The Biggest -ism of All
For the past several months, I have been following Tom Peters' blog at tompeters.com. I even post a few comments from time to time (if you can imagine that.)
A recurring theme lately has been about health care in the US. Tom has a number of readers and posters from the UK. Many like the system that they have and they have posted anecdotes to support their feelings. Another recurring theme is that something needs to be done about health coverage in the US, that we are the only developed country in the world without some sort of full coverage and that we as a country are slackers for not doing so.
The word socialism keeps cropping up. Tom made the following comment following a recent posting "The "horror of socialism" is a uniquely (?) American thing. We do allow a socialist military--though with our second ammendment, many of us are mini-militias. (I personally think that any Congressman who votes against some form or other of universal access ought to be required to vote in parallel to get rid of Social Security. If we wanna dump "socialism," let's not screw around!)"
OK, so Social Security is socialist (if you think about it, a sort of "naive transparancy" allowed this program to be named with an honest description of its true intent. Is certainly doesn't happen any more.) I get that. I don't get the military/socialism comment. I also get it that Medicare/Medicaid as well as the Prescription Drug coverage is socialist.
What I also get is that none of our current socialist benefits are constitutional without stretching the Commerce Clause to the point of snapping. So, do two (or three, or four) wrongs make a right?
Tom Peters is all about new ways of thinking, having written various books about excellence and about how companies need to re-engineer themselves from the outside, in. Throughout his writing is the concept of how rampant, passionate, innovative and disruptive competition/capitalism is necessary to succeed and thrive today. So, if capitalism and competition are so absolutely necessary for success in business, how can total government control of our hospitals, doctors, medicine, pharmaceuticals, etc. be such a good thing? People continue to bemoan the fact that insurance companies, hospitals, drug companies and others make a profit and that those entities that are publicly traded focus intently on their stock prices and dividend amounts at the expense of morals and the greater good.
Is it not possible to have a great product, yet produce a great ROI? Is it OK that an actor can pull down $30 Million for starring in a movie, but a drug company CEO cannot make $30 Million if his company creates a drug to fight Erectile Disfunction? If I choose to go to the movie theater to watch the aforementioned actor and pay $9.00 for a ticket (plus $4.00 for a $1.00 soda and $5.00 for a bucket of artery-clogging buttered popcorn), this discretionary expenditure is OK, but spending the same amount for a pill that took 10 years to bring to market is not.
You might say, "that drug is necessary to keep you alive and in good health" and that may be true, but where do you draw the line? Viagra is a medicine, but is it necessary? What if twenty years of painstaking, Herculean effort produces a pill that can thwart heart attacks? And what if the pharma company spent $1 Billion on R&D and trials to get it to market? When it all shakes out, the actual cost of production of the pill is $1. How much will the company be allowed to charge for each pill? Their patent will most likely expire in a few years, at which time generic manufacturers will jump in and sell the pills for $1.50. Will they be able to recoup their sunk costs? What about the 15 other drugs that never got to market for one reason or the other? Who pays for their development?
Plus, if medicine is so important to our human existence that we need the government to give it to us, why don't we have government control of food production, automobile manufacturing, home building, and other things that contribute to our basic sustenance?
If you asked me to make a list of things that government does really well and at a good value, I would be hard pressed make a long list. The military does fairly well, but it is so micro-managed by lawmakers, that the fact that our personnel can get any job done with what Congress has 'given' to them is a testament to their tenacity. Fire and rescue works out pretty well, too. But then I start looking at the Post Office, Medicare with all of its fraud, expensive and poorly built roads, DMV, Fannie Mae, TARP, etc. and I get sick thinking about what will happen if Nancy, Harry, Barnie, Chris, Steny and the rest start fixing medicine the way they fixed the financing of housing (which is what REALLY started this whole finance mess.)
I honestly don't think that anything they do on Capitol Hill will make anything better. Seriously. These are the same people that think Cap and Trade will fix "manmade global warming". But, if I could wave a wand and make something magical happen, I think that this would be what I would do: FOLLOW THE MONEY.
That would be the basis of all regulation. Just FOLLOW THE FREAKIN' MONEY. The government has statistics on how much money goes in and comes out of just about everything. If it looks like some one or some thing is making too much money, check it out. Immediately. Don't wait 4 years for an investigation to be approved. Just start looking. Nothing wrong with looking is there? Making a LOT of money is a sign of one of two things: no competition or illegal activity. If it illegal, shut it down. Quickly. If there is no competition, find out why. (Maybe we should put TMZ on the case...)
Then there is the iPod Syndrome.
There are a ton of MP3 players on the market. 99% of them suck. In spite of being controlled like a Taliban wife by Apple, the iPod is still a superior product and as such can demand a higher price and people are more than willing to pay that higher price. Because there is competition in the MP3 market, the government watchdogs would give it a pass.
However, if a Morgan Stanley can make $3 Billion profit in one year and give away $750 Million in bonuses to managers and arbitraguers, then I would send in the sniffers and they had better find SOMETHING.
Also, I would allow the sniffers to sniff Congress and the Executive branch as well as business. What's good for the goose...
It is really just common sense. That is why I know that it will never come to be.