On markets and health care, who is to blame?

Today's Quote of the Day, from Physicians for a National Health Plan (PNHP) deals with two types of markets and their relationship to health care. It is based on an article in the Journal of the American Medical Association. The theory of the various market systems is not my specialty, however, this articles does a good job of simplifying the competing market models.

Individual resources and choices determine the distribution of health care, with little sense of collective obligation or a role for government. Known as market justice, this approach derives from principles of individualism, self-interest, personal effort, and voluntary behavior. The contrasting approach, social justice, allocates goods and services according to the individual's needs. It stems from principles of shared responsibility and concern for the communal well-being, with government as the vehicle for ensuring equity.

Now, I actually think that Ayn Rand did a good job of "imagining" the worst case scenario in the social justice market in Atlas Shrugged. If you are looking for the worst-case scenario in the market justice model, look no further than health care in America.

Software development - I believe in market justice. Auto manufacturing - I believe in market justice (more so than many Democrats and Republicans that feel we should prop up Michigan's failing auto industry). A system which decides the very life and death of people - not so much.

...Social justice in health care requires universal coverage and ensured access to care, whether through social insurance, private insurance, or some combination.

...health care has become a valuable commodity that created normously influential vested commercial interests with little motive to abandon market justice. Medicine, which might have played a role in promoting social justice, has not done so, and has been transformed by the imperatives of market justice. Fragmented and struggling to come to terms with externally imposed pressures, medicine is losing both its political force and moral compass. The medicalization of health has simultaneously enhanced the investment in health care goods and services while distracting clinicians and policy makers from attention to the needs for health promotion and disease prevention and constraining the capacity to meet the expanding challenges to public health. Market justice may have outlived its role in US health care.

Has market justice outlived its role? That remains to be seen. Remember that it was only a year and a half ago that I brought you a video of John Edwards excoriating Democrats to quit talking about "affordable health care" and "access to health care" and to start talking about Universal Health Care. Now, we have all three Presidential Candidates from our party talking about Universal Health Care without worry. How long until we have a leader that embraces true Single Payer? I guess it depends on what happens after the next election. Read this over again....

...health care has become a valuable commodity that created enormously influential vested commercial interests with little motive to abandon market justice.

Insurance companies make billions of dollars every year. They have thousands of lobbyists on Capitol Hill, which reminds me of yesterday's Doonesbury strip...

It isn't the will of the people that stands in the way of Universal Health Care, it's the will of the Democrats in Washington. It is the Democratic Party's fault that there is not better health care in this country, it is the fault of those who were in leadership before and those who are in leadership now. No priority is too important for them to put it aside while they go shoot 18 holes of golf with a health care lobbyist. Remember the facts from Michael Moore's film Sicko?

SiCKO: There are four times as many health care lobbyists as there are members of Congress.

* According to the Center for Responsive Politics (www.opensecrets.org), in 2005 there were 2,084 health care lobbyists registered with the federal government. With 535 members of Congress, that's 3.895 lobbyists per member.

Look at what Open Secrets tells us:

Yeah, the reason that drugs cost so much is because of "research".

Big Pharma Spends More On Advertising Than Research And Development, Study Finds

ScienceDaily (Jan. 7, 2008) — A new study by two York University researchers estimates the U.S. pharmaceutical industry spends almost twice as much on promotion as it does on research and development, contrary to the industry’s claim.

The researchers’ estimate is based on the systematic collection of data directly from the industry and doctors during 2004, which shows the U.S. pharmaceutical industry spent 24.4% of the sales dollar on promotion, versus 13.4% for research and development, as a percentage of US domestic sales of US$235.4 billion.

The research is co-authored by PhD candidate Marc-André Gagnon, who led the study with Joel Lexchin, a long-time researcher of pharmaceutical promotion, Toronto physician, and Associate Chair of York’s School of Health Policy & Management in the Faculty of Health.

Now, $114 Million in lobbyist is chicken feed to a sector that spends about $58 BILLION on advertising. That $114 million comes at a time when they aren't even fighting for anything. Now, imagine what happens when we go up against them? What will the health insurance and pharm industry spend - $1 Billion? $10 Billion?

This isn't going to be some kissy-kissy, smooch-smooch, arbitration - it's going to be Harry & Louise war.