Who Wants the Government to be in Charge of your Well-Being?

In my last post I took a jab at Medicare for its embarrassingly compromised medical reimbursement policies. Today’s victim is the Food and Drug Administration (FDA). A NY Times article reports that an investigation of the FDA by its own “F.D.A. Science Board” finds it in “a crisis.”

More specifically: it’s desperately short of assets and poorly organized. It’s therefore unable to keep up with scientific advances and poorly equipped to protect public health. – The preceding comments are straight out of the article. Over the past two decades, the agency’s responsibilities have soared but its appropriations have stayed the same. Think about it. You’re a hospital administrator in a small rural town – you’re hospital has 15 beds. Your hospital is not-for-profit, and therefore your entire budget is based upon a fixed tax base that isn’t changing or increasing in value. Over a 20 year period, you must admit and treat increasing numbers of patients, to the point where you must serve 3X as many patients today than you did in 1987. But the local government has allocated new tax dollars to other projects – a new water tower, a new fire district, a public park or two – and kept your tax levy the same. Therefore you have 1/3 of the resources per patient than you did 20 years ago. So you can’ t hire additional doctors, or buy new computers, or add new beds. Factor inflation into the mix and its probably more like 1/5 the resources. All because someone at the county political district decided money was needed for other projects…projects that got that board member elected. Sounds ridiculous doesn’t it? This is what’s happened to the FDA. This is what happens to all government-run agencies at some point. This is what happens when elected members of government, with layers of competing interests and political agendas, are in charge of something that didn’t get a lot of press before they campaigned. It doesn’t work, and it’s embarrassing that the FDA’s computers can’t recognize road salt from table salt.

It’s embarrassing that their computer system is so old that its prone to break down when it’s needed most – like during a recent E. coli food contamination scare. It’s embarrassing that it’s 2007 and reports must still be handwritten. It’s embarrassing that the FDA’s systems can’t talk to other government systems, like U.S. Customs – so we have no idea if imported foods are safe until months after people have been consuming them.

The report concluded that the “F.D.A.’s ability to provide its basic food system inspection, enforcement and rule-making functions is severely eroded, as is its ability to respond to outbreaks in a timely manner.” Garret A. FitzGerald, a pharmacologist from the University of Pennsylvania, blamed a “cabal of Congressional majorities and presidential administrations that has serially stripped the agency of assets.”

Committees with competing interests always compromise. Stand alone enterprises with dedicated, passionate architects don’t. And some people actually want the government to be in charge of our health care…

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Our Dependence on Government-Payor Medical Care May Kill Us…

Just about anyone who doesn’t work directly for the U.S. Department of Health and Human Services, and has experience in health care, could not argue that Medicare’s reimbursement formularies adequately reimburse hospitals and doctors – AND keep a straight face.  Medicare reimbursement, the bane of many hospitals’ existence, began, like many government programs, with a benevolent purpose and a seemingly meaningful methodology.  And, like many government programs, has been so re-written, picked, prodded, subject to compromise, restricted by budgetary constraints, and sterilized by bureaucratic red tape and competing political interests…that the “well-meaningness” and logic are as endangered as the cancer patients I’m about to discuss.  To give you an idea of what government is capable of, just look at the present U.S. Tax Code.  Congress has created the necessity for an industry that costs this country upwards of $265 billion annually, just to comply with it.

The latest casualty in Medicare’s inconsistent, non-hippocratic formulary, may be 60,000 people per year with Non-Hodgkin Lymphoma.  A NY Times article says that Medicare may arbitrarily cut its reimbursement for a new class of promising cancer drugs…the only treatment option for many disease sufferers.  The drugs, Bexxar (GlaxoSmithKline) and Zevalin (Biogen Idec.) , part of a group called radioimmunotherapies, will be critical, life-saving drugs, if hospitals can afford to offer them as treatment options.

Marion Swan, a spokeswoman for the Lymphoma Research Foundation, says the drugs are the only option for some patients. “Our number one concern is that patients have access to all viable treatment options,” she said, “and it looks like this might be denying access.”

The worst part is that the Federal rules prevent hospitals from offering drugs to non-Medicare patients, if they cannot offer them to Medicare patients.  This means anyone with regular insurance or the ability to pay for potentially the only drug that will save them, will be denied access.

This is where socialized medicine fails us…

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