Friday, February 01, 2008

Healthcare Reform: Be careful what you ask for, you might get it.

"I quit when medicine was placed under State control, some years ago," said
Dr. Hendricks. "Do you know what it takes to perform a brain operation? Do you
know the kind of skill it demands, and the years of passionate, merciless,
excruiating devotion that go to acquire that skill? That was what I would not
place at the disposal of men whose sole qualification to rule me was their
capacity to spout the fraudulent generalities that got them elected to the
privilege of enforcing their wishes at the point of a gun. I would not let
them dictate the purpose for which my years of study had been spent, or of my

I observed that in all the discussions that preceded the enslavement of
medicine, men discussed everything--except the desires of the doctors. Men
considered only the 'welfare' of the patients, with no thought for those who
were to provide it. That a doctor should have any right, desire or choice
in the matter, was regarded as irrelevant selfishness; his is not to choose,
they said, only 'to serve.' That a man who's willing to work under
compulsion is too dangerous a brute to entrust with a job in the
stockyards--never occurred to those who proposed to help the sick by making life
impossible for the healthy. I have often wondered at the smugness with which
people assert their right to enslave me, to control my work, to force my will,
to violate my conscience, to stifle my mind--yet what is it that they expect to
depend on, when they lie on an operating table under my hands?

Their moral code has taught them to believe that it is safe to rely on the
virtue of their victims. Well, that is the virtue I have withdrawn.
Let them discover the kind of doctors that their system will now produce. Let
them discover, in their operating rooms and hospital wards, that it is not safe
to place their lives in the hands of a man whose life they have throttled. It is
not safe, if he is the sort of man who resents it--and still less safe, if he is
the sort who doesn't." -- Ayn Rand, Atlas

We definitely need to improve our methods, costs, and distribution of healthcare in the U.S. But we also need to be cautious and diligent in assessing the reforms enacted. It would be best if the medical professionals, hospital corporations, drug companies, and insurance companies worked together to provide long-term, sustainable business models that create win-wins for themselves and the public. Otherwise we are likely to pay a cost, not only in measurable dollars, but in decreased quality of the healthcare provided. Look what a quick reaction mentality has brought us over the last eight years: another Vietnam war, a costly and bureaucratic airline security policy, knee jerk interest rate reduction and tax rebate while in deficit spending, etc.

Any quick fix, reactionary plan is usually a poor plan regardless of which political party is involved.


JMG said...

Have you watched Michael Moore's movie Sicko? It takes a really interesting look at health care in various countries. (Obviously, he's not gonna put the negative stuff about other countries in there, but the movie makes you think nonetheless.)

Until something is done about the power that big pharma has in our health care system, no meaningful reform can take place.

Tony Arnold said...

The problem with the drug companies is also typical of many industries and many groups regardless of what side of the arguement they may be on. That is, what gives me the most short-term gain.

Big Pharma, reacting rationally to the public corporation system, is concerned first and foremost of with making sure their stock price always goes up--forever. Which is unrealistic and ultimately forces behavior witnessed in Enron for example.

This forces Big Pharm to be concerned with providing treatment drugs rather than cures. It also forces them to inflate their prices to get a quick return on investments.

A large part of the problem is that drug patent life needs to be extended. Things have changed in our society and our gov't regulations, such that the time to develop, test, and approve a new drug safely is almost equal to the life of the patent such that drug companies only have 1-3 years to recoup hundreds of millions of dollars of investment before the drug goes generic. Or worse, drugs companies rush to market and manipulate approval to have more time in the market before patent expiration, which we have seen puts dangerous drugs on the market.

The patent life has not changed while the new drug introduction time has lengthened.

We too often forget in our society that profits are necessary for a company's survival long-term and without that long-term survival, society loses the good or service provided. Governments forget this, executive managers forget, employees and unions forget it, social reformers forget it, and consumers forget it. Typically, anyone of these groups forgetting this point are doing so because they are focused on maximizing their own short-term gain. Myopic is a term that could be more often applied outside of the field of ophthalmology.

JMG said...

This forces Big Pharm to be concerned with providing treatment drugs rather than cures.

That's the sad thing. Instead of promoting good overall health and striving to provide cures for diseases, these companies protect their bottom lines by coming up with new drugs to treat all kinds of symptoms. And those drugs cause other symptoms which can be treated with other drugs. It's much more profitable to have a population of sick people (or people who just think they're sick) than to have healthy people.

That seems very immoral to me.