From: terry@npd.Novell.COM (Terry Lambert)
Subject: Re: FDA still at large
Organization: Novell NPD -- Sandy, UT
Date: Thu, 30 Jul 1992 20:44:21 GMT

In article <92211.202315DGS4@psuvm.psu.edu> <DGS4@psuvm.psu.edu> writes:
>In article <1992Jul29.172942.16494@gateway.novell.com>, I write:
>>
>>        I can not agree with the idea that "expensive" treatments should not
>>be used.  Their use encourages both improvement in the procedures (lowering
>>cost) and developement of alternative procedures to accomplish the same
>>goals (also lowering cost).  When the cost reaches common use levels, the
>>treatments become commonly used.  The United States is a leader in
>>biotechnology precisely because of the market-driven bent of our medical
>>system.  Eye glasses and Insulin are
>
>I'd like to see you offer a single piece of evidence that supports this rather
>explicit claim.

Precisely which point are you contesting, and on what grounds?

1)	Use of expensive treatments being disallowed on the basis of an
	"economy of numbers" is a bad idea.

2)	Capitalism is an applicable principle in the developement of
	medical procedures and treatment protocols.

3)	Purchasable materials (such as drugs and physician time), where
	the perceived benefit outweigh the perceived costs, will be
	purchased (a reiteration of a capitalist theme).

4)	The United States is a leader in boitechnology.

5)	The capitalistic system in use in the day-to-day operation of
	the United States as a country has something to do with the
	United States being a leader in biotechnology.

6)	Insulin and eyeglasses are sold.

7)	Insulin and eyeglasses would cost more if less people wanted to
	buy them.

8)	The cost of eyeglasses and insulin are outweighed by the
	alternatives, which are poor vision or blindness, in the first
	case, and blindness, impotence, gangrene, and death in the second.

Clarify, and I'll be happy to respond.

>>two of the many results of this.  If there are to be additions to the list in
>>the future, they certainly will not come about in a cost/benefit system of
>>socialized medicine.
>
>Funny, but quite a few medical products, drugs,and techniques are
>developed in Canada, Germany, Switzerland, the Netherlands, etc., etc.,
>Face the facts, there is a continuum of combining market and government
>in health care.  Our current combination provides high cost, low access to
>most cost-effective procedures for a large percentage of the population,
>and extraordinary levels of interference by third parties (both government
>and private) in the doctor-patient relationship.  Maybe, it provides faster
>technological growth, but that claim has never been proven.

First, I would have to argue that most medical advances come from people
who believe that they can get a return on their investment.  Whether this
is a private physician/clinic in one of these countries, or whether this
is the result of the large provate medical and pharamaceutical firms in
these countries is inmaterial (although Sandoz Pharmaceiticals, whose home
office is, I believe, in Basil, Switzerland, is one of the largest
privately held companies of it's type in the world, and certainly expects
to make a profit).

Government has never been able to provide anything by a few large scale
service cost-effectively.  This is why there are firms contracted by
government to provide utilities, garbage collection, and other services
traditionally though of as belonging in the province of government.  It
is cheaper than providing the services itself.  This is why there is a
provision for government granted monopolies, usually utilities, but
including police protection in some cities.

Second, I would have to argue that the high cost associated with health
care is a direct result of the malpractice insurance requirements due
to a lack of civil liability legislation limiting the damages which can
be claimed.  I will be bombarded, I am sure, by many people for this
viewpoint, but I suggest that those same people agree with you that our
ficticious Mr. Joneses life is not worth $20,000.  It doesn't matter if
they agree with you on quality of life, expected duration of that life,
or social responsibility ("greatest good").  They have placed a rather
arbitrary limit on Mr. Joneses expected value to society, and complain
when I suggest the same in the post facto (after the damage is done)
case.

Third, I agree that there is way too much interference in the private
developement of medical protocols and procedures, both by the
government and by special interest groups.  Look at the recent attempts
to legislate ethics in the RU-486 case.  Most people think that a simple
pill is involved, and do not realize that a physician-administered shot
is required as a followup (per the developer of the drug).  It reminds
me of the "Come the revoloution" joke that derives it humor from the
"freedom fighters" advocating opression when their views are challenged.
Litigation by the government and scpecial interest groups doubtlessly
exerts a retarding influence on anyone advocating anything but the status
quo in medicine (or any other branch of society, for that matter).  It
doesn't even have to be real: a threat of litigation or a perceived
threat of litigation is enough.  The company which manufactures RU-486
hasn't even implied they will distribute in the US, which is sad, given
it potential to treat several types of cancer in women.  I suppose that
coat hangers, which can be used for the same purpose, have greater social
benefit in their ability to keep clothes off the floor than a drug which
can be useful in treating cancer.  Go figure.


					Terry Lambert
					terry_lambert@gateway.novell.com
					terry@icarus.weber.edu
---
Disclaimer:  Any opinions in this posting are my own and not those of
my present or previous employers.

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