I recently read Think Like A Freak, which inspired me to do so and led to the following ideas for 2015.
When drug companies, hospitals, and doctors threaten to slow down or abandon research, this needs to be our go-to response – “So what?” Let’s not assume that slower or less research will lead to less health or earlier deaths. We could all learn by tracing the “so what” path and seeing where it leads.
So what if a lot less money went into biomedical research? In theory, that money would go elsewhere. It would seek other profitable ventures, which might help address other health-giving needs like education, technology, or food production. Biomedical research does not have the monopoly on creating new ways to support health.
Freaky Idea #2: We start setting limits on drug prices.
This calls for an entirely new mechanism, one that would have to survive a long gauntlet of legislators and lobbyists. I do not have high hopes for this one, though if we implemented Freaky Idea #1, we might be able to do a lot of interesting things.
There may be a back-door to set a ceiling on drug prices. Nearly all drug research is at least partly supported by government funds. There is no reason that those funds could not attach a few strings. For example, the entities receiving government research funds could charge no more than $50,000 per Quality-Adjusted-Life-Year that their drug achieved. (Need a refresher on QALY’s? See Your Money or Your Life.) Researchers would be motivated to find drugs that deliver the most health, which would boost what they could then charge. Gone would be the dartboard, who-can-keep-a-straight-face approach to drug pricing.
This would avoid the situation we currently have where U.S. taxpayers subsidize the research, buy the product, and pay most of the profits. Since other countries negotiate prices, drug companies’ profits are much lower from patients living elsewhere. Our current approach is like handing a kid a bludgeon and then being surprised when he hits us with it.
Freaky Idea #3: Health reform becomes a set of rules, instead of a socialist plot.
It’s been nearly five years since the Affordable Care Act passed, and there are still people wondering when the death panels will start. It’s just a set of rules for health insurance marketing and benefits. No one is going to kill your grandmother. (Yes, there are lots of other topics addressed in the law, but consumers are mainly concerned with health insurance.)
Rather than fanning the flames of fear, legislators could work to adjust the law. They could do this, knowing that they will not be shunned for “giving in”. They are not socialists by accepting that the law is the law, in other words.
Here’s to a Happy New Year and a 2015 full of freaky ideas!