31 January 2010

The real revolution

While I have been following political battles such as the struggle to enact health-care reform with keen interest, I do not accord those things the degree of preoccupation that many of my fellow liberal bloggers evidently do. Let me explain why.

I've seen an estimate that the net additional number of deaths in the US due to our cruel and inefficient health-insurance system, compared with what we would have under a universal-coverage system such as other developed countries have, is about 45,000 per year -- that is, implementing an optimally-structured system of socialized medicine in the US which worked exactly as intended would save 45,000 lives (net) per year. I've also seem claims that this figure is somewhat exaggerated, but let's assume for the sake of argument that it's correct.

In mid-2001 the FDA approved Gleevec, an anti-leukemia drug (which also shows signs of being effective against other forms of cancer) developed by Dr. Brian Druker at Oregon Health & Science University about four miles from where I am typing this. By the end of 2007 Gleevec had saved more than 100,000 lives.

If the 45,000-per-year figure above is accepted, then under the best-case scenario, implementing an ideal system of socialized medicine in the US would produce a net savings of about 300,000 lives over a six-and-a-half-year period. In fact, over the same period, one technological innovation, which most people reading this have probably never heard of, actually did save more than a third of that number, without epic political battles, billions of dollars wasted on pork and bribes, kowtowing to Joe Lieberman, or any kind of bureaucratic infighting other than the usual struggle needed to get a new treatment approved by the FDA.

And don't forget that, as the last year has shown all too clearly, an ideal health system is not politically possible. The best we could realistically get from Congress (the current Senate bill plus a few amendments, perhaps including a public option) would certainly be a huge improvement over the current system and would save many lives, but not 45,000 a year. Even if we do get that "best we could realistically get", it will very likely achieve less reduction of human death and suffering each year than the continued use of Gleevec alone does. And Gleevec is just one such technological innovation. How many others are out there now in use, or being developed in the lab, that you (and I) have never heard of either?

Almost certainly, our current rate of technological progress is doing far more every year to improve the human condition than every political reform we seek, combined, could ever do. Health-care reform would be beneficial and is worth fighting for, but technological progress is much more important. It also has the advantage of being mostly unaffected by politics, although Bush's stem-cell research funding restrictions were a major exception -- hence my observation that Obama's repeal of those restrictions was actually a more important accomplishment, measured by practical effects, than passing health-care reform would be.

This is part of a broader general principle. In a posting more than three years ago, I wrote:

"Technology has done far more to expand individual freedom and improve human life than ideology has. The enlightened skepticism which eroded away religious certainties during the Renaissance would have had a much harder time getting started without the printing press. It was industrialization and mass production, not ideology, that triggered the greatest explosion of material pros- perity in history. It was vaccines and antibiotics and modern nutrition, not ideology, that freed most humans from the scourge of premature death. It was the nuclear bomb, not ideology, that kept the developed world free from major wars from 1945 on (by making the consequences of such wars too terrible to risk). It was mostly modern contraception, not ideology, which began to free human sexuality from ancient religious taboos. Today it is the internet, not ideology, which is enabling ordinary people all over the planet to outflank and roll back the power of big media, totalitarian governments, and the like, and is making censorship (whether motivated by leftist or rightist "concerns") more and more impractical."

Technological progress is almost unstoppable and is global in its effects. A few votes in Congress can kill a political reform, but research is much more difficult to obstruct; in the worst-case scenario, scientists will move to another country and continue their work there (as some American stem-cell researchers went to work in Britain during the Bush years). And socialized medicine in Britain or France does not benefit anyone outside those countries, while a new medical treatment developed in Britain or France rapidly comes into use around the world, including here in the US -- just as such innovations here benefit people everywhere.

The real revolution is in the laboratories.


Blogger Sue said...

would a person with no insurance be able to receive Gleevec? Do those uninsured like myself get the same care as those with insurance? What would I do if I had a cancer diagnosis? Technology is needed and needs funding, cures do save thousands of lives, but can we all equally partake in the fruits of their labor?

31 January, 2010 12:08  
Blogger Infidel753 said...

would a person with no insurance be able to receive Gleevec?

Probably not. Would a person with or without insurance be able to receive Gleevec if Gleevec had not been invented? Absolutely not.

Both broader insurance and technological innovation save lives. My point is that technological innovation saves far more.

but can we all equally partake in the fruits of their labor?

The benefits of modern technology are never absolutely equally distibuted. The rich benefit more than the middle class, the middle class benefit more than the poor, the one-and-a-half billion who live in rich nations benefit more than the five-and-a-half billion who live in poor nations. But everyone does benefit.

Political reform advances slowly and clumsily and with great difficulty and vast cost and with enormous compromise with reactionary forces. Technological innovation advances quickly and (relatively) easily and at much less cost and can ignore reactionary forces. Political reform benefits only the country in which it is carried out. Technological innovation benefits the whole world.

