Blinded By Hysteria About “Socialized Medicine”

Glenn Reynolds presents the usual conservative hysteria against health care reform.  He brings up the usual nonsense lines that reform will bring about “socialized medicine” as he writes about the benefits of modern health care while ignoring the problem that our system denies such care to tens of millions. He ignores the frustration of  those of us who practice medicine who realize how far we are falling behind the rest of the industrialized world in so many ways.

As I’ve stated many times in the past, you can tell that an article on health care reform is not worth reading when they bring up scare stories about Great Britain as a government run system of this type is not on the table here. The British system is opposed by virtually all supporters of health care reform. His arguments against “socialized medicine” and the British system may or may not be true, but they have no relevance with regards to the current health care debate. Those who rely on scare stories about “socialized medicine” are just avoiding a discussion of the real issues under consideration.

Of particular absurdity is his argument against preventive medicine because of examples where receiving preventive medicine might not have mattered. This has no bearing on the many cases we see of people who do die because they did not receive routine preventive medicine, or did not have coverage for routine treatment of chronic medical diseases.

I had seen this op-ed as not being worth any time commenting on after writing about the absurdity of equating health care reform with socialized medicine so many times in the past. Then I reached the last paragraph:

It’s ironic that the same Democrats who were pushing the medical prospects for stem-cell research during the last election are now pushing a program that will make such progress far less likely.

While the right claims that it is health care reform which will limit health care, this shows just one example how it has really been Democrats who in many ways have been pushing to expand health care choices and reduce interference from restrictive government regulations. Besides stem-cell research, we have also seen this as conservatives have tried to limit or ban abortion and birth control, and their interference in end of life decisions such as with Terri Schiavo.

Reynolds, with his hysteria about “socialized medicine” and lack of understanding of the harm caused by corporate medicine and practices of the insurance industry, sees irony in Democratic support for eliminating the restrictions on embryonic stem-cell research. While his view that health care reform will make such progress any less likely are based upon his irrational views on the health care system, perhaps at least some readers will see his conclusion and question which side is really the one which is responsible for reducing health care choices in this country.

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20 Comments

  1. 1
    Fritz says:

    I don’t think it hysteria to figure out that government-managed health care (whether you want to call it “socialized”, “single payer”, “public option”, ‘Extended Medicare” or whatever) will look really closely at money shoveled at big pharma.  In the long run it was perhaps unfortunate for them to let European government-run plans pay COGS while Americans had to pay much more.  But when we all are paying COGS (much to the benefit of our health care cost burden), it is reasonable to wonder what the impact will be on R&D.  A lot of research is already paid for by the government — but will we now be on the hook for rug development and testing?  Or will it coast?

    Maybe this could be mitigated by easing the rather extreme FDA testing and regulatory requirements for new drugs and treatments.  But I don’t see that as all too likely.  Victims of a bad drug are quite visible and countable — and their survivors sue.  People who die because a new drug is still in testing are just, well, dead.

  2. 2
    Eclectic Radical says:

    It’s worth noting that no one in Washington, even the liberal advocates of reform, are currently arguing for single payer. Indeed, single payer advocates have been left out of the debate to the same degree that the most conservative anti-reform voices are being left out. The debate is largely about a funded mandate (with or without a public option) on the Democratic side and an unfunded mandate with no public option and a rationing of care to Medicare consumers on the Republican side.
     
    Regardless of one’s dire predicitions of rationed care in Democratic plans, the only health care plans advocating rationing of any kind are GOP plans.
     

  3. 3
    Ron Chusid says:

    “It’s worth noting that no one in Washington, even the liberal advocates of reform, are currently arguing for single payer. Indeed, single payer advocates have been left out of the debate…”

    True, and a British system is even further from what is being considered than single payer. Conservatives tend to ignore these distinctions, lumping government-run programs, single-payer programs with private practices, and the type of hybrid system being advocated.

  4. 4
    Ron Chusid says:

    Fritz,

    “Maybe this could be mitigated by easing the rather extreme FDA testing and regulatory requirements for new drugs and treatments.”

    True, in some cases it has taken longer for drugs to make it to market here than in Europe. Of course that also shows that the European systems with more government involvement does not necessarily translate into decreased access to modern medical therapy. On the other hand, we have had several cases in recent years of drugs being released and then having to be pulled from the market as major side effects were found. In some cases this might have been because it took more time and larger numbers to realize the side effects were a problem. In other cases it looks like the pharmaceutical companies were hiding negative research on their drugs.

  5. 5
    Eclectic Radical says:

    It can be argued that the problem is not overly stringent FD regulations and testing standards, but their inconsistent inspection of the testing process and application of the standards.
     
    I am greatly in favor of research, but I am also greatly aware of the danger of the dumping of improperly tested drugs on the market… or drugs whose risks the manufacturers knew about and ignored. FDA-approved drugs like Halcyon and Phen-Phen have gone through very public recalls, while the relaxing of some safety standards have led to commercials that essentially list ‘sudden and massive death’ as a potential side effect of, say, a hair loss treatment.
     
