Wednesday, September 23, 2009

Milling: Global Medical Collapse?

Wendy Milling has a new column at, warning that "H.R. 3200 Will Collapse Global Medicine".

Here's an excerpt:
What has been missing from the national discussion on health reform is an analysis of the dynamic consequences of significantly increasing the level of statism in the medical field.

If the United States implements H.R. 3200, the resulting conditions will not come to resemble that of any current Western medical system or bestow any of their purported advantages. The U.S. medical system will collapse, and it will take down every major medical system throughout the world with it...
(Read the full text of "H.R. 3200 Will Collapse Global Medicine".)

Too many supporters of "universal health care" say that "medicine should be about patients, not profit".

Yet it is precisely the profit motive and the opportunity to create and trade value that drives medical innovation. As Milling notes:
The demolition of profits and a more austere and coercive environment will result in the flight of significant numbers of these people from the medical field. As the profits in the industry disappear, so will the supply of mental capital, as the best minds that would otherwise fuel the advancement of the sector will leave it for more profitable ones. It is worth noting here that the term "brain drain" was coined to describe such a loss from Great Britain after socialized medicine was instituted there in the 1950s.

This will be seen in many forms. There will be decreased interest in medical school among the best and brightest youth. There will be early retirements by experienced but frustrated doctors. The caps on prices and reimbursements will squeeze medical equipment manufacturers, who will lay off engineers and decrease their product development. Pharmaceutical and biotech companies will make cuts in research and development and lay off scientists, and their drug pipelines will become empty. Fewer smart people will choose a career in healthcare management or allied industries.

There will be no rescue of the medical system by productivity. Productivity in medicine will itself be in need of rescue.
And what will be the end game?
The decay would be characterized by a pervasive increase in doctor shortages, unmotivated and incompetent doctors, overworked medical professionals, expensive and virtually useless public and private insurance plans, poor quality and deteriorating medical products and services, few biomedical advancements, desperate patients, black markets, unsafe medical tourism, physically and psychologically incapacitated patients, and foreshortened lives.

In such a state, world medicine would be vulnerable to powerful stressors that could push it past the breaking point. That stressor would likely be the onset of a flood of end-of-life demand by the Baby Boomer demographic, at which point the system would become irreversibly overwhelmed. At current life expectancies for U.S. males, this would occur around the year 2021.

At some point, all national plans would go bankrupt, necessitating either a move toward laissez-faire, or a descent into sub-industrial medicine.
(Emphasis mine.)

Which of those paths do we want? The choice is ours.