Okay, So The Free Market Isn’t Exactly “Free”

First things first, The Atlantic published a Health article online recently. It’s a doozy, and after reading it, we did wonder, did it need to be this long?

However, it addresses a poignant issue: Drug companies are motivated by malleable policies that end up creating more incentive for hair regrowth drugs than ones fighting global diseases that are “Biblically”-severe i.e. malaria, Dengue fever and others.

You might say, well, it is what it is, the free market dictates. But this isn’t a free market issue. Patents, intellectual property laws and other complex factors, all rooted in government policies, guide huge corporations to create the drugs that they do.

And now, Jamie Love, a radical thinker, and the director of Knowledge Ecology International, has a crazy idea that is being discussed at leading organizations like the World Health Organization. According to the article,

“Love’s idea suggests the use of cash prizes — rather than patents — to incentivize research; say, $2 billion for an effective therapeutic drug for Chagas disease. A cure, once developed, proven, and awarded a prize, would then exist as open-access intellectual property, with manufacturers around the world competing to produce the drug in the most cost effective manner.”

It’s a game-changing idea, and some larger corporate interests (like pharmaceutical companies) and the U.S government, don’t want this idea lobbied any further. In fact, The Atlantic says that the U.S. has outwardly stymied negotiations through actions of Nils Daulaire, an assistant secretary for global affairs at the Department of Health and Human Services (HHS).

If you get one thing out of the article, though, it’s this frightening quote within a quote. Love was in the early phases of lobbying his idea. He was assisted by Robert Weissman, who now runs an advocacy group called Public Citizen. Love just successfully got an Indian chemist to make a drug that could be administered at $1/day, that was BEING SOLD AT OVER $10,000 PER YEAR under patent-protected prices. The article quotes Weissman saying:

“Before all this, we had a meeting with the U.S. Trade Representative and we were talking about how keeping these prices and patents in place was costing millions and millions of lives in Africa… And the Trade Rep. said to us — I’ll never forget this — ‘I don’t work for millions of people in Africa.’”

“I don’t work for millions of people in Africa.” That’s terrible. But that’s like an insurance company pressuring hospitals into lowering prices for those “covered” causing them to have to charge exorbitant rates to uninsured people to stay profitable. The insurance agent could then say the same thing, “I don’t work for people my company doesn’t cover.”

That got us thinking about our battle here in concierge medicine. Yes, we like making money. But we are fighting FOR the free market. We want to make money providing a service, not through unscrupulous negotiations or clever policies. It feels like larger groups (insurance companies, pharmaceuticals, etc.) win by what they deprive more so than what they provide.

In the end, we don’t want groups to make healthcare decisions to increase profits for “who they work for.” That’s to the detriment of our nation’s health. Hence the imperative of concierge medicine: We work for our patients, and our success depends upon it. We believe more concierge doctors, working for more patients, will benefit the nation. Now, the question is: what motivations will get more doctors to consider this business model? Will it come from Uncle Sam, with a type of stimulus (not likely), or the insurance companies (who can factor the yearly fee into meeting deductibles), or… ?