Thinking Outside the Box on Healthcare

[Jata (Parijata Mackey)]

From: http://ieet.org/index.php/IEET/more/miller20090913/ or
http://embraceunity.com/?p=344

Thinking Outside the Box on Healthcare
by Edward Miller

The healthcare debate is shockingly narrow. We have the do nothing
crowd, the privatize it more crowd, the single-payer people, and the
public option folks. On the more radical end of the mainstream debates
are those calling for more general practitioners, preventive care/
incentives, and co-ops. Of the bills pushing through congress now, I
have a feeling the public option is the only one with any teeth, but
there are a million other non-mutually-exclusive ideas which could be
implemented.

If we shift the focus to not just prevention but an anti-aging
paradigm, we can delay death, improve productivity, and enhance
wellbeing. Unfortunately the short term bias of individuals,
corporations, and the government collectively shifts the focus towards
lucrative disease-specific research. Most diseases are merely a
symptom of aging, which is the root problem. There is no excuse for
the NIH to fund disease-specific research when the money could be
spent so much better on fundamental aging research which the market is
not already providing. The SENS Approach has already laid the roadmap
for what needs to be studied, yet funding is grossly insufficient, and
as with all things regarding aging, time is of the essence.
Think Outside of This

Setting aside genetic engineering for now, even simple things like
vitamin deficiencies cause an inordinate amount of medical problems,
and this is especially sad in a country like the US which, despite
being the wealthiest in the world, still has vitamin D deficiency
among the majority of the populace. Unfortunately this is part and
parcel with our overall short-term bias.

Unintended consequences of current government policies are wreaking
havok on us. Red meat, corn syrup, and many other American dietary
staples are heavily subsidized by our government. Eliminating those
subsidies, and maybe even taxing these to cover the externalities of
their unsustainable production, would do as much to improve our health
as just about anything that is being proposed. Additionally, banning
the use of antibiotics on healthy farm animals, as the Obama
Administration has openly supported, would prevent the outbreak of
antibiotic-resistant diseases. Furthermore, promoting local farmer’s
markets would improve the quality of our food and our communities.

Libertarians often rail against the FDA, as the Life Extension
Foundation does effectively, and much of the complaints are absolutely
justified, but what is often overlooked is the archaic patent system.
Not only are patents granted too frequently, and there is actually
much to be said for dismantling the patent system entirely, we have a
sort of tragedy of the commons when it comes to corporate patents.
Although having the freedom to grant your patent to someone else in
theory seems like a good idea, in practice what happens is all the
researchers end up ceding their patents to their employers and the end
result is a sort of medical servitude and reduced incentive to
innovate. Yet if corporations, which shouldn’t be legal persons
anyways, were not legally entitled to hold patents, they would still
have incentive to hire researchers who could use their facilities and
license back the discoveries at fair rates (standardized to a certain
percentage floor).

The NIH should not fund any research which will go toward patented
research, ever. All research which is conducted with public money must
go towards the commons or else it is corporatism plain and simple.
Open Source Medicine would enhance innovation and reduce costs.

Also, as Kevin Carson argues, there is plenty of room for small low
cost community clinics staffed by general practitioners or even the
sort of “barefoot doctors” described in the article. Seriously, you
don’t need to waste the time of an MD for a simple ear infection, and
such things constitute a huge proportion of healthcare.

As Robin Hanson notes here, we simply spend too much on healthcare.
True, a huge amount of that is a result of waste, fraud, abuse, and
the problems mentioned above, but some of it is a result of simply
spending too much money on ridiculous experimental treatments and so
forth that we shouldn’t be doing at all since there really isn’t any
evidence that they help. One way many countries deal with this issue
is rationing, but in fairness, this article was mainly arguing for a
reorientation of our priorities and an elimination of subsidies, tax
breaks, etc for healthcare providers. While I disagree with the
argument that the quantity of treatment itself is a problem, I think
it is useful to think about just how much we value healthcare, and how
effective each extra dollar really is, because too often this issue is
ignored completely.

Lastly, one area in which significant gains could be made is via
automation. If we could fund research of automated systems and robots
to assist care-providers, we would be able to spend less on care-
providers. More would be able to live at home without the need for
medical supervision, and for those who live at the hospital, there
would be less need for nurses and nurses’s aides to take care of the
dirty details, and more time to look after their social and emotional
wellbeing. I’m not just talking about robots like ASIMO or R2D2 to
fetch you things, though there is certainly a place for that. I am
also thinking on a very practical level. There are already motorized
wheelchairs, machines which aid people in the bathroom, or help them
up the stairs, or shift them around to prevent bedsores. There are
even robotic exoskeletons being developed. These sorts of things which
can not only maintain the health of the elderly and disabled, but
actually give them back lives of relative normality, but most of the
machines are patented and the designs are secret. Open innovation and
government funding could speed this up immensely.

Please, think outside the box guys!