TCS Daily


Free the Elderly

By James D. Miller - January 31, 2007 12:00 AM

Let's give pharmaceutical freedom to our elderly. Elderly Americans should be legally permitted to use any drug their doctor approves of, even if the drug has not been approved by the Food and Drug Administration (FDA).

Consider a 90-year-old man suffering from severe kidney disease. He would like to take an experimental drug, but his doctor can't get him in on the clinical trials. As a result, the man must wait nine more years until the drug is approved by the FDA. Unfortunately, this man's advanced age means he has only a slight chance of living another nine years.

On average around 12-15 years elapse between the discovery of a medicinally useful chemical compound and that compound's approval by the FDA. This is an intolerable delay to impose on the elderly who often have life expectancies of less than 12-15 years.

Nobel Prize winning economist Gary Becker (my former advisor) wants to eliminate many of the FDA regulations and quickly allow all drugs to be sold that pass a "reasonable safety standard." As Becker writes, "Eliminating all requirements except a reasonable safety standard would vastly reduce drug prices in the U.S., as companies would be encouraged to develop additional compounds to compete for customers."

The argument for freeing the elderly from the FDA's grasp is even stronger than the case for weakening the agency's hold over the rest of us. By requiring that drugs undergo extensive testing trials, the FDA increases the average safety of drugs that do enter the market at the cost of increasing the time it takes for these drugs to reach consumers. This safety/speed tradeoff, however, makes little sense for Americans who have a high chance of dying before a drug finally gets approved by the FDA.

Everyone would benefit if elderly Americans could use unapproved drugs. By allowing pharmaceutical companies to earn some revenues earlier than they otherwise would, elderly pharmaceutical freedom would increase drug companies' incentives to research new products. Furthermore, drug companies could use data on how the elderly responded to new drugs to determine if younger people should be given their products. The FDA would probably even be able to use this data to speed up its drug approval process.

Some would argue that my plan would turn our elderly into guinea pigs. But I would say that senior citizens have acquired the wisdom needed to make their own medical decisions. Perhaps to provide some protection for the elderly, however, the government could limit their choices to drugs that pharmaceutical companies have spent at least $40 million developing. Forty million is well below what it costs to develop a drug, but far more than anyone would spend developing quack medicine.

James D. Miller writes "The Game Theorist" column for TCS and is the author of Game Theory at Work. He keeps a blog here.


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89 Comments

Better yet
'Let's give pharmaceutical freedom to our elderly. Elderly Americans should be legally permitted to use any drug their doctor approves of, even if the drug has not been approved by the Food and Drug Administration (FDA)'

Better yet let's give pharmaceutical freedom to all Americans should be legally permitted to buy and use any drug without a doctors approval. We are not children!

Freeing the Elderly
Your plan might make it much more difficult to hold double-blind tests of new drugs; more people would think they had an incentive not to participate in such tests and would just take the unproven medications regardless of their possible danger or inefficacy. In this way, progress in developing new medications might be harmed.

Pharms and Regulation
I wonder how much better off the elderly shall be under teh Universal Health Plan? Then we can have yet another agency deny treatment of even approved drugs. After all, as has been pointed out to my by recent posters on this site, big brother knows best.

Clinical trials have nothing to fear
Would it? His plan merely allows people to access unapproved medicines. It says nothing about the cost of such medicines. Though it is possible that unapproved medicines will cost less than approved ones (no track record, pricing in risk, etc), medicines provided during a trial are often free to the test subject. If that still holds, a substantial benefit will still exist for individuals to enter the trial.

One caveat: anti-biotics
Mis-use of anti-biotics have created bacteria immune to their effects.

But maybe in the grand scheme, the suviving humans will have a more robust immune system.

No half measures!!! Let's go all the way!!
Get rid of the FDA. Let the market take care of it all. The drug companies surely would never sell anything harmful - that would damage their reputation.Let them do their own testing undisturbed, and issue press releases when its done: that's all we really need. Labels would almost certainly reflect the contents of the pills inside, but if they were a little vague, who cares? Are consumers children that they have to have everything spelled out for them.

I dont undertstand these feeble baby steps in the direction of market freedom. Government off our backs!!! Let the market rule!!!

eric has finally said something intelligent. Even if it was by accident.
I agree, the FDA is a useless organization that serves to make drugs more expensive and kills people by decreasing the availability of new drugs.

