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Of Death and Taxes

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Both my wife and I are in our eighth decade, and neither of us would have reached this point if it were not for the advances of modern medicine. I would've died twenty years ago if not for CAT scans, and Pat would've died two years ago if not for flexible bronchoscopes. Both these instruments and MRIs were developed after 1965, when the federal government took on the burden of paying for all our care once we reached sixty-five.

Medicare has created what economists call "effective demand" -- demand that becomes effective when the consumer has access to money to pay for the product that he desires. Federal money provides anyone over sixty-five with the wherewithal to pay for whatever treatments his doctor prescribes, no matter how expensive. So, with federal money available medical technologists have developed life saving procedures that were previously unaffordable.

In 1968, Dr. Shigeto Ikeda produced the first commercial flexible bronchoscope, and, by the early eighties, the video bronchoscope. In the early 1970s, Dr. Godfrey Hounsfield and Dr. Allan McLeod Cormack produced the first commercial CAT scan machine. GE now dominates that market, and, along with Philips and Siemens, dominates the MRI market, as well. The medical division of GE now has revenue of more than $17 billion annually. I believe that these medical advances would have been delayed, or perhaps never have occurred, were it not for the availability of government funding -- and as evidence I offer the fact that GE sold its MRI patents in 1971 before it realized their potential profitability. It reentered the MRI market in 1981, once its profitability had been demonstrated.

If Medicare-like protection is offered to all Americans, I have little doubt that American scientists will rise to the occasion and develop new lifesaving procedures that American capitalists will find ways manufacturing them profitably. Therefore, a lot of us are going to live a lot longer, and the only problem with that is that it will mean the federal government will be spending a lot more money on us before we die.

Within the past year, two of my close friends have died as a result of metastasized malignant melanomas. Although malignant melanomas are almost invariably fatal, my friends continued to receive medical treatments costing, between the two of them, more than $1 million, until they died.

Scientists are now concentrating on finding a biogenetic cure for melanoma. Two years ago a drug, PLX-4032, seemed promising. Patients taking the drugs went into remission. Hopes were high. Then, a year later, the drug's effectiveness waned, and trial participants began to die. Still research continues. Now scientists hope to combine PLX-4032 with other promising drugs so that melanoma may not be a death sentence, but at what cost? The journal, Current Opinion in Investigational Drugs, reports that "the cost to bring PLX-4032 to market, assuming success, could be in the region of US $1.5 billion..."And that's only if the FDA were to approve it. Only God knows what the cost of the treatment will be.

I think we are caught in the midst of a healthcare cost spiral, and if the healthcare bill passes, more scientists will do more research and find more ways to keep more of us alive. If the government creates "effective demand" through a new healthcare bill, profit-seeking entrepreneurs will find a way to meet that demand, and we will all benefit. More of us will take more treatments and stay alive for more years. All three of these factors will vastly increase healthcare costs. No one, Democrat or Republican, or the Congressional Office of the Budget (COB), has included those costs in their forecasts. That's because no one can measure the creativity of scientific minds, particularly when the money is there to pay for it.

All of us want to live longer, and none of us want to pay more taxes. But it's time to recognize that we can't have it both ways. I'm very happy to be alive, and I'm grateful to the scientists that invented the CAT scan that has kept me alive. My wife, Pat, is very happy to be alive, and she is very grateful to the scientists who invented flexible bronchoscopes. We are both very grateful to Medicare, which pays most of the costs of utilizing those inventions. We are more than willing to accept an increase in taxes that would make it possible for people under sixty-five to get the same healthcare we do. The only alternative is national bankruptcy.