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June 24, 2012 - Freedomain Radio - Stefan Molyneux
44:43
2167 A Doctor's View of Obamacare

Mary J. Ruwart, Ph.D. is a former pharmaceutical research scientist and Assistant Professor of Surgery. She has worked extensively with the disadvantaged in low-income housing and was a contender for the 1992 Libertarian Party Vice-Presidential nomination.

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Well, hello everybody.
It's DeFan Molyneux from Free Domain Radio.
I am enormously honored to have Dr.
Mary Ruart on the line.
Thank you so much for taking the time this morning.
I'm glad to be here.
So, like all, I suppose, free market fans of healthcare, your heart must have sank a little bit with the ruling late last week from the Supreme Court on Obamacare.
I wonder if you could talk a little bit about your reactions and your thoughts about this rather Not exactly stunning U-turn, but a very significant change in course in US healthcare.
Yes, it is devastating.
In so many ways, I hardly know where to start.
I guess the only part of the healthcare that really struck down was the Punishment to states if they didn't expand their Medicaid program as the government wanted them to do.
Originally, the way the bill read was that if a state was not going to expand their Medicaid program, they'd lose all Medicaid funding, which for some states, that's like 10% of their budget.
So they struck that down.
But everything else was upheld by a five to four vote.
Incredible and scary was that it's legitimate for Congress to tax us if we don't buy something that they want us to buy.
You know, in the original bill, there was a penalty if you did not buy health insurance.
And this penalty is in the neighborhood of $700 per person, or up to about 60% of the health care premium.
Whether those numbers will hold in the actual implementation of the program, I don't know.
But that was kind of where it was at.
And this individual mandate really was put in there because I think of all the things that libertarians did to kill Clinton care and libertarians did kill Clinton care.
I was involved in doing that and about 80% of the people who were against it and who convinced the American public it was a bad idea were libertarians.
I recognize their names.
And so this was put in to pacify people and tell them that they could keep their old health insurance And they're doctors, but it's kind of a red herring.
And it was the thing that almost undid Obamacare.
However, even though it's called a penalty in the Obamacare Act, or what they call the Affordable Protection Act, the APA, it actually was interpreted as a tax by the Supreme Court because that was the only way they could get it to be constitutional.
And isn't it bizarre to think that you can get a tax, normally a tax is on something that you buy, but a tax on economic inactivity is like, you know, you go to a gas station and they say, do you want gum with that?
And you say, no, I don't want any gum right now.
And they say, well, here's the tax on the gum.
And it's like, but I didn't buy, it's a very, very bizarre, I mean, even by legal standards, which are bizarre enough, it's a very bizarre interpretation.
That's right.
In fact, it's so bizarre that I'm not sure it can't be challenged, even though it was the Supreme Court.
It'll be interesting to see what happens.
The bad news about all this, of course, is that it's going to really penalize young people and old people.
It's going to penalize the young people because the insurance companies are forbidden to use Past medical history is a way of pricing the insurance.
So they have to take basically all comers.
They can price it based on age and tobacco use, for example, and the community that you live in, but they can't, you know, if you have diabetes, for example, you can't be excluded from And you can't be charged more.
So what this is going to mean is that I think private insurance is going to probably double in cost when this is fully implemented in 2014.
And what that will mean is that young people especially are going to be hurt because a lot of young people would buy health insurance if it was affordable.
But when it gets to be very pricey for them, it doesn't make a lot of sense because statistically they are going to need it.
Well, it's also struck me as well that one of the great things about insurance when it is sensitive to health habits, in other words, if premiums can rise based upon poor health habits, What it provides you is a very early warning system as to your future expected health.
So if you're eating too much, if you're not exercising, then your premiums will rise.
And that's a price market mechanism to say, look, you are engaging in unhealthy behaviors.
If that is artificially suppressed, then it relies on people's long-term thoughts about their health in 30 years versus their immediate pleasures of today, which is not a very reliable way of helping people guide their health choices.
Well, that's right.
And what's happening to the young people is they're either going to pay a $700-plus tax or they're going to buy health insurance at these inflated prices.
