Amen. Also, regarding the progress made in military weapons development as an example of how much great innovation results when the government runs things, it should be pointed out that even in this area, most of the advances were from private companies chasing profits, not from government labs. Only when a project was too large and expensive for a private company, such as the Manhattan Project, did the government actually run things.

You are missing a critical point about the military spending: the government is paying people to perform research in an effort to develop new weapons. Under this Health Care plan, the government is only paying for inexpensive already performed results.

Massive difference.

"This is like complaining that farmers only grow crops many people want to to eat"
The Lefties do that too. Just strike up a conversation at any Whole Foods store, and you'll get that complaint about farmers. The people who shop at Whole Foods can't understand why more farmers don't grow pesticide-free arugula. They ignore the fact that the Safeway down the street sells more iceburg lettuce in one hour than the Whole Foods sells arugula in a month.
Feelings, not facts, drives every Lefty argument.

From my own experience on the military side of the aerospace industry, I can say that mr. Klein is in error, the government hinders as much as it helps innovation and it often constrains how that innovation may develop, ignoring potential applications for those the procuring agency is focused on. In the past, when we had multiple competing manufacturers, innovation appears to have progressed much faster than it currently appears to within aerospace.

'Yes, it's tragic there are rare conditions that affect only a small number of people,,,' Not everyone faced with that situation has seen government research funding as the only hope. See the Cystic Fibrosis Foundation, which has privately raised many millions over decades to seed or finance small-drug research -- with good results. I should know: My son has CF and takes several of the drugs developed with CFF assistance. These kids used to die by eighteen months age; my son is eighteen years old and about to go off to college. But I fear for him if health care is nationalized.

The piece by Scott Atlas which you linked stated that most medical research is done in U.S hospitals.

When I worked in the pharmaceutical industry, I attended a conference presented by the Canadian equivalent of the FDA. They had devised a sort of blackmail system for increasing pharmaceutical research in CAnada. They allowed marketing of an American company's products in Canada at a price which would allow the company to make a little money if the American company opened a Canadian subsidiary and/or conducted some of its drug development research in Canada. And they maybe would not force the company to disclose its data to third-party manufacturers before the patent expired.

Canadian doctors who participated in clinical trials under this coercive arrangement had a marked tendency not to provide all the data required by the study protocol. They needed a lot of "baby sitting" by study coordinators. American doctors who did not cooperate in providing full data were quickly dropped.

Other countries which actually had some companies which did their own pharmaceutical research often registered their products in the U.S. before they registered them in their own price-controlled countries. The American consumer pays for the vast majority of drug research all over the world. If price controls are instituted here, research will be severely curtailed.

Incidentally, prices for new drugs in the U.S. went up dramatically when it became mandatory to facilitate marketing of a company's products by generic manufacturers after the expiration of a patent. In the old days, companies evened out the prices of innovative drugs and older drugs, since they could make some money off older products long after they were introduced. The exorbitant prices of new drugs partly reflect higher research and regulatory costs now, and partly reflect the short window of time over which costs must be recouped.

Pharmaceutical monopsony around the world only "works" because of the persistence of supply and demand pricing in the U.S., which funds all meaningful private sector drug research.

But this is an unfair shift to U.S. consumers of the cost of benefits enjoyed all around the world. It is a proper role for government to bring to bear all resources economic and diplomatic to make populations abroad pay their fair share of drug innovation. Including tariffs.

One paradigm that you need to factor in is that with nationalized health care, there is no competition. This will drive down the quality of health care, and INCREASE the cost.

While a comparison to a single national defense purchaser is a stretch, let's look at it in economic terms. In health care, there is one purchaser, and in military defense, one purchaser. In health care, who is the competition? No one. In military defense, who is the competition-the rest of the world. The fact that there is competition will drive military innovation. It also controls costs.

Health care will see less innovation and higher costs.

My son has CF and takes several of the drugs developed with CFF assistance. ... But I fear for him if health care is nationalized.

My son also has CF and I feel the same way. The insurance company and the HMO I was previous inusred with have never once baulked at the cost of my son's care. I fear for my son's health if Obama gets his way.

Drug companies focus on common conditions. This makes sense from every social and economic perspective. That this is used as an effective and frequently used argument against free market health care shows how the opponents of US-styled health care control the debate, to the point where they can redefine meanings, subvert obvious paradigms, and control the public's emotional responses like dogs salivating at a Pavlovian bell. The emperor not only has no clothes -- he's lost his mind.

When Cimetidine was first introduced for stomach (peptic) ulcer disease --affecting 40 million Americans alone -- it replaced remediation via massive surgical removal of parts of the stomach, esophagus, and Vagas nerve with a pill.

That pill-- as revolutionary as it was --had to be taken three times a day, was only partly effective, didn't help everyone, and had many side effects.

Over the ensuing 25 years pharmaceutical companies, in the pusuit of profits, have refined the pill a dozen times, with each new iteration helping patients in different subsets of this disease, in mopre specific ways. The pills are now easier to take and more effective over a wider range of the disease.

