If we fear Dr. Big Brother, and we should, we should also fear medical chaos. That is, it's perfectly possible to spend trillions of dollars every year on healthcare, and yet get disappointing results, if the money is spent by individuals and groups working at cross-purposes to each other. That is, if the trial lawyers wake up every day looking for people to sue, and if the regulators live in fear of investigators and scrutinizers to the point that they are paralyzed into inaction, and if doctors and hospitals fight the government when they aren't fighting each other, and if patients' groups are upset with everybody who might be slowing down a cure, even as limited-government activists seek to repeal much or all of the whole system, then it's easy to see that we are financing conflict, even chaos, not constructive medical effort.
Some would say, of course, that such struggling between interest groups is simply freedom in action, in a pluralistic and diverse country. Indeed, they might say that such struggling is the essence of our Madisonian system--checks and balances writ large.
And yet for all the importance we should attach to freedom, we should also remember the importance of consensus, teamwork, and common purpose. Otherwise we risk decay and decline amidst chronic squabbling. And the extreme version such squabbling and feuding is what Thomas Hobbes warned about four centuries ago--"the war of all against all." The illustration above is not meant to be taken literally, it's simply meant to evoke the idea that if we spend our time feuding, big missions, such as improving the health of the commonweal, will be left undone. Fighting may satisfy certain primal impulses, but fighting should not be an end in itself.
So how to get things done? Thus we come to the importance of leadership. If we can agree on certain goals, then we should figure out how to achieve those goals. Here at Serious Medicine Strategy, we have argued that curing big-killer diseases ought to be a goal that Americans can rally around. And we will need leaders to articulate those goals, and guide us toward achieving them.
In the meantime, we all might consider other ideas, too, about using healthcare as a platform for creating more jobs and growth. That's what the Japanese are doing, according to a report on the Nippon Keidanren in Japan Today:
The Japan Business Federation, the country’s most influential business lobby, is considering proposing that the government include health-related businesses as a key field for the creation of new demand under the nation’s growth strategy . . . the federation plans to call for extending remote medical care using the Internet and satellite connections as well as implementing joint development of drugs with Asian countries.
Japan, of course, is in something of an economic and political eclipse. Major Japanese companies, such as Toyota and Sony, have had serious problems, as has the country as a whole over the last 20 years. However, Japan should never be underestimated, and the power of the "Japan Inc." idea should not be underestimated. It worked before, it could work again--in more countries than Japan.