When Government Plays Doctor

[carlfense]

When Government Plays Doctor

 

This week, concerns about swine flu have dominated the media and many government officials. While the American people should be made aware of infectious diseases and common sense preventative measures, much of the hysterical reaction from government only serves to remind us how detrimental to your health it can be when government plays doctor.

 

As a physician, I have yet to see any evidence that justifies the current level of alarm. Influenza typically kills around 36,000 people every year in this country and hospitalizes a couple hundred thousand. So far there are only a handful of confirmed deaths attributable to this strain, and most of those sickened have or will fully recover. Every death is tragic, but I see no reason to deal with this flu outbreak any differently than we typically deal with any other flu season. Instead, government in its infinite wisdom is performing even more invasive screening at airports, closing down schools and sporting events, and causing general panic.

 

We had a similar outbreak in 1976, with only 1 death from the flu, but mandatory vaccinations killed at least 25 before the program was abandoned.

 

When government gets involved in healthcare decisions, the cure is so often worse than the illness. And yet, this administration will likely consolidate the government's power over your health with sweeping new reforms that are already being discussed in the Senate.

 

Government has not improved healthcare, and has not made it cheaper. Quite the opposite; costs have skyrocketed, and quality has gone down in many ways. Gone are the days of the country doctor making house calls, or of voluntarily giving away medical services at charity hospitals. The bureaucratization of healthcare these past 45 years has made things worse. It saddens me as a doctor that physicians are less and less accountable to patients, but more and more accountable to government red tape, insurance companies and attorneys. It seems so perverse to me that important medical decisions that will directly affect the lives of all or nearly all Americans are being hashed out behind closed doors in Washington rather than between doctors and patients.

 

There is perhaps nothing more valuable to a human being than his or her health, which is why I've always considered the practice of medicine so crucial to our well-being. Any intrusion by government into the privacy and trust between doctor and patient is detrimental to the art of medicine. It distorts the whole dynamic of who the client really is when doctors must answer more to government or insurance companies than to their patients. The best solutions to improving quality and lowering costs of healthcare would be measures that put decisions back into the hands of patients and doctors, where they rightfully belong. I have introduced HR 1495 The Comprehensive Healthcare Reform Act, which promotes health savings accounts and tax deductibility of healthcare costs as an important step in this direction.

 

The unfortunate reality of this recent health crisis, as with any crisis, is that it presents opportunities that the unscrupulous will take advantage of, while the fearful become more compliant.

 

Medical costs will continue to rise regardless of government involvement. New technologies and drugs are expensive by themselves, plus the more effective medicine becomes, the more we will have to spend to treat people. (As medicine increases the average life span we are adding years to the most medically expensive segment of people's lives . . . old age.)

 

And finally, the decline of the general practice physician (As RP quaintly refers to as a "country doctor") has far less to do with governmental involvement and far more to do with the capitalistic impulse to earn money. (This is something R. Paul should be well familiar with.) After graduation most doctors have approximately $250,000 in school debt. Starting salaries for general practice physicians are roughly half that of specialists. For example, pathologists starting salaries are around $250,000, while general practice physicians start out at around $120,000. When you are staring down the barrel of $250,000 in school debt, it's easy to see why specializing is a more attractive option than general practice.

 

One option to increase the numbers of general practice physicians would be to institute some program of loan forgiveness for doctor's who choose to go the general practice route. (Unfortunately this requires governmental intervention and tax dollars.) Another option would be to increase the salaries of general practice doctors to match or exceed those of specialists. This increase in cost would of course be passed on to the patients.

 

It's interesting to me that RP as a physician and a crusader against governmental intrusion would complain about something (the lack of general practice physicians) that can probably only be changed by governmental intrusion of one sort or another. I suppose that is why he just complains and doesn't offer any suggestions as to what to do about it. That would force him to contradict himself.

 

 

(I have a very personal view of this whole scenario playing out. My girlfriend is entering her second year of medical school, and I don't think she will be able to turn down the $$$ of specializing to go the general practice route. I can't say that I blame her.)

You're forgetting about the cost of medical malpractice insurance which is not cheap.

 

I just touched on a few subjects that l thought should be clarified. What are your thoughts on malpractice insurance?

Malpractice insurance many times is a deciding factor in what field a practitioner decides to take up. When you are paying in upwards of $20,000-$30,000 depending upon the field of expertise, it takes a huge bite out of your salary.

 

I never stopped to think about the cost of insurance varying for different fields. I suppose that makes sense . . . many more chances to harm someone as a surgeon than as a pathologist. Interesting.

[SOCALHUSKER]

When Government Plays Doctor

 

This week, concerns about swine flu have dominated the media and many government officials. While the American people should be made aware of infectious diseases and common sense preventative measures, much of the hysterical reaction from government only serves to remind us how detrimental to your health it can be when government plays doctor.

 

As a physician, I have yet to see any evidence that justifies the current level of alarm. Influenza typically kills around 36,000 people every year in this country and hospitalizes a couple hundred thousand. So far there are only a handful of confirmed deaths attributable to this strain, and most of those sickened have or will fully recover. Every death is tragic, but I see no reason to deal with this flu outbreak any differently than we typically deal with any other flu season. Instead, government in its infinite wisdom is performing even more invasive screening at airports, closing down schools and sporting events, and causing general panic.

 

We had a similar outbreak in 1976, with only 1 death from the flu, but mandatory vaccinations killed at least 25 before the program was abandoned.

 

When government gets involved in healthcare decisions, the cure is so often worse than the illness. And yet, this administration will likely consolidate the government's power over your health with sweeping new reforms that are already being discussed in the Senate.

