Great idea, because the US Federal government does everything so well — so let’s put them in charge of the most important thing of all: our health care.

Dwyer’s well meaning post said, “if a single-payer system were to deliver on advocates’ promises…”

If — if only…

The US healthcare systems is indeed broken. And Dwyer is right that something needs to be done to negotiate better prices with drug companies. But the high prices are actually a symptom of other things — why not fix those other things?

For starters, it is a well known fact that drug companies do not pursue cures; rather, they largely pursue new drugs that will be patentable (and therefore expensive), and that must be taken for a long time — i.e., treatments, not cures. Cures have no ROI.

There are several problems lurking in the above. One is: why are drugs even patentable in the first place? Patents lead to high prices. You might think, “If drug companies could not patent drugs, they would not pursue research”. Well, that is only true because drug companies are for-profit entities. In contrast, universities often research cures, because they have a different mission. Perhaps drug research should not be the province of drug companies, but instead it should be non-profit institutions that do drug research…

Another problem is the high cost of drug trials: it sometimes costs a billion dollars to go through a phase 3 trial. But that is because the trial must pay the full cost of treatment of all of the patients in the trial — costs that would be paid by the insurer if the patient were not in the trial. Perhaps a drug trial should only be required to pay for the additional costs….

The advance of knowledge in cellular biology and medicine should be reducing health care costs, just as advancing technology has reduced the cost of electronics — Moore’s Law. But it hasn’t, because we have institutional barriers. We need to remove those institutional barriers. If we did that, health care costs would fall on their own.