Bad Economics But Good
Medicine
Ocean County Observer
Medical World News editorially applauded Dr. Marvin Moser
for taking to task hospitals that grew “fat” with excess instrumentation, house
staff, and costly technology that does nothing more than increase hospital and
physician income.
This of course is a touchy subject to all concerned. To the
taxpayer part of whose annual donation to the
Here we have an enduring paradox in a system of National
Health. Insurance (a euphemism for socialized medicine do make the system
sounded more palatable to Americans who have cut their teeth on the nostrum
that “socialized” is a dirty word), the care is spread more evenly throughout
the population but as it becomes expensive (health care is, after all, open
ended) governments tend to ration health care. For example, most nations will
gladly subsidize pediatric services because as babies grow older they require
less and less care, and become increasingly independent of medical services. On
the other hand (election speeches to the contrary) governments are increasingly
aware that after a certain age the population becomes more dependent on medical
services and uses them with greater frequency. Thus for the geriatric
population medical care and medical costs spiral upwards. The government’s
response is to seek ways of rationing medical care, and that is exactly what
tends to occur in socialized systems.
In the process of distributing the beneficence of medical
care more evenly than the free enterprise system bestows, socialized systems
slow the rate at which this care can be dispensed. It is rationed.
Deprived of the incentives that propel the private sector
the socialized sector system fails to provide for the exuberant innovative
geysers that burst forth with important medical advances. The research arm of
medicine subsidized but not controlled by government has been magnificent.
The pharmaceutical companies have provided important
therapeutic modalities; and doctors in practice, because they have been able to
see diseases from all sides by virtue of the plethora of instrumentation and
chemistry that can be focused on a case, a patient or disease entity,
incorporate this information into their collective experience. After a case is
completed it is easy to look back and decide that only a small portion of the
collected information was important. But if in one case in a thousand the extra
tests reveal something unique, then roads are open for new categories or sub
categories of disease (this is anecdotal stuff that no longer is acceptable).
Thus it is
disappointing to read the Moser bewails the high cost of care, Medicine is a
cauldron bubbling with facts and events. Cut back on the energy put into the
process (the sop called wasted excess testing) and the boiling will stop and
nothing will penetrate the flat calm. Nothing will surface to give us new
insight. Moser and his restrictions impose a closed book. All is known, all
progress is behind us.
Of course new stuff is good not bad. The