 

Government has not improved healthcare, and has not made it cheaper. Quite the opposite; costs have skyrocketed, and quality has gone down in many ways. Gone are the days of the country doctor making house calls, or of voluntarily giving away medical services at charity hospitals. The bureaucratization of healthcare these past 45 years has made things worse. It saddens me as a doctor that physicians are less and less accountable to patients, but more and more accountable to government red tape, insurance companies and attorneys. It seems so perverse to me that important medical decisions that will directly affect the lives of all or nearly all Americans are being hashed out behind closed doors in Washington rather than between doctors and patients.

 

There is perhaps nothing more valuable to a human being than his or her health, which is why I've always considered the practice of medicine so crucial to our well-being. Any intrusion by government into the privacy and trust between doctor and patient is detrimental to the art of medicine. It distorts the whole dynamic of who the client really is when doctors must answer more to government or insurance companies than to their patients. The best solutions to improving quality and lowering costs of healthcare would be measures that put decisions back into the hands of patients and doctors, where they rightfully belong. I have introduced HR 1495 The Comprehensive Healthcare Reform Act, which promotes health savings accounts and tax deductibility of healthcare costs as an important step in this direction.

 

The unfortunate reality of this recent health crisis, as with any crisis, is that it presents opportunities that the unscrupulous will take advantage of, while the fearful become more compliant.

 

Medical costs will continue to rise regardless of government involvement. New technologies and drugs are expensive by themselves, plus the more effective medicine becomes, the more we will have to spend to treat people. (As medicine increases the average life span we are adding years to the most medically expensive segment of people's lives . . . old age.)

 

And finally, the decline of the general practice physician (As RP quaintly refers to as a "country doctor") has far less to do with governmental involvement and far more to do with the capitalistic impulse to earn money. (This is something R. Paul should be well familiar with.) After graduation most doctors have approximately $250,000 in school debt. Starting salaries for general practice physicians are roughly half that of specialists. For example, pathologists starting salaries are around $250,000, while general practice physicians start out at around $120,000. When you are staring down the barrel of $250,000 in school debt, it's easy to see why specializing is a more attractive option than general practice.

 

One option to increase the numbers of general practice physicians would be to institute some program of loan forgiveness for doctor's who choose to go the general practice route. (Unfortunately this requires governmental intervention and tax dollars.) Another option would be to increase the salaries of general practice doctors to match or exceed those of specialists. This increase in cost would of course be passed on to the patients.

 

It's interesting to me that RP as a physician and a crusader against governmental intrusion would complain about something (the lack of general practice physicians) that can probably only be changed by governmental intrusion of one sort or another. I suppose that is why he just complains and doesn't offer any suggestions as to what to do about it. That would force him to contradict himself.

 

 

(I have a very personal view of this whole scenario playing out. My girlfriend is entering her second year of medical school, and I don't think she will be able to turn down the $$$ of specializing to go the general practice route. I can't say that I blame her.)

 

You are completely wrong on the point highlighted. As technology and medicine improve, the cost will not rise but will instead be substantially lower. Basic economics proves that. Supply and demand controls price, they don't rise just because they can. If there's a high demand and low supply, yes, the prices rise. If supply is high and demand is low, then prices fall. An improvement in technology and medicine would undoubtedly create more supply and would therefore lead to lower prices.

 

Without government intervention we would also see an increase in competition, which also leads to lower prices. Government regulation of pharmaceuticals, research and procedures is what leads to the high costs of medicine. If there wasn't as much unnecessary regulation in place you would see more people/companies entering the medical field, leading to more competition, better service, better ideas/technology and of course, lower prices.

 

I'll address the rest of your points later. I gotta run.

Not true. The nature of patent law prevents it. And as the companies are trying to make a profit, and care nothing if someone lives or dies, as long as their stock prices go up, how do you think prices would go down? Hell, drug companies dont even want to cure people, or prevent illness or disease, they want to find longterm or permanent treatments to keep a steady flow of overpriced drugs.

 

And furthermore, supply and demand really shouldnt be applied to the things that keep people alive.

 

Wow!!!! Sorry, but supply and demand are economic forces, they don't discriminate and therefore can't be changed/manipulated without some serious and unintended sonsequences. Our current economic crisis is a great example of that.

 

Yes, companies are trying to make a profit and no one is disputing that. Fortunately, the only way they can do that, is if their medication works and more people live. Well, that would be the case if the market was allowed to properly function. Instead, we see special interests lobbying for more regulation and government intervention; making it way to expensive to produce, weeding out the competition, and therefore keeping prices high. The government regulation is what guarantees high prices and horrible service, not the greed of entrepeuners. If government intervention in the market was reduced, we would see an increase in effort to please the customer, because in a market based economy that's the only way to make a profit. If you don't please the customer, they don't buy and you don't profit. It's as simple as that.

 

Yes carlfense, I believe some regulation is good to an extent. As long it prevents fraud and the infringement on other's rights, but when special interest are the ones creating regulation to further their monopoly on medicine, that's when I draw the line. If we used the Constitution to regulate, there would be no need for the government to further intervene in the market.

 

A lot of the problems we are seeing in the medical field are a direct result of government intervention. People forget that when we interfere with the market, the consequences/rewards are not only felt by those directly affected, but by all those with a hand in the pot. When one entity of the market is artificially pushed up, it automatically creates a decrease in another entity. That's just the way the market works. Someone brought up the increase in demand of specialities and the decrease in general practitioners. Did you ever think that maybe the government intervening in another aspect of the medical field could have created that problem? Yes, there are other factors to consider but the government intervention is a major part of the problem. When creating regulation they don't think about the long term consequences or the effect it will have on the whole, rather they look at the immediate benefits and who it is helping, not who it hurts.

