Letter: Lowery gets healthcare dead wrong

Jarrod Lowery,

After reading your article in the IDS last Thursday, I felt compelled to contact you.

While I agree that measures need be taken to increase the supply of health care and decrease the demand, the changes you proposed are grossly irresponsible.

The idea that eliminating the Food and Drug Administration would lead to an equilibrium with better health and cheaper care lacks a basic understanding of market realities. Furthermore, allowing doctors to practice unlicensed would cause significant societal harm with minimal benefit.

While increasing supply sounds easy from an economic perspective, business and market realities mark your ideas as dead on arrival when it comes to achieving better health outcomes.

Basic economics teaches us about the power of information asymmetry. As it relates to selecting a physician or medication, consumers lack the ability to make an informed decision regarding which procedure or treatment is safe. In fact, this information asymmetry is what spawned the advent of the modern FDA, which was founded in 1906 (and further expanded in 1938).

Before this point, people were able to sell any drug or compound that they wanted. Because individuals do not have the resources to test medicines for efficacy and safety, they lack the basic information to make an informed decision.

This is where the government can step in and use regulation to bump the equilibrium to one that yields higher societal benefits.

The relative caution with which regulators approve drugs is perfectly debatable; whether these regulators should even exist is not the right question to ask.

As for allowing unlicensed physicians, your case for this being a primary factor in a lack of health care supply is even weaker. According to data from the World Health Organization, the United States has an average of 26 physicians per 10,000 residents.

Removing the outliers in the data, the world averages just 16 physicians per 10,000 residents. In fact, the United States leads the United Kingdom, Australia, Japan, Canada and many other western nations in the number of physicians per capita.

We could surely increase the number of physicians in the United States even more by eliminating licensing requirements. However, does the public really want a multitude of new unqualified and unlicensed people claiming to be doctors?

Perhaps more damning than the high number of physicians is the relatively poor outcomes the U.S. health care system produces. Despite being hailed as the most advanced system in the world, our system trails many other nations as measured by infant mortality rate and life expectancy.

I believe that your article lacked a solid understanding of how your proposals would influence public health.

Rather than eliminating regulation and licensing requirements surrounding doctors and pharmaceuticals, maybe we should try to better allocate care efficiently and coordinate that care so it is most effective. I would propose attempting to safely accelerate the approval process at the FDA to get more drugs on the market.

Beyond this, to increase the availability of medical services, maybe we could do as you suggested and push for more nurse practitioners with enhanced capabilities. I understand and respect a libertarian perspective; however, blind ideological ignorance is dangerous when turned into the law of the land.

You are in an extraordinary position to influence public opinion as a columnist at the IDS. It would be a shame to squander such an opportunity when you have the potential to positively shape the public debate with well-written commentary.
 
Sincerely,
 
—Kent Iglehart