The Power To Regulate Healthcare is the Power to Destroy It

On Aug. 2, 2009, the New York Times reported that the government's "war on cancer" isn't going particularly well:

Forty years after President Richard M. Nixon declared war on cancer, death rates have barely changed.

Cancer researchers will tell you that people are surviving longer after being diagnosed with cancer, but that doesn't mean that cancer can be cured, nor even that treatment is necessarily helping.  If medical tests for cancer, far more common these days for the most common cancers, detect illness earlier than they used to, people will live longer after the cancer is detected but they won't die any later than they would have died if the cancer had never been found.

During the 2008 meeting of the President's Cancel Panel, Dr. Scott Ramsey gave his view of the reason why so little progress was being made:

The biggest barrier, in his opinion, was that almost no adult cancer patients - just 3 percent - participate in studies of cancer treatments, mostly new drugs or drug regimens.

There are more than 6,500 cancer clinical trials seeking adult patients, according to clinicaltrials.gov, a trials registry. But many will be abandoned along the way. More than one trial in five sponsored by the National Cancer Institute failed to enroll a single subject, and only half reached the minimum needed for a meaningful result, Dr. Ramsey and his colleague John Scoggins reported in an editorial in the September 2008 issue of The Oncologist.

Part of the reason most oncologists steer clear of drug trials is money.  When doctors treat a patient with an approved chemotherapy drug, they get reimbursed more than the drug actually costs and the difference adds to their bottom line.

If the patient is in a trial, on the other hand, the patient gets the drug free from the sponsor.  There's no markup by the doctor so he makes nothing.

There's also a great deal of paperwork associated with a drug trial, and there may be legal liabilities if things don't work out well.  For many doctors, the extra costs, the paperwork, and the risks of getting sued are simply not worth it.

This isn't the only article on the subject.  On Aug. 7, 2009, the Times reported that even though the "stimulus" added $8.2 billion to the NIH research budget, any research that involves human volunteers faces other obstacles from federal ethics regulations.

No one denies the need to shield human subjects from undue risk. But current regulations have become so stringent and unwieldy that the ethics oversight system often impedes the kind of careful research we should be promoting. As two highly regarded medical ethicists, Dr. Norman Fost of the University of Wisconsin and Dr. Robert J. Levine of Yale, put it in the Journal of the American Medical Association, the system regulating the use of human subjects is "increasingly dysfunctional."

What's going on here?  Progress in cancer treatment has ground to a halt for want of people to participate in clinical trials.  Other research is being held back:

Some scientists deliberately design their studies more conservatively than they would like in order to placate fastidious review boards. Onerous paperwork regularly delays projects for months and inflates costs. A report last year in the journal Science warned that such paperwork is at "risk of pricing large clinical trials out of reach."

Stanford University researchers have estimated that it cost them about $56,000 in administrative wages, 18 months of delay and 10,000 pages of paper to make a small change to an already-approved research program that simply compared the progress made by patients attending different types of addiction-treatment programs. [emphasis added]

The Times has noticed that government regulations are pushing up the cost of research and, in many cases, wasting the money.  Both of the Times articles pointed out that about one-third of cancer trials are abandoned before they're completed.  What a lot of our money down the drain!

If the government can't manage the power we've let it assume over medical research, how do we expect bureaucrats to handle the power they want to give themselves over medical practice?  Remember, if your doctor sees any Medicare patients, he's not allowed to give a treatment that's not approved by Medicare, even if you're willing to pay.

What's going to happen if the medical board tells your doctor that it's too bad that the approved drug didn't work, that's the procedure, and you simply can't have any other treatment?

Medicare reimbursements are already so low they don't cover costs; that's why a lot of doctors won't take Medicare patients.  Mr. Obama is talking of taking billions in "waste and fraud" out of Medicare.

Since they can't cut rates any further, the only way to cut costs will be to give fewer treatments.  How does it help society to give health insurance to people who don't have it if you then deny treatment to people who've already paid for it?