[rawhide]

Or an OB/GYN. very high malpractice insurance.

 

clarification: obstetrics/pediatrics

[SOCALHUSKER]

A few more RP articles on the cost of healthcare. He makes too much sense not to read.

 

Lowering the Cost of Healthcare

 

Diagnosing Our Healthcare Woes

 

Free Market Medicine

[carlfense]

When Government Plays Doctor

 

This week, concerns about swine flu have dominated the media and many government officials. While the American people should be made aware of infectious diseases and common sense preventative measures, much of the hysterical reaction from government only serves to remind us how detrimental to your health it can be when government plays doctor.

 

As a physician, I have yet to see any evidence that justifies the current level of alarm. Influenza typically kills around 36,000 people every year in this country and hospitalizes a couple hundred thousand. So far there are only a handful of confirmed deaths attributable to this strain, and most of those sickened have or will fully recover. Every death is tragic, but I see no reason to deal with this flu outbreak any differently than we typically deal with any other flu season. Instead, government in its infinite wisdom is performing even more invasive screening at airports, closing down schools and sporting events, and causing general panic.

 

We had a similar outbreak in 1976, with only 1 death from the flu, but mandatory vaccinations killed at least 25 before the program was abandoned.

 

When government gets involved in healthcare decisions, the cure is so often worse than the illness. And yet, this administration will likely consolidate the government's power over your health with sweeping new reforms that are already being discussed in the Senate.

 

Government has not improved healthcare, and has not made it cheaper. Quite the opposite; costs have skyrocketed, and quality has gone down in many ways. Gone are the days of the country doctor making house calls, or of voluntarily giving away medical services at charity hospitals. The bureaucratization of healthcare these past 45 years has made things worse. It saddens me as a doctor that physicians are less and less accountable to patients, but more and more accountable to government red tape, insurance companies and attorneys. It seems so perverse to me that important medical decisions that will directly affect the lives of all or nearly all Americans are being hashed out behind closed doors in Washington rather than between doctors and patients.

 

There is perhaps nothing more valuable to a human being than his or her health, which is why I've always considered the practice of medicine so crucial to our well-being. Any intrusion by government into the privacy and trust between doctor and patient is detrimental to the art of medicine. It distorts the whole dynamic of who the client really is when doctors must answer more to government or insurance companies than to their patients. The best solutions to improving quality and lowering costs of healthcare would be measures that put decisions back into the hands of patients and doctors, where they rightfully belong. I have introduced HR 1495 The Comprehensive Healthcare Reform Act, which promotes health savings accounts and tax deductibility of healthcare costs as an important step in this direction.

 

The unfortunate reality of this recent health crisis, as with any crisis, is that it presents opportunities that the unscrupulous will take advantage of, while the fearful become more compliant.

 

Medical costs will continue to rise regardless of government involvement. New technologies and drugs are expensive by themselves, plus the more effective medicine becomes, the more we will have to spend to treat people. (As medicine increases the average life span we are adding years to the most medically expensive segment of people's lives . . . old age.)

 

And finally, the decline of the general practice physician (As RP quaintly refers to as a "country doctor") has far less to do with governmental involvement and far more to do with the capitalistic impulse to earn money. (This is something R. Paul should be well familiar with.) After graduation most doctors have approximately $250,000 in school debt. Starting salaries for general practice physicians are roughly half that of specialists. For example, pathologists starting salaries are around $250,000, while general practice physicians start out at around $120,000. When you are staring down the barrel of $250,000 in school debt, it's easy to see why specializing is a more attractive option than general practice.

 

One option to increase the numbers of general practice physicians would be to institute some program of loan forgiveness for doctor's who choose to go the general practice route. (Unfortunately this requires governmental intervention and tax dollars.) Another option would be to increase the salaries of general practice doctors to match or exceed those of specialists. This increase in cost would of course be passed on to the patients.

 

It's interesting to me that RP as a physician and a crusader against governmental intrusion would complain about something (the lack of general practice physicians) that can probably only be changed by governmental intrusion of one sort or another. I suppose that is why he just complains and doesn't offer any suggestions as to what to do about it. That would force him to contradict himself.

 

 

(I have a very personal view of this whole scenario playing out. My girlfriend is entering her second year of medical school, and I don't think she will be able to turn down the $$$ of specializing to go the general practice route. I can't say that I blame her.)

 

You are completely wrong on the point highlighted. As technology and medicine improve, the cost will not rise but will instead be substantially lower. Basic economics proves that. Supply and demand controls price, they don't rise just because they can. If there's a high demand and low supply, yes, the prices rise. If supply is high and demand is low, then prices fall. An improvement in technology and medicine would undoubtedly create more supply and would therefore lead to lower prices.

 

Without government intervention we would also see an increase in competition, which also leads to lower prices. Government regulation of pharmaceuticals, research and procedures is what leads to the high costs of medicine. If there wasn't as much unnecessary regulation in place you would see more people/companies entering the medical field, leading to more competition, better service, better ideas/technology and of course, lower prices.

 

I'll address the rest of your points later. I gotta run.

Not true. The nature of patent law prevents it. And as the companies are trying to make a profit, and care nothing if someone lives or dies, as long as their stock prices go up, how do you think prices would go down? Hell, drug companies dont even want to cure people, or prevent illness or disease, they want to find longterm or permanent treatments to keep a steady flow of overpriced drugs.

