We can see why Republicans have to keep up the flimsy lie about how Trumpcare would bring good care for everyone in this interview with Craig Garthwaite, an economist at the Northwestern University’s Kellogg School of Business and a registered Republican who believes in market-based solutions to health care but also criticizes Trumpcare for being likely to kill too many poor people. To his credit, Garthwaite admits that the healthcare debate is really about how many of the poor should be killed to maximize benefits to the rich, and that single-payer healthcare would actually be better for everyone except for the rich. Of course Republicans in Congress can’t admit this, since most of their own constituents are actually poor.
Craig Garthwaite
Well, the rest of the world drafts off of the innovation generated by the profits of the United States. If I’m running the health care system in another country, and if I have the United States here to generate huge profits to provide incentives to develop new drugs, I can choose to provide lower prices that take innovation less into account. I mean, the world of the Western European systems might be a little bit different if they had to think more carefully about that point.
Sean Illing
That’s an interesting point. Do you think these other countries are producing better overall health outcomes for their citizens?
Craig Garthwaite
I think it becomes a question of what that means, right? If the choice is between access to the best parts of the American health care system versus the best parts of any other system, I’d rather be in the United States. Now if we take a more Rawlsian view and you ask me which system I’d prefer if I didn’t know where I’d end up in society or how much income I’d earn, I’d probably want to be in another country.
Garthwaite presents a false dichotomy, though. Innovation in research and development of new cures and treatments doesn’t have to just come from drug companies chasing huge profits. It can come just was easily from non-profit and publicly funded universities, hospitals, and research institutes, for a fraction of the price we now pay. Most of the “innovations” by private companies are just building on the research funded by non-profits and government agencies (not only in the US but in many of those countries worldwide that provide universal healthcare but also fund their universities, hospitals, and research institutes very well), anyway. Even with a single-payer system, we could get as much innovation as we are willing to use tax dollars to subsidize, by expanding research grants to universities, hospitals, and research institutes, at a fraction of what it costs to get that innovation from private drug companies, because we won’t have to pay parasitic CEOs and stockholders, but can pay the scientists responsible for most innovations directly (most of whom are also willing to work for less than drug company counterparts are paid). And government-subsidized scientists are much more likely to be ethical and responsible about how they choose, conduct, and disseminate their research than drug companies, which tend to do things like exaggerate the benefits and downplay the harms of the treatments they develop, and avoid research into treatments and vaccines that are less profitable because they treat problems that affect poor people more, or that affect very few people. Most health scientists innovate because they love science, because they want to keep getting more and better grants and jobs to do even more and better science, because they want the prestige associated with making scientific breakthroughs, and because they want to improve and save people’s lives; they don’t need the promise of astronomical profits to motivate them to come up with better treatments, vaccines, and cures.