Smith
Faculty Opinion Article
The 30
Seconds Outlook
August 15, 2009
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“If you think health care is expensive now, wait until you
see what it costs when it's free.”
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— P. J. O'Rourke, The
Liberty Manifesto, 1993 |
In the previous Outlook, the Obama
health care plan was considered from
the standpoint of a medical family
member, a patient, and a leading
columnist. Here, the plan is as
assessed by Glenn Treisman, MD, PhD,
professor, clinician, and
researcher:
“Excellence in health care in the
U.S. has been a major export and is
currently a successful industry. The
Obama plan will not lead to
excellence, but rather to the
'adequate’ health care of England,
Canada or France.
We have
a huge program of health care
exportation and biotechnology, where
we provide leadership in the world.
The U.S. is the place where new
drugs are developed and is the
driver of health care development in
the world. Giving up our most
successful industry in terms of
‘progressive’ development seems
stupid when our economy is in
trouble.
Excellence in health care is
based on the premise that life is
sacred, and that every life is of
equal value, and that one cannot put
a dollar figure on the value of a
human life. Working in this
manner, healthcare has extended life
20 years in the last century, an
extension of years when people are
at their peak productivity. This, in
turn, has lead to the massive
technology advances of the 20th
century. Based on the idea
that life is sacred, and has
intrinsic value, our doctors have an
ethical commitment to preserve life
at any cost.
The current debate has
proposed the idea that this ethic is
too expensive, and that we cannot
afford it. New technology
is always expensive, but becomes
rapidly less so as it spreads. This
has been seen in fiber optic
communication technology. Technology
is expensive at first, but becomes
affordable with continued use. New
drugs eventually become generic, new
techniques eventually become
routine.
Doctors
trained with the idea that every
life deserves their total devotion
and attention become excellent
providers and are creative and
dynamic in their pursuit of mastery.
Doctors who are taught not
to get too excited by death if the
treatment is expensive, inconvenient
or the patient is old, are
bureaucratic, unenthusiastic and
driven by income rather than by the
love of medicine.
Nowhere
in human endeavor is the spirit of
Americanism (all men are created
equal, all life is sacred, and
freedom and equality must be pursued
at any cost) more alive than in
medicine. If we export that view
with our technology and mastery, so
that students trained here from the
rest of the world are imbued with
it, we ultimately champion the value
of life as sacred. This will be more
effective for freeing the world than
any political slogan or campaign.
The German and Socialist
utilitarianism that led to the
Holocaust was based on the premise
that a life is only as valuable as
it is to the society it serves, and
when it becomes too expensive, we
stop supporting it. There is no room
in that philosophy for the concept
that life has an intrinsic value
that cannot be calculated. The Obama
plan is a move in the wrong
direction.”
The purpose of insurance is
shared risk, which is most efficient
when it is directed at catastrophic
risk. In this setting, insurance
companies invest the money they hold
and make payments only in event of a
catastrophic illness. Giving
insurance companies a small piece of
every healthcare transaction is
stupid, and increases health care
cost needlessly.”
John A. Haslem
