Beware Monkey Traps
It is said you can trap a monkey by putting a nut through a small hole in a gourd. The monkey reaches in and grabs the nut, but then his fist won’t fit back through the hole. Greedy monkeys will literally let themselves be caught rather than let go of the nut. So far, no commenter on my essay seems willing to let go of the nut of effective medicine, held in the gourd of the second half of medical spending.
As an analogy, imagine you ran a software company, whose many offices had different wage levels and work cultures, with average work hours ranging from seven to fourteen per day. Surprised to see these offices were equally productive, you randomly changed wages, inducing changes in work hours. You again found offices that worked more did not produce more; after seven hours people got tired and added as many bugs as they fixed. If instead of just cutting wages to get only seven hours of work, you just told everyone "watch out for bugs," you would be in a monkey trap, refusing to let go of the nut of productive work in the gourd of extra work hours.
So begins my first reply at CATO Unbound. I go on to argue that it is a monkey trap that keeps health policy experts from endorsing my proposal to "Cut Medicine In Half." You might think that humans wouldn’t fall for such a simple trap, but consider our military policy of "Leave No Man Behind":
Depicted in the film Black Hawk Down, this mission resulted in the deaths of 18 soldiers. In fact, the strategy of enemy Somali militiamen focused on the American policy of not leaving any soldier behind; they knew that if they managed to shoot down a helicopter, the Americans would move in to defend the helicopter’s crew.
Since I suggest "showing that you care" signals explain our inclination toward excess medicine, and solidarity signals are said to explain "leave no man behind," perhaps monkeys are inclined to never let go of food as a signal to would-be thieves.
I'm new to this discussion, so I'm not sure if this point has been made yet, but I don't hear many folks these days when discussing the cost of health care raise the question about the ROOT CAUSE of the mess it all is. In my mind, focusing on the health system is looking at symptoms or consequences, not sources or causes. Imagine the impact on health care if people received better education about their own bodies, felt empowered by that knowledge, and took more of their own responsibility to be healthy. So many people are of the mindset "full steam ahead, damn the torpedoes!" when it comes to their lifestyles, figuring "the doctor will fix it" when they get sick or injured. It is a classic case of co-dependency in our society, where the sick need the health professionals, and the health professionals NEED the sick (an unhealthy society is, after all, great job security!)
How do we wake up the sleeping "beast" that is the vast majority of Americans who won't do preventively for themselves what no advertisement campaign in the world will "fix?" Sure, we can see some progress over the years, most notably, the decrease in tobacco dependency. Maybe we're even exercising more. But the increase in childhood obesity and diabetes alone should scare the hell out of all of us. There are no quick fixes for those conditions. To me, they're the "canaries" in the dark cave of health care. Kids depend on us for education, and they obviously aren't getting it. And we aren't giving it.
The cynical side of me says a lot of corporations stand to benefit from keeping the masses in the dark about their bodies and good health. Does anyone LIKE the proliferation of drug commercials on TV? And what do so many of them suggest: "talk to your doctor about Drug X." We're going to experience a great deal of pain and financial drain before the cart gets put in back of the horse where it should be. I'd like to hear just one Presidential candidate suggest this approach instead of all the other crap I've heard so far. Anyone else with me on this?
God can giveth the cancer, and he can taketh it away. G, don't you believe in miracles? :)