Glenn Reynolds on the hidden cost of national health care
By: Glenn Harlan Reynolds
OpEd Contributor
July 12, 2009
Lots of people are beginning to question the cost of President Barack Obama's healthcare "reform" plans, and with good reason. (Just compare the original projections for Medicare with what it wound up costing in reality).
But there's another cost that isn't getting enough attention. That's the degree to which a bureaucratized healthcare system will squash medical innovation just as we reach a point where dramatic progress is possible. To see how important that is, I don't have to look any farther than my own family.
Perhaps our medical history is more involved than most, but probably not by a lot. And yet many members of my family are living better, happier lives -- or, heck, just living -- because of medical innovations made in recent decades, innovations that probably wouldn't have been made under a government-run health system. And as medical technology progresses by leaps and bounds, the next few decades are likely to see much greater progress, unless it's throttled by bureaucrats.
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.
It doesn't always work that way, of course. The rise of proton-pump inhibitors like Nexium or Prilosec has made ulcer surgery a thing of the past. But to the bureaucratic mindset, those pills are a cost, and ulcer-surgery expenses can be dealt with by rationing. Let 'em eat Maalox while they wait.
I exaggerate, but . . . well, maybe I don't. The truth is, despite the great promise of new medical technology out there now, in terms of new cancer treatments, biotechnology, nanotechnology, and more, the potential marvels of the next twenty years will never be developed unless some developer thinks there's a market.
And with bureaucrats in charge of deciding what treatments to pay for, the existence of such markets will be much less certain. Oh, sure, federally-funded medical research will still go on at the NSF, NIH, etc. But turning that research into actual products is a different story.
My family benefited from innovative treatments that probably wouldn't be around if the United States had adopted socialized medicine when that was first proposed over half a century ago. In 20 years from now, a lot more treatments -- and, probably, dramatically better treatments -- won't be around if we adopt a national healthcare program now.
It's ironic that the same Democrats who were pushing the medical prospects for stem-cell research during the last election are now pushing a program that will make such progress far less likely.
Glenn Harlan Reynolds, a law professor at the University of Tennessee, hosts "InstaVision" on PJTV.com and blogs at InstaPundit.com.
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