So the other night I'm randomly channel surfing while getting ready to hit the hay. I came across a PBS Frontline story entitled, "Hunting the Nightmare Bacteria". 
 Being an old chemistry major and being interested in science in general I was quickly reeled in. 
Specifically the feature focused on outbreaks of KPC, an increasingly found form of gram-negative bacteria that are resistant to known antibiotics.

From a paper found on the National Institutes of Health website by Ryan et al.:

Klebsiella pneumoniae carbapenemase (KPC)-producing bacteria are a group of emerging highly drug-resistant Gram-negative bacilli causing infections associated with significant morbidity and mortality. 

Basically this once rare form of bacteria has had outbreaks at hospitals, beginning in the New York and New Jersey area. Since it is not impacted by known antibiotics there is no known cure. It has proven fatal and other survivors have lost limbs. They live in fear of the infection returning.
There are other gram negative bacteria as well, deadly and resistant to existing antibiotics, that are showing up as well. From an article in the New York Times:
The bacteria, classified as Gram-negative because of their reaction to the so-called Gram stain test, can cause severe pneumonia and infections of the urinary tract, bloodstream and other parts of the body. Their cell structure makes them more difficult to attack with antibiotics than Gram-positive organisms like MRSA.

On a more general level the story dealt with the lack of development of new antibiotics to combat these increasingly prevalent and potent bugs. There are many reasons for this but the market does play a role.
According to the story it costs between $600 million and $1 billion dollars to develop a new drug and bring it to market. Obviously the pharmaceutical companies have to recoup that money and eventually show a profit. For antibiotics that can prove problematic.
Antibiotics have been over prescribed and overused. The two biggest transgressors are medicine and agriculture. Antibiotics are prescribed routinely at the first sign of a sniffle. They are extensively used in modern factory-farming agriculture in the raising of livestock. They get into the food supply and water supply.
With all this use comes decreased effectiveness as the bacteria mutate and develop resistance to the drugs. Evolution can be a bitch.
The other part of the scarcity is the economics of it all. There is a recognition that antibiotics are overused. And by their very nature antibiotics, even when used properly, are only intended for a finite period of time until the patient gets better. 
Therein lies the rub. Why spend a billion dollars developing something that should be used sparingly and only for a short period of time? 
As one pharmaceutical company worker put it (paraphrasing), I can produce a cholesterol drug that people need to basically take every day for the rest of their lives, and make billions in profits, or put a billion dollars into developing a new antibiotic that even those using it will only need for a period of days or weeks.
In the face of these increasingly toxic gram negative resistant bacteria there are now only one or two major companies working actively on new lines of antibiotics. Pfizer built a whole new facility to work on the issue but pulled the plug a couple of years ago. As the report stated we are about to enter a brave new world of increasingly deadly bacteria combined with decreasing availability and efficacy of antibiotics. The studies in the U.S. have not been done to determine how many of the approximately 99,000 bacterial deaths each year are from Gram negative bacteria. But in Europe where such studies have been done it is thought that 2/3 of the 25,000 bacterial deaths each year can be ascribed to the gram negative strains. Source for these figures is the same New York Times article cited above.
As I watched this show it struck me that here again we see the practical limits of leaving everything up to the free market. The pharmaceutical companies are not villains in this story, they are pursuing profits in a legal and lawful way, nothing egregious about that. But you can't argue that having no research and development of antibiotics is in the public interest.
The free market tells the companies to develop and market drugs for chronic conditions. The public interest says we need sane policies about antibiotic use and a steady supply of existing antibiotics and development of drugs to combat the gram negative bacteria. 
So there are several ways to address the issue. The free market purists say "oh well the increased mortality we are about to experience is the price of freedom." Most humans would find that answer unsatisfying and at some level, grotesque. On the other side one might argue for government takeover of something so important and vital to the public health and safety. In between are a range of other options. 
It would seem to me that between the NIH and CDC here, or maybe even under the guise of the WHO of the UN, governments could direct and fund independent research and development of necessary, but not profitable, drugs. Or governments could provide incentives and money to private companies to ensure the work was done and new antibiotics were available. The mechanics of how the costs and profits are split would be an interesting detail to work out.
But the larger point is this, the free market does not always arrive at the answer that is in the best interest of the public, or the nation, certainly not in the long run. 
We saw that with the whole discussion over energy policy in the late 70's and early 80's. We started down the path of energy independence and government providing seed money into the development of clean, renewable energy sources. Then Reagan pulled the plug on all of it and said the free market would decided what energy sources were best. Since the production and distribution channels already existed for fossil fuels we know what answer the market came up with. And as a country and a planet we would have been in a much better place if the Carter initiatives around energy had been allowed to continue.
The whole matter of development and availability of effective antibiotics is just another example. The market doesn't know public or national interest. It does not take a long range view in its cost/benefit analysis. That is why we have governments.

