Thursday, October 22, 2009

Popular Mechanics Interview Provides Health Care Perspective

Of all places to find a unique perspective on the health care debate, I was ready a copy of Popular Mechanics (the current issue) over this past weekend. The magazine's Editor-in-chief interviewed inventor Dean Kaman, who invented, among other things, one of the first insulin pumps for diabetic patients.

While I won't record the whole interview, some highlights from that interview confirmed a number of things that I've believed about the health care debate all along. Kaman says that the current debate (from both sides) is completely backwards. Instead of cutting costs of innovation and technology to save costs, we should be spending more on innovation and technology in health care.


PM: Yet health-care costs do keep rising. Is there a point at which we simply can't afford the most advanced treatments?

I think this debate shows a fundamental lack of vision, a lack of confidence, a lack of understanding of what's possible.”

Kamen:
Diabetes alone, if you include all of the long-term, insidious consequences of a lifetime of diabetes, is responsible for about 30 percent of the federal reimbursement for healthcare. Taking care of the diabetic every day is a small piece of it. But what if tomorrow we could wipe out diabetes, suddenly everybody takes a pill and it cures the people that have it, and it inoculates the other people so they'll never have it? Forgetting what a great life that would give people and their families, you take care of 30 percent of what now we project as this insurmountable problem of healthcare, which they project is going to kill us.


Well, it would kill us if we look at the 30-year actuarial data based on our 19th century confidence in technology. But I'm sure in 1920 if you asked actuaries to say what percentage of our GDP are we going to spend taking care of people with polio, they'd say: "They get polio, it goes to their lungs, they sit in iron lung machines, they could live a whole lifetime with three people watching over them. We can't support them all."


But what did it cost to deal with everybody with polio? Oh, $2 apiece. We gave them the Salk vaccine. But in the 1920s Salk wasn't around yet.

PM: So you're saying that rather than trying so much to control costs, we should be encouraging new cures?

Can somebody in this country explain to me why we ought to be spending about twice as much supporting sports as on all of our pharmaceuticals?
Kamen: Every drug that's made is a gift from one generation to the next because, while it may be expensive now, it goes off patent and your kids will have it essentially for free.

Whatever the marketplace, if talented people are given resources they're going to keep driving us to having better, simpler, cheaper solutions to problems. And, by the way, if they come up with a better solution but it can't be cheaper—which, in the beginning, most things aren't—nobody says you have to buy it. If you think this new drug is too expensive, it's not a good deal, we have a crisis, buy the old one. It's a generic now. It's cheap.

You can't look at the problem and say, "I want them to do more, better, faster miracles—and not invest in research, not invest in development, and have those miracles delivered to me free." It's unrealistic. And people know that about most things. They do. Nobody expects that just because they've made computers better they're going to give them to you free.

Kamen: We spent on all pharmaceuticals in the United States last year $260 billion. That means all those vaccinations to prevent diseases, all those pills to treat diseases, all those pills to cure them so we don't have to treat them anymore. We spent in all branches of all our pharmaceutical suppliers, $260 billion.

That's certainly way up from what it was in the early days of the world, but we also spent way more money on computers and other things that didn't exist back then, either, and we don't claim we have a computer crisis. We spent more money on our iPhones last year than we did ten years ago cause there were no iPhones. But let me compare $260 billion to other things. How much did we spend in the United States last year on tobacco? $88 billion. That's a significant piece of 260. It's the reason we spent some of that 260. How much did we spend last year on alcohol? The government doesn't subsidize that, you don't have a right to it, it's discretionary spending and if you were really in trouble you would probably spend a little less on alcohol. We spent $90 billion.

Last year what did we spend in the United States on soft drinks? $121 billion. Nearly half of what we spend on all of our pharmaceuticals, on soft drinks. I'm not against soft drinks—I think you ought to buy all the soft drinks you want.

Last year what did we spend supporting professional sports? $409 billion.

Now if somebody in this country wants to explain to me that we ought to be spending about twice as much supporting sports as on all of our pharmaceuticals, then stop spending. You don't like that drug? You don't want to cure this disease? Don't buy it. But don't make villains out of people so that we can turn what is a real social responsibility issue into a political debate.

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This blog is about my opinions and world view.  I am a conservative, evangelical Christian.  Generally speaking, if you post a comment, I'll allow you to express your view.  However, if you say something hateful, untruthful, or just generally something I don't like, I may remove it.

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