Monday, August 31, 2009

Some Practical and Ambitious Ideas for REAL Healthcare Reform

Lost in all the misleading statements or outright lies about the costs of healthcare reform coming from democrats, or the fear-mongering tactics of republicans, is a recognition of the reality that “YES our healthcare system needs to be reformed and YES there are some practical, non-partisan ways that we can seriously reform the system without* creating the dreaded “public option”.

The Practical:

Some popular non-partisan ideas I’ve heard tossed around include the right to pool insurance risk across state lines, and opening up private insurance markets allowing consumers greater choice in who their service provider will be. A practical idea Obama has endorsed is instituting an electronic billing and prescription system. A more populist idea is eliminating the prohibition of coverage denials based on pre-existing conditions- but this could be paid for by savings realized from passing some minor (or major) tort reform. All of these ideas are pragmatic and relatively non-partisan ways to realize some serious cost savings whether taken as a whole or instituted incrementally.

The Ambitious:

My own original, and admittedly very ambitious idea, is that significant savings can be realized by making some key changes to the U.S. intellectual property regime (USPTO) and the Food & Drug Administration (FDA) approval process for pharmaceuticals and medical devices.

Working together, the USPTO, the FDA, and the pharmaceutical / med device industries can take a number of steps in their mutual interests that will lower the cost of healthcare for everyone.

Approximately 20% of healthcare cots in the U.S. are linked to prescription medication**. Pharmaceutical and medical device companies spend billions of dollars to approve a single drug or device, and for all we hear about multi-billion dollar blockbusters, most drugs never even make it to market. At present, U.S. law grants new drug / device inventors a 20-year “monopoly” on the manufacture of new drugs. This system ensures that pharmaceutical companies will continue to invest the billions of dollars it costs to develop a new drug, because they know that they will be able to reap ample rewards over an extended period of time if they are successful. While this system works, there is plenty of room for improvement.

First, the USPTO should move to decrease the patent life on new, innovative pharmaceuticals and devices from 20 to 18 years. Concurrently, the federal government should expand the size of the currently under-funded and under-staffed USPTO to ensure that patents for new drugs / devices are processed within a matter of weeks (rather than many months or even years), while also taking steps to further streamline the patent application process. In this way, inventors, and companies would be swapping some extended patent life for a faster and cheaper patent process, cutting through delays and red-tape at the USPTO.

Second, and most importantly, the FDA should also be expanded so that New Drug Applications (NDA’s) can be processed in months, rather than years. Red-tape should be removed from the approval process wherever possible and the costs and numbers of clinical trials demanded before approval should be decreased substantially.

By decreasing the time and costs associated with the patent and drug approval processes, the pharmaceutical and device industries would more than make up for their sacrifice of 2 years of patent life with faster and higher upfront earnings, Considering the “time-value” of money and that $1 today is worth more than $1 next year, these companies might be convinced to support such reform. Most importantly, the U.S. consumer, along with both public and private insurance payers would all benefit in that generic, and thus cheaper, versions of prescription drugs will be available 2 years faster than they are at present, saving EVERYONE money. The savings these reforms would generate would more than off-set the nominal costs of expanding the sizes of the FDA and USPTO, especially when compared with the costs associated with any “public option” currently under discussion.

*(it is my hope that even the most die-hard supporter of universal healthcare would at the very least substitute the above underlined “without” with “before”)
**The Economist (a couple of weeks ago!)


Friday, August 7, 2009

Socialists, Fascists, and the Debate on Universal Healtcare

Socialists, Fascists, and the Debate on Universal Healthcare

There is a lot of name calling going on in the news today. Nancy Pelosi and the mainstream media are calling conservatives who protest healthcare reform (and I use the term “reform” loosely) “nazis”. Fired up conservatives are calling Obama, Pelosi, and their supporters “socialists”. So which one is it? Are we in fact much like the Weimar Republic in the 1920’s, a faltering Republic with weak institutions being torn between feuding factions of socialists and fascists? One would like to think not.. To try to get to some sort of conclusion, I thought it would be an interesting thought experiment to define exactly what is “socialism” and what is “fascism”, and then look at the positions and ideology of today’s political parties on today’s immediate issues to see if the recent political name-calling is warranted, or if it is just over exuberant political rhetoric.

