some people die just so that others don't have to suffer from arthritis pain?

If someone wants to make the argument that truly lifesaving drugs, or drugs that otherwise have great societal benefit deserve protection from lawsuits, I'll at least listen to that argument. But to say that no drug company should be able to be sued over any drug doesn't sit right with me. Especially when I as a taxpayer have to pick up the tab.

The lawyer and the judge have no social utility. They have a negative value. Remove these incompetent oppressors, we are all better off. Explain why they cannot be sued for their harmful carelessness.

Vioxx is far less dangerous than aspirin. When you claim otherwise, you sound dishonest or stupid.

"With respect to drugs the FDA has approved - those drugs are sold for a profit, and I believe it makes sense for the seller to pay for the costs associated with that drug."

Your qualifier makes no sense. If I sell a drug the FDA hasn't approved, I shouldn't be liable? Why does FDA approval make me more liable?

Aspirin and other NSAIDs kill and hospitalize tens of thousands of people a year. Is Justinian really proposing that the manufacturer of aspirin be required to pay damages (and don't forget that Justinian is against limiting pain-and-suffering damages) to each of these people for these well-known side-effects? If we assume $5 million per death and $500,000 per hospitalization, we're talking about $76 billion in annual damages to be paid by the aspirin industry. (And keep in mind the typical Vioxx jury awarded far more than that assumption per death or hospitalization on the rare occasion they found Merck liable.) If so, the damages would exceed the profitable revenues from the sale of the drug -- unless the price was increased to over $100 dollars a bottle. That doesn't make healthcare cheaper. It would provide a lot of new jobs for lawyers, though. Heck, if Justinian's strict-liability regime passes, I might quit my job and become a multi-millionaire through aspirin litigation. But it's not clear why medical consumers are better off making me a multi-millionaire.

It's funny how leftists are complaining about private health insurance because it has administrative costs of 20 percent, but demand health insurance to be provided through a tort system that has administrative costs of 55-65 percent.

"Then how about a sliding scale of utility for preemption purposes? Viagra has little or no social utility - it simply promotes recreational sex, so why not allow people to sue if they're injured over it? Vioxx was hardly a lifesaving drug, but merely another painkiller. It has more social utility than Viagra, but not by a large margin; come on, should some people die just so that others don't have to suffer from arthritis pain?"

Ah, so it's morality that's at issue. Justinian doesn't think drug manufacturers should be allowed to sell drugs that make people's lives better when it just simply leads to sex or pain relief. Of course, food is also FDA approved, and Justinian's principle also implies that trial lawyers also get to decide to stop us from eating fatty foods or drinking, by suing those industries out of existence: Ben & Jerry's has even less utility than Viagra.

"[T]hose drugs are sold for a profit, and I believe it makes sense for the seller to pay for the costs associated with that drug."

But why? Car manufacturers rarely pay the costs of car accidents; swimming-pool manufacturers don't pay the costs of drownings; nor does Anheuser-Busch pay the costs of drunk-driving crashes. Note that your position has turned from once arguing *against* moral hazards, to taking the position that drug manufacturers should pay for all "costs," which would only create a even *larger* moral hazard.

"All of the other risky activities you cite are not preempted."

That's true, but preemption literally has nothing to do with whether a moral hazard is present. And note, you can't sue a shark, or a cliff you fall from while rock-climbing, or a tree you hit while skiing. You can't sue gravity. But we, as a society, are willing to fit the health-care bill anyway.

"Then how about a sliding scale of utility for preemption purposes?"

Isn't this the *very basis* of the Texas Republican platform that abortion-pill manufacturers, et al., shouldn't receive the benefits of damage caps and suit preemption? Weren't they called hypocrites for that?

"[S]hould some people die just so that others don't have to suffer from arthritis pain?"

Should *some* people die because we're unwilling to put highway speed limits at 40 mph? Should *some* people die because we're willing to allow convertibles, or atv's, or motorcycles? Should *some* people die because we aren't willing to ban swimming pools? In my opinion, yes.

"Give me liberty..." how does that saying go again?

"Your qualifier makes no sense. If I sell a drug the FDA hasn't approved, I shouldn't be liable? Why does FDA approval make me more liable?"

Read what I write, Ted. Read! If a drug isn't approved by the FDA, it shouldn't be for sale at all. And if you do sell it, you should of course be liable.

As for your aspirin hypothetical? First, you don't cite any authority for your "tens of thousands" statement; is there any, or are you just ballparking it? And of those deaths/hospitalizations, how many are from overdoses? Second, as you stated, the risks of aspirin are well-known, whereas Merck concealed the risks of Vioxx. Your $76 billion figure presumes that juries would find them liable in 100% of cases - not likely, or aspirin manufacturers would already be deluged by lawsuits.

"Ah, so it's morality that's at issue. Justinian doesn't think drug manufacturers should be allowed to sell drugs that make people's lives better when it just simply leads to sex or pain relief."

It's not a morality issue at all. I don't care how much Viagra is sold, or how much sex people are having. I just don't want my tax dollars to pay for the medical costs associated with Viagra.

When should you be able to sue the manufacturer of a fatty food? When the manufacturer mislabels the product and claims it has fewer calories/fat grams/etc. than it actually does. Other than that, I don't support failure to warn suits against the food industry.

And for the record, Ben & Jerry's has more utility than Viagra: First, it can be used by people of all ages and genders. Second, as a food product it can sustain life whereas Viagra can't. Third, priaprism isn't a side effect of eating Ben & Jerry's. And finally, Ben & Jerry's doesn't run gross commercials showing guys throwing footballs through tires and other lame sexual metaphors.

Justinian: Anytime you need my research assistance, let me know. I will gladly fetch references for your edification.

I suspect that data will have no impact on your criminal cult indoctrination. Ted, by dint of his IQ of 300, compared to your average one, is catching a glimpse. He still has zero tolerance for any discussion of his cult indoctrination into believing in supernatural legal doctrines. These are idiotic to the 8th grade science student, and cause the utter failure of the lawyer profession. By his forbearance for the idiotic supernatural doctrines, he too becomes idiotic and ridiculous. Idiotic is totally contagious. I shouldn't even be hanging out too long with you victims of criminal cult indoctrination. I feel my own idiocy coming on.

These are not suicide attempts, genius. They are old people who have lost half their blood before passing out, from ulcers caused by aspirin. This problem was to be remedied by the NSAIDS. The lawyer has deterred the production of NSAIDS. I expect a resurgence of stomach bleeding thanks to the lawyer.

"Each year, use of NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) accounts for an estimated 7,600 deaths and 76,000 hospitalizations in the United States." (NSAIDs include aspirin, ibuprofen, naproxen, diclofenac, ketoprofen, and tiaprofenic acid.)

Source: Robyn Tamblyn, PhD; Laeora Berkson, MD, MHPE, FRCPC; W. Dale Jauphinee, MD, FRCPC; David Gayton, MD, PhD, FRCPC; Roland Grad, MD, MSc; Allen Huang, MD, FRCPC; Lisa Isaac, PhD; Peter McLeod, MD, FRCPC; and Linda Snell, MD, MHPE, FRCPC, "Unnecessary Prescribing of NSAIDs and the Management of NSAID-Related Gastropathy in Medical Practice," Annals of Internal Medicine (Washington, DC: American College of Physicians, 1997), September 15, 1997, 127:429-438, from the web at http://www.acponline.org/journals/annals/15sep97/nsaid.htm, last accessed Feb. 14, 2001, citing Fries, JF, "Assessing and understanding patient risk," Scandinavian Journal of Rheumatology Supplement, 1992;92:21-4.