First of a Spenglerian series.
Why do we see so little sustained political support for medical progress? And, as an inevitable consequence, so little actual medical progress? Perhaps it's because, strange as it might seem, politicians and policymakers like it that way. Not consciously, of course--but, as psychologists and anthropologists know, any behavior repeated long enough must serve some sort of purpose. And so there must be some purpose served by the relentless over-regulation and litigation that has befallen the medical/pharma sector. And as a result, the steady decline of the sector's productivity thus falls into the category of not only "predictable surprise," but also, weirdly enough, "desired outcome."
Meanwhile, the very name of this blog, Medical Progress Today, has an antique feel to it. Unabashed endorsement of "progress" bespeaks a bright optimism; it's a bit of neo-Victorian progressivism that's increasingly incongruous in the present-day political-cultural context. Indeed, it's a forward-looking vision plunked in the middle of--or sinking below--an increasingly polarized and atomistic society, in which even the elites have subsided into the unproductive mire of zero-sum "gotcha" politics and superficial demotic grandstanding.
Why can we say this? Let's consider three medical news items, gleaned just from the last few days. Each speaks to a huge problem--and yet nobody in Washington seems to be listening.
First, The Washington Post reported that incidents of pharmaceutical drug shortages across the country have nearly quintupled in the last eight years. These are not trivial drugs; as the Post put it: shortages include "drugs used to relieve pain, fight cancer or infections, anesthetize surgical patients, treat cardiovascular disease, and manage psychiatric conditions." In other words, lives are being lost because of these shortages. The Post also adds that other vital products have gone missing: "Critical intravenous nutritional supplements and drugs for controlling attention-deficit hyperactivity disorder are also hard to find." This item was noted at MPT, of course--and at few other places.
Second, speaking of shortages--in the future--the Israeli newspaper Ha'aretz reported that Teva, the Israel-based pharmaceutical giant best known for generic drugs, is considering abandoning its efforts to create its own new drugs. As Ha'aretz put it, "More than half have reached the pivotal stage of human clinical testing. The drugs under development are for conditions from diabetes to nervous disorders and cancer." That is, a major company, operating in one of the most technologically forward-looking countries in the world, seems to be giving up on engendering its own medical progress.
Third, in a blog posting for The Fiscal Times, entitled "The Health Cost that Can Ruin the Economy," Michael Hodin, a former Senate staffer for the late Daniel Patrick Moynihan, argued that a cure for Alzheimer's Disease--or at least a significant improvement in treatment--is essential, because, as he put it, "the Alzheimer's trajectory is fiscally unsustainable." And yet, Hodin lamented, "Today, we focus on managing illness through care models. Looking ahead, this is less and less adequate-as populations age globally. . . . Twenty-first century demographic realities require a new approach to care." In other words, we need better treatment and cures--and we're not seeing them.
But are the chattering classes interested? Are they buzzing about taking necessary steps to expand the supply of new treatments and cures, now and in the future? Have important leaders in Washington DC made earnest speeches about the need to make medical progress, today and tomorrow? Has anyone held a hearing to knock bureaucratic and business heads together? Glance at any news or op-ed page over the last week--or the last ten years--and decide for yourself. So once again, we are reminded that ideas--good, bad, or absent--have consequences.
Yet, of course, the pols and pundits are interested in the healthcare issue; it's just a different issue than medical progress. Everyone in Washington is always up for a rumble over the Affordable Care Act, aka, Obamacare. And no what matter the Supreme Court might decide later this year, the battle over health insurance promises to be an endless fight, with no ultimate winner and no ultimate loser. Why? Because there's never a final judgment on economic distribution issues, and that's what the health insurance fight is all about--who gets more, and who gets less; those fights have occurred in every society and civilization, and they can be never be settled.
By contrast, progress in technology is mostly cumulative, in the sense that, say, the wheel was never uninvented. But progress in distributional issues is always chimera: It could all change in the next election, the next revolution, or the next conquest.
It's still worth fighting for lower tax rates and lesser regulation, because such measures usually lead to greater economic growth--and economic growth means productivity growth, which is to say, technological advancement. Over the last two-and-a-quarter centuries, the US has seen many politico-economic regimes, and will likely see many more. But in today's America, both the rich and the poor are better off than in the past, not because they won a political fight, but because producers have been winning their fight against scarcity.
So again, technology is progressive--while politics, as the historian Vico wrote three centuries ago--is inevitably recursive. That is to say, no true progress is assured for either side; politics is a see-saw. And as we shall see, paradoxical as it may seem, that may be exactly what the elites want. Even if they don't quite realize it.
Why? That's a long sad story--to be continued.