And of course, it's going to mean fewer employers are going to offer health insurance or the employees are going to have to pick up the bill.
And it's going to hurt the elderly, especially because, as you know, in this country, once you turn 65, you're basically forced into Medicare because there aren't private insurers who will Who will take you on at that age.
They've been driven out of business by Medicare.
So Medicare is going to be cut back.
Payments to hospitals are going to be cut back over the next 10 years.
And there's already quite a few doctors who won't take Medicare patients or do so sort of as their charity Part of their practice because they don't really get fully reimbursed.
So now, if hospitals are going to lose some reimbursement on Medicare patients, and they're already losing money on these patients as it is, there's going to be a lot of disincentive to give the elderly surgery and other things that happen in a hospital setting.
It's going to get to the point where the doctors say, well look, you're 75 years old, you might want to just put your affairs in order and not go through all this chemo or not go through all this surgery that you might extend your life for a few months or a year or two.
So there's going to be a lot of incentive on doctors to not recommend treatments that are common today for the elderly.
Or bypass surgery, for example.
And there's actually going to be, according to the Act, there's going to be boards that look at the efficiency of such treatments for different age groups.
And there's definitely language in there suggesting that a doctor could be penalized for recommending For example, cardiac bypass surgery for an elderly person who might, you know, might keep them alive for another 10 years, but because they're retired, they aren't considered as valuable to society.
So this has already started.
Oregon actually had a plan to do that, and it created so much backlash that I think they withdrew it.
In England, at the moment, under the National Health Service, recent reports have come out in The Guardian that suggest Quite statistically significantly that over 100,000 elderly people are allowed to die in hospitals simply because the doctors do not feel that the resources are worthwhile to treat them.
Oh, that's right.
There is no way to outstrip economic reality if you're not going to ration based on price and based on charity and based on the kindness of strangers, then you're going to end up rationing based upon governmental decree, and that is something you really can't appeal.
Well, that's right.
And I know the statistics on Canada and Britain are very poor in that respect.
You know, even kidney dialysis, which is a life-saving treatment, is denied frequently to British patients over 55 and can't.
So I believe that the Medicare patients, as opposed to the Medicaid patients who are the indigent, the Medicare patients are going to be basically sidelined by the medical profession.
And, you know, The elderly just are not going to get good care.
Now the Medicaid patients, the ones that we think of as indigent, they're going to actually increase in number because now That program's going to be expanded to include single adults who make 133 percent or less of the poverty line income.
And in most states, this isn't happening.
You know, usually if it's an adult, it's adult-dependent children that are helped.
So the Medicaid program is going to greatly increase.
Even worse than Medicare.
There are many, many doctors who simply refuse to take Medicaid patients.
And this is going to just continue.
So these patients, they can't get in to see their doctor.
So what they do is they go to the emergency room so they can get treatment.
And that's much more expensive and I don't think it's an exaggeration to say that that will also cost lives because when the emergency room is clogged up, that creates significant wait times for people who may have more subtle injuries.
You know, they're not holding their arm in their other arm, but you know, they've got some internal injury that's not so obvious, but they don't get seen because it's clogged.
Right, right.
So what we're going to do is have a lot less quality medical care.
We're going to be paying a lot more for it, too, because obviously the same thing happened in Massachusetts with RomneyCare.
Even though in Massachusetts they have the highest per capita ratio of doctors per patients, the waiting time to get in to see your doctor is longer.
So that's what we all can expect is to take longer and longer to see a physician, pay more one way or the other.
Because it's going to be increased private premiums.
It's going to be less Medicare, so the elderly better have enough money to go overseas or to Canada or Mexico to get help if they really need it.
The young people are going to be penalized because they're going to have to either buy insurance At a very high rate or they're going to get this extra tax.
So it's just going to be a nightmare.
And because it's going to be so bureaucratically regulated in terms of what a doctor can offer his patient, there's going to be a lot less people who are willing to go into the medical profession.
In fact, there's already been some doctors who have retired, you know, in expectation that this is coming and they just don't want to Practice medicine that way.