As to drug companies never intentionally releasing harmfull drugs because such releases wreck their expensive reputations, that to is a completely true statement that has been proven over and over again.

You have nothing to say until you acknowledge and apologize
To a 1/30/2007 assertion I made, giving an accurate figure for the number of Americans without health insurance, Mark replied as follows:

>1) The idea that there are 45 million without insurance is just another of your lies.

Documentation for my figure can be found here
http://www.census.gov/Press-Release/www/releases/archives/income_wealth/005647.html

Mark owes me and this board an acknowledgement of error and an apology.

Ehanced Role for the FDA
“Government off our backs!!! Let the market rule!!!”

I believe the current FDA role in the medical market does more harm than good.

Nevertheless, the FDA can/should have a critical role in medical markets.
1) The FDA should continually evaluate new and existing medications/procedures. The testing and history of all medications/procedures should be identified, documented and electronically published.
2) Based on their analysis of testing and usage, the FDA should RATE each medication or procedure…say on a scale from 1 to 100. Those medications that fall into the riskier range of the scale should require written proof of acknowledgement and waiver of liability from the consumer (and possibly their doctor in some cases).

This new role transforms the FDA into the “MOODYS” of medications. The patient/consumer receives dual benefits…they are released from medical serfdom, while at the same time retaining an independent, enhanced expert advisor.

Actually, your statement is wrong
Of course MTG doesn't need me to interject my opinion in the matter but your statement of:

"But in practice you're saying all the problems are due to the government - ok - but you don't have a plan for government changes to make things work better and change a system that leaves 45 million uninsured, spends the highest percentage of GDP in the industrial world on health care, and still posts mediocre public health numbers. If you can't describe what needs to be done, maybe you can point to somewhere that does it better."

is WRONG. I don't dispute the Census figure that you cite (although I've never been enamored with CensusLite) but it doesn't actually support your statement of a system LEAVING 45 million uninsured.

You're making a leap of faith when you equate one being without insurance to the system leaving one without insurance. In fact, numerous studies have demonstrated problems with the Census figure, including:
- it ignores the obvious fact that many people choose not to be insured
- it equates being without insurance for a few days as one changes jobs to being without insurance for the entire year
- it treats Medicaid (or State program) eligible but not enrolled as uninsured

Further, some (and I'm not saying you're one of them) equate not having insurance to not having access to health care. Everybody in this country has access to emergency health care. If you don't have insurance you might not get the absolute best care but you will get treatment for any life threatening ailment. Of course if you have insurance you might not get the absolute best care either.

I don't disagree with your premise that everybody should have health insurance but I do disagree that the system actually leaves 45 million uninsured. We can leave whether or not "Legislating Responsible Behavior" (forcing people to buy health insurance) is a good idea, a bad but necessary idea, or just a bad idea for another day. Unless, of course, that was the intent of the thread...

Misuse is a tiny part of the problem.
I would argue that the government is the reason that people are overusing antibiotics. Specifically, government involvement in the health insurance market, which has ensured that most people in America do not pay the costs of their healthcare decisions. Doctors regularly prescribe expensive, broad-spectrum antibiotics to patients with viral infections as a placebo. People accept this behavior because they only pay their $25 co-pay, and the microbes get stronger.

The problem of drug-resistant microbes is one that we have always had to face and will always have to face. They will adapt and evolve to whatever new drugs we throw at them. Admittedly, uselessly dispensing antibiotics to patients who have viral infections probably does not do much good, but the development of drug-resistant bacteria is nothing new and will continue whether we regulate antibiotic prescriptions or not.

The real problem is that we are running out of new weapons to throw at bacteria. Why are so few new antibiotics being developed? Government interference. Take a look at this article from the Medical Journal of Austrailia, which discusses the increasing barriers that governments throw-up in the path of drug development. As bureacracy costs go up, the value of drugs like antibiotics, vaccines, cancer treatments and more decrease sharply. Companies focus on drugs like Lipitor and Prilosec that are used daily for years rather than drugs like antibiotics, that are used occasionally in small amounts.

The government, and its interference in these areas, is the reason for the problems, not the solution.

