TALKING BACK TO MICHAEL MOORE.

TALKING BACK TO MICHAEL MOORE. The responses to Michael Moore's documentary Sicko have been as swift as may be expected. It was heartening to see the media suddenly combing through all the evidence they had been given. Even Sanjay Gupta accused Moore of fudging his data! I don't remember Gupta showing much critical acumen before.The newest installment to this thoughtful criticism is Paul Howard's op-ed piece in today's Washington Post. Howard presents a defense for the markets in health care. It's slightly unfortunate that the piece begins with a story having to do with the medical choices available for an extremely well-paid professional athlete and his family:

Here's one story you won't see in Moore's film: During the recent NBA playoffs, Derek Fisher, a point guard for the Utah Jazz, discovered that his daughter Tatum, then 10 months old, was diagnosed with a rare form of cancer called retinoblastoma. (There are only 350 annual cases of retinoblastoma in the United States) Left untreated, the cancer grows on the retina until it causes blindness and death. Luckily for Tatum and her family, the U.S. is the global leader in cancer treatment and research.Tatum's story is a microcosm of how the United States is revolutionizing cancer treatment. After her diagnosis, Fisher and his family flew Tatum to the world-renowned Memorial Sloan Kettering Cancer-Center in New York where doctors are testing an experimental procedure that didn't exist even a year ago. At Memorial Sloan, Dr. David Abramson and his colleague Dr. Pierre Gobin enrolled Tatum in a clinical trial where cancer-killing drugs are injected directly into the eye in an attempt to not only kill the tumor, but to save a child's eyesight. After treatment, Tatum's doctors were optimistic that her prognosis is good.

It is wonderful if Tatum's life can be saved, and even more wonderful if her sight can be saved, too. Nobody would argue differently. But many of us wonder if Tatum would have gotten the same care had her parents not had the wealth they do.Howard goes on to reassure us on that point:

Think Tatum's story is one of a kind? Think again. America's commitment to the treatment of patients with rare diseases is unmatched. The Orphan Drug Act, passed by Congress in 1983, gives companies tax incentives and seven years of market exclusivity in return for developing treatments for rare diseases. (The FDA designates "orphan" drugs as those that treat diseases affecting fewer than 200,000 American patients annually.) According to the FDA, in the decade before the act passed there were fewer than 10 products approved for orphan diseases; today, there are over 300.

Mmm. But note that Howard argues that all this points out how well the markets are functioning. Yet it took government intervention, in the form of the Orphan Drug Act, to make the market research drugs for rare diseases. That is not evidence of the benefits of the markets but rather evidence for the need to apply correctives when markets fail to provide certain products.The debate Sicko has provoked is welcome, but it certainly takes some very odd forms.

--J. Goodrich