 

And furthermore, supply and demand really shouldnt be applied to the things that keep people alive.

 

Wow!!!! Sorry, but supply and demand are economic forces, they don't discriminate and therefore can't be changed/manipulated without some serious and unintended sonsequences. Our current economic crisis is a great example of that.

 

Yes, companies are trying to make a profit and no one is disputing that. Fortunately, the only way they can do that, is if their medication works and more people live. Well, that would be the case if the market was allowed to properly function. Instead, we see special interests lobbying for more regulation and government intervention; making it way to expensive to produce, weeding out the competition, and therefore keeping prices high. The government regulation is what guarantees high prices and horrible service, not the greed of entrepeuners. If government intervention in the market was reduced, we would see an increase in effort to please the customer, because in a market based economy that's the only way to make a profit. If you don't please the customer, they don't buy and you don't profit. It's as simple as that.

 

Yes carlfense, I believe some regulation is good to an extent. As long it prevents fraud and the infringement on other's rights, but when special interest are the ones creating regulation to further their monopoly on medicine, that's when I draw the line. If we used the Constitution to regulate, there would be no need for the government to further intervene in the market.

 

A lot of the problems we are seeing in the medical field are a direct result of government intervention. People forget that when we interfere with the market, the consequences/rewards are not only felt by those directly affected, but by all those with a hand in the pot. When one entity of the market is artificially pushed up, it automatically creates a decrease in another entity. That's just the way the market works. Someone brought up the increase in demand of specialities and the decrease in general practitioners. Did you ever think that maybe the government intervening in another aspect of the medical field could have created that problem? Yes, their are other factors to consider but the government intervention is a major part of the problem. When creating regulation they don't think about the long term consequences or the effect it will have on the whole, rather they look at the immediate benefits and who it is helping, not who it hurts.

 

The problem with a free market in pharmaceuticals is that change will only come as a result of terrible consequences. (i.e., drug companies will lose customers and sales only after causing deaths and birth defects.) In that way the free market WILL create change, but it will only change following suffering.

 

The system of regulations we have now PREVENTS (most of the time!) the harm from occurring. This is especially important because the terrible side effects of many drugs aren't readily apparent, and some don't occur until they manifest as birth defects in a subsequent generation.

 

Check out the case of DES as one prominent example:

http://www.descancer.org/timeline.html

 

Read enough of these cases (unfortunately I've had to) and you might change your ideas about not needing regulations.

 

(And who are the special interests that are supposedly pushing for more and more regulation? Drug testing facilities? A lot of the time those are research universities...)

[sarge87]

Or an OB/GYN. very high malpractice insurance.

 

clarification: obstetrics/pediatrics

Agreed, there is a shortage of good OB/GYN doctors in the industry right now because of this.

[sarge87]

When Government Plays Doctor

 

This week, concerns about swine flu have dominated the media and many government officials. While the American people should be made aware of infectious diseases and common sense preventative measures, much of the hysterical reaction from government only serves to remind us how detrimental to your health it can be when government plays doctor.

 

As a physician, I have yet to see any evidence that justifies the current level of alarm. Influenza typically kills around 36,000 people every year in this country and hospitalizes a couple hundred thousand. So far there are only a handful of confirmed deaths attributable to this strain, and most of those sickened have or will fully recover. Every death is tragic, but I see no reason to deal with this flu outbreak any differently than we typically deal with any other flu season. Instead, government in its infinite wisdom is performing even more invasive screening at airports, closing down schools and sporting events, and causing general panic.

 

We had a similar outbreak in 1976, with only 1 death from the flu, but mandatory vaccinations killed at least 25 before the program was abandoned.

 

When government gets involved in healthcare decisions, the cure is so often worse than the illness. And yet, this administration will likely consolidate the government's power over your health with sweeping new reforms that are already being discussed in the Senate.

 

Government has not improved healthcare, and has not made it cheaper. Quite the opposite; costs have skyrocketed, and quality has gone down in many ways. Gone are the days of the country doctor making house calls, or of voluntarily giving away medical services at charity hospitals. The bureaucratization of healthcare these past 45 years has made things worse. It saddens me as a doctor that physicians are less and less accountable to patients, but more and more accountable to government red tape, insurance companies and attorneys. It seems so perverse to me that important medical decisions that will directly affect the lives of all or nearly all Americans are being hashed out behind closed doors in Washington rather than between doctors and patients.

 

There is perhaps nothing more valuable to a human being than his or her health, which is why I've always considered the practice of medicine so crucial to our well-being. Any intrusion by government into the privacy and trust between doctor and patient is detrimental to the art of medicine. It distorts the whole dynamic of who the client really is when doctors must answer more to government or insurance companies than to their patients. The best solutions to improving quality and lowering costs of healthcare would be measures that put decisions back into the hands of patients and doctors, where they rightfully belong. I have introduced HR 1495 The Comprehensive Healthcare Reform Act, which promotes health savings accounts and tax deductibility of healthcare costs as an important step in this direction.

 

The unfortunate reality of this recent health crisis, as with any crisis, is that it presents opportunities that the unscrupulous will take advantage of, while the fearful become more compliant.

 

Medical costs will continue to rise regardless of government involvement. New technologies and drugs are expensive by themselves, plus the more effective medicine becomes, the more we will have to spend to treat people. (As medicine increases the average life span we are adding years to the most medically expensive segment of people's lives . . . old age.)

