Greed... is Not Good!

Teva Pharmaceuticals factory in Jerusalem (Axios)

I have of late been re-thinking my position about the state of health care in this country. As a conservative leaning staunch supporter of a free market economy, I saw the state health care here to be a beneficiary of that. As far as technological advances in medicine, I believe the US does not have many peers - if any. While there are some countries that may surpass the US in one area or another, overall I don’t think there is a country that can match us in our overall medical advancement.

This is why any time an international figure needs the best health care available on the face of the planet, they come here. And yet when it comes to ranking health care in this country compared to others - we do not fare so well. We are currently ranked 27^th. How is this contradiction explained? The issue is not the state of the care itself, but the cost. That is where we fail and fail miserably.

The fact is that the wealthy fare quite well here. They get the best health care this country has to offer because they can afford to pay the ridiculously high insurance premiums that the vast majority of us cannot.

Now it’s true that most people have health insurance. But the premium for full coverage is so high that the only way to lower it somewhat is to have high deductibles. Which reduces health insurance to catastrophe coverage. Meaning that for most of their medical needs, they pay out of pocket even while still paying a relatively high premium for the catastrophe coverage they do get.

This is unlike some other countries where health care is paid for by the government. Which is why many of them rank higher than us despite the fact they do not have the same level of medical advancement the US does.  

So why do we not have universal health care as a guaranteed right? Would that not be the best of both worlds? That is what many progressive Democrats running for office suggest. But that is not the panacea they are presenting it as.  Because the cost to the taxpayer would be astronomical. There is no such thing as a free lunch. The question then becomes, is it worth it? Maybe it is. After all it works in Canada and Israel. Why can’t it work here?

This is where I become conflicted. Part of the reasons we are so advanced is the profit motive that is the hallmark of a free market economy. The revenue that technological advances produce for the corporations is huge. That makes the incentive to research and develop them just as huge.  

In order to continue these advances a universal government funded health care system would need to allow that incentive to stay in place.While it might be true that some individuals working in the field do so as much for altruistic reasons, it is not true in the corporate boardrooms that pay for their salaries to research and develop those advances. For them, it’s all about the money. Any attempts to curb profits will surely dis-incentivize medical research.

And yet, the idea that only the rich are the most likely to get the best medical care leaves me with an ethical dilemma. How can any ethical society allow its poor to not get the best health care? Why should money be a factor in determining life and death decisions? Maybe we should bite the bullet, legislate universal health care coverage and pay for with across the board increased taxes? Maybe that is one area that does need to be socialized! 

I don’t have an answer to that question. But I keep picturing in my mind the many patients that die because they can’t afford the treatment they need. How many times for example have I heard stories about people having to make a decision about whether to buy food or buy the prescription drugs they need to survive?! Because they don’t have enough money for both.

I bring this up because of what I read this morning  about what I consider a major Chilul Hashem. The Israeli pharmaceutical giant, Teva, is being sued along with several other drug companies for price fixing. From Axios: 

Prosecutors for 44 U.S. states outlined Saturday why they filed a lawsuit accusing 20 drug firms of conspiring to inflate prices... (P)rosecutors alleged after filing the suit in the U.S. District Court in Connecticut Friday that Teva Pharmaceuticals USA orchestrated the scheme with 19 other drug firms to stifle competition for generic drugs and increase prices sometimes by more than 1,000%...

The allegations concern treatments for health issues including cancer, diabetes, high cholesterol, epilepsy and high blood pressure, per Reuters. Connecticut Attorney General William Tong told AP that the states "have hard evidence that shows the generic drug industry perpetrated a multibillion dollar fraud on the American people." 

I can barely fathom the enormity of the Chilul HaShem here. That a Jewish company cares only about money - completely disregarding the health of people that need their life saving drugs at an affordable price is a Chilul HaShem of unimaginable proportion. 

I have no clue whether any of the company’s executives are religious. But in this case it doesn’t matter that much. It comes out of Israel - a  Jewish state whose existential claims are derived of the bible. I can’t tell you how angry that makes me. To say I am disappointed in the Jews behind this unfathomable price gouging is an understatement. It’s sickening!

This has pushed me a bit more into the ‘universal coverage’ column. Because once the government gets involved in actually paying for it, there probably will be more oversight. That would hopefully prevent this kind of travesty from ever occurring again. Never again will a patient be denied treatment because they  can’t afford it.

What about the financial incentive I was talking about that is necessary for progress to continue? That should not be tampered with. But the price gouging at levels Teva et al are being accused of goes way beyond a profit motive. It is a level of greed that borders on murder. That needs to be stopped.

There are of course other problems with universal health care. For example the fact that it is free will surely clog up emergency rooms and doctors offices with unnecessary visits. Why not go to the doctor for even the most minor medical reason if it’s free? There is also the phenomenon that elective procedures can sometime be backlogged for months because of the increased demand on health care now offered for free.  This has actually been reported to be the case in some countries that have socialized medicine.

These – among other problems - are all things that need to be tackled. I am therefore not committed to socialized medicine as the solution to all the problems. There might be other ways to solve some of them. For example the government can regulate the kind of price gouging Teva et al is accused of by controlling the amount they allow these companies to raise their prices allowing them a reasonable profit margin and requiring them to justify any price increases. But so far, the overall problems only seem to be getting worse.