    There is clearly a better balance to be found.
     

  6. 6
    Fritz says:

    I am wondering where the money will come from for development and testing as health care dollars tighten.  Even without single-payer, it is clear that health-care providers will get exemption from anti-trust rules so that they can force cheaper prices from Big Pharma — getting closer to COGS. 

  7. 7
    Ron Chusid says:

    “It can be argued that the problem is not overly stringent FD regulations…”

    Or from the perspective of discussing the issue, the problem is adhering to ideological positions and talking points without looking at the specifics. Libertarians generalize with talking points (always anti-government) such as that the problem with the FDA is keeping drugs from market as they are more likely to be blamed for problems while nobody knows about those who suffer from drugs not being approved.

    Like many libertarian talking points on government and the economy it has a grain of truth which get people to continue to repeat it but the line is a gross over-simplification. Sometimes drugs are kept off the market too long. Other times drugs get on the market which should not. Fritz’s take on the talking point that “People who die because a new drug is still in testing are just, well, dead” misses the fact that the FDA cannot just keep drugs off the market without anyone realizing that drug might have been used as we do have information on drugs which are in the pipeline and we do have information about drugs which have been approved in other countries.

  8. 8
    Ron Chusid says:

    That argument, while often raised by opponents of health care reform, is a pretty weak argument. Much of the money for research in this country comes from government and health care reform will not change that. If anything, allowing the government to save money from much of cost-shifting which increases Medicare costs, which would occur if we had less uninsured, would free up more money for research.

    Pharmaceutical companies will still perform research in order to remain in business. There is plenty of room to cut drug costs while still leaving plenty of money for research. They spend far more on marketing than research, with the best estimates showing they spend about almost twice as much on promotion as they do on research and development. It would be a good thing if drug companies had less to spend to try to influence physicians, and a good thing if they stopped direct to consumer marketing of prescription drugs. They could even survive and continue research with less profits than they now make if necessary.

  9. 9
    Fritz says:

    I did say “development and testing”.  Much research is paid for by tax dollars and then given to Pharma.  Which is also objectionable.

    Of course I would like fewer drugs to be perscription only — that should be restricted IMO to those drugs that cause community damage when misused (perhaps antibiotics).

  10. 10
    Ron Chusid says:

    From a libertarian perspective I can understand the argment to allow people to be allowed to take their own risks if they are the ones to suffer the consequences. On the other hand, I see on a daily basis the types of misconceptions people have about their medications (often after looking up things on line) and the harm that can be done when prescription medications are not adequately monitored.

  11. 11
    Fritz says:

    Ron, I think even more of their effort will go to lifestyle drugs, since there will be less pressure to contain costs there.

  12. 12
    Fritz says:

    Ron, why do you think that pharma companies, if they are legally barred from spending money on advertising their current products, will thben spend more money on research to develop more products that they will not be allowed to promote?

  13. 13
    Ron Chusid says:

    Fritz,

    I never said pharmaceutical companies should be legally barred from advertising. The point is that this leaves the pharmaceutical companies a place to cut costs if government programs pay them less without having to give up research and development.

  14. 14
    Fritz says:

    Ron, I’m sorry — most people who decry pharma advertising to layfolk want the practice to be banned.   

  15. 15
    Charles says:

    RE: Fritz, you wrote an intelligent argument that cites real facts and issues. The anti-reform hysteria that dominates the debate does not; that is the massive hurdle we have to overcome before we can begin to debate the logistics and details that we’d all like to discuss.

  16. 16
    Jake S. says:

    All this worry about R&D drying up? I don’t know guys, how many more friggen drugs to we need to treat heart disease, erectile dysfunction, and insomnia when the obvious cure for all three is DIET and EXCERCISE?

  17. 17
    Ron Chusid says:

    Diet and exercise will help many people but it is not the cure. We still need pharmaceutical R&D. I just don’t buy that it will dry up and the pharmaceutical companies will decide to give up this business, even if profits are less.

  18. 18
    Fritz says:

    I would much rather take a pill than diet.  I don’t find a moral good in either dieting or doing boring exercise (physical activity I enjoy is an entirely different matter).  People who think it is a moral failing that I want to take a pill and continue to eat heartily have swallowed the Puritan line.

  19. 19
    Ron Chusid says:

    Fritz,

    It is not just the Puritan line that says that often diet and exercise is preferable to taking a pill. Pills will not always substitute for the benefits of diet and exercise. (It might be the Puritan line to argue as someone did above to claim that all problems are due to people failing to diet and exercise enough).

    Still, you do show that we will still need the pharmaceutical industry. Even if it were the case that diet and exercise would solve all medical problems, plenty of people will still require medications as they will not follow diets and exercise programs.

  20. 20
    Fritz says:

    Yeah, Ron, I know pills don’t always do what you want.  But there really is a Puritan streak about some of the “get out there and exercise” bit.  Or maybe it’s just living in the Seattle area that exposes me to more of that.  There are a lot of people here who run on smug.

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