Push & Pull Mechanisms

            Pogge addresses the egregious moral failing of developed countries to provide life-saving medicine by presenting a market-based solution. He maintains that large biotechnology companies are not innately ‘evil’. Moreover, the system needs to be reformed to incentivize certain endeavors (research on prevalent diseases that affect the world’s poorest populations) while preserving incentives for innovation. The alternative scheme that Pogge presents seems to protect the good parts of the existing system, while reforming the not-so-good parts.

            Within his proposed plan, I found myself considering the advantages and disadvantages of push and pull mechanisms. Although he ultimately chooses to pursue a plan using the pull mechanism, I believe that the push mechanism may possess several advantages that Pogge did not include in his report. Perhaps he considered more than he included in his report yet still believed that the advantages of the pull mechanism trumped those of the push mechanism. He seems ambivalent when it comes to whether one is objectively better than the other. In fact, he concedes that there is “no general answer” to whether the push mechanism or pull mechanism works best and perhaps “either type may be superior in different contexts” (Pogge 20). In the following paragraphs I will briefly respond to the three reasons why Pogge believes that pull programs can be more effective.

            His first reason for believing that pull programs would be more effective is that motivating several innovators to work on a problem would lead to more successful outcomes; if many different companies work towards a solution, one of them is bound to find it. Push programs, he argues, are more likely to fail. I am skeptical of whether a push system would inhibit success such as he suggests. Perhaps push systems would result in similar numbers of long-term successes but the solutions would take longer to discover due to the lack of competition. 

            Furthermore, a push system may be more productive and may lead to more overall successes and/or more effective uses of time and resources. One major advantage of the push mechanism is that it eliminates the possibility of two or more biotech companies spending copious amounts of time and resources on similar research. Although the finished product (a new medicine) may come about in a much more timely manner (which may be important in some cases such as the AIDS epidemic—perhaps this is why Pogge says that the use of push or pull is contextual), ultimately one or more of the competing companies could have conducted their efforts in another area of research. 

            Additionally, the monetary rewards in a pull system must be substantial (greater than the costs of a push system) in order to account for the risk of failure. In one of Pogge’s examples, he calculates that for a given project the company would either need to be paid $60 million (push) or rewarded $200 million (pull). Perhaps this extra money could be used to fund more projects/different research. All in all, it is hard to say whether the extra money saved in a push scenario could be used to establish a more productive system than a system in which the pull mechanism is used.

            His second reason for endorsing pull programs is that push programs are more likely to fail if the researchers assigned to a given project are chosen based on an outsider’s opinion rather than researchers’ own assessment of their capabilities. This problem may have a simple solution. Perhaps innovators should seek their own projects and apply for funds in a process similar to applying for grants. This allows the innovators some freedom in choosing their projects as well as some ability to calculate a reasonable sum of money needed for the research.

            His third reason for preferring pull systems is that push systems are more likely to fail due to weaker incentives. I believe that this problem can be ameliorated to some extent. Perhaps the government can provide bonus incentives for timeliness or offer increments of funding based off of progress. Nonetheless, it is hard to argue with a solution that is based off of the free market principles—especially when one wishes to encourage innovative solutions to problems.

            Just like Pogge, I am not sure whether push mechanisms or pull mechanisms would be more effective. Nonetheless, it is not necessarily important at this time whether one works better than the other. Pogge has put forth a complex, intelligent solution to significantly lowering the GBD. Most significantly, it provides a strong starting point for reform that must occur.