Absolutely not! Workers, storm the gates of Pfizer!!
It is clear that these "corporations," with their "profit" and their "bottom lines" simply do not care about the children. If they did, they would provide all of the AIDS drugs that Africans needed totally free of charge. But nooooooo... They claim they have "shareholders" who have "entrusted the management with investment capital" and "expect a return, or they will move their money to other endeavors and NO new drugs whatsoever will be developed."

Hooey. We need to take this out of the hands of the private sector, with their profit-focused thinking and hand it over to the same people who gave us the DMV and Post Office: The United States Governemnt. There is no surer way to drive out all profit-centered (or cost-centered) thinking than to bulldoze the drug companies, and replace them with giant Federal buildings. We can kick out all of the profiteers, and replace them with people who get proper union representation, at least three months off a year and deliver the same sort of stellar and speedy service we have come to expect from the same group of people who renew our driver's licenses. Eventually.

Furthermore, we know the government always produces safe and effective products. Take the levees in New Orleans, for example. When has the private sector ever produced an example of an agency that verifies the claims made by product manufacturers and issues certificates to those who meet their high-standards? Why, you would need an entire labortory filled with underwriters to accomplish such a task!

Seize their assets, seize their research, and permit our leaders to appoint political cronies to run the new agency. Mike Brown is looking for a job.

Forgot the citation for the article.
The web address is:
http://www.mja.com.au/public/issues/181_10_151104/cha10412_fm.html

The census number is accurate. Yes, can quibble about "leave."
You have 45 milliion people without insurance. If you want to quibble about the term "leave," go ahead, but it is just a quibble. The adverse consequence of higher rates for thos who are insured and higher costs for those treated in ERs rather than clinices (see below) are very real.

>Everybody in this country has access to emergency health care. If you don't have insurance you might not get the absolute best care but you will get treatment for any life threatening ailment.

a point which I have repeatedly brought up, in the context of how much more expensive this is than providing timely non-emergency care.

Real Freedom
Let's allow elderly people to buy drugs when and where they want as well... Canada, Mexico, why force them to participate in a market that isn't competative?

A little lame, but nice try.
The DMV, since it went online, works pretty well. The Post Office delivers the mail for less than it would cost me from FedEx. Government put a man on the moon, won WWII, invented the Internet, and hundreds of other now highly profitable for users and commercializers technology.

And saying government has a role isn't remotely calling for nationalization of drug companies. You don't find anyone I hear signing on to your joke agenda. However my joke end-the-FDA agenda is eagerly echoed by Mark. Are you for it too?

>Mike Brown is looking for a job.

His Clinton-appointed predecessor was highly competent. Is there some reason you're blaming government, the concept, rather than the Bush administration??

moreover, "leave' wasn't what Mark quoted and called a lie
He said:

>1) The idea that there are 45 million without insurance is just another of your lies.

This is incorrect, and offensive. I'm waiting for an acknowledgement of the error and an apology

Canada and Mexico are not competitive
Their drug prices are subsidized.

HUh?
Government put a man on the moon.

So what? Was it done EFFECIENTLY? This doesn't even begin to address the issue of opportunity cost.

If it weren't for a Soviet Union, that wouldn't have been even remotely adviseable. Notice, we can't go back.

As for the internet, stop sniffing Al's left over hashish

And
Cross subsidized by us.

Yup!
We did put a man on the moon. DARPA developed DARPAnet, which became the Intenet. If you don't think so, instead of making a witless hashish reference, bring your evidence.

We alos built an Interstate highway system, Etc. etc. etc.

Am I saying everything government does is done well??? Not in any way. Am I saying we should have government do everything? No how, no way. Am I saying that all government projects are advisable? Still less.

All I'm saying is the obvious: some things work and reflex "government bad evil wrong' is not a reasoned or analytical position.

Why is that so threatening?

And...
Egregiously preferential pricing of US medicines has propped up the Canadian National Health System for decades…it may have failed otherwise.

Small volumes of meds are currently purchased from Canada by US citizens at Canadian prices (30-70% discounted from US prices). If Americans could legally buy Canadian drugs at Canadian prices, the financial solvency of most pharmacies in the US would be threatened. More importantly to Canada, their supply at heavily discounted product would be in jeopardy. If the US Congress moves in an uncharacteristic “free trade” direction to allow Americans to purchase meds overseas, expect Canada for one to nix the plan on their end.

