Some thoughts from Jim Pinkerton:
…every billionaire eventually discovers that vast wealth is little better than health insurance when it comes to securing good health. Wealth and health insurance are both forms of finance, and whether the plan is deluxe or bare-bones, finance is retrospective — after you get sick, people get paid to treat you. And yet what plutocrats — and all of us — really need is prospective, even preemptive, medical science, the kind that produces not just wellness plans, but actual vaccines and cures. The rich can afford the best doctors, and the plushest hospital suites, but if that scientific spadework isn’t done in advance, if the right cure doesn’t exist when it’s needed, it can’t be bought on short notice at any price. The polio vaccine, for example, took 17 years; genuinely effective treatments for AIDS took 15 years. Cures cannot be impulse purchases. They can’t be bid for on eBay, or even at Sotheby’s.
And the Democrats’ preferred policies will only make things worse. It’s mass murder, really. Or at least manslaughter. If I can be so uncivil.
iPancreas — there’s an app for that.
Jobs had pancreatic cancer? And survived it, initially? Either he has really invasive regular work-ups, or he was damned lucky. Most victims of pancreatic cancer die because it’s so invisible to normal diagnosis. Six months ago, one of Japan’s finest animators, Satoshi Kon died suddenly of pancreatic cancer. It killed him before he could finish the movie he’d been working on. Nobody had an inkling until it metastasized to his bones, and it was way, way too late..
A very good column. As I’ve said enough times to bore TT regulars, I am utterly bewildered by why ordinary folks swallow the notion that the fact that the United States spends (and earns!) huge chunks of its income on medicine is bad. I mean, geez, look what we spend on iPhones and broadband ISP service and 42″ plasma HDTVs and Blue-Ray discs every year. And we consider that a point of pride, evidence that we’re technologically hip and rich enough to afford techie toys, not to mention the field gives great jobs to our young people.
Why is the fact that 20% of our GDP (or whatever) is in biology and medicine by contrast considered bad? Isn’t medicine a boffo 21st century field in which to be the world leader? Aren’t we happy that our sons and daughters are growing up to be well-paid doctors, surgeons, PhD biologists? Would we rather be China, earning 20% of our GDP in making steel and cheap plastic sex toys? Russia, earning it in crude oil, Xbox game backgrounds, and occasionally wheat? Bah.
Maybe the transmutation of worries about health — which we all must bear, starting when you reach middle age and a cough doesn’t go away for a few weeks (OMG lung cancer! Aieee!) — to worries about healthcare costs is a weird form of denial. We imagine that if we can pay then a cure will always be possible. The niggling little fact that this is not true perhaps makes us get a little hysterical in our insistence that the issue is the bill. WHAT IF I CAN’T PAY?! Might be a way to drown out the little voice that whispers What if there’s just nothing they can do?
Has not the Left always taken this view about everything people buy? “Why do you need to spend so much money on a car when a Folkswagon can get you there? After all, if you spend too much, that just means you’re stealing from someone else in our technologically-static fixed-sized economy!” The modern rhetoric is just a riff on an old theme.
Organic food, T.
Jobs had pancreatic cancer? And survived it, initially? Either he has really invasive regular work-ups, or he was damned lucky. Most victims of pancreatic cancer die because it’s so invisible to normal diagnosis.
You’re right. One of my wife’s friends was diagnosed with pancreatic cancer last year and died two weeks later.
As for money buying health, some people forget that Sam Walton (founder of Wal Mart and then the richest man on earth) died of cancer.
Oh, and Rainforest Crunch. Taxes. Photovoltaics. Affirmative action. Tenure. And have you priced ecotours?
This is like “$100,000 Pyramid” — “Is it ‘hypocrisy’, Carl?”
As I’ve said enough times to bore TT regulars, I am utterly bewildered by why ordinary folks swallow the notion that the fact that the United States spends (and earns!) huge chunks of its income on medicine is bad.
From the article:
The number of new drugs approved by the FDA has fallen by two-thirds since the ’90s.
It is not how much is being spent on health care that is the problem, but increasingly, how little is being achieved for it.
Two things that determine the future of a country are the strength of its R&D and the quality of its citizens. Is the quality and quantity of R&D in the US increasing? Is the US attracting and keeping the best citizens? Educating the best citizens?
It is not how much is being spent on health care that is the problem, but increasingly, how little is being achieved for it.
And what proof do you have that “little” is being achieved, huh? Aside from the deceptive to the point of fantasy horseshit — I use the term advisedly — from those vicious lying bastards at the UN and their fellow travelers, on life expectancy at birth (a red herring) or when they say 20% of health care “quality” is “access” to health care, meaning is it paid for by taxes or not?
Please don’t say your source is, for example, the same media that spins such absurd fantasy about the motives of mass murderers, the correlation between gun control and reduced crime in cities, or the “settled science” of global warming. I’ve just had lunch.
No, the throwaway fact from the article about the number of new drugs approved by the FDA won’t do. If nothing else, it could easily be the case — and very likely is, in fact — that the problem there is centered on the word “approved.” The FDA doesn’t like approving new drugs. It’s scary stuff. There’s no upside — you don’t get a lot of praise in the press for not regulatin’ stuff — and the political downsides, if you approve Vioxx or thalidomide, are considerable. (Think of the BP blowout and the Administration’s regulatory “solution”: stop all offshore oil drilling.) The burdens the FDA has laid on the approval of drugs are fantastic, and constitute the single largest factor in the remarkable soaring price of drugs.
