Sunday, February 24, 2008

The fantasy pharma of the Left

The left, of course, has its own fantasy solution set: drugs should be both innovative and cheap. But clinical trials for a single successful drug cost $500 million, and not because the labs have outrageous administrative overhead. Even if the government were in charge of running them, they would still be on the hook for that $500 million, which would have to come out of taxes. We can get existing drugs on the cheap by essentially stealing the property of shareholders in drug firms, who risked a lot of money on drugs that they reasonably expected to be profitable under existing laws. But that's a one-trick pony. We cannot get new drugs at bargain basement prices.

Many people are holding out the hope that the government can somehow substitute for the pharmas, bolstered by the ludicrous claim that the government really discovers all the drugs. This is arrant nonsense; government-funded research discovers targets that might someday turn into drugs, if the Big Pharma chemists can: find a molecule synthesis can be economically mass produced; keep the molecule from killing rats, mice, dogs, or humans; get the molecule into a form that does not have to be directly injected into the bloodstream; tweak the molecule so that the liver doesn't immediately chew it into pieces that no longer affect your target; and shepherd the entire thing through years of clinical trials. That's just off the top of my head; research chemists will undoubtedly have more.

There is no evidence of a nationalized industry that consistently does cost effective innovation. Yes, you have a list of things invented by the government--but that number is a small fraction of a fraction of one percent of the number of things in the private sector. If the universe of products were your house, the government would have invented one washer inside the tap of your bathroom sink; the private sector would have developed every other thing you use. Even where the government is given credit for "inventing" something, such as DARPANet's invention of the internet; it turns out that 99% of the process of actually turning it into a product that was useful to end-consumers was handled by private actors, most of them corporations like Netscape, Microsoft, and AOL.

This is why when you start to make a list of all the state-run economies that have produced large numbers of innovative products with a high level of consumer satisfaction, you have to throw your privately manufactured gel pen aside in disgust. For whatever reason, the government is just not good at producing innovation.

Before you say it, I know that you are leaning forward in your chair, your eyes alight, preparing to demand "What about the military?!" and lean back triumphantly in your chair. My friend, have you ever taken a close look at the military procurement process? It costs a fantastic amount of money to generate products that often aren't even wanted by the end users--how many times have you read about some military service being forced to buy some gargantuan piece of equipment they don't want because the thing is being manufactured in a key congressman's district? This is how we spend four percent of our national income on something that most of the American public never sees. Forgive me if I'm not excited about applying the same process to health care.

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Australia: Public hospital negligence kills again

A DEVASTATED family has been left angry and searching for answers since their beloved grandmother died after tripping on unfinished roadworks outside the Royal Hobart Hospital. Margaret Wakefield, 77, died in hospital last week after falling near the entrance to the new emergency department. The fit and active grandmother had been going to the hospital to visit a sick relative, and now her family is struggling to comprehend how a simple day out turned to tragedy.

Katie Wakefield, 20, was with her grandmother going to visit a relative in the hospital last Thursday. Miss Wakefield, 20, from Rokeby, was carrying her 18-month-old daughter, Shaelah, while her four-year-old son Justin was holding his great grandma's hand. Then Mrs Wakefield tripped on a section of raised footpath, believed to be the base of an old emergency department sign that had been removed. Miss Wakefield and her children were horrified to see their nan on the ground with blood streaming from her face. "She hit her face on the ground. I thought she'd broken her nose. There was blood everywhere and her glasses were stuck to her face," Miss Wakefield said.

She managed to get her conscious grandmother to the emergency department and waited about two hours for attention. They then spent several hours waiting for scans before being sent home. But soon after leaving the elderly woman's condition worsened. "On the way home she started vomiting so we called an ambulance," Miss Wakefield said. "She just got really confused and couldn't walk, she started deteriorating and they did a scan and found she had a blood clot forming in her brain. "She went into a coma and was on life support, and after that she died."

Miss Wakefield reported the problem pavement to hospital staff and a safety barricade was erected. The pavement has since been repaired. But they can't ignore the irony of having their grandmother die from an accident outside a hospital. "You come to hospital to get better, not to die," Miss Wakefield said. "It's simple: if things hadn't been sticking out of the footpath, she wouldn't have died. "And because of her age they should never have sent her home from hospital in the first place, she should have been kept in for observation."

Hospital community relations director Pene Snashall said condolences had been extended to the family in what was obviously a very sad time for them. She said the RHH was unable to comment further until a coronial inquiry was held.

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