Basically, for me, it all boils down to public choice theory. Once we’ve got a comprehensive national health care plan, what are the government’s incentives? I think they’re bad, for the same reason the TSA is bad. I’m afraid that instead of Security Theater, we’ll get Health Care Theater, where the government goes to elaborate lengths to convince us that we’re getting the best possible health care, without actually providing it.
That’s not just verbal theatrics. Agencies like Britain’s NICE are a case in point. As long as people don’t know that there are cancer treatments they’re not getting, they’re happy. Once they find out, satisfaction plunges. But the reason that people in Britain know about things like herceptin for early stage breast cancer is a robust private market in the US that experiments with this sort of thing.
The country that has the highest survival rate for breast cancer is Cuba.
Having been through the breast cancer mill three times, it’s amusing to hear such a robust defense of the incentive system for pharmaceutical development. It’s like the argument to fund the F-22 based on the value of commercial applications for the neat-o wing coatings that were developed. If that’s what we ultimately want, we should find a way to do that, and not prop up some Rube Goldberg model.