Following are a pair of op-eds by two well-informed activists for healthcare freedom in America.
Asking for trouble in health care
November 24, 2008 - 5:38 PM
PAUL HSIEH, M.D., GUEST COLUMNIST
In the 1990s, politicians wanted to make home ownership as universal as possible. They used laws such as the Community Reinvestment Act to force banks to make unsustainable loans to millions of people. They also expanded quasi-government agencies such as Fannie Mae and Freddie Mac to guarantee these loans.
This scheme could last only a few years. In 2008, the housing bubble finally burst and economic reality caught up with the politicians. American taxpayers were stuck with the tab for these "toxic" mortgages. The result was the Wall Street Bailout of 2008 and the worst economic crisis since the Great Depression.
In 2008, politicians want to guarantee "universal health care" with new laws and new government programs. President-elect Barack Obama wants to require health insurers to sell policies whether or not those policies are economically sustainable (for instance by requiring them to issue policies regardless of pre-existing conditions). He has also proposed creating a massive new "National Health Insurance Exchange" to help ensure "universal coverage."
But no politician can evade the laws of economic reality. Massachusetts' program of "universal coverage" requires hundreds of millions of dollars of federal money a year to stay afloat, paid for by the taxpayers of the other 49 states. If the U.S .attempted this at a national level, there would be no one to bail us out.
When Obama's proposed national system inevitably collapses under the weight of market inefficiency and bureaucratic overhead, this will merely pave the way to fully socialized single-payer health care. Health care spending now comprises one-sixth of the U.S. economy. Forcing taxpayers to pay for everyone's medical expenses would make the $700 billion Wall Street bailout look like pocket change in comparison.
Even worse, under nationalized health care the government will eventually have to ration medical services to control costs. This is already commonplace in other countries. A Canadian woman who feels a lump in her breast oftens wait months before she receives the surgery and chemotherapy she needs. In contrast, an American woman can get the treatment she needs within days.
According to The Telegraph, Great Britain's National Health Service paid bonuses to primary care physicians who reduced the numbers of referrals to hospital specialists - thus forcing those doctors to choose between their oaths to their patients or the government which pays their salaries. Whenever government attempts to guarantee a "right" to health care, it must also control it. Bureaucrats then decide who gets what health care and when, not doctors and patients.
The fundamental problem with "universal health care" is the mistaken premise that health care is a "right." Rights are freedoms of actions (such as the right to free speech), not automatic claims on goods and services that must be produced by others.
Individuals are legitimately entitled to health care that they purchase with their own money, are promised by prior contractual agreements, or are given to them via voluntary charity.
Attempting to guarantee an alleged "right" to health care must necessarily violate someone's actual rights - the rights of those compelled to pay for it. The ultimate victims will again be the taxpayers, just as they were the ultimate victims of the Wall Street bailout.
Instead of universal health care, we need free market reforms that reduce costs, reward individual responsiblity, and respect individual rights. Some examples include eliminating mandatory insurance benefits, repealing laws that forbid purchasing health insurance across state lines, and allowing individuals to use Health Savings Accounts for routine expenses and to purchase low cost, catastrophic-only insurance for major expenses. Such reforms could lower costs up to 50 percent, making health insurance available to millions who cannot currently afford it.
We can't go back in time and avoid the Wall Street Bailout of 2008. But we can still make the right decision with respect to health care. We must reject calls for "universal health care" or else we'll be faced with a massive "Health Care Bailout of 2018." The events of the past few months have taught us some important lessons about economic reality. The only question is whether we're willing to learn from them.
Hsieh, of Sedalia, is the co-founder of Freedom and Individual Rights in Medicine.
Freedom from the FDA
By Richard E. Ralston
November 28, 2008
It took the Food and Drug Administration more than a century to grow into a massive, expensive, wasteful, inflexible, ineffective, distant and indifferent bureaucracy. It now violates a founding principle of the practice of medicine: "First, do no harm."
The FDA does a lot of harm, every day. Why do we allow that?
The FDA has kept some unsafe or ineffective drugs off the market (although a consortium of independent research organizations could have done the same thing). But at what cost? We can summarize in ten ways how the FDA threatens or does real harm to our health:
1. The FDA adds billions to the development cost and price of new drugs.
2. The FDA delays the availability of new drugs for years.
3. The FDA prohibits the use of new drugs that treat conditions for which other drugs are available, regardless of how much better they might work for some patients.
4. The FDA withholds new drugs—even those that passed initial safety tests—from terminally ill patients, in the name of preserving safety. When one of these patients wins access to the drugs by going to court, the FDA, apparently in a relentless effort to protect the health of the dead, appeals the ruling until the patient dies, at which time the appeal is of course dismissed.
5. The FDA and Congress allow the drug approval process to be politicized to protect the interests of firms with political pull or to serve the anti-corporate political agenda of those who would rather see Americans die than allow any investors or businesses to make money developing new medications.
6. The FDA suppresses off-label use of drugs with proven ability to treat other conditions and restricts the circulation of information about such successful off-label use of drugs that have already been approved as safe.
7. The FDA actively seeks to extend the authority it so ineptly applies to drugs—and for which it asserts to have insufficient staff—to controlling all vitamins and food supplements. Whenever the reach of the FDA exceeds its grasp, it always tries to extend its reach.
8. The FDA constitutes a roadblock to new developments in anti-aging drugs by refusing to consider any science that would extend healthy lifespans—because "aging is not a disease."
9. The FDA states that it lacks the resources to ensure human drug safety but requests more resources to review veterinary medicine.
10. The FDA now publishes lists of drugs it approved but the safety of which it questions—leaving physicians in the lurch and creating a potential jackpot for litigation.
The FDA adds billions of dollars to the cost of developing new drugs and delays their use for years. Yet it is so obsessed with predicting exactly how each drug will perform for any patient—with any condition, in any dosage, for any length of time and in any combination with any other drug or combination of drugs in any dosage—that it often loses sight of safety. So a few years ago the FDA proposed the creation of a new "Drug Safety Board" to provide for drug safety. One would have thought that was the purpose of the whole agency.
That hypocrisy is consistent with the history of the agency. Every failure to fulfill its purpose is met with a review or a study by another government-related organization hired by the FDA to make recommendations. The recommendations are always the same: more staff, more budget, more authority, more buildings, more office furniture and more regulations.
If we want the tremendous progress in the development of medications in recent years to continue, we must act to eliminate the awesome ability of the FDA to destroy that progress. The first steps in reform should be to direct the FDA to focus entirely on safety and allow physicians and their patients to determine efficacy. Research must be encouraged, not restricted, and information on that research must be open to all.
Richard E. Ralston is Executive Director of Americans for Free Choice in Medicine.