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Thursday, October 5th 2006

Once Again Into The Breach

The New York Times makes yet another argument that the American health care system is undervalued/not as bad as it seems.

But the American health care system may be performing better than it seems at first glance. When it comes to medical innovation, the United States is the world leader. In the last 10 years, for instance, 12 Nobel Prizes in medicine have gone to American-born scientists working in the United States, 3 have gone to foreign-born scientists working in the United States, and just 7 have gone to researchers outside the country.

The six most important medical innovations of the last 25 years, according to a 2001 poll of physicians, were magnetic resonance imaging and computed tomography (CT scan); ACE inhibitors, used in the treatment of hypertension and congestive heart failure; balloon angioplasty; statins to lower cholesterol levels; mammography; and coronary artery bypass grafts. Balloon angioplasty came from Europe, four innovations on the list were developed in American hospitals or by American companies (although statins were based on earlier Japanese research), and mammography was first developed in Germany and then improved in the United States. Even when the initial research is done overseas, the American system leads in converting new ideas into workable commercial technologies.

Dr. Boehm argues that the research environment in the United States, compared with Europe, is wealthier, more competitive, more meritocratic and more tolerant of waste and chaos. He argues that these features lead to more medical discoveries. About 400,000 European researchers are living in the United States, usually for superior financial compensation and research facilities.

This innovation-rich environment stems from the money spent on American health care and also from the richer and more competitive American universities. The American government could use its size, or use the law, to bargain down health care prices, as many European governments have done. In the short run, this would save money but in the longer run it would cost lives.

The Health Care Blog of course takes offense.

Today a libertarian blogger who’s a professor from George Mason University, which prior to today was best known for its basketball team’s Cinderalla NCAA run last year, gets given a full column in the nation’s paper of record in which he actually says that the “American health care system may be performing better than it seems” because our scientists win more Nobel Prizes than those foreigners do! And we have more innovation in developing new treatments here!

Besides playing around with semantics and reducing the argument to less than it is, Holt decides to insult the reputation of Dr. Cowen’s institution. Holt attacking Dr. Cowen’s reputation based on his academic appointment, and indeed insenuating he doesn’t know what he’s talking about looks kind’ve foolish with this CV.

Holt doesn’t seem to address most of Dr. Cowen’s points. All he appears capable of is insulting the Harvard educated economist (here’s Holt’s CV by the way),

If wing nuts like this want to spout complete garbage on their loony-toons blog, well he has a first amendment right to do so.


Matthew Holt may think the winds, they are a changing. Maybe. But thank God, right now he’s genuinely on the outside looking in when it comes to REAL health care policy. I sit on fluff boards for organized medicine as a 20 something year old kid, where I never say a word, and probably have more influence on legislation and the national course.