So we've got a lot of things working against us.
This also means there'll be less innovation in healthcare.
There won't be room for it.
There won't be a place to do it because everything's going to be so highly regulated that it won't be easy for doctors to pioneer new techniques or new ideas.
In fact, it could become criminalized to some extent, since if a new Actis is not on the list of accepted treatments and you offer your patient a treatment that's not on the accepted list, you as a doctor could go to jail.
So it's very punishing and it's a worldwide problem because the US is truly the place where most of the medical innovation takes place.
So if we are shut down, if we are Put in a position where we are not innovating anymore.
It reflects out into the whole world.
They can't copy techniques that we don't have.
It's also, I think, quite tragic.
And this is a long-term problem that a lot of people don't seem to recognize.
I think most doctors that I've ever met and talked to, they go into the profession.
I mean, of course, they want to make money and we all got to live, but they genuinely want to help people.
And of course, prior to the rise of government-controlled, regulated, and managed health care, Doctors regularly gave pro bono work.
They regularly took chickens in return for treatment.
How many doctors, when somebody comes in coughing up half a lung, are going to sit there and say, well, you don't have enough cash on you, so go back out on the street.
They're not going to say that.
They're going to find ways to make it work.
But the more that we control doctors through the power of the state, the more that we force them to bend under ever-crippling regulations, the more we treat them as greedy, selfish, mean people who require the compulsion of the state to treat the poor and those who You know, are otherwise indisposed to pay.
I think the more that you destroy their incentive, you destroy their goodwill, you create a sort of win-lose scenario where doctors become a lot more guarded, they're a lot less trusted, they're a lot less respected.
That's a very soft effect, but I think it's going to have quite a strong effect in the long run.
Well, yes.
In fact, every time, like when Canada and Britain implemented their universal healthcare program, which is essentially what this is going to be, because it is going to drive out the private insurers.
What has happened both times is we've had a great influx of doctors from those countries and other healthcare workers who have decided they aren't going to work under that system and they come to us instead.
Well, of course, now there's really nowhere for them to go, although I'm going to guess that many of them may end up in India or in Canada or in Mexico.
As part of offering their services to medical tourists from the U.S. who need to, for example, the elderly who aren't going to get care in the U.S. anymore.
And that's very sad.
And I wanted to talk a little bit about this idea that the private insurers are going to be driven out of business because if they can't charge, what's going to happen?
They have to charge these huge premiums because they have to accept everyone.
On the other side of that coin, this Affordable Health Care Act, and it's kind of a joke because I say affordable and it's just driving prices up, so it's encouraging states to set up these exchanges where they get subsidies to help out people who still can't afford the private insurance.
So what's going to end up happening is you've got the Hello?
Can you hear me?
Oh, hi.
Sorry about that.
Yep.
I'm not sure what happened.
Okay.
Good.
We had some sort of exciting technical hiccup, but we're fine.
It's never good.
You know, it's never a full home production if you don't have at least one of those.
That's right.
That's right.
The concerns that you had about young people not being able to pay and...
Well, I think we finished the lack of innovation and we were talking about concerns that you had over young people not being able to pay for healthcare insurance.
Yes, well, I don't remember quite where we were on that.
We got cut off, but everybody's basically going to suffer on this because the only way that...
This very expensive program can be put into place is either more taxes, which will be done in part on the young people as they pay the tax instead of Getting health insurance.
And also, it'll be inflation.
So again, the elderly are going to be hurt because many of them are on fixed income.
So while they're forced to go out of the country if they want treatment, they will also find that their dollar is worth less.
So it's really going to be a total disaster for the Supreme Court decision came out because it reacted accordingly.
It knew it was bad for the economy.
The only silver lining in this whole thing in my mind is that there's enough opposition for this.
It's conceivable that It will be morphed into something that is more acceptable.
Although, on the downside, once again, had the Supreme Court thrown this whole thing out and said, no, there's just too much in here.
Try again.
Congress might have been able to go back and put something a little better together.
Now they've got this Affordable Health Care Act that they need to work with.
