u/firehmre

i used to roll my eyes when people said pharmaceutical companies would rather treat symptoms forever than actually cure a disease. it sounded like standard internet paranoia.

but then i found an actual research report from Goldman Sachs from april 2018, and it’s honestly one of the most bleak things i’ve ever read. they say the quiet part out loud: curing people is bad for long-term cash flow.

the report is called "The Genome Revolution" (written by analyst Salveen Richter). in it, they explicitly ask the question: "Is curing patients a sustainable business model?"

they didn't just ask the question; they provided a real-world case study to warn investors. they used Gilead Sciences and their Hepatitis C drugs (Sovaldi and Harvoni) as the ultimate cautionary tale.

here is the actual financial timeline:

• in 2015, Gilead released a genuine medical miracle. their new drugs had a Hepatitis C cure rate of over 90%.

• because the drug was incredible, their us revenue absolutely skyrocketed to $12.5 billion that year.

• but because the drug actually worked, they rapidly shrank the pool of infected people. they basically cured their own customer base.

• by 2018, Goldman estimated their us sales for those treatments would plummet to under $4 billion. (actual revenue reports confirmed this massive slide).

Goldman’s takeaway for investors? "In the case of infectious diseases such as hepatitis C, curing existing patients also decreases the number of carriers able to transmit the virus to new patients, thus the incident pool also declines... this could represent a challenge for genome medicine developers looking for sustained cash flow."

they even point out that treatments for chronic conditions pose "less risk to the sustainability of a franchise."

it’s not a cartoon villain conspiracy. it’s just the cold, hard math of fiduciary duty. a patient who needs a daily pill for 40 years is a highly valued recurring revenue stream. a patient who is cured in 30 days is a financial loss. we've built a system where the ultimate medical triumph is actively punished by the stock market.

sources if you want to read the financial breakdown:

• CNBC covering the GS report: https://www.cnbc.com/2018/04/11/goldman-asks-is-curing-patients-a-sustainable-business-model.html

• bio pharma dive covering the revenue crash: https://www.biopharmadive.com/news/gilead-hepatitis-c-revenues-slide-fourth-quarter-earnings/516494/

The way the public talks about AI risk completely misses the mark. Everyone is stressing out about AGI or deepfakes, while militaries are currently using commercial cloud infrastructure to automate target generation at an industrial scale.

There used to be a physical bottleneck in war—human analysts had to actually sit there and look at drone feeds or read intercept logs. It took days. Now, systems like "Lavender" are just ingesting massive amounts of surveillance data, text messages, and location tracking, and assigning human beings a threat score from 1 to 100 based on statistical correlations. At one point, it generated an automated kill list of up to 37,000 names.

The military defense for this is always: "A machine doesn't shoot. A human always makes the final call."

But cognitive psychologists call this automation bias. When an algorithm is spitting out thousands of targets a day, the human analyst gets completely overwhelmed. Reports show officers spending like 20 seconds reviewing a target file before authorizing a strike. They are literally just rubber-stamping the machine's output because it's too fast to actually double-check.

Worse, the algorithms are reportedly pre-authorized to accept a fixed ratio of civilian collateral damage (like 15 to 20 civilians per low-level target). It's just a math equation built into the factory settings.

So what happens when the model makes a statistical error (which all ML models do), an exhausted analyst clicks 'approve' after 20 seconds, and innocent people die? Who committed the war crime? The cloud host? The software engineer? The analyst? The machine? There is a massive "responsibility gap" and international law has zero answers for it.

If anyone wants to understand the actual mechanics of these systems and the legal vacuum we're in, there's a breakdown of it here that talks about the specifics: https://youtu.be/8W3NXmn75YQ

Curious how other people view the liability issue here. Are we just completely sleepwalking into this?