Why computers work and health care doesn’t
March 11, 2008 – 11:02 pm by JohnI think arguing by analogy is quite effective as a way to introduce an argument to someone whose beliefs are very different from yours. It can be quite instructive. Bill Walker wrote a good article last month about the contrast between the computer industry and the health care industry. Instead of reflexively saying, “If the State doesn’t do something, people will get sick and die and bankrupt themselves paying for medical care and only the rich will be healthy”—instead of beginning with a result and contriving ways for the State to achieve (or prevent) that result, I encourage my Statist friends to begin with principles and philosophize about how we as a society can go about protecting those principles—and I encourage them to think about how Statism is so obviously wrong and harmful in some situations and some industries, and try to understand how wrong and harmful it is in other situations and other industries.
For instance, the computer industry. It is one of the less regulated industries in our country, and it is one of the most innovative, productive, cost-effective, and beneficial sectors of our society. Bill Walker’s article doesn’t give a lot of details about statistics, health-care legislation, or economic disruptions that have led to high prices, shortages, and waste, but his analogies of what would happen to the computer industry if it were regulated like the health-care industry are valid.
And what about those guys who run the computer industry? They’re… dropouts! Steve Jobs, Bill Gates, Larry Ellison… the whole industry is dominated by billionaire dropouts. How have we gotten along so long without credentialed professionals? …
The IRS will make buying computers tax-deductible for employers, but not for you. Employees will be forced to buy computers through Hardware Maintenance Organizations (HMOs) run by their employers. To lose your job will mean to lose your computer, your ISP, and your primary-care AMA programmer.
He concludes:
Can Market Medicine Be Safe?
Most people can see that the market works best for computers. There are few calls for nationalization of Apple or Intel. But when it comes to health care, it is just assumed that only government can provide safety… in spite of its record of both approving dangerous drugs and stalling valuable therapies.
Of course we need impartial testing of drugs and medical protocols. Do we really think we get that under the current system? Is the FDA somehow exempt from the law that every regulatory agency is captured by the industry it “regulates”? I’d feel a lot better if the next Celebrex or Thalidomide were also going to be tested by competing companies and nonprofits, instead of essentially by the prospective manufacturer under the “supervision” of the FDA. Maybe Underwriters’ Laboratories, the AMA, a few universities, etc. could expand into the job.
In any case, even if you think the FDA is exempt from the evolutionary laws that govern bureaucracies, there is no advantage to preventing competition. If some people wish to use only the FDA approval system, fine. That shouldn’t restrict anyone else with an incurable disease from using a medicine approved by the AMA, or UL, or the Mayo Clinic. Any group should be allowed to make lists of “approved” drugs and protocols, and patients and doctors should be allowed to choose.
The FDA and the patent office have created a medical system that is driven by drug companies. Do drug companies have all the right incentives to find the downsides of their patented product pipelines? I’m not at all anti-drug-company; they do good work, but wouldn’t medical systems driven by (say) life insurance companies, or hospital chains, or academic research, each have their own advantages? Again, competition is the key to progress.
Then there’s biological terrorism. If the survival of our nation depends on the speed at which we develop new cures for artificially engineered viruses… do we want to bet on our current system of government agencies and committees, or on the market?
(By the way, the acronyms of all the hypothetical computer-regulatory agencies he conjured up are the same as the acronyms of real-life medical agencies or oganizations, like the AMA, NIH, and DEA… You probably got that.)