As I repeatedly affirmed in the posting, insurance reform is important and worth fighting for. But technological innovation is much more important. Both are beneficial. But technological innovation saves more people more easily and more quickly and at less cost. That's my point.

31 January, 2010 13:27  
Blogger TomCat said...

Infidel, that's an interesting take, but my perspective is that of someone who went without health care for many years before recently willing my SSDI appeal and thereby qualifying for Medicare. The reason I have been so long absent from your fine site is that, to mitigate the damage that did to my health, I've been running to more medical appointments than a blue dog has GOP fleas.

Health care is a basic right, and should be available to all. If we can't get that right away, lets get as much as we can, because if we don't, another generation will pass until someone has the courage to try again.

31 January, 2010 13:51  
Blogger Infidel753 said...

You, too, miss my point. Again, I repeatedly affirmed in the posting that health-care reform is important and beneficial. What I'm saying is that technological innovation is far more important and beneficial.

31 January, 2010 14:12  
Blogger Holte Ender said...

Technology is always dragging society along in it's wake. You are right, politicians invent nothing, the wheel; the printing press; wooden or iron ships; trains; planes; automobiles nor do they make medical breakthroughs.

I detected a fatalism in your post, very much 'a that's the way it is', I suppose after paying attention to what our elected officials achieve, you could well be right. Having a president who realizes these things wouldn't be enough, we would need a political system full of people willing to fund R&D with benefits for humanity the pay-off.

In the current climate here in the US, it could never happen. But it will happen, somewhere.

31 January, 2010 14:27  
Blogger Sue said...

Infidel, Tom and I did get the point of the post but we are just Adding to it by saying ALL of us should be able to take advantage of technological discoveries and advances in medicine. I know you believe that too but sadly our government does not.

31 January, 2010 14:34  
Blogger Infidel753 said...

What I'm talking about is the very opposite of fatalism -- the fatalists are those who believe that all we can hope for is the limited range of what politicians can achieve, or that everything is controlled by dark forces behind the scenes. I know that the progress that really matters is the product of trained minds who function independently of politics and its tiresome limitations.

As for funding, Oregon Health & Science University where Dr. Druker works (to name one example) has received a lot of stimulus funds from the Obama adminstration, but government is not its main source of money.

31 January, 2010 16:36  
Anonymous Leslie Parsley said...

So, I "think" what you are saying is that we could have the best health care system in the world with everyone having insurance - and all the other bells and whistles - BUT, if we don't have the technology, it's for naught. Without having the technology to treat disease - from cancer to MS to Parkinson's - HC is virtually insignificant. Am I on the right track?

31 January, 2010 17:49  
Anonymous Anonymous said...

My friend and I were recently discussing about how technology has become so integrated in our day to day lives. Reading this post makes me think back to that discussion we had, and just how inseparable from electronics we have all become.

I don't mean this in a bad way, of course! Societal concerns aside... I just hope that as the price of memory drops, the possibility of copying our memories onto a digital medium becomes a true reality. It's one of the things I really wish I could see in my lifetime.

01 February, 2010 01:28  
Blogger Infidel753 said...

LP: Not sure how you get from my calling it "important and beneficial" to "virtually insignificant" -- what I'm saying is that technology accomplishes a lot more than politics and with much less difficulty and compromise. But, true, a delivery system that serves everybody is only worth as much as what exists for it to deliver.

I'm getting pretty much burned out on blogging about politics or even reading about it, frankly -- I'm trying to point out that it's not the only or the most important game in town.

Here's another way of looking at it. The life expectancy in Britain is about two years longer than in the US. That's the difference socialized medicine makes. The life expectancy at birth right now is around 80 years compared with around 40 years a century ago. That's the difference that technological progress has made -- so far.

Anon: You will.

01 February, 2010 01:36  
Blogger tnlib said...

"Insignificant" was a very poor choice.

"I'm getting pretty much burned out on blogging about politics or even reading about it, frankly -- "

That I can understand, but don't stop blogging, please. I'm a little bored with the politics myself. I think I expressed on another blog (Truth) that if we're not preaching to the choir we're arguing with a winger who sounds like a broken record. The bottom line is we're often saying the same thing in our blogs and in our comments as everyone else.

I'll always be interested in politics but there are other things going on is this world - as you just proved in these last two posts and MadMike proves everyday.

01 February, 2010 06:50  
Blogger Infidel753 said...

Oh, I could no more stop blogging than I could stop breathing. I just want to broaden the range of things I write about, instead of being dragged back to politics all the time.

Political blogs do have a tendency to all cover the same things -- I'm trying to get away from that.

Mad Mike has a good site. Despite the name I think he's a bit more sane than the rest of us.

01 February, 2010 08:23  

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