Not only does this kind of market system process help everyone, it is precisely one of the reasons US healthcare has led the world.

They don't do this in government-controlled systems, and you will never ever know what you will be missing because it will never come to pass.

The opponents of US healthcare who redefine

Sir:

I believe that there are more reasons that military technology development is not a apt comparison with the rest of government technology development, especially medical.

First, the US military is subject to foreign competition. If you go to war with second best technology you wind up second best.

Second, even though the Government is the sole purchaser of weapons there is usually strong competition for the business. This leads to use of cutting edge technology.

Third, the military realizes that it is the lives of their fellows that are on the line. They seek the best balance between caution and risk in selecting technologies.

Fourth, the military realizes they must use the best technology to reduce the bad side-eefects of going kinetic as well as protecting their own. They even see technology as a way to reduce the times they have to go kinetic.

I often laugh at statements such as those of Mr. Klein. They seem to think that waste is a modifying adjective for DoD. Perhaps someday he or his kin will tell us of an organization that entails no waste.

seems to ensure a much-higher rate of military technology innovation

Um, those are for profit companies (GD, Lockheed, etc) doing that research.

This clown has no point.

I remember reading that the original director of the Lockheed Skunk Works, the place that developed- among others- the SR71, told his replacement never to take a contract with the Navy if he could help it; the Air Force was a pain to work with, but the way the Navy wanted to change specs and screw around with things during a project always greatly increased costs and made everything take longer. That's on very high-tech projects the Navy wanted BAD; three guesses what'll happen with health care being totally run by the government.

Also, if you look back, an awful lot of weapons did not come out of government arsenals; some citizen had an idea, worked on it, made it work and THEN the government bought it and went on from there.

I'm coming around to the view that "social justice" is the most obscene phrase in the English language.

Ezra says:

"Pharmaceutical companies, for instance, spend less on drug research than on administration and marketing. You could say that administration and marketing increase their profits, which in turn let them spend more money researching drugs. But if research is so important, then maybe the profits being enjoyed by the industry are in fact too small."

I spend less on clothing than on food. You could argue that food keeps me alive and thus helps me earn more money and put it in the bank. But if clothing is so important, maybe my savings account balance is too small!

Yeah, that's "logic" for ya. It didn't make sense to me either.

Ezra says:

"Pharmaceutical companies, for instance, spend less on drug research than on administration and marketing. You could say that administration and marketing increase their profits, which in turn let them spend more money researching drugs. But if research is so important, then maybe the profits being enjoyed by the industry are in fact too small."

I spend less on clothing than on food. You could argue that food keeps me alive and thus helps me earn more money and put it in the bank. But if clothing is so important, maybe my savings account balance is too small!

Yeah, that's "logic" for ya. It didn't make sense to me either.

MayorOmalleySuxs--

I don't want to detract from the thrust and conclusions of your post. . . but as a surgeon I just want to do a few minor corrections so the next time your present your argument it will be more accurate.

1. The surgery that was done for stomach ulcers really couldn't be considered "massive surgery" -- you could generally be done in less than two hours. And while it generally involved cutting the vagus nerve and often involved removing part of the stomach, the esphagus itself was never removed -- unless there was something completely different going on.

2. It's not completely accurate to say that pharmaceutical companies have "refined the pill." There were two things that happened -- one was a new type of ulcer medication that acted on a completely different mechanism arrived on the scene. Cimitidine is a "H2 Blocker" -- the new drugs, which are more potent, are "Proton Pump Inhibitors."

The second thing was a physician from the West Coast of Australia was able to demonstrate that a lot of ulcers were produced by a certain type of bacteria -- "H. Pylori" -- and that bacteria could be eradicated with an antibiotic regiment, thereby curing the ulcer disease.

But like I said -- could post in general, and I agree with you.

Ezra Klein is a know-nothing pinhead with an artificially inflated sense of self-worth. His Delusions of Near-Adequacy are beginning to get on my nerves.
Actually, mI see Klein and Obama cut from the same cloth preferred by American bien pesants: it matters whether you have fact, data, evidence, logic, or thought, what matters is eloquence. I thought Plato kicked this crap to the curb a couple of thousand years ago, but evidently not well enough.

Whoops.
"it matters *not* whether you have ..."

Who the heck is Ezra Klein? Who is he related to that he gets such attention as a 25 year old wonk with little life experience? Why is he quoted so much and linked to so much? Why do people seem to care what he says? This is not snark. These are honest questions.

Ezra says:

"Pharmaceutical companies, for instance, spend less on drug research than on administration and marketing. You could say that administration and marketing increase their profits, which in turn let them spend more money researching drugs. But if research is so important, then maybe the profits being enjoyed by the industry are in fact too small."

Another case of progressives pointing to progressive-caused problems as demanding more govt control. Getting a new drug thru four rounds of FDA mandated clinical trials is an administrative ordeal, taking years and costing tens of millions. Big Pharma likes it cuz it keeps them from being blindsided by small labs and research centers. Their value-added isn't really the research but the FDA compliance.