Just as an example of FDA idiocy: you may know that “combination” therapies are a hot topic of research in cancer; in more than one case two drugs togetheer do more than either separately. But have you ever noticed that all approved combinations are of existing drugs? No one deliberately investigates new combo therapies, meaning a combo of an existing drug plus a new one, or two new ones? There might be some real gold there. But it can’t be done. Because the FDA insists that each drug of a potential combo must first get approved, which means each drug must, individually, be proved superior to existing therapies. Proving a new drug not harmful, and somewhat helpful (but not as good as any existing single-drug therapy) is not enough to win approval, not even approval to try it in combination with some other drug.
So there’s a whole avenue of promising research, cut off at the knees, because of brain-dead regulation by the FDA. Good thing Washington bureaucrats are burnin’ the midnight oil, protecting us against any headlong heedless rush into the future, eh?
“So there’s a whole avenue of promising research, cut off at the knees, because of brain-dead regulation by the FDA.”
so time for the fda to go? (me yes) i think many fed. gov’t reg agencies. could be vastly scaled back.
“It is not how much is being spent on health care that is the problem, but increasingly, how little is being achieved for it.”
And what proof do you have that “little” is being achieved, huh?
One of my responses might be because there is a whole avenue of promising research, cut off at the knees, because of brain-dead regulation by the FDA…
The nature of any “social contract”, even for medical issues, is that it can either be dominated by government or by non-governmental entities. Before the rise of socialism, communism and Progressivism, the only people served by government domination were royalty or people blessed by them. The “divine right of kings” has been replaced by a group of “elites” that style themselves as smarter than the Great Unwashed, etc. So, if we were to structure a deregulation of health and medicine similar to the decommissioning of the civil/commercial aviation industry during the late Seventies and early Eighties, what should it entail?
One thing to keep in mind: once achieved, actual cures for diseases tend to become the most cost-effective treatments. That sounds absurd, but only for those ailments where a cure already actually exists. To get there involves an investment, to which the company taking the risk deserves a return on its investment, just like any other business decision. If we were to restructure whatever role government plays so that it would encourage actual cures, that might be a start.
Heck, it’s entirely likely that a well-informed public would do the job without government help: if you could get an insurance policy from a company that invests in cures, wouldn’t you do so in order to get access to them first? But, in today’s environment, the rest of the world largely has waited for American pharma and medicine to come up with new treatments and therapies, avoiding the cost and risk. That’s one of the things that’s really unfair about today’s setup, IMO.
And, enjoying an improvement in life expectancy is not a right; it requires effort individually, including ponying up money voluntarily. I don’t accept the notion that it’s somehow something we’re supposed to just give away; I have to pay for health care coverage for my wife and kids, and I do so, knowing that (a) it will improve their life expectancy and quality of life, and (b) the coverage available this year has increased in cost and has gone down in coverage due to the “cadillac tax” part of Obamacare.
So, we’re headed in the wrong direction. I hope we change.
This is why the Glebbies need to eat our brains. We are obviously not using them by allowing the idiocy you’ve remarked upon. There really doesn’t seem a solution to bad government (which makes reducing its size imperative.)
Stossel had a recent column where he says Boehner is no better than Pelosi in cutting spending (2% at best.) We need to be making real cuts and eliminating departments. I’d go along with eliminating the FDA and letting adult buyers beware.
“We need to be making real cuts and eliminating departments.”
if you look at epa’s “original” mandate, they should have been done 1995.
original – 7- 10 air pollutants i think
Ironclad liability limitations combined with a more permissive regulatory attitude at the FDA would go quite some way towards stimulating new treatment R&D (IMNSHO, of course).
It isn’t necessary to eliminate the FDA, or even its ability to approve drugs. All you would need to do to change things very helpfully, I think, is remove the necessity for Phase III trials, the huge expensive studies in which drugs prove they are more effective than the gold standard. By all means keep the smaller, cheaper trials in which the maximum safe effective dose (if any) of new drugs is established, and important side effects noticed. And by all means let the FDA collect data on how effective a drug is.
But I find it bizarre — and it costs a ton — for the FDA to restrict drugs to only those drugs that it considers effective. Shouldn’t a patient be free to try anything he chooses, provided he is made aware of the risks and potential benefits, and chooses knowingly? I understand the original purpose was to reduce the number of innocents preyed upon by quacks. But that original, modest, reasonable goal has metastasized horribly into this gigantic gatekeeper that sets the terms and agenda for drug development, and tells us what medicine we can and can’t take.
I agree about collecting and reporting data. I just don’t think they should be regulating.
Again, CP speaks wisdom. The primary goal of regulating consumer goods and services is to prevent fraud. (When you buy a juicy steak from the store, you don’t want an E. Coli farm, hence meat inspectors.)
In “Free to Choose”, Milton Freedman argues that doctors should be able to prescribe any drug they want for their patients — CP’s proposal is even more modest than that.
When it comes to medical innovation/spending/socialised medicine I think I can add a personal insight.
Before working in aerospace, I worked for a company that made implantable medical electronic devices. In my R&D dept. we worked on some real leading edge technologies such as ventricular assist devices, pacemaker electrodes that keep the growth of necrotic tissue at bay, thin film deposition of synthetic bone for hip implants, cochlear implants etc. I could go on and on.
Most of this work was done in conjunction with another partner or customer. NONE of these frims were from a country that had socialised medicine.
The not-so-dirty-little-secret is that the desire to make our company and, in return, me some money is what drove our little innovation group. Several of our products became additional lines of production for my employer; who rewarded me nicely.