And that's harder than starting from scratch, in my opinion, because of this bill.
So I don't know.
You know, I just don't know how this is going to come down any way but bad for everybody.
I don't see anybody winning on this at all.
Well, unfortunately, there will be some very entrenched special interests who will win, and there will also be some congressmen and women who will get re-elected based upon false promises that they can't fulfill.
And I just wanted to mention this pre-existing condition is something that I think all decent men and women are concerned about it.
I mean, let's say somebody made, they either have some genetic problem or they've just made bad life choices and they now have diabetes.
Okay, so the fact that they've made bad life choices I don't think should be a reason to deny them treatment.
Of course, you know, they're human beings and compassion and so on.
But I think what people don't really understand about healthcare, because they separate it from all other kinds of insurance.
I mean, if you could buy fire insurance for your house after your house had burned down to the ground, everyone would understand that that system could never conceivably work.
But the whole point of insurance, like life insurance, I remember I started buying it when I was about 22 or 23, and it was dirt cheap, because I was very young and healthy, and I put a little bit of extra in.
So by the time I was in my, I think, late 30s, It was paying for itself because they invested a little bit of what I paid in and so on.
So it was really not expensive at all for me to buy this stuff when I was young.
And of course the purpose of health insurance is you're supposed to get access to it when it's cheap when you're young and then it's supposed to pay for itself through investments as you get older.
So the problem is because you suddenly put this law in which that you can't stop people with pre-existing conditions They have to put that cost somewhere.
And the easiest place to put it is on the young because the young are going to protest less about losing health care insurance because of increased prices relative to the aged.
So I just really wanted to point out that the solution to this is not, well, let's deny people with pre-existing conditions, but to have a free market system where there's a very strong incentive to get people in when it's as cheap as possible and have it pay for itself as you age.
Oh yes, by all means.
In fact, if you think about how this would work in a free market, you know, a young family would have health insurance for their children, and then as the children matured, they would probably continue whatever plan that was,
and if it was accompanied by some type of savings plan, you know, that would be portable wherever they went, whichever employer they went to, that would be a really great It would be the standard.
Just as today, the standard is tipping in a restaurant, even though no one forces us to do it.
The standard would be getting your health care at an early age and keeping it and having it be portable.
And that's something that we can't do today, partly because we get it through our employer oftentimes.
And also, when you move from state to state, the insurance companies cannot necessarily Keep you, so to speak.
Because even like Blue Cross and Blue Shield, which is national, is different in every state.
So different states have different rules.
And it's not easy to cross those state lines, although some insurers are making it a little bit easier than it used to be.
So that's all going to change under Obama.
Right.
And another thing, too, is that I don't think people realize quite as much that...
When you have a free market insurance I think people don't realize that when you have free market insurance you also get free education because most people would buy health insurance for their children before they started to try and have children because you don't want to be trying to get health insurance for a child who's born with some sort of birth defect Exactly.
And so insurance companies would want to make sure that as few as children as possible would be born with birth defects so there would be lots of material and calls and screens and all of that to try and make sure that people did whatever they could to minimize the chance of these.
So there's a massive amount of free education that is put in place which is not the case when you get Medicare and Medicaid because they make money off treatment even more so than cure.
Whereas insurance companies make money off you being healthy, and that's what they're really going to strive to do.
So there's a huge incentive for education, for making sure you go and get your checkups and all of that, which is in the free market system, which is becoming less and less the case in the government system.
Well, and that brings me to another point.
The system that we have now is actually very highly regulated.
I'll say the healthcare industry is probably the most highly regulated already before even Obamacare.
And because of that, there's been a shift from prevention to treatment.
And I think we should talk about this a little bit as a better way.
You know, what could we do, given that healthcare is getting less affordable as time goes on?
And I think that would be of interest to our audience here.
I agree.
Because only people in the profession are really aware.
And that is that the high cost of health insurance we have now is not due to greedy doctors and greedy pharmaceutical companies, greedy insurance companies, but it's due to the fact that we have all these regulations that make it very, very difficult To have affordable health care.
And of course, as you know, I was in the pharmaceutical field for a long time.