So last night the family was sitting around talking about the recent shenanigans in DC around the government shutdown and the debt ceiling.
The TV was on in the background and the story was about the Virginia's governor race. They were talking about Ken Cuccinelli, the GOP candidate and incumbent Attorney General. Specifically they were detailing how much of his focus and energy is on social issues, especially dealing with female reproductive health. Dude is downright obsessed.
At one point it was mentioned that he was in favor of outlawing contraception, even the birth control pill. This blew my wife away, as in how in 2013 could we possibly have to be fighting about something so basic that so many women use? I reminded her that the "conscience clause" that so many conservatives want to add to Obamacare was about the last vestige of health care reform nullification demands the GOP took off the table before their abject surrender.
You know the "conscience clause"? That's where an employer is given the right to object to, and opt out of, paying for plans that provide coverage for anything the employer finds morally objectionable. Presumably it would be for employers to be able to say that the health care plans they offer to their employees will not cover female contraception, at least not without a copay as mandated by Obamacare.
Well this must have gotten my subconscious working and in the wee hours of the morning I awoke with a thought. "Why is it that only female contraception goes against God's will, but erectile dysfunction medications do not?"
I mean at the heart of it that does seem to be the moral/religious objection to the Pill and female contraceptives. (I know, we all know it's really about control of women and certain people always being afraid that someone is having more fun in this life than they are, women having sex with less fear of consequences, etc.) But taken at face value the objection seems to be that contraception is interfering with God's plan. Only God decides when, where and how life begins. By taking the Pill women are taking the power away from God and making that decision on their own. (We won't get into a discussion about how God supposedly gave us all free will, but so many conservatives will fight like hell to be sure nobody is allowed to exercise it.)
And if that's true then why is it morally okay for a man to take Viagra or some other erectile dysfunction drug? Obviously God intended for you to have a limp dick or you wouldn't have one. He has decided you should not reproduce (which we are often reminded is the only acceptable reason for sexual relations). By taking an ED drug and being able to have a boner you are thwarting God's plan. 
Yet the Ken Cuccinelli's of the world never talk about outlawing ED drugs. And apparently nobody believes there needs to be a conscience clause added to Obamacare to allow employers to opt out of paying for treatments that are so obviously morally objectionable. 
A glaring inconsistency if you ask me. Sticks out like a sore thumb.

Been just dumbfounded and sick over the whole government shutdown and debt ceiling "crises" and the potential harm to our country and its citizens both short and long term.
But one piece keeps eating at me and wasn't sure if it was just me or if this is also one of the more galling aspects of this catastrophe for others as well.
The GOP, surrendering any sense of responsibility and decency to its most rabid wing, plunges the nation into crisis and shuts down the government. Its members then try to make political hay out of it by having daily faux outrage outbursts on camera as they discover that another government facility, monument, or park is shuttered. Or that some government function isn't happening and so some group is not having its needs attended to.
What part of government shutdown didn't they understand when they so gleefully decided to throw yet another tantrum over Obamacare and turn the lights off on the government? You can't decide not to fund the government and then be outraged that the WW2 memorial isn't open, or that families of deceased soldiers aren't getting their checks?
And then to try to blame the whole non-functioning piece on the White House or Senate Democrats. Like they were the ones who wanted the government to stop functioning. 
And we won't even get into how selective their outrage is. Cancer patients not getting their last chance treatments from the National Institutes of Health? The CDC not up and running as we head into flu season? Bare bones at the NOAA as we make our way through hurricane season? No Head Start for thousands? No food for young mothers and children in the WIC program? No personnel to adequately take care of food inspections as a salmonella outbreak unfolds? 
Hardly a mention from the GOP on those items. Can't wrap yourself in the flag and use veterans as a photo-op for those issues. 
Polls show the GOP is taking the blame for the shutdown and their brand is tanking. It is well deserved. They are reaping as they have sown. They created the shutdown and they should own it. Yeah, GOP, you did build this. 

More random thoughts on the government shutdown and what is going on in Washington.

So basically these Republicans, who claim to be the true protectors of the country and the Constitution, don't understand anything about democracy or the U.S. Constitution. More accurately some of them probably do, but don't care.

Let's recap. The Republican standard bearer in 2012 ran against the Affordable Care Act, aka ACA aka Obamacare. He stated he would repeal it "day one". His party supported him in this proposal. They lost. He lost by about 5 million votes. His party lost two seats in the Senate allowing the Democrats to keep control of that chamber even though they had twice as many incumbents and open seats up for grabs as the GOP did. The GOP lost 10 seats in the House. They lost the overall national popular vote for the House. They maintained control of the House only through severe gerrymandering in many states. This is only about the 5th or 6th time in American history where the party that won the popular vote did not end up being the majority party in the House. 

Despite all this they refuse to yield to the voters will. They use their only leverage, control of the House, to bring the government to its knees, unless the policies they ran and lost on, are enacted. This is unprecedented. To my knowledge it was only tried once before - in 1995 by the GOP again. 
So basically the modern GOP, if it can't win at the polls, decides to use political extortion, beyond the methods laid out in the Constitution, to get its way. All the time proclaiming to be working for "what the people want".