 

And finally, the decline of the general practice physician (As RP quaintly refers to as a "country doctor") has far less to do with governmental involvement and far more to do with the capitalistic impulse to earn money. (This is something R. Paul should be well familiar with.) After graduation most doctors have approximately $250,000 in school debt. Starting salaries for general practice physicians are roughly half that of specialists. For example, pathologists starting salaries are around $250,000, while general practice physicians start out at around $120,000. When you are staring down the barrel of $250,000 in school debt, it's easy to see why specializing is a more attractive option than general practice.

 

One option to increase the numbers of general practice physicians would be to institute some program of loan forgiveness for doctor's who choose to go the general practice route. (Unfortunately this requires governmental intervention and tax dollars.) Another option would be to increase the salaries of general practice doctors to match or exceed those of specialists. This increase in cost would of course be passed on to the patients.

 

It's interesting to me that RP as a physician and a crusader against governmental intrusion would complain about something (the lack of general practice physicians) that can probably only be changed by governmental intrusion of one sort or another. I suppose that is why he just complains and doesn't offer any suggestions as to what to do about it. That would force him to contradict himself.

 

 

(I have a very personal view of this whole scenario playing out. My girlfriend is entering her second year of medical school, and I don't think she will be able to turn down the $$$ of specializing to go the general practice route. I can't say that I blame her.)

 

You are completely wrong on the point highlighted. As technology and medicine improve, the cost will not rise but will instead be substantially lower. Basic economics proves that. Supply and demand controls price, they don't rise just because they can. If there's a high demand and low supply, yes, the prices rise. If supply is high and demand is low, then prices fall. An improvement in technology and medicine would undoubtedly create more supply and would therefore lead to lower prices.

 

Without government intervention we would also see an increase in competition, which also leads to lower prices. Government regulation of pharmaceuticals, research and procedures is what leads to the high costs of medicine. If there wasn't as much unnecessary regulation in place you would see more people/companies entering the medical field, leading to more competition, better service, better ideas/technology and of course, lower prices.

 

I'll address the rest of your points later. I gotta run.

Not true. The nature of patent law prevents it. And as the companies are trying to make a profit, and care nothing if someone lives or dies, as long as their stock prices go up, how do you think prices would go down? Hell, drug companies dont even want to cure people, or prevent illness or disease, they want to find longterm or permanent treatments to keep a steady flow of overpriced drugs.

 

And furthermore, supply and demand really shouldnt be applied to the things that keep people alive.

 

Wow!!!! Sorry, but supply and demand are economic forces, they don't discriminate and therefore can't be changed/manipulated without some serious and unintended sonsequences. Our current economic crisis is a great example of that.

 

Yes, companies are trying to make a profit and no one is disputing that. Fortunately, the only way they can do that, is if their medication works and more people live. Well, that would be the case if the market was allowed to properly function. Instead, we see special interests lobbying for more regulation and government intervention; making it way to expensive to produce, weeding out the competition, and therefore keeping prices high. The government regulation is what guarantees high prices and horrible service, not the greed of entrepeuners. If government intervention in the market was reduced, we would see an increase in effort to please the customer, because in a market based economy that's the only way to make a profit. If you don't please the customer, they don't buy and you don't profit. It's as simple as that.

 

Yes carlfense, I believe some regulation is good to an extent. As long it prevents fraud and the infringement on other's rights, but when special interest are the ones creating regulation to further their monopoly on medicine, that's when I draw the line. If we used the Constitution to regulate, there would be no need for the government to further intervene in the market.

 

A lot of the problems we are seeing in the medical field are a direct result of government intervention. People forget that when we interfere with the market, the consequences/rewards are not only felt by those directly affected, but by all those with a hand in the pot. When one entity of the market is artificially pushed up, it automatically creates a decrease in another entity. That's just the way the market works. Someone brought up the increase in demand of specialities and the decrease in general practitioners. Did you ever think that maybe the government intervening in another aspect of the medical field could have created that problem? Yes, their are other factors to consider but the government intervention is a major part of the problem. When creating regulation they don't think about the long term consequences or the effect it will have on the whole, rather they look at the immediate benefits and who it is helping, not who it hurts.

 

The problem with a free market in pharmaceuticals is that change will only come as a result of terrible consequences. (i.e., drug companies will lose customers and sales only after causing deaths and birth defects.) In that way the free market WILL create change, but it will only change following suffering.

 

The system of regulations we have now PREVENTS (most of the time!) the harm from occurring. This is especially important because the terrible side effects of many drugs aren't readily apparent, and some don't occur until they manifest as birth defects in a subsequent generation.

 

Check out the case of DES as one prominent example:

http://www.descancer.org/timeline.html

 

Read enough of these cases (unfortunately I've had to) and you might change your ideas about not needing regulations.

 

(And who are the special interests that are supposedly pushing for more and more regulation? Drug testing facilities? A lot of the time those are research universities...)

I don't think anyone would go for no regulations, but the reason for lower drug prices in Canada and other countries is because of subsidies and a sort of caveat emptor when it comes to litigation in those countries as well.

 

Awards for lawsuits in those countries is a mere pittance as compared to here when you're are talking millions of dollars.

[SOCALHUSKER]

Nobody said anything about no regulation. We all agree that regulation is needed to help the consumer. However, when regulation hinders competition, leading to the rising costs and poor service because no other options are available, the consumer loses anyways.

 

A free market solution is not without regulation. It merely means the government or some other outside force is not interfering with the transactions between consumer and producer. There are still plenty of ways to enforce regulation without the government picking the winners and losers. That we are even having this discussion goes to show us the flaws that come with that approach. Why not give individuals, the free market, and more freedom a chance?

[carlfense]

You said that "government regulation of pharmaceuticals is what leads to the high costs of medicine." That is incorrect. New medical technology and drugs are expensive themselves, NOT because of regulations.