And in 1962, regulations were passed that dramatically changed the industry.
And it took about 30...
...amendments were blank checked for the FDA. Keep adding things.
And I was able to calculate that about 80% of the cost of our pharmaceuticals are due to regulations that harm us instead of help us.
And the way they harm us is they require so much testing that the time to take a A product from the lab bench to the marketplace has grown from 5 to 15 years.
So that means if you're an AIDS patient or a cancer patient and you want to get the latest treatment, you've got to wait 15 years to do it.
And these people don't have enough time, which is why cancer patients sued the FDA to be allowed to buy drugs that were in human testing, human safety testing, but had To save our own lives by taking a drug that is not FDA approved.
Now, I could We'll go on and on, and I am actually writing a book about this because it's so involved.
But basically, because of the way the FDA is operating, it's very difficult for, like, nutritional companies to go to the doctors and say, hey, do you know that fish oil will, you know, help your cardiovascular patients and it helps this and this and this way?
So what ends up happening is one company jumped through these hoops that the FDA puts in place.
So that they could get prescription fish oil.
So they could talk to doctors legally.
And the copay that you have for fish oil, which is virtually identical to what Walmart has, is as much as you would buy it for at Walmart.
So your copay is one thing, and then of course the The insurance company is paying four or five times that much for this prescription, simply because unless you jump through all the FDA hoops, they will not let pharmaceutical or nutritional companies talk to doctors about the merits of vitamins and minerals and proteins and the prevention of And you actually talked,
I think, quite powerfully about the folic acid controversy, which caused a huge number of birth defects because of the amount of regulatory holdup for a treatment or a preventative measure that was well proven and understood in every other country.
That's right.
Well, in the 80s, we knew that folic acid prevented birth defects.
It's a B vitamin, so it can't be patented.
It's common.
And any pharmaceutical company that tried to make the claim or a nutritional company that tried to make that claim would be shut down by the FDA because the FDA says if you don't jump through our hoops, which on the average cost about $500 to $600 million out of pocket, You can't say these things.
No one's going to do it for folic acid because it would go generic the first day it came out.
And who's got 15 years to spend doing that?
You know, many young children were born with spina bifida and really terrible birth defects for which they have to be institutionalized because the FDA would not allow them, not allow the folic acid manufacturers to talk about this.
Even though we knew about it in the 80s, it wasn't until the 90s.
And the Center for Disease Control, another government agency, was talking about this already.
I mean, it was, the cat was out of the bag.
They might as well let the companies talk about it, but no.
There are many, many instances like this and many drugs that never make it to market that could save lives because it's actually much harder to bring a new drug to market where you You know, it's the first cure of its kind because you don't know how to test it, and you might have to retest a number of times to satisfy the FDA's statistical requirements.
And if you have to do that, your patent's gone by the time you get it to market.
So it's generic.
The first day, you never recover your costs.
There's a lot of disincentive for prevention and treatment that actually works in diseases where we've never had treatment before.
And yet, strangely enough, psychotropic drugs seem to sail through, and you get antipsychotics given to three-year-old children, way off-label, and this all seems to work fine.
It's just the stuff that can actually prevent birth defects that seems to get held up.
Sorry, this is one of my bugaboos, because I just think this stuff is unholy for kids, and this is the perverse system that we have.
That's right.
Well, and see, again, you can trace it all back to the FDA and these 62 amendments, because if you think about it from the drug manufacturer's point of view, they have to put, because there's so much risk, they're going to put all this money into developing a drug and at the last minute the FDA can say no.
So first of all, they have to consolidate.
You know, the companies are merging because they can't take this big hit.
And then to make their money back, It's very hard to do it by just curing something by a single treatment.
The only thing that really makes sense from a financial standpoint is a drug that people will take for their whole lifetimes and something that people are motivated to take.
Let's face it, a lot of people are depressed these days, largely because of government regulation screwing up their life.
They might not even be aware of how it's doing it.
And so antidepressants are, for the pharmaceutical companies, one of the few things they can count on.
They know they're going to sell these things because people are depressed.
