USDA Threatens to Prosecute Anyone Who Tests a Cow for Mad Cow Disease
NPR reported today on a USDA threat to prosecute anyone who tests a cow for mad cow disease. A beef producer asked the USDA to test all his cows. He offered to pay for the testing. The USDA not only refused to test his cows but told him they would prosecute anyone else who tested them.
This is the one of many example of vested business interests using government agencies as pawns to undermine the health and safety of the American people. The same type of behavior is rampant in healthcare. Our system is a regulated beaurocracy that systematically suppresses innovation that could help the consumer.
One can turn to the Harvard Business Review for an analysis of “the most entrenched, change-averse industry in the United States.”
Christensen, CM; Bohmer, R; Kenagy, J. Will Disruptive Innovations Cure Health Care? Harvard Business Review, Sep-Oct 2000, pp. 103-111.
“Imagine a portable, low-intensity X-ray machine that can be wheeled between offices on a cart. It creates images of such clarity that pediatricians, internists, and nurses can detect cracks in bones or lumps in tissue in their offices, not in a hospital. It works through a patented “nanocrystal” process, which uses night-vision technology borrowed from the military. At 10% of the cost of a conventional X-ray machine, it could save patients, their employers, and insurance companies hundreds of thousands of dollars every year. Great innovation, right? Guess again. When the entrepreneur who developed the machine tried to license the technology to established health care companies, he couldn’t even get his foot in the door. Large-scale X-ray equipment suppliers wanted no part of it. Why? Because it threatened their business models.
“What happened to the X-ray entrepreneur is all too common in the health care industry. Powerful institutional forces fight simpler alternatives to expensive care because those alternatives threaten their livelihoods. And those opponents to low-cost change are usually lined up three or four deep. Imagine for a moment that our entrepreneur was able to license the technology. Even then, he would probably face insuperable barriers. Regulators, afraid of putting patients at risk, would withhold approvals. Radiologists, who establish the licensing standards that regulators enforce, don’t want to lose their jobs, so they’d fight it, too. Insurance companies, which approve only established licensed procedures, would refuse to reimburse for it. And hospitals, with their large investments in radiology and emergency departments, want injuries to flow to them–so they, too would join the forces holding back change.”
At the MIT Future of Health Technology Summit we discuss these issues every year among some of the top leaders in healthcare. The consensus last October was that aligning business incentives with the safety and well being of patients was the core of the problem and that radical change was necessary. Frankly, the only way I see this happening is massive consumer revolt causing major political repercussions. It is essential that every healthcare consumer concerned about themselves, their children, and the elderly in their family to become educated, to take charge of their own healthcare and the healthcare of their loved ones, and to demand accountability and political action.
Let’s hope aging baby-boomers will still have the mojo to act on this. It will make stopping the Vietnam war look like a cakewalk. Check out Robert McNamara in “The Fog of War.” If that doesn’t get your juices flowing, try seeing “Apocalypse Now” for the third time. When I finished my 100th mission over North Vietnam in 1968, there were only about 25000 dead U.S. soldiers and it was clear that we were in the wrong place at the wrong time. It took more than another 25,000 to get people to wake up. In healthcare we have more than four Vietnams of medical error every year. That doesn’t count lives that would be saved without systematic suppression of innovation.