Tuesday, June 30, 2009

Thomas Sowell sums up the health care discussion...

...or what passes for discussion:

Politicians may talk about "bringing down the cost of medical care," but they seldom even attempt to bring down the costs. What they bring down is the price-- which is to say, they refuse to pay the costs.

I am reminded of a book from the 70s, Forty Centuries of Wage and Price Controls,which is happily still in print.

Monday, June 29, 2009

"$1300 Device Might Have Saved Jackson's Life/Promoters Should Have Provided It"

That's the opinion of George Washington University Law School professor John Banzhaf, who makes a powerful argument for the much wider dispersal of a public good:

Since it now appears that Michael Jackson was dead even before paramedics arrived minutes after receiving a 911 call, and that his doctor administered CPR virtually from the time Jackson collapsed, it's clear that the only thing which might have saved his life was a $1300 Automatic External Defibrillator [AED] -- something which his promoters and/or his handlers should have provided beforehand, says Professor John Banzhaf of George Washington University.

To paraphrase the old saying, "for want of a nail, the kingdom was lost," it now appears that, for want of a $1300 AED, a concert tour costing and grossing tens of millions of dollars, not to mention a musical genius who could have earned even more than that for himself and others in the future, has been irrevocably lost, says Banzhaf, noting that only defibrillation can save the life of someone once he suffers from sudden cardiac arrest [SCA].

After investing millions of dollars in concern preparation and promotion, paying tens of thousands for a four-hour comprehensive medical exam, and assuring that a doctor would be with Jackson 24 hours a day, it seems clear that those behind the tour should have paid a few thousand dollars more to be sure that an inexpensive AED was always available, especially for someone who apparently suffered from drug addiction, anorexia, and other conditions which increase the chances of SCA.

While not always successful, AEDs have proven to be remarkably effective, even in untrained hands, which is why millions are now positioned in so many public places as well as in health clubs, offices, and even private homes, says Banzhaf, noting that in Jackson's case the cardiologist who was with him would have known how to use the device. But, without an AED, even the trained cardiologist was unable to save Jackson's life, says Banzhaf.

Entertainment personalities, key men at corporations, and even many middle-level employees are often provided with free comprehensive medical exams as well as free health club memberships, personal trainers and/or dietitians, week-long wellness programs, and other measures designed to insure that they remain healthy and able to perform their assigned jobs, notes Banzhaf. It's an inexpensive way of protecting an important and expensive investment, he argues.

Perhaps, in addition to this lengthly and expensive list, companies should provide AEDs in the homes and offices of all those whose lives are so valuable to them, says Banzhaf, noting that an AED can be considered as a form of term life insurance -- something we hope is never needed, but is there if the unexpected occurs.

While a star -- and allegedly a primadonna -- like Jackson may well resist if not refuse to acquiesce in intrusive measures to safeguard his health -- such as drug interventions, imposing healthier eating habits, limits on plastic surgeries, etc. -- it is hard to see why even the fussiest or most demanding personalities would object to having a small and unobtrusive AED available in their homes and offices, as well as wherever entertainment events are rehearsed or performed.

Banzhaf observes that often the tragic and unexpected death of a famous person focuses the public's attention on a cause of death which could have been prevented, and spurs people to have checkups, seek treatment for conditions, etc. Perhaps Jackson's death will serve as a catalyst to bring more AEDs into the home, which is where 80% of SCA attacks occur.

Indeed, about 95% of people who experience SCA die before reaching the hospital, which is often when debilitation can first be administered. In rare instances, very promptly and properly administered CPR can keep a victim alive until a defibrillator can be administered.

But, as Michael Jackson's tragic and possibly unnecessary death teaches us, even a trained cardiologist performing CPR immediately may be nowhere near as effective as an AED, argues Banzhaf.

So why wasn't this part of the stimulus package? What does the government do, anyway?

Health Care: Real People Speak

The Health Central Network, a website devoted to health and wellness concerns, features a subsidiary site, MyBreastCancerNetwork.com, hosted by P.J. Hamel, herself a breast-cancer survivor.

A look at the comments shows considerable skepticism, even hostility, to President Barack Obama's health care plan, which is perceived by all these commenters as ushering in rationing and scarcity.

And unfairness. In particular, commenters flagged Obama's admission during last week's "town hall" that he would be willing "top up" coverage for his own family--that is, go beyond the government ration.

Obama can afford to, of course. But right now, these breast cancer survivors, and their loved ones--and those who might fall victim to breast cancer in the future--have a bleak road ahead of them. Why? Because all the signals coming out of the Obama administration suggest that there will be less money, not more, for health. (Of course, it's not clear that Republicans would want to spend more, and that's the puzzling paradox. Why is it that both parties seem determined to spend less, when the American people want to spend more? And so for now, it's the Democrats who are making these decisions, and so they, and their plan, are the natural focus.)

Moreover, it's worth noting that breast-cancer activists are matched in their enthusiasm by activists for 100 other illnesses, and then another 100, and then another 100. Easily 25 million people are part of a disease-group network. So why don't they have a proper voice on national policy?

Why Do Both Political Parties Want to Spend Less on Health Care, When the American People Want to Spend More?

My post, on what Steve Jobs' liver transplant tells us about the future of US health care, appears on Fox Forum, the opinion section of FoxNews.com.

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