• Republican Health Care

      James P. Pinkerton makes good points about how Republicans might present a more optimistic health care policy. While Democrats redistribute,

      “[a] more intelligent approach would be to think of the public’s demand for health care as an opportunity rather than a liability. Our economy is driven by the harmonious convergence of entrepreneurial exuberance and insatiable consumer demand. Those are good things — so let’s have more of them.The opportunity now exists for Republicans to reassociate themselves with the creation of health. Let the Democrats own the redistribution of healthcare dollars and the management of scarcity; Republicans have a chance to own the much more powerful issue of solving health problems…”

      Good so far, but then he says:  

       “In most cases, it is cheaper to cure a chronic disease than to finance the long-term treatment of it. And prevention is cheaper still…” 

      But prevention isn’t free. It’s valuable and enhances life, but I don’t see how it saves money. As I’ve written on before, preventative health care does not necessarily lower costs. Often prevention lets people live long enough to get even more expensive diseases.

      Pinkerton points out that there are exceptions: a cure for Alzheimer’s, for instance, would save billions. Taking care of the elderly would cost less, and some elderly people would be productive longer. Also, he reminds us that

      “we undertook a national campaign against AIDS. A disease completely unknown in 1981 became manageable, at least in the United States, by the early 1990s. AIDS in America is still a serious disease, but it is not a death sentence; its treatment is akin to that of diabetes. And along the way, our understanding of viruses and retroviruses has vastly improved, a great boon to our understanding of, among other things, cancer.

      Thanks to these victories for medical progress, which are distinct from “health-care reform,” our lives are not only better, but longer. The life expectancy of the average American has soared from less than 50 years in 1900 to nearly 80 years today.... Woe betide the American politician who lets himself be associated with anything close to a death panel…
      Given our experiences with malaria, polio, and AIDS, why aren’t we making similar national efforts on other diseases, such as cancer, heart disease, and diabetes? Is it too cynical to suggest that maybe the current federal government is less interested in medical research, which might extend people’s lives, than it is in public health insurance, which extends state power? A chronically ill senior, in poor health and anxious about his next dialysis session, is likely to be a diligent AARP dues-payer — and a Democratic voter…”


      But I get nervous when advocates use the word “we.”

      “We might offer a variation on the Ansari X Prize, the $10 million reward that helped inspire inventors and entrepreneurs to reach space in private vehicles. In the past, we used all manner of public and private tools to build the railroads, to win our wars, and to reach the moon. If we set a great national goal — a goal that inspires our best and our brightest — we may be pleasantly surprised by the outcome. At a minimum, we could push back the onset of the disease. This wouldn’t take a tax increase. It would take a coordinated and catalytic effort here in the United States, pulling in the best scientists, along with corporations, medical schools, philanthropists, and maybe even a sovereign-wealth fund or two…”

      But who is “we?” The NIH? My medical researcher brother, who is presently obsessed with fighting the "pharmascolds," tells me that:  

      “Currently industry investment in innovation exceeds the NIH by two-fold. I believe the era of importance of NIH has come to an end (and as a lifelong successful NIH panhandler, I have the credibility to say that).”

      I wrote Pinkerton to ask:

      Who is “we?” The X Prize was offered by a private entrepreneur. Most who say “we” mean government. But I assume government would fund cronies and squander the money Synfuel style.

      Pinkerton replied:

      “I am perfectly happy to see the government fund such an X-Prize, and perfectly happy to have the debate as to whether it should be run the way that the British government ran the prize for a working chronometer back in the 18th century, as described in the book "Longitude," or whether it should be run according to Robert Byrd principles. I am not as pessimistic as you and your brother would seem to be.   I believe that the government can get things done, when the public gives it a clear goal and there is good leadership.  That's how we won our wars--the ones that we won--got the railroads built, the Internet, etc.” 

      I’m too skeptical of government to agree. What do you think?

      Health Care