 

You claim that regulation hinders competition. Do you have any evidence of that? The truth of the matter is that only the large companies can really afford the R and D costs of the pharmaceutical industry anyways. It's not like a cottage industry is going to spring up that creates miracle cancer drugs. (actually...the "free market" did lead to a cottage industry that made miraculous claims...they were called quacks and they peddled miracle elixirs.)

 

And actually . . . a free market solution is by definition not regulated. How exactly is the government interfering now? By requiring the testing of drugs before they are marketed to make sure that they don't do more harm than good? How is that not a positive? You are thinking big theories, when the reality is that the consumer would suffer if your ideal was reached.

[SOCALHUSKER]

Here's a report by the AMJ outlining the expansive role healthcare lobbyist have taken in creating and introducing regulation.

 

Health Care Lobbying in the United States

 

Yeah, let's put those who look to profit the most from the regulation, in charge of creating it.

 

As long as we have regulation and government interference that panders to special interest, we will never have quality and cost effective healthcare in this country. Notice, I'm not saying that we shouldn't have regulation, but that we don't need regulation created by special interests and carried out by the government.

[carlfense]

Here's a report by the AMJ outlining the expansive role healthcare lobbyist have taken in creating and introducing regulation.

 

Health Care Lobbying in the United States

 

Yeah, let's put those who look to profit the most from the regulation, in charge of creating it.

 

As long as we have regulation and government interference that panders to special interest, we will never have quality and cost effective healthcare in this country. Notice, I'm not saying that we shouldn't have regulation, but that we don't need regulation created by special interests and carried out by the government.

 

Who said that? I said that only large corporations can afford the research and development costs of new pharmaceuticals. I didn't say they should be in charge of regulating them....actually...that's what you are saying when you advocate for less regulation. (as in the companies self-regulate, if the drugs cause ill effects the consumers will slowly move away from them)

 

What's your definition of cost effective medicine? Because prices will rise regardless, I can provide countless articles if you'd like. (plus Dr.'s opinions). And as has been shown, the more effective medicine is, the longer we have to pay medical bills...therefore...the more expensive it is.

 

Anyways. It's moot. The pharmaceutical regulation we have now is here to stay for the foreseeable future.

[strigori]

When Government Plays Doctor

 

This week, concerns about swine flu have dominated the media and many government officials. While the American people should be made aware of infectious diseases and common sense preventative measures, much of the hysterical reaction from government only serves to remind us how detrimental to your health it can be when government plays doctor.

 

As a physician, I have yet to see any evidence that justifies the current level of alarm. Influenza typically kills around 36,000 people every year in this country and hospitalizes a couple hundred thousand. So far there are only a handful of confirmed deaths attributable to this strain, and most of those sickened have or will fully recover. Every death is tragic, but I see no reason to deal with this flu outbreak any differently than we typically deal with any other flu season. Instead, government in its infinite wisdom is performing even more invasive screening at airports, closing down schools and sporting events, and causing general panic.

 

We had a similar outbreak in 1976, with only 1 death from the flu, but mandatory vaccinations killed at least 25 before the program was abandoned.

 

When government gets involved in healthcare decisions, the cure is so often worse than the illness. And yet, this administration will likely consolidate the government's power over your health with sweeping new reforms that are already being discussed in the Senate.

 

Government has not improved healthcare, and has not made it cheaper. Quite the opposite; costs have skyrocketed, and quality has gone down in many ways. Gone are the days of the country doctor making house calls, or of voluntarily giving away medical services at charity hospitals. The bureaucratization of healthcare these past 45 years has made things worse. It saddens me as a doctor that physicians are less and less accountable to patients, but more and more accountable to government red tape, insurance companies and attorneys. It seems so perverse to me that important medical decisions that will directly affect the lives of all or nearly all Americans are being hashed out behind closed doors in Washington rather than between doctors and patients.

 

There is perhaps nothing more valuable to a human being than his or her health, which is why I've always considered the practice of medicine so crucial to our well-being. Any intrusion by government into the privacy and trust between doctor and patient is detrimental to the art of medicine. It distorts the whole dynamic of who the client really is when doctors must answer more to government or insurance companies than to their patients. The best solutions to improving quality and lowering costs of healthcare would be measures that put decisions back into the hands of patients and doctors, where they rightfully belong. I have introduced HR 1495 The Comprehensive Healthcare Reform Act, which promotes health savings accounts and tax deductibility of healthcare costs as an important step in this direction.

 

The unfortunate reality of this recent health crisis, as with any crisis, is that it presents opportunities that the unscrupulous will take advantage of, while the fearful become more compliant.

 

Medical costs will continue to rise regardless of government involvement. New technologies and drugs are expensive by themselves, plus the more effective medicine becomes, the more we will have to spend to treat people. (As medicine increases the average life span we are adding years to the most medically expensive segment of people's lives . . . old age.)

 

And finally, the decline of the general practice physician (As RP quaintly refers to as a "country doctor") has far less to do with governmental involvement and far more to do with the capitalistic impulse to earn money. (This is something R. Paul should be well familiar with.) After graduation most doctors have approximately $250,000 in school debt. Starting salaries for general practice physicians are roughly half that of specialists. For example, pathologists starting salaries are around $250,000, while general practice physicians start out at around $120,000. When you are staring down the barrel of $250,000 in school debt, it's easy to see why specializing is a more attractive option than general practice.

 

One option to increase the numbers of general practice physicians would be to institute some program of loan forgiveness for doctor's who choose to go the general practice route. (Unfortunately this requires governmental intervention and tax dollars.) Another option would be to increase the salaries of general practice doctors to match or exceed those of specialists. This increase in cost would of course be passed on to the patients.

