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</o:shapelayout></xml><![endif]--></head><body lang=EN-US link=blue vlink=purple style='word-wrap:break-word'><div class=WordSection1><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></p><div style='border:none;border-top:solid #E1E1E1 1.0pt;padding:3.0pt 0in 0in 0in'><p class=MsoNormal><b><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>From:</span></b><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'> John Clark <johnkclark@gmail.com> <br><b>Sent:</b> Wednesday, 4 November, 2026 6:14 AM<br><b>To:</b> spike@rainier66.com<br><b>Cc:</b> ExI chat list <extropy-chat@lists.extropy.org><br><b>Subject:</b> Re: [ExI] Why is “cost of living” such a big problem?<o:p></o:p></span></p></div><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal>On Wed, Nov 4, 2026 at 8:59<span style='font-family:"Arial",sans-serif'> </span>AM <<a href="mailto:spike@rainier66.com">spike@rainier66.com</a>> wrote:<o:p></o:p></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'> </span><o:p></o:p></p><blockquote style='border:none;border-left:solid #CCCCCC 1.0pt;padding:0in 0in 0in 6.0pt;margin-left:4.8pt;margin-right:0in'><div><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span class=gmaildefault><i><span style='font-size:13.5pt;font-family:"Arial",sans-serif'>> </span></i></span><span class=m7509927710949410414gmaildefault><i><span style='font-size:13.5pt;font-family:"Georgia",serif'>John look at that list below. If the developers of those medications have no way to make back the cost of development and qualification thru FDA many times over (to cover the risk) investors would not put money in those companies and none of those medications would exist.</span></i></span><o:p></o:p></p></div></blockquote><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><b><span style='font-size:13.5pt;font-family:"Tahoma",sans-serif'>>…And the cost for developing those drugs should be <u>entirely</u> paid for by United States citizens and by nobody else?! …..<o:p></o:p></span></b></p><p class=MsoNormal><b><span style='font-size:13.5pt;font-family:"Tahoma",sans-serif'><o:p> </o:p></span></b></p><p class=MsoNormal><b><span style='font-size:13.5pt;font-family:"Tahoma",sans-serif'>No, the cost for developing the drugs should be paid for by investors, which can be from anywhere. How the companies make back their money is a function of intellectual property law, which has merit. Information wants to be free, but information producers want to be paid. If IP law is not robust, investors will not dump piles of money into medical research. That is always an inherently risky bet. It is why it is called research, rather than refind. It hasta pay off big if one chooses the right company.<o:p></o:p></span></b></p><p class=MsoNormal><b><span style='font-size:13.5pt;font-family:"Tahoma",sans-serif'><o:p> </o:p></span></b></p><p class=MsoNormal><span class=gmaildefault><b><span style='font-size:13.5pt;font-family:"Tahoma",sans-serif'>>…Are you sure you're a libertarian? </span></b></span><o:p></o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><span class=gmaildefault><b><span style='font-size:13.5pt;font-family:"Tahoma",sans-serif'>John K Clark<o:p></o:p></span></b></span></p><p class=MsoNormal><b><span style='font-size:13.5pt;font-family:"Tahoma",sans-serif'><o:p> </o:p></span></b></p><p class=MsoNormal><b><span style='font-size:13.5pt;font-family:"Tahoma",sans-serif'>Of that, I have never been surer, but I will qualify my response: Libertarian is not one party, any more than either of the two mainstreamers are unified parties. A perfect example of that will be seen in the next congress. I confidently predict the new party in power will use most of its term fighting itself. Its mainstream will fight its emergent socialist wing. Eventually that will split the party. We have seen this before.<o:p></o:p></span></b></p><p class=MsoNormal><b><span style='font-size:13.5pt;font-family:"Tahoma",sans-serif'><o:p> </o:p></span></b></p><p class=MsoNormal><b><span style='font-size:13.5pt;font-family:"Tahoma",sans-serif'>spike<o:p></o:p></span></b></p><p class=MsoNormal><b><span style='font-size:13.5pt;font-family:"Tahoma",sans-serif'><o:p> </o:p></span></b></p><p class=MsoNormal><b><span style='font-size:13.5pt;font-family:"Tahoma",sans-serif'><o:p> </o:p></span></b></p><p class=MsoNormal><span class=gmaildefault><b><span style='font-size:13.5pt;font-family:"Tahoma",sans-serif'><o:p> </o:p></span></b></span></p><p class=MsoNormal><b><span style='font-size:13.5pt;font-family:"Tahoma",sans-serif'><o:p> </o:p></span></b></p><p class=MsoNormal><span class=gmaildefault><b><span style='font-size:13.5pt;font-family:"Tahoma",sans-serif'><o:p> </o:p></span></b></span></p><p class=MsoNormal><span class=gmaildefault><b><span style='font-size:13.5pt;font-family:"Tahoma",sans-serif'><o:p> </o:p></span></b></span></p><p class=MsoNormal><span class=gmaildefault><b><span style='font-size:13.5pt;font-family:"Tahoma",sans-serif'><o:p> </o:p></span></b></span></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal> <o:p></o:p></p><blockquote style='border:none;border-left:solid #CCCCCC 1.0pt;padding:0in 0in 0in 6.0pt;margin-left:4.8pt;margin-right:0in'><div><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'> </span><o:p></o:p></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'> </span><o:p></o:p></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'> </span><o:p></o:p></p><h3 style='margin-top:0in'><span class=m7509927710949410414gmaildefault><span style='font-family:"Arial",sans-serif'> </span></span><span style='font-family:"Arial",sans-serif'>Examples of Price Disparities (Estimated Out-of-Pocket / List Price)</span><o:p></o:p></h3><table class=MsoNormalTable border=0 cellpadding=0><thead><tr><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><strong><span style='font-family:"Arial",sans-serif'>Medication</span></strong><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><strong><span style='font-family:"Arial",sans-serif'>Common Indication</span></strong><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><strong><span style='font-family:"Arial",sans-serif'>U.S. Retail Price (Approx.)