US healthcare lobbyists outspend other pressure groups
BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7443.786-c (Published 01 April 2004) Cite this as: BMJ 2004;328:786All rapid responses
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Re: Janice Hopkins Tanne: US healthcare lobbyists outspend other
pressure groups
Currently in the US, when one includes tax subsidies and public
employee benefits, the tax-financed share of health spending is nearly
60%. Thus public spending, not private outlays, already pays the majority
of US health costs.(1) The provision of health care by the welfare state
inevitably fosters incentives that repress innovation and favor
unproductive work. These political incentives include risk avoidance,
empire building, seeking of perks and privileges, enlarging one’s budget
and corruption.(2) One common form of this unproductive work is lobbying
of the government for favors.
In a government-controlled health system, investment and rewards are
not determined by meeting patient needs, but instead by avoiding blame and
satisfying the preferences or political agendas of a powerful elite. Not
surprisingly, decisions regarding the provision of health care, including
the choice of which medications will be covered, are also politicized.
Currently, the costs of research and development for the introduction of
new medicines are about $400 million, and failure rates during clinical
testing are 25% for Phase I, 50% for Phase II, 15% for Phase III and 25%
for post-Clinical FDA Filing and Approval. In addition, a patent
typically expires after a drug has been on the market for 12 years (3).
As a result, it should be no surprise that Pharmaceutical companies find
it in their interest to lobby. To expect otherwise is sheer folly.
As von Mises and Hayek have argued, without private property and free
markets, efficient coordination and rational economic activity are
actually “impossible”. (4) One reason for this impossibility is that the
incentives created by government systems include the promotion of
unproductive work like lobbying. This is unavoidable, and should not be
news at all.
(1)Woolhandler S, Himmelstein D; Paying For National Health insurance
– And Not Getting It; Health Affairs (21) July/Aug 2002, pp.89-95.
(2) Berger PL, The Capitalist Revolution: Fifty Propositions About
Prosperity, Equality, and Liberty; Basic Books, New York; 1986 pp.175-187
(3) Healy PM, Myers SC, Howe CD; R&D Accounting and the Tradeoff
between Relevance and Objectivity; Journal of Accounting Research; vol.
40, no. 3 (June 2002):677–710
(4) von Mises L, Economic Calculation in the Socialist Commonwealth p.48;
Ludwig von Mises Institute; originally published 1920, 1990 edition
(http://www.mises.org/econcalc.asp)
Competing interests:
None declared
Competing interests: No competing interests
Yes, it is all about money.
I have a friend who is all wrapped up in the Nostradamus thing and he
keeps talkin about a new world order that we "desperately need".
With all due respect to the many fine doctors out there who do what is
right I hasten to point all my fingers at those who are in the game for
the money.
And that, my friends, represents the majority of practising physicians
today .
It cannot possibly continue along this path; we are sitting idly by while
a large portion of our fellow citizens are killed by inappropriate medical
intervention, by unproven methods resulting in iatrogenic population
control and all of this is done in the name of the greatest of Altruists -
Medicine.
Looking at the mammoth medical monopoly and their shenanigans I become
speechless and short of breath (SOB)
I notice that the "greatest deception in the history of medicine" (Dr.
G.Mann), the cholesterol fairy tale (tail?) is still in business and, it
must be observed, doing very well. I cannot and will not believe that the
majority of physicians prescribing statins to lower cholesterol today are
that naive that they believe in what they are doing.
I don't think that Nostradamus was all he is cracked up to be by some
cynics today. But I prefer listening to those believers and will join them
as they walk to the tune of a different drummer.
Competing interests:
None declared
Competing interests: No competing interests
Public spending does come from private outlays!
After reading and re-reading the comment by Dr.Fleming I have come to
the conclusion that the good doctor would be well-advised to stick with
"doctoring" at the famous Mayo Clinic in Minnesota. Writing is not for
him.
His comments are of a quality and relevance that only a mother could like
.--- I rest my case.
However, something else is bothering mw about Dr. Fleming's view of the
world of illness and I don't find much comfort in it.
It is the profit motive that has largely destroyed Humane Medicine, and
the elimination of that ought to be our number one priority.
Until that is done we keep on killing and maiming our fellow citizens in
the name of altruism .
As long as we look at medicine as a "business" we will stay lost in the
"greenback jungle".
Competing interests:
None declared
Competing interests: No competing interests