 

It's interesting to me that RP as a physician and a crusader against governmental intrusion would complain about something (the lack of general practice physicians) that can probably only be changed by governmental intrusion of one sort or another. I suppose that is why he just complains and doesn't offer any suggestions as to what to do about it. That would force him to contradict himself.

 

 

(I have a very personal view of this whole scenario playing out. My girlfriend is entering her second year of medical school, and I don't think she will be able to turn down the $$$ of specializing to go the general practice route. I can't say that I blame her.)

 

You are completely wrong on the point highlighted. As technology and medicine improve, the cost will not rise but will instead be substantially lower. Basic economics proves that. Supply and demand controls price, they don't rise just because they can. If there's a high demand and low supply, yes, the prices rise. If supply is high and demand is low, then prices fall. An improvement in technology and medicine would undoubtedly create more supply and would therefore lead to lower prices.

 

Without government intervention we would also see an increase in competition, which also leads to lower prices. Government regulation of pharmaceuticals, research and procedures is what leads to the high costs of medicine. If there wasn't as much unnecessary regulation in place you would see more people/companies entering the medical field, leading to more competition, better service, better ideas/technology and of course, lower prices.

 

I'll address the rest of your points later. I gotta run.

Not true. The nature of patent law prevents it. And as the companies are trying to make a profit, and care nothing if someone lives or dies, as long as their stock prices go up, how do you think prices would go down? Hell, drug companies dont even want to cure people, or prevent illness or disease, they want to find longterm or permanent treatments to keep a steady flow of overpriced drugs.

 

And furthermore, supply and demand really shouldnt be applied to the things that keep people alive.

 

Wow!!!! Sorry, but supply and demand are economic forces, they don't discriminate and therefore can't be changed/manipulated without some serious and unintended sonsequences. Our current economic crisis is a great example of that.

 

Yes, companies are trying to make a profit and no one is disputing that. Fortunately, the only way they can do that, is if their medication works and more people live. Well, that would be the case if the market was allowed to properly function. Instead, we see special interests lobbying for more regulation and government intervention; making it way to expensive to produce, weeding out the competition, and therefore keeping prices high. The government regulation is what guarantees high prices and horrible service, not the greed of entrepeuners. If government intervention in the market was reduced, we would see an increase in effort to please the customer, because in a market based economy that's the only way to make a profit. If you don't please the customer, they don't buy and you don't profit. It's as simple as that.

 

Yes carlfense, I believe some regulation is good to an extent. As long it prevents fraud and the infringement on other's rights, but when special interest are the ones creating regulation to further their monopoly on medicine, that's when I draw the line. If we used the Constitution to regulate, there would be no need for the government to further intervene in the market.

 

A lot of the problems we are seeing in the medical field are a direct result of government intervention. People forget that when we interfere with the market, the consequences/rewards are not only felt by those directly affected, but by all those with a hand in the pot. When one entity of the market is artificially pushed up, it automatically creates a decrease in another entity. That's just the way the market works. Someone brought up the increase in demand of specialities and the decrease in general practitioners. Did you ever think that maybe the government intervening in another aspect of the medical field could have created that problem? Yes, there are other factors to consider but the government intervention is a major part of the problem. When creating regulation they don't think about the long term consequences or the effect it will have on the whole, rather they look at the immediate benefits and who it is helping, not who it hurts.

Sorry, but at some point morality needs to trump profit. The current system is bad enough but further removal of government from medical care will take us on a time trip. Cant afford the new drug that will cure your disease? Off to the cemetery with you. Do you find this acceptable? I dont. But that ddug company wouldnt have a second thought about it, after all there is no profit in it.

 

Paper work has been a leading cause of doctors not wanting to go into general practice, and that is as much the fault of the insurance industry as the gov, and the current administration wants to change that.

 

Profits. The real core problem of everything. What is a reasonable profit anymore? If you have the same profit two years in a row is now considered to a bad thing, and not stable. And will then drop the price of the stock. If company A made $100 million, and competing company B makes $125 million, company A gets considered to be a bit of a failure, which is absurd. So Company A's stock drops. And stock price is really the only thing that matters to businesses.

 

Unrestricted Capitalism, like every other 'ism', ONLY works on paper. In all the 'isms' there is no thought to human nature.

[SOCALHUSKER]

You said that "government regulation of pharmaceuticals is what leads to the high costs of medicine." That is incorrect. New medical technology and drugs are expensive themselves, NOT because of regulations.

 

You claim that regulation hinders competition. Do you have any evidence of that? The truth of the matter is that only the large companies can really afford the R and D costs of the pharmaceutical industry anyways. It's not like a cottage industry is going to spring up that creates miracle cancer drugs. (actually...the "free market" did lead to a cottage industry that made miraculous claims...they were called quacks and they peddled miracle elixirs.)

 

And actually . . . a free market solution is by definition not regulated. How exactly is the government interfering now? By requiring the testing of drugs before they are marketed to make sure that they don't do more harm than good? How is that not a positive? You are thinking big theories, when the reality is that the consumer would suffer if your ideal was reached.

 

No offense carlfense, but you are incorrect. Yes, the technology and drugs themselves may be expensive but regulations that require companies to conform to higher standards, procedures and all other red tape they wouldn't normally adhere to does cause the price of production to rise. When this happens, the producers don't just eat the extra costs, they send them on to the consumers in the form of higher prices. So yes, you're right about technology and drugs being expensive, but the extra cost of the regulation is what causes the prices to rise even more.