They're scared.
Life is tough, so they want these drugs to make them feel better.
And since they've outlawed all of the other mind-altering drugs, these are just basically a milder version.
Right.
So if anyone did come up with a one pill cure for depression, which I'm not saying is possible, that would be much less financially interesting to them because what they try and sell these drugs as is like insulin for diabetes is something you have to be on for the rest of your life.
So it's quite a cash cow.
Now you've talked a lot about the head count and I'd really like to make sure that...
My audience hears this very clearly because, you know, when I mention it, I'm just some idiot on the internet who doesn't know what he's talking about, which is actually probably a fair criticism, but you've done some, I think, very powerful analysis on the, frankly, the death count of the FDA, which is not something you're going to hear about a lot of the mainstream media, but I think it's really important information to get across.
I wonder if you could talk a little bit about your methodology and the numbers that came out of it.
Sure, sure.
Well, as I said earlier, the 1962 amendments We've extended the time it takes to get from the lab bench to the marketplace from 5 to 15 years.
So right there, there's an added 10 years of waiting.
Now, for the drugs that are currently on the market, we have an idea of an estimate, shall we say, of how many lives they save.
And we know which decade they came out in.
And of course, this increase to 15 years has been gradually increasing over time.
You can calculate for each decade what the amendments added to the development time and then Look at the drugs that came out during that period.
You can calculate how many people died waiting for these life-saving drugs.
And so if you take it from 62 to, I think it was 2002, a 40-year period, what you find is that there's about 4.7 million people that died prematurely waiting for these drugs.
And that's the small number.
Because you can also determine, and I haven't, I'm just using other published studies to do this and putting them together.
So it's not even my estimates.
I'm just doing the math that follows from these estimates.
And we know That innovation has been stifled by these regulations at least 50%, probably more like 75%, but let's just take the more conservative number, 50%.
And when we calculate the loss of lives due to loss of innovation, even if we decide that the Drugs that were lost were only 25% as effective as the ones we have today, then we'd have another 4 million people dying, and if they were as effective, it's 20 million.
Okay, so now we've got somewhere between 4.7 and 24.7 million people who have died since 1962 prematurely because of these amendments, and I haven't even gotten started.
Because the big number is actually very difficult to calculate.
And that's the one that talks about the difference between what we would have prevention-wise if the amendments had never been passed and what we have now.
And that number is huge.
It's probably bigger than the other numbers I've talked about so far.
If you look at this, what you also recognize is that when a pharmacist...
Sorry, I just want to make sure I understand that last part, when you talk about what would be there in terms of prevention rather than treatment.
I think I get it, but I'm not sure that I do.
If you could just break it down a little more.
Sure, sure.
I'd be happy to.
Well, we talked about, for example...
Folic acid and how it could have prevented birth defects.
Now, it's well known now.
So now it's kind of, you know, happening.
That's good.
So that's just a delay.
But, you know, I was involved in research, for example, on prostaglandins and liver disease.
And the FDA actually called me up and said, oh, we're so happy you've got this patent.
We're going to help you get this on the market because there's nothing for liver disease.
We're so excited.
So I was pretty excited, too, but I was naive at the time.
What I didn't realize is that even though the FDA was very favorably disposed towards this, because it was a new cure, as I talked about earlier, we didn't know how much compound we'd need to treat.
We didn't know how often we'd have to treat or how many years we'd have to treat because liver disease is a chronic disease.
We weren't sure which parameters we should look at in terms of blood parameters or something that would tell us If we were actually curing these people, because we didn't want to take a piece of their liver every time to look.
And by the time we did this study, which would take several years, if we had to repeat it because it didn't give us the statistical significance that the FDA wanted, the drug would be off patent, would go generic the first day of marketing, and we wouldn't recover our development costs.
So the company made a business decision not to develop it.
And this happens a lot.
So this is one of those things that, you know, we could have something innovation-wise that would help people.
And as far as prevention, you know, and I guess I kind of got off track there because this is innovation, not prevention.
But, you know, at Upjohn, what we did, the research scientists didn't drink, didn't smoke, kept our weight down.
