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The Google memo has made the rounds — it’s been analyzed, debunked, picked apart — and now it’s made it onto The Weeds. On the August 9 episode, Sarah, Matt, and Ezra unpack the circumstances surrounding the firing of Google engineer James Damore.
Damore wrote a 10-page memo arguing against the company’s policies to enhance workplace diversity, insisting that the company’s gender gap in leadership positions and engineering jobs was the result of biological differences between women and men, though it’s been pointed out by the researchers he cites that he misapplied their work.
As Sarah points out in the episode, and in her gender wage gap explainer, Damore’s argument ignores underlying issues of systemic sexism that make women less likely to seek out jobs in workplaces like Google.
She also argues that the diversity issues at some organizations could stem from the presence of colleagues like Damore — that women likely “don’t want to work in an environment where their colleagues think they are mentally inferior to them, where they haven’t been encouraged to think, ‘Yes, you are someone who belongs here; yes, you are someone who's going to be just as successful.’” She continues: “It seems like an explanation that should fly back at this guy for why aren’t there as many women in tech? Well, it’s because you’re writing memos like these ones.”
The Weeds team also explores options for drug pricing and what regulations the government can institute to make medicine more affordable, while still encouraging drug companies to innovate. They also break down a study that shows doctors who attended less rigorous medical schools were more likely to prescribe more opioids to patients.
You can listen to the episode here, or subscribe to the show on iTunes here.
Here’s Ezra talking about the importance of innovation in medicine:
Bernie Sanders — he's had in the past, I don't know if he's reintroduced it in this Congress — but he's had an idea I've always thought is a pretty good one.
The way we do drug pricing right now is based on patents. The reward for creating a drug is that you patent it, and then you get — I forget the length of exclusivity — but before other people can make generic versions of that drug, you get 12 years, or something like that, and during that period, the market is not working. You have a government-granted monopoly on this product. You're the only one who can sell it, and so you can charge basically any price, because nobody can come into the market and undercut you in the way that, like, Apple comes out with a cool new iPod, and somebody else can't sell you Apple's iPod but they can make their own iPod; they’ve gotta do it a little bit different, but you're able to have competition in these spaces.
What Sanders has argued, and other people have argued this too over the years, is that at the very least [we should have] a parallel system. It would be wise, because drug innovation is something we want to incentivize, and the way we're doing it is currently very inefficient. It also incentivizes companies to create "me too" drugs that just allow them to basically renew their patent on something but doesn't really work any better or just looks like something somebody else has done, so a lot of the innovation we're getting is just chasing these monopolies, with no real thought for what people need or where the innovation will be most useful.
So [Sanders] has argued that we would have to have a fund — and it would have to be quite big — that would allow for prize-based drug innovation. So the government would say if you are a company that manages to create a pill — and I'm just completely using a hypothetical example here — a pill that could be a massive improvement on current AIDS cocktail regiments, or if you could create an AIDS vaccine, let's say. You would get — again, I'm picking a number out of thin air here — $5 billion, but as soon as that happens — and it doesn't have to be a company; you could be a university, you could be a guy in your garage — you get this $5 billion check, and then the formula is immediately generic so anybody can make it. And so it could be available at very low cost to the public.
And then the government could say what do we feel the most strongly about getting innovation in, and opioids might be a real place for this. If you can create a treatment that is clearly an improvement on current anti-addictive pharmaceuticals, then you would get this huge windfall, and anybody would be able to make the treatment. Or if you could get a treatment that somehow is able to help the obesity crisis, you could get this huge amount of money.
One thing I would note: Democrats are thinking about how to bring drug prices down, but they're not thinking, in a real way, about how to bring innovation up, and we really somehow need to do both. It's often presented as a choice, but the system we have right now is not one oriented toward innovation; it's one oriented toward profit-making, with innovation being one side effect, but also a lot of waste being a side effect, and a lot of people not being able to buy drugs being a third side effect. And I would like to see both Democrats and Republicans thinking a bit harder on this.
Show notes:
- “Google’s Ideological Echo Chamber”
- Sarah’s piece on the gender wage gap
- Matt’s article about gender bias in venture capital firms
- Matt mentioned this study out of Northwestern’s Kellogg business school on diversity in the workplace
- Vox’s Julia Belluz on drug pricing
- Julia’s piece on back pain
- Sarah’s story on the cost of Sovaldi
- White paper from Princeton on physician education
- Atul Gawande’s Cost Conundrum piece in the New Yorker