It was an honor to be on a panel of " doers" -- people who are actually working on making health care more personalized and convenient -- and to be able to listen again to those who raise the capital and create the conditions necessary to commercialize new treatments.
I spoke mainly about the negative impact comparative effectiveness research is having on innovation, life expectancy and economic growth. I emphasized the value of medical progress to our nation in the centuries ahead. Ironically, the demand for leisure time and longer life that medical innovation generates and more efficient production of food, housing and energy allows has reduced the number of workers per retirees worldwide. Even china ( especially china, because of its birth control policy) is likely to ' run out' of workers in manufacturing to pay for government health and pension programs. As I noted, health care will be the leading industry of the 21st century meaning it will be the source of economic growth just as energy and manufacturing was in the 20th. But if the united states does not do it, no one really will. Russia is too corrupt, China is too strategic and commited to rationing, Singapore too small, India too parochial, Europe too wedded to welfare statism and unable to resist the rise of Islam.
There are many things that Americans can do to accelerate commercialization. However, most of them are opposed by a culture and a politics hostile to that enterprise at every important step. This oppositon is bi-partisan and reflects the belief that technology is used to pollute, displace and disrupt traditional relationships and nature purely for profit. The number of organizations that promote the view that commercialization deepens disparities and enriches corporations at the expense of the public's health, wealth and safety has steadily increased, as have the number of law firms that sue on the same basis. There have been a proliferation of laws, rules and regulations that add time and cost to the process of innovation to erode the inequalities commercialization creates.
If we organize medicine in America to suppress health care spending, innovation and demand for innovation it will harm our civilization for generations to come and leave us weaker than we already to defend democracy. This may sound overwrought, but it's only because I am being brief. What if America had not invested in the military might or the medicines Europe and the developing world relied on the past half century? Would another nation done so if it were able? ( Britain perhaps. Or Israel) But it is largely because of American leadership in both spheres democracy has spread and inequality has declined.
What I took away from the Aspen conference and why it is so valuable was the importance of something Milton Friedman said: “I do not believe that the solution to our problem is simply to elect the right people. The important thing is to establish a political climate of opinion which will make it politically profitable for the wrong people to do the right thing. Unless it is politically profitable for the wrong people to do the right thing, the right people will not do the right thing either, or if they try, they will shortly be out of office." The conference was a step towards establishing the sort of climate change Friedman thought necessary.