Health Care: Discovery Blocked Presentation © 2006 by Barry Brownstein

Disclaimer  The following slides are not meant as medical advisement. They are intended to stimulate thought and make you aware of differences in medical opinion.  Medical consumers are no different than other consumers – the best consumer is an informed consumer.

True or False?  The “war on cancer” which has cost billions of dollars since it was initiated has made tremendous progress. All that is needed is more money to finish the job.

True or False?  The earlier the diagnosis for cancer the better. More cancer screening is always advised.

True or False?  The most appropriate cure for heart disease is surgery.

True or False?  Lipitor and other statins are the most effective and safe way to lower cholesterol.

True or False?  The best treatment of lower back pain is rest and then surgery if pains persists and abnormalities are detected.

Headline 5/03/06  “Tens of millions of students will no longer be able to buy non-diet sodas in the nation’s public schools under an agreement announced Wednesday between major beverage distributors and anti-obesity”  True or False? – Diet sodas are healthier than regular sodas.

“Government Science – An Oxymoron?”  Scientific research depends on trial and error but yet:  “It is difficult for bureaucrats to fund conflicting theories because it would look hit or miss. Most of the money would be "wasted," and politicians fear any such accusation. So they tend to put all their eggs into a single basket.”- Bethell  “Government bureaucracies set up to do science – e.g. National Institutes of Health– obstruct the pursuit of alternative theories. Committees of experts decide who is to get funded, and these committees are inevitably run by scientists who are at peace with the dominant theory.”

Are Health Care Problems a Market Failure?  “Government has been the largest single player in the U.S health care market since the 1960s”  Consumers don’t pay directly for services and they pay 14 cents of every health care dollar spent.  Consumers pay little directly and thus demand expensive, inefficient service. What if homeowners insurance covered the routine and easily affordable such as changing light bulbs?

A Few Reminders  Natural vs. positive rights  It is the the prevention of competition which is harmful.  Genuine inefficiencies will generate market processes for their own correction  “To announce that one can improve on the performance of the market, one must claim to know in advance what the market will reveal” - Kirzner

A Few Reminders Continued  The wholly superfluous discovery process rearranges opportunities for profits  The economic problem is the utilization of dispersed knowledge any use of coercion which suppresses the use of knowledge is damaging to the consumer and market process  When consumer choice is restricted barriers to competition usually exist

Natural Rights vs. Positive Rights  Finite and defined- right to not be coerced, if you do not violate someone else’s rights  win-win (not scarce, one person’s use of self-ownership doesn’t conflict with someone else’s use)  Ill-defined- whatever advances ‘the common-good’ (i.e. ‘right to a good job’, ‘right to health care’,)  win-lose- there is no “right to a particular state of affairs unless it is the duty of someone to secure it.”

Medicine: Technical Science vs. Healing Art  Uses information  deals with outcomes reductionistic  Newtonian  Doctor increasingly superfluous  patient plays passive role in healing  Uses knowledge  deals with causes holistic  Quantum  Healing highly dependent on doctor  healing depends not only on doctor and medicine but as importantly on patient

19th Century Physicians Not licensed but certified. l Competing paradigms existed: n orthodox (allopathic) – bloodletting, mercury, arsenic as a tonic n homeopathic – non-toxic compounds, fresh air, diet, hygiene n eclecticism – herbs, rest etc.

American Medical Association (AMA) 1847  “The very large number of physicians in the United States...has frequently been the subject of remark. And if we add to the 40,000 the long list of irregular practitioners who swarm like locust in every part of the country, the proportion of patients will be still further reduced.”

Goals of the AMA  Establish medical licensing laws  Destroy proprietary medical schools  Eliminate heterodox medical sects

After The Flexner Report  N umber of medical schools falls from 131 to 69  Number of medical students falls, especially women and Afro-American students

The AMA's War Against Competition Continues  midwifes  nurse practitioners  acupuncturists  chiropractors  vitamins and herbs  self-care

Barriers To Responsibility  Medical licensing which encourages dysfunctional patient/client interaction  Heath care as a positive right  State laws barring certain insurance classifications  “Taxis” type thinking which maintains illusion of control

Consequences of Ending Medical Licensing  Fraud is still prohibited since knowledge of quality is valuable certifications increase  choice increases  price falls  quality increases  innovation increases  patient responsibility increases