Peter Huber is a Manhattan Institute senior fellow, an MIT-trained engineer and a lawyer who has authored several books, including Hard Green: Saving the Environment from the Environmentalists and Galileoís Revenge: Junk Science in the Courtroom. In this provocative City Journal article, Huber observes that the complexity of modern diseases virtually assures that a “one-size-fits-all” socialized medical system will fail:
That is the real crisis in health careónot medicine thatís too expensive for the poor but medicine thatís too expensive for the rich, too expensive ever to get to market at all. Human-ity is still waiting for countless more Lipitors to treat incurable cancers, Alzheimerís, arthritis, cystic fibrosis, multiple sclerosis, Parkinsonís, and a heartbreakingly long list of other dreadful but less common afflictions. Each new billion-dollar Lipitor will be deliveredóif at allóby the lure of a multibillion-dollar patent. The only way to get three-cent pills to the poor is first to sell three-dollar pills to the rich.
With almost $30 trillion under management, Wall Street could easily double the couple of trillion it currently has invested in molecular medicine. The fastest way for Washington to deliver more health, more cheaply, to more people would be to unleash that capital by reaffirming patents and stepping out of the way.
On the other side of the pill, molecular medicine can only be propelled by the informed, disciplined consumer. Any scheme to weaken his role will end up doing more harm than good. Foggy promises of one-size, universal care maintain the illusion that the authorities will take good care of everyone. They reaffirm the obsolete and false view that health care begins somewhere out there, not somewhere in here.
Neither Pfizer nor Washington can ever stuff health itself into a one-price uniform, One America boxónot when health is as personal as ice cream, genes, and pregnancy, not when every mother controls her personal consumption of carbs, cholesterol, Flintstones, and Lipitor. But the thought that government authority can get more bodies in better chemical balance than free markets and free people is more preposterous than anything found in Das Kapital. Freedom is now pursuing a pharmacopoeia as varied, ingenious, complex, flexible, fecund, and personal as life itself, and the pursuit will continue for as long as lifestyles change and marriages mix and match. Given time, efficient markets will deliver a glut of cheap Lipitor for every glut of cheap cholesterol. And given time, free people will find their way to a better mix.
Read the entire article here.
It may or may not be obvious that I disagree with almost every word of this, for reasons too numerous to list in a blog comment. There is little evidence to conclude that “unleash[ing] that capital by reaffirming patents and stepping out of the way” will likely have a marked effect on overall mortality and morbidity.
While this is not to deny the importance of innovation, public health and preventive medicine measures will assuredly have a greater salutary effect on population health than innovation of the latest biologics, which often involves nonsubstantive changes (Prilosec to Nexium, for countless more examples, see Brody’s Hooked).
In any case, to assert that nationalizing health care would dampen innovation is merely to state the obvious, because any system involves trade-offs between public health policy and rent-seeking behavior. The real argument would be to show why a particular health care model that exerts downward pressure on drug prices and other health services would produce worse health than one which exerts no pressure at all (see the Medicare prescription drug benefit) on drug prices (and thereby presumably fuels innovation).
This analysis, I submit, is wanting, though Epstein in his latest book tries to supply it. Still, as much as I disagree, I think the MI’s voice is important in this debate, so thanks for posting it.
What infuriates me the most is the we (I speak as a proud Democrat) allow others to dictate the debate, and in the process, change the direction of the fight. What most Democrats want is NOT Socialized Medicine, it is Universal Healthcare. There is a distinct difference. Socialized Medicine is the on-size-fits-all method that is described in the article. Universal Healthcare is like SCHIP, where you give sick poor kids free health care.
I’ll be the first to admit that, as a middle-class citizen, if I can afford better medical care, I want to be able to buy it. And that is what I or anyone in the US can do. But that shouldn’t preclude those who are too poor from receiving universal medical care in the same way every citizen is entitled to a public defender after they are arrested.
However, the opponents of Universal Healthcare (i.e. insurance companies) push that Universal Healthcare = Socialized Medicine and some are more than happy to perpetuate that falsehood and spread it as gospel.