Thanks to ill-advised treaties signed in the past, the best bargain hunting US consumers can hope for is the “black market” we have now.

Because it leads down that old slippery slope
While the post office is much maligned, it does get the job done and cost less than most private carriers, they are one of a few real positive examples. Generally speaking, the government gets into things in a halfassed manner and does a halfassed job that costs taxpayers twice as much.

And, when you are talking healthcare, the investment types really get nervous! Taken as a total industry, healthcare is a full 15% of the U.S. economy and one of the most profitable (especially the drug companies and insurance companies). A hostile government takeover of healthcare is seen as a very bad investment strategy (especially for their personal investment portfolios) and one to be avoided.

and they have a very valid point!

Universal healthcare has proven negatives everywhere it is tried. But there are upsides to it as well. Still the overall cost and the long waits for elective surgery and specialist care is well documented.

All-in-all I don't really have a dog in this hunt. I don't like what I've seen of universal healthcare so far in the world and I do think the present U.S. system is overpriced and rediculously inefficient. I tend to believe the trap is a free-market system that is not free. The government needs to get entirely out of it or take it over. Either is probably perferrable to the present system.

I would like to see a change that is far more affordable for the average to low-end joe. And drug prices!! Arrrgggghhh!!

Government is almost never the answer.
Government does, however, have a role. Government has a legitimate role in providing for internal and external security. Government also has a legitimate role as an arbitrator in disputes between the rights of one person/entity and the rights of another when they cannot reach a legitimate agreement with any means (i.e. the court system.)

In providing for these three things, government adds value to a country rather than subtracting it. Furthermore, since there is nobody else who could legitimately provide for any of these three, they are required roles for the government.

How about the post office? You cite FedEx as an example, and totally miss the point of FedEx. FedEx is a company that is designed to get packages from one point to another quickly and conveniently. They fill a role that the government does not. To suggest that nobody else could do the job of the Post Office more efficiently than that esteemed institution could is to ignore all evidence of human economic experience. The Post is a burecratic, inefficient, behemoth without any motivation to innovate, take risks or better serve their customers. It is an idiot giant that does silly things like raise prices when it wants to make more money. Contrast this with Wal-Mart, and tell me I am wrong.

Private agents can accomplish most of the goals of government more efficiently and with better results. Providing assistance for the needy can be much more easily accomplished through mutual-aid societies and charities than through the government. These groups can tailor their aid to individuals, provide in-kind assistance, and can take advantage of their greater knowledge of local conditions and personalities to deal more effectively with the recipients.

The internet is an absolute proof of this. How many people were on the DARPAnet? Could you recieve streaming audio/video clips? Could you find information from recipies for gumbo to how the Allies won the battle at el Alamein? Government might have assembled the first set of hardened, networked servers that would permit people to send primitive email, but they did not develop it in to what it is today. Private industry did that, by paying attention to supply and demand in the quest for profits.

The FDA is an agency that is charged with keeping food and drugs "safe." They are hit with lawsuits, congressional hearings and bad press every time a dangerous drug is discovered on the market, but they get no such press when a good drug is not developed because of their onerous bureacracy and demands for endless testing. Government is never held accountable for the things that do not happen because of all of the onerous regulations they place on private industry.

Government is not always bad, but it is almost always inefficient, and substantially less effective than private industry could be.

So: you do think the FDA should be abolished??
sorry to cut to the chase, but you're dancing around the central issues.

But with regard to your specifics:

>To suggest that nobody else could do the job of the Post Office more efficiently than that esteemed institution could is to ignore all evidence of human economic experience.

The thing is, efficiency is not the only factor here. The Post office has to deliver to everywhere, not just to convenient places. All kinds of money can be made cherry picking moneymaking aspects and cutting away stuff that's a loser. The PO, by its function and nature, can't do that. Focusing on the things it won't do as well as private industry ignores this whole element.

> Contrast this with Wal-Mart, and tell me I am wrong.

They pay their workers living wages and health care benefits, is one distinction. But please see above.

>Private agents can accomplish most of the goals of government more efficiently and with better results.

'most goals???" law enforcement? fire protection? pollution regulation and enforcement? public health protection? Sure, charitys do great work & should continue. That doesn't mean they can take it all over.

>The internet is an absolute proof of this. How many people were on the DARPAnet? Could you recieve streaming audio/video clips...

