Health Care

Bottlenecking Generics

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You’d think that if someone seriously wanted to reduce health care costs in the U.S., he would want to streamline the approval process for generic drugs.

Just the opposite seems to have occurred.

Whereas five years ago the FDA typically approved a new generic drug within 16 months of the manufacturer’s application, the typical delay is now more than 26 months. The budget for the FDA’s generics office is only $51 million for 2010: up from 2009, but still clearly insufficient to meet the need. It’s hard to think of many ways that an additional $30 million or so could be invested with better near-term payoff on the nation’s collective medical bill.

Executives at a generics meeting joked that the government spends less on reviewing applications for new generic drugs than the New York Yankees spend on the payroll for the left side of their infield.

A rapacious and greedy Technocracy

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technocracy

Obama health care plan online. (Relax. It’s a joke. Or, is it?)

The image is by editorial cartoonist Winsor McCay and I came across the image at the wonderful art blog linesandcolors.

Update: In the comments, Michael Kennedy adds: “CBO says there are not enough details to score the new “bill.” What else is new?”

Yes. What else is new? Also, this via Drudge: “An unapologetic Danny Williams says he was aware his trip to the United States for heart surgery earlier this month would spark outcry, but he concluded his personal health trumped any public fallout over the controversial decision….This was my heart, my choice and my health,” Williams said late Monday from his condominium in Sarasota, Fla.”

Be aware: If the health care plans don’t work as smoothly as gamed by the white paper crowd, the connected will exempt themselves from the worst of it. They always do. Do Senators tend to fly coach?

So, doesn’t change mean change?

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“The small bill aims to make health insurance more accessible, affordable, and portable — without increasing government control, jeopardizing the quality of care, or breaking the bank” Small-Bill Proposal for Sensible Health-Care Reform

“We have to learn to do health care in fundamentally new ways in the next twenty years. The changes needed are much more radical and sweeping than anything envisioned in the current legislation — and it will take a very different mindset to make them happen. The current bill is a classic example of steady state, blue social model thinking: it is more interested in keeping the status quo going by pumping more money into it than it is in the basic restructuring needed to build a system that will work in the future.” Walter Russell Mead

The latter excerpt (thanks to LG for the link) highlights, in a way, the frustration I experience practicing in a teaching hospital. It’s all chasing zanaflexhome state and federal dollars and arguing reimbursement rates. Well, naturally. But the really innovative things that we could do? Who, exactly, is doing them stateside? The “cash-only” doc drop-outs? Walmart, Walgreens and CVS clinics? Concierge practices and out-sourced medical diagnostics? I suppose government regulation makes it impossible to be innovative in the most radical way.

Seriously, I am so in the weeds with the day-to-day – just crushed by it – that I have no idea. We should be thinking innovation and nimbleness, and instead, our thinking is staid, staid, statist-ly staid. Because the Walter Russell Mead post makes the point that technology is going to throw the medical profession for a loop, and I think we are not ready to absorb those changes as a profession. Despite all the academic blather (because of ?), we are not ready.

What do you think are the important health care trends the current national “discussion” is missing?

Lamb Amidst the Feral Hogs

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Brian Lamb continues in a tradition of respect for Everyman and for history. Some trading and lobbying may well be part of any but the most unimportant of legislation. Still we should know what is in a bill with the potential of this one. Few bills have the means to change, limit, even shorten our lives than has this one. Sure, many a legislator’s career will be affected if we know – but isn’t that the point? Aren’t they supposed to be willing to stand, publically, by their votes? And a shortened career is not, of course, a shortened or damaged or stunted life.

Lamb’s long and old argument to open up such discussions has seldom seemed more important than it does here. (Note earlier requests.)
Side note: Feral Hogs. Hat tip – Fox News, Instapundit, and (surprise) the Mother Jones article Reynolds linked.

Bribes With Other People’s Money Aren’t Always That Attractive

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We have our faults. We are tempted by power and money – that’s no less true of Americans than any other nation. But we aren’t fatalistic. We are pretty sure that God helps them that helps themselves. And we may covet but we don’t believe that is a sign of injustice but rather of sin. So, all in all, I’m feeling pretty good about us; Obama’s attempts at turning us on bankers or insurance companies or. . . Well, we haven’t been turning in anger or with our raised fists. The biggest movement of the last few months may be anti-tax, but it seems more an argument for standing on our own feet, for independence, for liberty. And if Ben Nelson can be bought, I can (with some pride) point out that Nebraskans can’t be. The poll isn’t some kind of middling, some kind of, well, we’re glad to get the money but it’s a nasty business. It’s I don’t want any of that tainted lucre.

It’s been a long time since I left, but one of my daughters is thinking of moving there. She’s the one with the “Sowell Bro'” t-shirt. I’m hoping she’ll be happy.