Regulatory Approaches to Improve the
Dissemination of Medical Innovations
A government, for protecting business only, is but a carcass, and soon fails by its
own corruption and decay. —Amos Bronson Alcott, 1799–1888
There's no trick to being a humorist when you have the whole government working
for you. —Will Rogers, 1879–1935
PITY YOUR poor senators and congressional Representatives. Many of them complain about the FDA's dragging its feet on approving new drugs and devices. They also want to promote business, so they favor policies that are good for drug and device manufacturers. They want jobs in their states and districts, so they eagerly promote the growing biotech industry and the jobs it creates. This leads them, in turn, to support rapid growth at the National Institutes of Health, which generates much of the basic scientific research leading to new products. They push Medicare to approve coverage of new gadgets and treatments more quickly. They want ever more medical innovations, and they want them disseminated ever more rapidly. Good for business, good for medicine, good for votes.
But while they argue for faster development, approval, and coverage of expensive new treatments, they complain that Medicare costs too much. The Medicare budget is rising too fast, and the aging population is rapidly increasing demand. Prescription drug coverage will add enormous expenses, and no one can figure out how to pay for it all. Furthermore, the