Friday, July 23, 2010

Why Are Top Officials So Uninterested in Serious Medicine? Why the Preoccupation with Finance, Not Science?

Why are our leaders so interested in healthcare, but uninterested in medicine?  More precisely, why are leaders so attuned to the finance of healthcare, but not the science of medicine? 

Those questions came to mind again, reading about the latest instance of Washington ignoring Serious Medicine, while paying ample attention to healthcare finance.  

Writing for The Daily Beast, Les Gelb, a former New York Times columnist and president emeritus of the Council on Foreign Relations, recalls a disturbing and revealing incident that happened in DC last month.  Arnold Fisher (pictured above) a real estate developer/philanthropist, had been the driving force in the effort to build a new center for brain-damaged soldiers just outside of Washington DC, near the huge government-military medical complexes in the immediate area.  But as Gelb tells the story: 

At the podium in Bethesda, Maryland, stood Arnold Fisher, the chief fundraiser for this precious center that may need to care for hundreds of thousands of victims, searching in vain for one White House official, one Cabinet officer, one member of the Joint Chiefs, one senator. He found none. And he asked again and again, “Where are they?”

Good question.   When it comes to medical science, political leaders are, indeed, hard to find.  But when it comes to healthcare finance, politicians are always on the scene.   Back on May 5, President Obama himself was eager to sign into law the Caregivers and Veterans Omnbus Health Services Act.   A needed and noble bill, no doubt, but the focus of the legislation, which will cost billions, is on financing--financing of maintenance.

The real challenge facing us, as Gelb writes, is that we have 300,000 veterans back from Iraq and Afghanistan suffering Post-Traumatic Stress Syndrome, and 360,000 vets with traumatic brain injuries.   Caring for them is a moral necessity, but curing them is a better plan.    

So obviously more research is needed on dealing with brain injuries.   After all, if we could cure brain injuries for wounded warriors, we would likely then know how to cure brain injuries for accident victims, stroke victims, and so on.  We would be on our way to the creation of a whole new industry. 

But that's where the two political parties start to peel off, when the focus shifts from finance to science.    While it should be obvious that wounded warriors should receive the best we can give them, the reality is that the Democrats are locked into a vision of healthcare austerity.  The Democrats' self-declared goal is to spend less on healthcare, not more.  

To Democrats, firmly in the grip of "Scarcitarian" ideology on healthcare--"less is more," as Shannon Brownlee, author Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer likes to say--spending money on "compassion" is fine, spending money on "economic stimulus" is OK, but spending money on medical research goes against the code.  As Obama administration officials are wont to say, the goal is "bend the curve" downward on healthcare costs, not upward.  So many spent as stipends to family caregivers is OK, but money spent on medical research, not OK.   

To be sure, regardless of avant-garde ideology, the Pentagon and the Department of Veterans Affairs are spending plenty of money on brain research, and Barack Obama even donated $250,000 of his Nobel Peace Prize money to Fisher's Fisher House project.  But just as obviously, those same officials feel hesitancy about being associated with such spending; as Gelb notes, neither Obama nor any other top administration  official joined philanthropist Fisher for the inauguration of the Maryland facility.   Such symbolism matters a lot--not only to wounded warriors and their families, but to researchers and entrepreneurs who are curious to know whether the nation thinks of brain-rehabilitation as a priority, or not.  

And so why weren't Republicans there at Fisher's event?   Perhaps they weren't invited.  Or perhaps they, too, are skeptical, in their own way, of medical research, since such research can ventures into areas, such as stem cell, about which they have ethical qualms.  Or perhaps Republicans have grown so hostile to federal spending that just don't wish to be seen at such events.  

And both parties seem to be firmly in the grip of finance-focus. That is, the problems America faces are to be solved by finance: taxes, spending, debt, financial "innovation," creative accounting, all that.  That's been the dominant ethos of the country for decades now.  Such financialist thinking represents a curious detour on the road to sustainable economic growth--and we have all suffered a jolting reminder of the limits to finance in the past few years.  But the political class hasn't yet woken up to the reality that not every problem can be solved by "stimulus," or a tax cut, or even a financial restructuring.   The real curve bender, on problems of all kinds, is technology.  Either we have the machinery that cleans up the BP oil spill, or we don't.  Either we have the weapons and vehicles that keep our troops safe, or we don't.  Either we have the high-tech that employs the next generation, or we don't.   Either we have the Serious Medicine to rehabilitate and cure, or we don't.  And if we don't, then no amount of financial casino-ing will save us, as individuals, or as a nation. 

So the great opportunity beckons--the opportunity to lead America toward a Serious Medicine Strategy.   A leader will step forward and say that medical research can lead us toward the full rehabilitation of brain injuries, just as medical research has led us toward full vaccines and cures in so many areas.  And that medical research will not only improve lives, but it will also create jobs and wealth for America, as we sell--or give, as national policy might dictate--the new brain-healing technology to the rest of the world.  

That's a Serious Medicine Strategy.  The elements are already in place, thanks to the work of Arnold Ficher and so many others.  All that's needed now are some leaders to connect all these elements, to connect the dots and bring the true power of this network into life.  

1 comment:

  1. If Arnold Ficher can find some way to ensure that his brain injury center can make Muslims feel good about themselves then Obama will be all ears.