We took lots of vitamins.
The MDs, on the other hand, smoke and drank and were overweight.
What was the difference?
Well, the way we induced disease in our animals back then in order to do the drug testing, There was only one way we could do it, for the most part, because we didn't have genetic tools back then.
We took away their vitamins.
So what this told us was, ah, you know, vitamins keep you healthy.
And so many diseases, cardiovascular disease, diabetes, you know, things like these are all related to nutritional status.
So if we were able to take what we know About vitamins from animal studies and apply it to people and talk to doctors frankly about this.
We would be way ahead in terms of prevention.
And cheaply.
And very cheaply as well, of course.
That's probably one of the reasons why.
Vitamins are cheap, you know.
Okay, so let me just play devil's advocate position and say, okay, but you're only looking at one side of the equation, Dr.
Ruart.
You're only looking at the lives that could have been saved by the earlier introduction of treatment.
But what about the lives that have been saved by the FDA withholding all of these nasty drugs that would have killed people from the market, where the unscrupulous companies would have dumped their toxins into people's bodies in a pseudo-cure and blah, blah, blah.
Well, you can actually calculate that, too, because we know what the...
The rate of withdrawal of new drugs was, and the side effect rate was, before the amendments passed.
And we can compare it to after the amendments, and we can project what would have happened if things had stayed the same.
And the number of people there, compared to these millions whose lives were shortened, was in the area of thousands.
And I'm talking probably under 10,000.
You know, it's very small.
There weren't that many problems, and the problems that we did have back before the 62 amendments were problems, for the most part, of our state of knowledge.
For example, thalidomide is a very popular case.
It was probably the biggest drug tragedy that there was before 62.
And this was a sleeping pill that People took, and it was a safer one than the barbiturates, which caused a lot of overdose deaths.
But women found out by using it that they could prevent morning sickness, so they were using it for that.
And that caused deformities in the children, loss of limbs.
Well, this only shows up in primates, you know, monkeys and people, basically, and one strain of rabbits.
So, you know, our state of knowledge at that time, first of all, we weren't as aware as we are now how sensitive the fetus is to drugs.
And we also weren't aware how to test it, you know, because we didn't know that if we did the experiment in rats that it wouldn't say what happened in humans.
So, you know, this was not an expected side effect.
And this is how most side effects are even today.
Now, there are exceptions to this.
And it's...
It's scary because one of the things that's happened, I believe, is that pharmaceutical companies are now putting out less safe drugs.
And the reason that they are is that if they have an old drug and they find a new use for it, they have to go through so much rigmarole with the FDA to be able to tell doctors, hey,
this also works for X. That it's smarter sometimes to start all over with a slightly different chemical and to develop that because then they get the market exclusivity and they can recover their development costs.
And they get a new patent, right?
Yes, but the downside of that is we don't know what side effects this new chemical will have.
We know the side effects of the old drug, right?
So, oftentimes we are introducing a less safe drug into the system, but we don't see it until it's already out there in the market because the clinical trials that are done have small numbers of people.
So, you know, if there's small genetic differences in how people react, you don't necessarily see it in the development phase.
So, you don't see it until it's out on the market and people are hurt.
Right.
Right.
So, I mean, I think it's, I mean, obviously the US, it's either going to go socialized medicine, which is what is going to happen without intervention, because the economic laws of expanding government power seem to be, you know, unless you throw a huge amount of moral and intellectual weight against them, they seem to be just like dominoes, you know, more regulation leads to more regulation.
Yes.
The price of this is going to go up and the government has a handy scapegoat and the insurance companies to say, well, it's these people who are charging more.
They're the greedy capitalists.
Let's eliminate them and everything will be free and rainbows will lick all of our wounds better and we will be flown off to magical fairy hospitals on the wings of government-sponsored unicorns and there will be all this wonderful stuff that will happen if we just get rid of these greedy capitalists.
But I love me some greedy capitalists.
I just love people who are going to make a lot of money off me being healthy.
Because right now, the system doesn't even make, and this is true of Canada as well, it doesn't make money off me being healthy and it doesn't make money off me being cured.
