Category Archives: Health Care

Regulation of the Day 98: Gastrointestinal Drugs

Did you know that the federal government has a Gastrointestinal Drugs Advisory Committee? It’s true. If you don’t believe me, you can attend their upcoming meeting on February 23. The topic of the day will be a new drug application to treat hepatic encephalopathy.

Hopefully some hepatic encephalopathy sufferers will be there. They can ask the Committee why the FDA takes as long as a decade (and as much as $800 million!) to approve medications that could be helping people and saving lives right now.

Explaining the Government Option in 41 Seconds

Watch this video by Caleb Brown, Austin Bragg, and Lester Romero. It’s part of a video contest; take a look at the other entries and vote if you like.

Is Cognitive Dissonance an Insured Condition?

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Rep. Diana DeGette is, without any apparent cognitive dissonance or trace of irony, proposing:

1) Require, by law, that people buy health insurance.

2) Remove health insurers’ antitrust exemption. But only after legally requiring everyone to buy their product.

You figure it out. Insurers are set to receive one of the largest coroporate welfare grants in history. No wonder so many firms are salivating over this year’s health care legislation. But they may pay an antitrust price for their legally mandated windfall.

Perhaps this is a warped Washington version of what one hand giveth, the other taketh away.

Robert Reich Gets It

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Some of the consequences of increasing government’s role in health care are easy to predict. One is that cutting costs requires cutting the amount of care. That means rationing. People judged not deserving of care would be denied it.

Another is that if government uses its increased bargaining power to lower drug prices, there will be less money for R&D. That means less innovation. That could well mean the end of increasing life expectancies.

Some people see these consequences and oppose more government in health care (I refuse to call President Obama and Congress’ proposal a reform; that word implies improvement). Others see those same consequences as reasons for supporting proposed legislation.

Today’s issue of OpinionJournal’s Political Diary (requires paid subscription) shows that Robert Reich, who supports government-run health care, realizes its effects on rationing and innovation, supports it anyway, and said so in a public speech at UC Berkeley in 2007.

Mr. Reich told the Berkeley youngsters: “You — particularly you young people, particularly you young healthy people — you’re going to have to pay more. And by the way, if you’re very old, we’re not going to give you all that technology and all those drugs for the last couple of years of your life to keep you maybe going for another couple of months. It’s too expensive . . . so we’re going to let you die'”

Reich goes on:

“I’m going to use the bargaining leverage of the federal government in terms of Medicare, Medicaid — we already have a lot of bargaining leverage — to force drug companies and insurance companies and medical suppliers to reduce their costs. What that means, less innovation and that means less new products and less new drugs on the market which means you are probably not going to live much longer than your parents.”

Whether you support more government in health care or not is up to you. But it is not disputable that those consequences exist. They should be factored into your opinion. Supporters of proposed legislation should acknowledge the effects of their ideas. Instead, they usually run away from them.

Kudos to Robert Reich for the intellectual honesty he displayed in his speech. More, please.

Why I Want a Public Option in the Health Care Bill

Rep. Steny Hoyer is now backing away from the public option, according to Politico. While surprising at first glance, this is a very shrewd political move.

A bill with a public option will probably not pass. Too much opposition. But one without it probably will. Conceding on the public option allows people who support more government involvement in health care to still get much of what they want.

They can always try for a public option later. People will always be dissatisfied with their health care. There will always be calls for reform. Politicians can always win votes by being seen doing something about it.

The main reason the public option has become such a lightning rod probably isn’t ideological. It’s just too big of a change for people to be comfortable with it. Institutions are sticky. Dislodging them with sudden, major changes always creates backlash. Inertia always wins.

But slow, persistent nudges can get the job done without backlash. That’s why even people who want nationalized health care are not calling for it in 2009. They thought the public option would be a small enough step in that direction for the change to stick.

They guessed wrong. That’s why smart tacticians like Rep. Hoyer are backing off. But they’re still going to offer a bill to increase the public sector’s health care presence, if by not as much as originally hoped. Baby steps. Give the electorate a little time to digest the change. Then take the next step.

That’s why I would like Rep. Hoyer and the rest of the leadership team to keep the public option. It very likely dooms their bill to failure. Government is far too involved in health care as it is.

Regulation of the Day 35: Doctors with Borders

In 49 states, it is illegal to practice medicine outside of a state in which you are certified. Tennessee is the lone state with an open market.

Jacob Grier found a news article showing how this closed-shop style of regulation puts a damper on efforts in California to provide free medical care for people who can’t afford it.

Regulation of the Day 15: The Color of Stitches

The fifteenth in an occasional series that shines a bit of light on the regulatory state.

Today’s Regulation of the Day comes to us from the Food and Drug Administration ($2.3 billion 2008 budget, 9,300 employees).

In §70.5(c) of Title 21 of the Code of Federal Regulations, the federal government reserves the right to regulate which colors may be used in surgical stitches.

Health Care Spending Up

Health care spending in 2007 went up to $2.2 trillion. That is 16.2% of GDP. All in all, we’re talking $618 per person per month — more than what a lot of people pay for rent.

The good news: the rate of increase is slower than in years past. The bad news: it’s still faster than real wages plus inflation.

The worse news: continued movement toward a third-party payment system will further reduce incentives to contain costs. People aren’t as careful spending other people’s money as they are their own.

Appreciating the Magnitude of the Problem

Incoming HHS secretary Tom Daschle hosted a town meeting in Dublin, Indiana to build support for the new administration’s health care policies. It is worth taking him seriously for a moment — he is going to head HHS, after all.

He said that “When we combine the stories of Dublin and multiply that times 300 million people, we begin to appreciate the magnitude of the problem.”

I went ahead and multiplied Dublin’s 697 people by 300 million. That yields a little over 209 billion people, or thirty times the earth’s population.

Yes, this is being too literalist. All the same, politicians are not to be taken at their word.

Keeping Health Care Costs High

The House recently passed the Mental Health Parity Act, which would require group health insurance plans to cover mental health expenses.

The bill still has a ways to go before it becomes law. Those of us who care about health care costs should hope it doesn’t get that far.

By requiring insurers to incur higher costs, the bill will make health insurance more expensive; companies pass on their costs. This could price some people out of affording health insurance.

People who want mental health coverage in their insurance plans should be able to buy it, obviously. But those who don’t need it – or can’t afford it – should not be required by law to pay for something they do not want.

Legislators should take a step back and ask if, maybe, they are one of the reasons health care prices are so high.