Smith Faculty Opinion Article

By Dr. John A. Haslem, Professor Emeritus of Finance E-MAIL WEB SITE

The 30 Seconds Outlook
August 15, 2009

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