To start, let’s look at the definition of the word “socialism” from the Merriam-Webster online dictionary…

· Main Entry: so·cial·ism*
· Pronunciation: \ˈsō-shə-ˌli-zəm\
· Function: noun
· Date: 1837

1 : any of various economic and political theories advocating collective or governmental ownership and administration of the means of production and distribution of goods

2 a : a system of society or group living in which there is no private property b : a system or condition of society in which the means of production are owned and controlled by the state

3 : a stage of society in Marxist theory transitional between capitalism and communism and distinguished by unequal distribution of goods and pay according to work done


Looking at definition #1, regarding “governmental ownership of the means of production and distribution of goods”, it would appear that the current administration’s take-over of both General Motors and Chrysler certainly meet the definition for “governmental ownership of the means of production”. Concerning the administration’s health care reform proposals, since “healthcare” is a service and services are a form of “goods”, any program that imposes government control of the distribution of such services would indeed qualify as socialism.

This leads to the next question, which is: “are conservatives fascists”?

As we did for socialism, first let’s look at the Merriam-Webster definition of fascism:

· fas·cism
· Pronunciation: \ˈfa-ˌshi-zəm also ˈfa-ˌsi-\
· Function: noun
· Etymology: Italian fascismo, from fascio bundle, fasces, group, from Latin fascis bundle & fasces fasces
· Date: 1921

1 often capitalized : a political philosophy, movement, or regime (as that of the Fascisti) that exalts nation and often race above the individual and that stands for a centralized autocratic government headed by a dictatorial leader, severe economic and social regimentation, and forcible suppression of opposition

2 : a tendency toward or actual exercise of strong autocratic or dictatorial control (early instances of army fascism and brutality)

So are conservatives fascists, or is Nancy Pelosi out of line? Philosophically, I will argue in a later blog that both democrats and republicans have been moving this country ever closer to a hybrid form of “corporate fascism”, but for now, sticking to today’s most immediate concerns, it would appear that conservatives most definitely are NOT fascists.

Looking at definition #1, conservatives who are protesting state control over healthcare are indeed strongly opposed to “exalting the nation… above the individual” as well as a “centralized autocratic government headed by a dictatorial leader”, “ severe economic and social regimentation”, and “forcible suppression of opposition”.. Let’s examine each of these components of fascism and see which side of the healthcare debate is actually acting playing the role of “fascist”..

1). “Exalting the nation above the individual”... On healthcare, conservatives want individuals to take care of their own healthcare. This is the exact opposite of the definition of fascism. Indeed, conservatives or more generally libertarians like me are generally criticized by liberals for “exalting the individual above the nation”…

2). “Centralized autocratic government headed by dictatorial leader”.. This one is too easy. Creating a government “option” for healthcare is just one more cog in what is becoming a “centralized autocratic government headed by” what I believe to be a benign and elected but nonetheless increasingly “dictatorial leader”.

3). “Severe economic and social regimentation”… turning to the democrat view on what caused the financial crisis, it is they who blame “the lack of regulation” and the “failure of laissez-faire capitalism” for the current crisis. The answer for them, of course, is more regulation- i.e. “economic…regimentation”.

4). “Forcible suppression of opposition”… It has been recently reported that in reaction to conservative opposition to “healthcare reform”, the Obama administration has issued a statement asking for his supporters to email the White House directly to report on any “fishy” stories that might be spreading “un-truths” about his “reform” plans… This is not so much “forcible” suppression, but it is indeed political intimidation, and is definitely evidence of a dictatorial mean-streak that is and should be quite concerning to just about anyone. The “forcible” part of the “suppression of opposition” comes into play by democrat leadership asking its union thugs to attend these meetings to counter what was at least initially genuine “grass-roots” conservative opposition. Yesterday’s violence at one of these town-hall meetings is evidence of the type of political discourse these unions have inserted into the public debate.

Nancy Pelosi has been quoted as saying that the conservatives attending these town-hall meetings are “subverting the democratic process” by expressing their opposition. And, if by “subverting the democratic process” she means “exercising their constitutional rights to peaceably assemble and question their leaders”, she may well be right. Unfortunately, though, what she views as “subversion” is in fact opposition to her political philosophy and policies. As such, it is she, her party, and her president, who are exhibiting both socialist and fascist tendencies, attempting to stifle legitimate debate, to label those that oppose their views as “extremists”, and to rapidly expand the size, scope, and control of the federal government before the American people have time to realize what’s happened and what they’ve lost: Their Freedom.


Saturday, August 1, 2009

The Duality of Religion- Great Emancipator or Mechanism for Control?

