Free market medicine on life support – America’s flirtation with greatness at an end?

Some in politics and the media might wonder why the American medical establishment might be so ‘up in arms’ about the run-up and passage of Obamacare.  Photo: Associated Press

“Think for yourselves and let others enjoy the privilege to do so, too” ~ Voltaire

SAN DIEGO, March 5, 2012 - A new friend recently taught me an invaluable lesson about life: tend to a garden of your own making—this is where happiness and health lies.

Some in politics and the media might wonder why the American medical establishment might be so ‘up in arms’ about the run-up and passage of Obamacare. This feigned surprise on the political left is disingenuous and morally bereft of substance; worse yet, it belies a true contempt for the inherently American character of freedom.

After all, nothing about the disdain for the ‘Affordable Care Act’ is difficult to comprehend. When the American Medical Association, the White House, and left-wing extremists conspired to pass an unpopular (and likely unconstitutional) bill through backroom deals and deal-making, it was nothing short of insulting to common folk and healthcare professionals alike.

The healthcare arguments at play in the American political arena are not so much about the concept of fairness, but rather the idea of fair play. America is the land of opportunity, not guarantees; it is a place where a social safety net and a vibrant, competitive marketplace ensure that human will and initiative will win out over apathy, laziness, and a moribund entitlement mentality. Without the preservation of innovation, research and development, our American institutions of bio-technology, pharmaceuticals, and clinical discovery will subside to substandard levels of care.

Nowhere is this better illustrated than in the words by Eli Lilly and Company on their recent blog posting, listing the cost of developing a new brand drug to market in the United States at well over $1 billion. Note that many have listed the true cost of such R&D at upwards of 4 billion dollars or more. Between 1997 and 2011, Pfizer spent well over $108 billion developing new medications that have saved countless numbers of lives and created jobs for hundreds of thousands of Americans.

Eli Lilly, like many big pharmaceutical companies, spends between $100 million and $1 billion on each new drug trial alone. I recently had the pleasure to meet one of Lilly’s best and most educated representative’s, Dana Schwartz, in a trip through the Midwest; their superb new blood thinning drug Effient, an oral medication, was developed at great expense to help people with coronary artery disease (who have undergone angioplasty) to lead improved and longer lives.

The complex new drugs that are developed and funded primarily by free market investors, and brought from factory to bedside, represent a necessary side of a healthy healthcare equation. Without such new innovation and risk taking, the next generation of patients—our children and grandchildren—will be stuck with old era drugs, outdated treatment modalities, and likely unable to rise to the challenge of the next great plague or disease state.

Like the healthcare law in general, the problem of medical funding, treatment approval, and government support for new technologies will be restricted by the Independent Payment Advisory Board (IPAB). If IPAB is allowed to remain and grow as an additional governmental bureaucracy, the result will be disastrous for the U.S.

Americans should support repeal of the Independent Payment Advisory Board called for in HR 452. The IPAB will be made up of 15 Presidential appointees serving 6 year terms. These non-elected officials will decide what yearly spending cuts must be made in the Medicare program, and will have broad influence of the newly created local/community Accountable Care Organizations (ACOs) that are springing up all over the country. If Medicare, Tricare, neighborhood-based ACOs and other insurance industry limitations are artificially imposed on the type of medicines and treatments that doctors can prescribe, the doctor-patient relationship (and America’s health) will be irreparably harmed.

Instead of political ‘puppetry’ in the healthcare arena, we need greater freedoms for competition between insurance companies across state lines, greater latitude for the innovation and development of new medicines, and broader liberty for patients and physicians.

The road toward socialism may be paved with government-laced sweeteners, but the government will soon run out of ideas and money, and we’ll be stuck decades behind clinical challenges we should be facing today, tomorrow, and every day into the future. In America, we’ve never been about settling for second or third best, and we shouldn’t sacrifice our nation’s long-term health and viability on the pagan alter of political convenience.

Doctor Dorin is a Hopkins-trained, board-certified anesthesiologist, practicing in a large group in San Diego. He is a small business owner, a Commander in the US Navy Reserves, and the Founder/President of America’s Medical Society, Inc. (AMS), a non-profit corporation created to serve and educate physicians and the general public in matters of national health-care reform and medical politics.

AMS and many other medical groups in the United States are convening in San Diego this May 5th and 6th, 2012 for a ‘Coalition of Doctors Conference’ to address issues of concern related to patient safety and the recent healthcare reform legislation.


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Adam Frederic Dorin, M.D., MBA

Doctor Dorin is a Hopkins-trained, board-certified anesthesiologist, practicing in a large group in San Diego. He is a small business owner, a Commander in the US Navy Reserves, and the Founder/President of America's Medical Society, Inc., (AMS) a non-profit corporation created to serve and educate physicians and the general public in matters of national health-care reform and medical politics

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