Healthcare Bias

by Chidem Kurdas

Proponents of the new medical entitlement program claim that it will improve the quality of healthcare by putting treatments to the test. Yet they ignore what’s already tested, and at great cost. This is part of a long-time pattern. Much of the political elite and the media routinely discriminate against the most useful medical technologies in existence, namely pharmaceuticals and biologics.

Pharmaceuticals are rigorously tested. Their quality and effectiveness are documented in randomized clinical trials that are the gold standard for testing treatments. They undergo a lengthy review by experts before being allowed to go on the market. No other medical technology is subjected to such extensive regulatory scrutiny.

The regulatory system imposes horrendous hardship on people who would benefit from certain medications that are kept out of the market, as well as a huge expense on everybody. Still, the fact remains that pharmaceuticals are better tested and proven than any other type of treatment.

That sharp difference is routinely ignored in public discourse.  The prescription drug industry is so demonized that it’s politically incorrect to say anything good about it.

When politicians want to squeeze savings from medical entitlements, they’ll sit on this industry, even though medications account for only 10% of  healthcare spending.  The main role of pharmaceuticals in the current dispute is the $80 billion saving the industry promised—in a probably vain effort to protect itself from price controls, which would almost certainly destroy the best hope for medical innovation.

When Congress wants to cut the cost of healthcare, it looks to medications—rather than, say, hospital procedures that cost many times as much, impose ghastly unpleasantness on the patient and have never been tested for effectiveness.  When the philosopher Peter Singer argues that healthcare should be rationed, his first example is—a biotechnology drug.

When people appear in the news with a healthcare sob story, chances are they’re complain about the cost of their prescriptions. Why should an itty-bitty pill cost so much money? Well, it took many years and several hundred million dollars to develop the little pill, but the consumer does not see any of that.

A common cognitive bias makes pharma companies vulnerable. You know your doctor in the flesh, know the hospital by direct experience, may bandy jokes with a nurse or technician. The entity that made the pills is a distant abstraction for most people. Human nature is skewed in favor of the specific and the known. Politicians cater to common biases, so they discriminate against the pharma industry. This is a deliberate tactic. You might not get political brownie points going against hospitals, but attacking drug makers is an easy way to score with constituents.

Which goes to show, the current healthcare legislation is not about quality or getting better value for the dollar, however frequently those notions get thrown around. What the bill does, regardless of changes in details, is to create an immense new entitlement gussied up with fake promises of quality and limiting costs. It will transfer income largely to providers of medical services of unproven effectiveness.

Pundits who recognize that the so-called reform is a bonanza for  those who will receive the money blame pharmaceuticals instead of medical services that count for 90% of spending. Bob Herbert writes in the NYT that the bill “will not control exploding health care costs and will leave industry leaders feeling like they’ve hit the jackpot.” The only two industries he mentions are insurance and, of course, prescription drugs.

If you were serious about improving the quality of care and getting better health for the dollar, pharmaceuticals would take central stage as the input with established effectiveness, not as a cash cow to milk for other purposes. Instead, what we get is vague promises of testing for quality with little or no notice of the reams of data that exist for pharmaceuticals, produced at great cost and sacrifice.

Truly, the greatest fraudsters of all history couldn’t even come close to competing with the politicos.

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