Tuesday, July 14, 2009

The Health Care Debate: Cost Containment v. Innovation

Glenn Reynolds, who is a law professor at the University of Tennessee and blogs at instapundit.com, wrote an interesting opinion piece on the current healthcare debate for the Washington Examiner a couple of days ago. His main concern is that a national healthcare plan will squash innovation in the name of cost containment:

President Obama talks about the importance of prevention in a way that suggests
that when people have heart attacks it's their own fault. But my wife, a longtime vegetarian and marathon runner, had a freak heart attack at the age of 37.

It wasn't from too many Big Macs. After some rough patches, she's now
doing well, thanks to an obscure and expensive anti-arrhythmic drug called
Tikosyn, and an implantable cardioverter/defibrillator. Not too long ago, she'd
have been largely bedridden. These medical innovations made the difference
between the life of a near-invalid and a life that's close to normal.

My mother had a hip replacement. Her hip didn't break - she basically wore it out
with exercise. When the pain got too bad, she got it replaced, and now she's moving around like before, only painlessly. Not too long ago, she would have been chairbound.

My father had prostate cancer; his doctor suggested waiting but on biopsy it turned out to be pretty aggressive. It was treated with radioactive "seed" implants. He's now been cancer-free for several years, without the side effects of earlier treatments -- or, worse, of cancer.

My daughter had endoscopic sinus surgery this spring. She had been sickly and
listless, complaining of constant migraine headaches, missing a lot of school, and generally looking more like a zombie than a teenager. Several doctors dismissed her problems, or prescribed antibiotics that didn't help much, until we found one who took the extra step.

A head CT scan done on a fancy new in-office machine showed a nasty festering infection, the surgeon cleaned it out, and now she's like a normal kid again. Before laparoscopy, her condition would probably have remained untreated, and she would have been another "sickly" kid. Better to be well.

The normal critique of socialized medicine is to point out that people have to wait a long time for these kinds of treatments in places like Britain. And that's certainly a valid critique. I'm sure my mom and daughter would still be waiting for their treatments, while my father and wife would probably be dead.

The key point, though, is that these treatments didn't just come out out of the blue. They were developed by drug companies and device makers who thought they had a good market for things that would make people feel better.

But under a national healthcare plan, the "market" will consist of whatever the bureaucrats are willing to buy. That means treatment for politically stylish diseases will get some money, but otherwise the main concern will be cost-control. More treatments, to bureaucrats, mean more costs.

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