It makes money off treatment.
And that really is the worst conceivable system that you could come up with.
In other words, it's a government system.
So, I think it really is incumbent upon us, you know, as thinkers, as people who care passionately about the future health and productivity of the planet, just to remind people that it is the force of the state that causes all of this mess.
There is no such thing as perfection in a state of freedom, but there's nothing that comes even close to it in a state of compulsion.
And we've gotten so used to this idea that healthcare costs are hugely problematic and they just go up and up and up.
Which is different from every other technological field that we can deal with.
It's different from veterinarian treatment here in Canada.
You can get an MRI for your golden retriever the same day.
The same day!
But you have to wait months to get one for somebody as inconsequential as, say, a human being.
In eye surgery, like LASIK eye surgery, the price keeps going down because it's largely not controlled by the state.
And there's so many other examples.
Computers, just think of how incredible computers have gotten over the last 40 years, where you see this kind of bloating, this kind of inefficiency, this kind of increased costs, and this continually reapplied political quote solution.
I just really urge people to look towards where the compulsion lies in the system, where the government control lies in the system.
That's my minor little rant, but I'd like to give you the last word and also to let my listeners know when your book is coming out.
Of course, I'll put your website, maryruart.com.
On the video and on the podcast, but I would love to read this book.
when is this book coming out and what else are you up to over the summer where people can come and chat with you?
Well, the book probably won't be out for at least another year.
It's a very difficult book to write, but if your readers want to learn more about this, I do have a paper that I can send to people and that explains some of what I've talked about today in terms of the FDA and its impact on the pharmaceutical I do have a paper that I can send to people I'm happy to send that out.
I can send it out to you and you can forward it to your listeners if they'd like it.
Also, I have a What's coming out in the next couple months is a new expanded version of Short Answers, which the Advocates is publishing for me or in conjunction with me, depending on how you want to think about that.
So that will be coming out shortly and has some material on health care.
Healing Our World, of course, is my I guess the book right now is my favorite book, and it just won the Lysander Spooner Award.
I'm so delighted.
I believe that all the recipients of the Lysander Spooner Award have to grow a giant ZZ Top beard.
I'm just trying to picture you with that, but I just wanted to point that you may not have read the fine print at the bottom of the recipient's award, but congratulations anyway.
Yes, and I mentioned that because the 93 edition of that book is available as a free download on my website, ruart.com.
And the nice thing about that for your listeners is if they feel like they'd like to learn more about this, another thing that they can do is read chapters five and six of Healing Our World.
My website is ruart.com, R-U-W. ART.com.
They can download that, read it, and if they want the expanded 2003 edition, that's available at my website too.
So just to give them a little more background and food for thought, so to speak.
And I really do want to thank you for the activism and the work that you've done in putting together all of this data, all of these arguments.
I found them invaluable in attempting to convince people of the hidden costs of regulation and to cut through some of the nonsense that people believe about the heavy hand of the state on the living veins of the nation.
So I really, really do want to thank you for all of the work that you're doing.
It's incredibly helpful to me and I'm sure many, many other activists to help to get the word out.
And thank you so much for your time this morning.
Well, you're welcome, Stefan.
I guess I feel very blessed to be in a position to have knowledge that I can share with other activists because it is very difficult.
You know, when we started out in the early 80s, at least that's when I got very active.
In the 70s, I became an objectivist.
But as far as real activism, I didn't do it until the early 80s.
And one of the things, one of the handicaps we had is that we had good theory, but we didn't have...
We didn't have the studies that we have today that really, I think, demonstrate beyond a shadow of a doubt that the compassionate choice is libertarianism.
So I'm just very thrilled to be in a position to share things that help people show the world that this is the way to go.
And I really think the pen is mightier than the sword and knowledge does set you free.
Both literally and figuratively.
So I'm looking forward to a better world.
It may not happen in my lifetime, but I know it's coming.
Well, if you take enough vitamins, I believe it will, because like Methuselah, you will live forever.
So thanks again for your time and have a great morning.
Okay.
Thank you.
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