The reasonb the Internet has been such a great success story is because it was developed by the governmennt and then, when mature, the product was handed over to the private sector, which ran with it. But its origin is and was in Darpanet; the protocols, which are coding as I type, were created there and are still in use. The things you cite build on this foundation. Or apparently you don't believe in foundaton.

So, again, back to the question: do you think the FDA should be abolished, like Mark?? If not, why not, since government is inefficient and less effective than private industry could be?

Thanks for your thoughtful note
What particularly impressed me was your recognition that the problems are deep and real and can't be dealt with simply by repeating slogans - either liberal or conservative.

I agree wholeheartedly with this:

>Arrrgggghhh!!

Let's go through this...
If we eliminated the FDA and tasked the Consumer Product Safety Commission with looking into issues of drugs and medical devices that failed to perform as intended (or actually caused harm) then we would rely a great deal more on physicians to make informed choices for their patients and we would come to rely far more on the integrity of ethical pharmaceutical houses.

However, to throw open the marketing of drugs (that are not yet approved by the FDA) for older people would be impossible to police. In the first place there are proportionately lots of such patients so the volumes could be very large and hard to track. Further, the diversion of such compounds for use by younger patients would be immediate and widespread. FDA approval would become practically meaningless.

People (with some money) living in developing nations with a modern medical profession (but without the FDA) might be able to afford state-of-the-art health care without expensive health insurance and without the (taxation) overhead of government entitlements. For example, in the Philippines. If Americans needed to move to the Philippines to enjoy up to date therapies (at affordable prices) unavailable in the US, then the flow of immigrants might reverse.

worth repeating: thank you Forest.
However, to throw open the marketing of drugs (that are not yet approved by the FDA) for older people would be impossible to police. In the first place there are proportionately lots of such patients so the volumes could be very large and hard to track. Further, the diversion of such compounds for use by younger patients would be immediate and widespread. FDA approval would become practically meaningless.

The CBO says that 45 million uninsured for the entire year is incorrect
http://www.cbo.gov/showdoc.cfm?index=4210&sequence=0


"The Congressional Budget Office (CBO) estimates that between 21 million and 31 million people were uninsured for the entire year in 1998--the most recent year for which reliable comparative data are available. Since then, the number who are uninsured all year probably has not changed substantially, given historical trends. The uninsured population is fluid, with many people gaining and losing coverage. For example, between half and two-thirds of the people who experienced a period of time without insurance in 1998 had coverage for other portions of the year.

The commonly cited estimate of 40 million uninsured comes from the Census Bureau's Current Population Survey (CPS). Based on a large nationally representative sample, the CPS has been collecting data on health insurance status since 1980."

The Census study you provided a link to (thanks for that) states "the CPS estimates of the number of people without health insurance more closely approximates the number of people who are uninsured at A SPECIFIC POINT IN TIME (my emphasis) during the year than the number of people UNINSURED FOR THE ENTIRE YEAR". (my emphasis)

How many of those who are uninsured are ILLEGAL IMMIGRANTS? Neither study mentions this (that I could find). Based on the Census figures for percentage by State, my educated guess is that a very high percentage. I guess this because the States (for the most part) with the highest illegal immigrant populations(CA,AZ,NM,TX,FL) have the highest percentage uninsured.

eric still lies
As you well know, there are many problems with those statistics.

They cover people who could afford health care, but choose not to buy it.
They cover people who are without health care for as little as one day.

Why you believe I should apologize for exposing your lies, is beyond me.

eric still can't read
mhoward proved exactly my point. That your claim is nothing but a lie.

There is no need to have a govt agency fulfill this role
UL and other private labs already do a better job of testing, and for less money, than do govt labs.

the only reason the USPS costs are less, is because of the massive subsidies it receives
The postal service does not buy it's own buildings, or pay tax or insurance on them for one thing.

Many of their adminstrative costs are covered in other budgets as well.

you can tell when eric knows he's beaten, he tries to change the subject
...

definitely
It kills people by causing drugs to be expensive and late to market.

govt setting prices is the new definition of competitive?
...

In other words, people are to stupid to know what is in their best interest
therefore govt should decide for them.

The census document speaks for itself
And accurately quoting the census figure is not a lie. If someone wants to introduce another figure as more accurately reflecting the situation, that is an appropriate response. Saying I am lying isn't. I'm not.