 

As far as regulation hindering competition what kind of evidence do you need? It should be fairly obvious that if regulations are enacted that only companies with adequate money/materials/manpower are able to comply with, competition will be driven away. Yes, the cost of research and development are high because of the many regulations being forced to comply with. Why do you think the richest pharmaceutical companies are the biggest lobbyist? They have the money to adhere to the new regulations, they help create, while their less rich competition is forced to quit because they can't comply. This leads to wiping out the competition and the ability of the remaining companies to price as they please. Here's a report taken from the South African Competition Commission about restrictions in adversting and its affects on competition in SA, the EU, Ireland, India and the US. Rules of ConductThis is just one area in which the regulations hinder competition and if those aren't good enough examples let me know and I'll send you more examples.

 

Also, you can check out Henry Hazlitt's Economics in One Lesson for a more clearer understanding of economics and the fallacies that are often associated with many policies and regulations.

[SOCALHUSKER]

Sorry, but at some point morality needs to trump profit. The current system is bad enough but further removal of government from medical care will take us on a time trip. Cant afford the new drug that will cure your disease? Off to the cemetery with you. Do you find this acceptable? I dont. But that ddug company wouldnt have a second thought about it, after all there is no profit in it.

 

Paper work has been a leading cause of doctors not wanting to go into general practice, and that is as much the fault of the insurance industry as the gov, and the current administration wants to change that.

 

Profits. The real core problem of everything. What is a reasonable profit anymore? If you have the same profit two years in a row is now considered to a bad thing, and not stable. And will then drop the price of the stock. If company A made $100 million, and competing company B makes $125 million, company A gets considered to be a bit of a failure, which is absurd. So Company A's stock drops. And stock price is really the only thing that matters to businesses.

 

Unrestricted Capitalism, like every other 'ism', ONLY works on paper. In all the 'isms' there is no thought to human nature.

 

This reads for you Strigori The Function of Profits You'd probably be best served reading the rest of the book also. Maybe it would help dispel many of the fallacies you currently harbor about free market economics. Also maybe read up about Austrian Economics which doesn't look so much into empirical data gathering and econometrics but more into human action and the deductive reasoning of axiomatic truths.

[carlfense]

You said that "government regulation of pharmaceuticals is what leads to the high costs of medicine." That is incorrect. New medical technology and drugs are expensive themselves, NOT because of regulations.

 

You claim that regulation hinders competition. Do you have any evidence of that? The truth of the matter is that only the large companies can really afford the R and D costs of the pharmaceutical industry anyways. It's not like a cottage industry is going to spring up that creates miracle cancer drugs. (actually...the "free market" did lead to a cottage industry that made miraculous claims...they were called quacks and they peddled miracle elixirs.)

 

And actually . . . a free market solution is by definition not regulated. How exactly is the government interfering now? By requiring the testing of drugs before they are marketed to make sure that they don't do more harm than good? How is that not a positive? You are thinking big theories, when the reality is that the consumer would suffer if your ideal was reached.

 

No offense carlfense, but you are incorrect. Yes, the technology and drugs themselves may be expensive but regulations that require companies to conform to higher standards, procedures and all other red tape they wouldn't normally adhere to does cause the price of production to rise. When this happens, the producers don't just eat the extra costs, they send them on to the consumers in the form of higher prices. So yes, you're right about technology and drugs being expensive, but the extra cost of the regulation is what causes the prices to rise even more.

 

As far as regulation hindering competition what kind of evidence do you need? It should be fairly obvious that if regulations are enacted that only companies with adequate money/materials/manpower are able to comply with, competition will be driven away. Yes, the cost of research and development are high because of the many regulations being forced to comply with. Why do you think the richest pharmaceutical companies are the biggest lobbyist? They have the money to adhere to the new regulations, they help create, while their less rich competition is forced to quit because they can't comply. This leads to wiping out the competition and the ability of the remaining companies to price as they please. Here's a report taken from the South African Competition Commission about restrictions in adversting and its affects on competition in SA, the EU, Ireland, India and the US. Rules of ConductThis is just one area in which the regulations hinder competition and if those aren't good enough examples let me know and I'll send you more examples.

 

Also, you can check out Henry Hazlitt's Economics in One Lesson for a more clearer understanding of economics and the fallacies that are often associated with many policies and regulations.

 

Likewise, no offense, but the advertising market is a far cry from the medical market. The costs of failure in medicine are too high to lay on the average consumer. If failures occur in advertising, profits are lost. If failures occur in medicine, lives are lost.

 

Those regulations (your demonic "red tape") are mostly requirements that drugs be adequately tested before they reach the market. Are you suggesting that we not test drugs and let the people "test" them themselves...with their lives?

 

And if you think that regulation is the cause of high research and development costs...well, you've already lost at that point. How many times do we all need to point out that these technologies are expensive in and of themselves? If we dropped regulations tomorrow do you think you'd be able to buy a pacemaker on the open market for $100? If so, that's absolutely ridiculous.

 

I don't need economics lectures; I remember those well. Here we are not dealing with pure economics though, we are dealing with morality. You can't just separate the issue into a theoretical exercise that supports your free market argument. (Let's do a reductio ad absurdum: If you want the cheapest medical plan possible, shoot anyone who is sick. I know that you aren't calling for that, it's just an example that we must weigh the morality of the issue when dealing with medicine.)

 

I think our main difference here is you are approaching medicine as just another player in the economic market place; it's not, and it can't be.

 

(And finally your Hazlitt excerpt focused on governmental price fixing, not on regulations that increase the safety of pharmaceuticals.)