</span></strong><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><strong><span style='font-family:"Arial",sans-serif'>Canada Retail Price (Approx.)</span></strong><o:p></o:p></p></td></tr></thead><tr><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><span style='font-family:"Arial",sans-serif'>Ozempic</span></b><span style='font-family:"Arial",sans-serif'> (Semaglutide)</span><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Arial",sans-serif'>Type 2 Diabetes / Weight Loss</span><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Arial",sans-serif'>~$950 – $1,000 / month</span><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Arial",sans-serif'>~$300 – $330 / month</span><o:p></o:p></p></td></tr><tr><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><span style='font-family:"Arial",sans-serif'>Eliquis</span></b><span style='font-family:"Arial",sans-serif'> (Apixaban)</span><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Arial",sans-serif'>Blood Thinner / Stroke Prevention</span><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Arial",sans-serif'>~$550 – $800 / month</span><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Arial",sans-serif'>~$130 – $150 / month</span><o:p></o:p></p></td></tr><tr><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><span style='font-family:"Arial",sans-serif'>Lantus / Humalog</span></b><span style='font-family:"Arial",sans-serif'> (Insulin)</span><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Arial",sans-serif'>Diabetes</span><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Arial",sans-serif'>~$280 – $350 / vial</span><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Arial",sans-serif'>~$30 – $45 / vial</span><o:p></o:p></p></td></tr><tr><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><span style='font-family:"Arial",sans-serif'>EpiPen</span></b><span style='font-family:"Arial",sans-serif'> (Epinephrine 2-pack)</span><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Arial",sans-serif'>Severe Allergic Reactions</span><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Arial",sans-serif'>~$550 – $650</span><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Arial",sans-serif'>~$100 – $150</span><o:p></o:p></p></td></tr><tr><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><span style='font-family:"Arial",sans-serif'>Xarelto</span></b><span style='font-family:"Arial",sans-serif'> (Rivaroxaban)</span><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Arial",sans-serif'>Blood Thinner</span><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Arial",sans-serif'>~$590 / month</span><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Arial",sans-serif'>~$135 / month</span><o:p></o:p></p></td></tr><tr><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><span style='font-family:"Arial",sans-serif'>Advair Diskus</span></b><span style='font-family:"Arial",sans-serif'> (Fluticasone/Salmeterol)</span><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Arial",sans-serif'>Asthma / COPD</span><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Arial",sans-serif'>~$350 – $400 / inhaler</span><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Arial",sans-serif'>~$80 – $160 / inhaler</span><o:p></o:p></p></td></tr><tr><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><span style='font-family:"Arial",sans-serif'>Januvia</span></b><span style='font-family:"Arial",sans-serif'> (Sitagliptin)</span><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Arial",sans-serif'>Type 2 Diabetes</span><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Arial",sans-serif'>~$320 / month</span><o:p></o:p></p></td><td style='border:solid #C4C7C5 1.0pt;padding:6.0pt 9.0pt 6.0pt 9.0pt'><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Arial",sans-serif'>~$165 /</span><o:p></o:p></p></td></tr></table><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'> <o:p></o:p></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'> <o:p></o:p></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><span style='font-size:13.5pt;font-family:"Tahoma",sans-serif'>I don’t use any of those, but I am glad they exist. Are you?</span></b><o:p></o:p></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><span style='font-size:13.5pt;font-family:"Tahoma",sans-serif'> </span></b><o:p></o:p></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><span style='font-size:13.5pt;font-family:"Tahoma",sans-serif'>spike</span></b><o:p></o:p></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'> <o:p></o:p></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'> <o:p></o:p></p></div></blockquote></div></body></html>