Just last week, HR 2749, which would bring almost the whole of food production in the US under much tighter FDA control was narrowly defeated but will be coming up for a revote.

For MayorOmalleySuxs and Narniaman:

I've been working with a group of surgeons lately who consider the introduction of Tagamet (cimetidine) and later the flexible endoscope as watershed innovations... which wreaked economic disaster on their practices as gastric recessions and then colon surgeries fell sharply.

Similarly, I worked with an ENT to announce a device he'd come up with that promised to turn a $1500 specialist treatment for positional vertigo into an $80 nurse treatment. He did not want his ENT peers getting wind of his association with it because he'd effectively be taking $10,000 or so out of their practices each month.

Every physician I've talked with praises medical innovation, but at the same time it is hard not to notice the visceral wariness of it.

To everyone defending the idea that we have the best military technology despite the fact that the government is the sole purchaser, to be honest we do not know that we wouldn't have better military technology if private individuals were permitted to purchase military technology. We don't know because we've never tried it.

No, I'm not arguing allowing private individuals to buy F-22 fighter jets. What I am noting is that there is a habit by sloppy thinkers to believe that things are better than the untried alternative because--well, because things are just fine the way they are. If the alternative is untried, then how can we possibly know?

We cannot know how much wealth has been given up with the untried alternative. We can guess, by looking at other examples through the world where they tried the alternate experiment. For example, for me, the only argument I need to see for socialized health care is how it has failed in Canada. We can also theorize by trying to understand the economic effects of a decision--which is for me the biggest argument against raising the minimum wage, since we just priced out of work a whole bunch of younger workers. But we really cannot know what would happen until we try it.

Of course, some experiments we probably shouldn't try.

Pharmaceutical companies have helped increase life expectancy a decade or more over the last three decades.

And for that, they can never be forgiven.

China is privatizing her healthcare as a way to reduce cost and raise standard and availability. My brother, a periodontist and a lecturer in HKU is invited to help them set up rules and standards for privatized healthcare. Seems like we are chasing the communist tail, while the communists see the capitalist light.

"""For all its waste, elevating the U.S. government to sole purchaser seems to ensure a much-higher rate of military technology innovation than if we left it to the private sector."""

This man knows even less about the military than he does about health care.

The stuff the military uses that actually *works* is usually either (a) COTS hardware (Commercial Off The Shelf) or (b) stuff that was patterned off of COTS. The military-only stuff is usually either (a) antiquated crap or (b) stuff there simply is no analog of in the civilian world.

And we...err...sorry--they (I'm not in right now) do not get the best stuff out there. Our solders are usually better equipped than most because our nation is richer than most, but they still get the minimum you think you can give them and still win.

Your Marines and Army Combat types will fight like hell with whatever you give them. If all they had was lead pipes and brass knuckles they'd still go into places like Falluja and come out on top. Certainly fewer of them would survive, but they'd go, and there would be a pile of bodies when they were done.

But don't confuse the results with the equipment. There is no military in the world that is better trained across the board than ours. Yes, some are better in the desert, or the snow, but you drop a 0311/11B anywhere in the world and he's at least had some familiarization with that environment.

Don't mistake the results they give you with the equipment you give them. If the country *really* cared they wouldn't be walking patrols with over 100 pounds of crap on their bodies.

For the commenter asking who is Ezra Klein, he is a 25-year-old political scientist (applying the Sotomayor standard, by which she was "a historian by undergraduate training"; I am an "economist"). But all you really need to know is that Ezra started his undergraduate career at UC-Santa Cruz way back in ought-one. That is the same town (and school I am sure) who gave us the recent youtube genius reporting on how the crops were doing and proposing the government develop a "perfect pesticide". I believe she is a professor of physics at UC-Santa Cruz. Or maybe it was political science. Anyway, that is who Ezra Klein.

They [private pharma companies] do productization research, and only for well-known medical conditions that have a lot of commercial value to solve.

Wait a second. Obama and pals keep telling us that the way that ObamaCare will cut costs is by not paying for treatments that aren't cost-effective, which apparently is the current practice. Well, how is paying for research into obscure medical conditions going to be cost-effective? If we're interested in controlling costs, shouldn't we be avoiding research that helps only a small number?

AK:

"Obamacare -- Helping the Marginal to Die"

Sorry -- I couldn't resist.

The comment about private pharma only researching "well known" conditions is also just plain false. My wife works for a large biotech that specializes in the less well known illnesses. Many of the companies products provide benefits for people a few hundred or thousand at a time.

The funny thing about capticalism is that the gaps get filled eventually.

The military also has a bidding process for developing new weapons, so there actually is competition in the creation of weapons. The difference between that and national healthcare is that the military is both the payer and the receiver of goods/services. The military can shop around while a patient won't be allowed to.

Some of these companies (such as Boeing and Barret) have civilian divisions/sales, so it's not like the government is their only customer.

(Some weapons can be exported to other countries as well, so there are multiple buyers anyway.)