People get the health care they deserve. Some folk don't appear to grasp the economic and financial foundations of the medicine business. That is perplexing, because they are very simple and easy to understand. Health care is extortion -- "Your money or your life." A doctor is a criminal, a member of an organized crime syndicate no government can control. Lawyers may reduce their fees to attract customers, but any doctor who reduces her fees is condemned by all her medical peers as an incompetent, until she has no customers. The very last thing the medicine business can tolerate is competition. They must remain a Mafia, in which every member is sworn to loyalty and the code of silence.
To repeat, no government can control the medicine mafia. We will all need a doctor someday, politicians and senior officials as much as anyone else. No one -- no one -- in any government can breath a word against doctors, or make any attempt to control their rapacious demands for more and more money for less and less work. Someday they will need a doctor, and the mafia never forgets, and never forgives.
The juvenile daydream that we can ever reduce the cost of the medicine mafia is a fairytale fantasy. The medicine business rules, and they will never surrender power. "Your money or your life," forever. Do you want out of this trap? Don't go to a doctor. Chose to die instead. That's your only escape route.
Cures for an Ailing System
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Payers and regulators need to balance the competing goals of curbing the growth in drug spending and promoting innovative treatments. All parties, government and private, should agree that insurance coverage will be linked to the demonstrated value of expensive new medicines. Congress should develop legislation allowing the FDA to promote competition among biopharmaceutical products when their patents expire, in a way that continues high standards of safety. In some specific circumstances (for example, unique drugs used primarily by the elderly), the Medicare program must be prepared to negotiate prices with drug companies. In sum, payers and regulators need to make decisions that involve great scientific and economic complexity, in order to make valuable new medicines affordable.
—Richard G. Frank, PH.D. Professor of Health Care Policy at Harvard Medical School
© 2007
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