Healthcare “reform” and suppression of innovation

To begin, the only reason I’m alive to write this diary is because I benefitted from high-tech medical innovation. In my case, it was computer-controlled 3D conformal, external x-ray therapy for recurrent prostate cancer. (BTW I’m happy to report nominal PSA values at five years and counting.)

So continued medical innovation and I have an intense personal relationship. For that reason, one key reason that both the House and Senate versions of health care “reform” deeply disappoint me is that they will badly damage medical innovation by removing most of the profit motive to fund risky research.

There are two basic reasons for this, both driven by political budgeting: price controls and limitation of market access. Market access will be collateral damage from “relative cost-effectiveness” judgments rendered by committees of political apparatchiks empowered by both House and Senate bills.

If you think that choking off medical innovation will only mean that currently untreated medical conditions will remain untreated, you aren’t seeing the whole picture. (As if ignoring the long list of currently-unsatisfactorily-treated medical conditions weren’t bad enough.)

Especially in the area of infectious disease, to fail to innovate is to go backwards.
As documented here, competent international medical experts are calling urgently for “ten new antibiotics by 2020″ to combat the steady accumulation of resistant strains. They cite this as one of the top priorities in medicine.

Virus mutation is no less of a problem than bacterial — arguably it’s a bigger issue.

I lament the time that will elapse, if anything like these ill-conceived health “reform” packages are enacted, before the full extent of the damage done by suppression of innovation is widely apparent. And there’s the conundrum of how to prove a negative: how to know if some individual sick or dying of a medical condition could otherwise have been cured?

But if an individual suffers an infection that we used to be able to cure, but can no longer, that may be a different matter.

The current debacle of H1N1 vaccine shortfalls nicely illustrates what happens when we stop innovating. The old incubation-in-eggs technology used to produce influenza vaccines should long since have been replaced by genetically-engineered fermentation processes that have been reliable for almost 25 years, since Eli Lilly first commercialized human insulin.

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