At a luncheon in Washington last week, I stumbled across something new in the Obamacare debate.<\/p>\n
Most of the attendees were reporters.\u00a0 The inevitable question came up: If not Obamacare, what?\u00a0 And when a Republican ran through an answer (equalizing tax treatment of insurance bought through employers and individually; allowing insurance policies approved in one state to be sold in all; HSAs and high deductible plans; medical liability reform), the reception was attentive, not dismissive.<\/p>\n
In other words, Washington is starting to take seriously the prospect of repeal and replace.<\/p>\n
An effective reform package will have more items in it that those mentioned at the lunch.\u00a0 Here is a link to a short (four and a half minutes) video from Pacific Research Institute that lays out the main points of the widely accepted alternative:\u00a0http:\/\/bit.ly\/1jeZYv3<\/a><\/i><\/b>.\u00a0 The video was produced to launch the Encounter Broadside\u00a0The Cure for Obamacare<\/i>\u00a0by PRI president Sally Pipes (http:\/\/amzn.to\/1fOpvLG<\/a><\/i><\/b>), which goes through the agenda in detail.<\/p>\n I want to put out an additional reform \u2013 at least in concept.\u00a0 It has to do with FDA certification of pharmaceuticals and medical devices.<\/p>\n Medicine has increasingly become a matter of prescribing drugs and implanting devices, each of which must go through a long and expensive approval process.\u00a0 We all pay for these costs and delays in four ways: 1) the outright expenses of trials, some of which are useful, some are not and some are capriciously imposed; 2) the capital costs on top of the direct costs, which accumulate like compounded interest as delays stretch to a decade and more; 3) the lost lives and restored health in the years that good drugs and devices are kept off the market and 4) the lack of competition because alternatives are trapped in the process.<\/p>\n To give two examples of this price, over the weekend a pair of\u00a0stories appeared about infectious diseases.<\/p>\n The first was a report out of the U.K.\u00a0\u00a0As\u00a0The Independent\u00a0<\/i>wrote: \u201cRoutine operations could become deadly \u2018in the very near future\u2019 as bacteria evolve to resist the drugs we use to combat them. This process could erase a century of medical advances, say government doctors in a special editorial in\u00a0The Lancet<\/i>\u00a0health journal.\u201d (http:\/\/ind.pn\/1gXRZFN<\/a><\/i><\/b>).<\/p>\n Beginning in the Lyndon Johnson Administration, the U.S. government started discouraging \u2013 including through the FDA \u2014 me-too drugs, particularly antibiotics.\u00a0 These were pharmaceuticals with small variants in their molecular structure.\u00a0 Often at least part of the motivation in creating and marketing them was to have a product on-patent or get around another producer\u2019s patent.\u00a0 The government\u2019s idea was that a drug was a drug and the small changes only inflated costs and profits.\u00a0 But the arguable result has been to slow the flow of antibiotic options and, with other factors, to accelerate the emergence of drug resistant bacterial strains.<\/p>\n