The Duality of Religion- Great Emancipator or Mechanism for Control?

Karl Marx argued that “religion is the opiate of the masses”, and to some extent, he was correct. It was not however, out of a desire to free the human mind and spirit from the shackles of religion that his communist disciples turned to atheism, though that may have been their false pretense. Their motive was in fact to control those shackles for themselves. Thus throughout history have dictators attempted to control or supplant religion in their efforts to control their populations.

All forms of dictatorship seek to either control, co-opt, transform, and ultimately destroy religion. Communist states like the former Soviet Union imposed atheism on its population from the top down, replacing God with State, substituting one ultimate authority with another. Fascist Germany, on the other hand, sought to control the Catholic Church by steadily eroding its independence and slowly turning it into a mouth-piece for the state. Communist China, interestingly, has utilized both strategies. Note the “Cultural Revolution” in which Maoist zealots destroyed Buddhist temples and ancient statues (see the “Longmen Grottoes” for an example of the defacement of these ancient relics) in an effort to “purify” society from religion. Today, China seeks to control religion, by co-opting the Catholic Church, insisting that bishops and priests be appointed and approved by the government. Once a religion is co-opted by the state, it becomes yet another mechanism of control for the government, which seeks to maintain the subservience of the minds and spirits of its population. When a religion has reached this point, it has lost its moral authority, and as a result, is destroyed, if not in fact, then in substance.

Most religions, by their very nature, seek to control people’s thoughts and minds by asking them to accept certain moral and ideological precepts based on “faith” alone. The danger of religion lies in the fact that when one accepts anything based on “faith”, without regard to “reason”, they may be controlled by an unchallengeable moral authority. This unchallengeable moral authority is both a temptation and burden for dictatorships: control religion, and you control the people. Let religion flourish, and risk losing your moral authority to a “higher power”. Perhaps in acknowledgement of this dilemma, and to remove this temptation from future political leaders, the writers of the U.S. Constitution had the foresight to insist upon “separation of church and state”.

On the other hand, religion can also serve as an immensely positive force. Religion inspires people to help others, to act charitably, and to generally lead honest and moral lives. Perhaps most importantly, it provides hope. Hope for a better life, now, and in the afterlife. It teaches people that they “deserve better” and it shows people that there is a power greater than “the state”. It is this hope that can drive people to question authority, to push for something better, to not accept the status quo, and most importantly, to believe that man is worthy of all the glory that the world (or God) has to offer. This belief in human “worthiness” inspires greatness in people, and great fear in those that seek to control human greatness.


The "right" to healthcare is immoral

The “Right” To Healthcare is Immoral

Freedom of religion, freedom of speech, the right to assemble, the right to bear arms, a free press… These are just some of the inalienable rights that are endowed to us by “our creator” and are enshrined in that most glorious of documents, the U.S. Constitution.

Today, our wise leaders are proposing a new “right”, the “right” to universal healthcare. After all, they argue, why should people go without healthcare? In a country that is so rich and powerful, how is that so many people have “slipped through the cracks”? There’s no denying that our current system is unsustainable and is a mess.
What the advocates of universal healthcare fail to recognize, however, is that unlike the inalienable rights I have listed above, the “right” to healthcare is a service, provided by people. It is not religion, or speech, or some basic liberty ingrained in human nature and quintessential to the existence of a free human mind. It is a service, provided by men (and women). It is provided by doctors, nurses, therapists, and countless thousands of other professional practitioners.

By declaring healthcare to be a “right”, our government is in reality allowing one citizen to place a claim over the life and productive output of his fellow citizens. No true “right” can be granted to one citizen at the expense of another. If I choose to be a Catholic, I am not taking away another person’s right to be a Buddhist. If the government chooses to make healthcare a “right”, it is taking away a physician’s right to choose who he will treat, how he will treat them, and the price he can charge for his service. How long can we expect doctors to serve as sacrificial animals to others before they seek out other professions in which they will be free to operate as they so choose and as is their right?

Assigning healthcare as a “right” is setting a dangerous precedent for this country. It is establishing as the law of the land that some individuals (i.e. healthcare providers) rights are to be sacrificed to the greater need of others (i.e. those that “need” healthcare). In this kind of system, no person’s rights are above being sacrificed to those who are in “need”, and all should be wary of being caught on the wrong side of a mob whose “needs” society judges to be more pressing than their own.

July 16th, 2009