Doesn't work that way
that some people could afford insurance doesn't mean they don't have it, that some people are between insurance policies doesn't mean they have it. Specifically, that deson't mean I was lying.

Because the fact is as I stated: at any given time, 45 million don't.

To repeat
To a 1/30/2007 assertion I made, giving an accurate figure for the number of Americans without health insurance, Mark replied as follows:

>1) The idea that there are 45 million without insurance is just another of your lies.

Documentation for my figure can be found here
http://www.census.gov/Press-Release/www/releases/archives/income_wealth/005647.html

You have no standing to make a comment
To a 1/30/2007 assertion I made, giving an accurate figure for the number of Americans without health insurance, Mark replied as follows:

>1) The idea that there are 45 million without insurance is just another of your lies.

Documentation for my figure can be found here
http://www.census.gov/Press-Release/www/releases/archives/income_wealth/005647.html

apology and aknowledgement
To a 1/30/2007 assertion I made, giving an accurate figure for the number of Americans without health insurance, Mark replied as follows:

>1) The idea that there are 45 million without insurance is just another of your lies.

Documentation for my figure can be found here
http://www.census.gov/Press-Release/www/releases/archives/income_wealth/005647.html

Not a lie. Apologize

You have no standing to comment
To a 1/30/2007 assertion I made, giving an accurate figure for the number of Americans without health insurance, Mark replied as follows:

>1) The idea that there are 45 million without insurance is just another of your lies.

Documentation for my figure can be found here
http://www.census.gov/Press-Release/www/releases/archives/income_wealth/005647.html

That said nothing of the kind, and you have no standing to make a comment
To a 1/30/2007 assertion I made, giving an accurate figure for the number of Americans without health insurance, Mark replied as follows:

>1) The idea that there are 45 million without insurance is just another of your lies.

Documentation for my figure can be found here
http://www.census.gov/Press-Release/www/releases/archives/income_wealth/005647.html

Please stop lyiing
The fact remains my figure was accurate. I was not 'lying," You were lying.

To a 1/30/2007 assertion I made, giving an accurate figure for the number of Americans without health insurance, Mark replied as follows:

>1) The idea that there are 45 million without insurance is just another of your lies.

Documentation for my figure can be found here
http://www.census.gov/Press-Release/www/releases/archives/income_wealth/005647.html

NO to a Medical Dictator
"FDA approval would become practically meaningless."

There is minimal Constitutional, logical or public policy basis for FDA "APPROVAL" of any medication/procedure.

Consumers should be responsible for their own health. The FDA is a medical dictator that unjustifiably abrogates the liberty of every US citizen.

Lemuel, We Get the Message
Feel free to quit with the copy/paste.

Unfortunately. . .
. . .if we actually insisted on charging market price for the drugs, there would be many people screaming bloody murder, in other countries and the US.

The pharma companies wouldn't be fond, either, since the likely result would be increased drug piracy in other nations. The government would need to actually back them, and come down on other countries that produced pirate generics for non-emergency reasons ( nobody cares if, say, Ghana pirates a drug, because they couldn't pay for it anyway; Canada and Britain are different stories ).

The 45 million is a valid statistic but it's not a real number
I'll try to be brief since I don't really have a dog in this fight.

Let's start with the first two paragraphs from "Rosen: No 'Crisis' of Uninsured" (Rocky Mountain News, 1/12/07) since it explains the problem better than I can. The full article can be found here:
http://www.healthdecisions.org/HealthInsurance/News/default.aspx?doc_id=101103

"If your goal is to lay a political foundation for socialized medicine in this country, what better way to do it than to create the public impression that we have a vast army of people - even better: children - who are permanently unable to obtain health insurance. Depending on who's throwing around the sensationalized figures, that army numbers from 46 million to 59 million. In fact, that army is AWOL; it doesn't exist in anywhere near those numbers. The National Center for Policy Analysis and Dr. David Gratzer, in his new book, The Cure, effectively debunk these myths.

The ploy is to pretend that a rotating aggregate or a snapshot is the same thing as a permanent population. Fifty-nine million is the aggregate number of those who at some time during the year, even if only for a day, were without health insurance. This is a meaningless statistic."

The Census Bureau did indeed conduct a survey that concluded 45 million people were uninsured but that number is a function of how the question was asked. If I conducted a survey of: "Which would you prefer: a slow painful agonizing death or Liverwurst?" my educated guess is that I could report that "Americans overwhelming prefer Liverwurst". As I'm sure you're aware poll questions (and survey questions) can be constructed to yield a desired response. I'm not saying that the Census Bureau had any hidden agenda in how the insurance question was phrased but the ACS survey is intended to provide legislators with policy insight and is designed with input from legislators and staffers who do have agendas.

OK, now let's look at the disagreement. On one side we have people who strongly favor socialized medicine, on the other we have people who are strongly opposed to socialized medicine. One side says "look, there are 45 million uninsured, we have to do something!". The other side says "those are manufactured numbers, your case is built on a lie". Ultimately we get down to "unfeeling heartless wretches" and "liars".

Now in my view this is exactly as intended. Full disclose - I think socialized medicine is a very bad idea and I think that less government is always better than more government. So disclosure aside, it seems to me that the politicians don't really want to solve the uninsured problem because it's much better to have it as a campaign issue. Both sides (pro-socialized, anti-socialized) feel strongly about it, both sides will make campaign contributions as necessary to prevent the other side from winning. It's the same with abortion and social security reform -> the career politicians want the issue so they'll never actually solve the problem (assuming a problem actually exists). It's perfectly understandable, if you're a career politician you've already got your talking points, you've got your charts and graphs, and you've got your finely honed sound bites. Why would you mess that up with a solution? You'd have to do all that work again for a new issue and that would interfere with your Pork-time.

It's often said that American politics is like moving the ball between the 40-yard lines. Socialized medicine and free market medicine are both end zone ideas and it will take someone with a vision and the courage to implement that vision to reach either end zone. There's only one person in Washington with enough courage for the job but he'll be gone in two years and his plate is already full. We're not going to see any meaningful change until the system collapses, until then the gutless wonders will nibble around the edges, pass non-binding resolutions to demonstrate the courage of their convictions, and ratchet up the acrimony. I think the old 40-yard line adage is wrong, I think we have all of vitriol and venom because they're trying to move the ball between the 49-yard lines. In other words, they're arguing over nothing so they have to intensify the argument. Yep, it's all a stupid waste of time and our tax money.

The 45 million uninsured doesn't have a basis in the real world and therefore is not amenable to a real world solution. If we ever got a real number the politicians would actually have to do something one way or the other. The fact that one side has been saying "40+ million uninsured" for years, while the other side has been saying "lies told by liars" for the same amount of time is a pretty clear indication that no solution is in the works. Again, it's the issue rather than the solution that's important. Oh, you need a solution? You want a solution? Too bad for you.

For what it's worth, I suspect the solution could be as trivial as educating the young and stupid about the enormous financial risk they're taking and how to buy insurance (buy the catastrophic health plan instead of the gold plated platinum plan) along with some tweaks to Medicaid for those with pre-existing conditions to get their cost down to more manageable levels. But where's the fun in a simple workable solution?

So much for being brief. I need to take my dog to the kennel...

I'd have to agree with you - Lem was not lying
Since lying means to knowingly tell a falsehood, you were not lying. What you quoted from the Census bureau was not a false statement. And even if the Census number turns out not to be accurate, you wouldn't have been lying as you wouldn't have known the figure you were quoting was incorrect (if it is).

Lem - I believe this is the first time I will have agreed with anything you have posted.

I do think that estimates of how many are uninsured for long periods of time give a more accurate picture of the uninsured issue than a snapshot in time. I also wonder how many of the uninsured are in this country illegally.

LOL
There needs to be a thoughtful and complete study done of the problem and sweeping recommendations made and inplemented.

The Arrrgggghhh!! was from personal experience.

I have a daughter taking singular, at $100 a month! My wife had to have some perscription (I can't remember what it was off hand) filled a couple of months ago and it cost me $150 for 30 pills. My present helath insurance doesn't cover perscriptions.

I have four kids and I well understand healthcare costs. I do agree we have a very good system as to ability to handle just about anything and get it taken care of immediately. But the prices are unreal! I can only be thankful that my family has been healthy and we have few trips to the doctor.

(It doesn't hurt that the head doctor at our hospital lives next door and her oldest daughter is in the same class as one of my daughters. Saves on office visits for common colds!!)

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