A Terrible Awakening
I awoke at 2:30 AM last Thursday morning to the sound of coughing, gasping, and crying. My oldest child Benjamin (four years old) had been fighting a cold all week, so coughs in the middle of the night were nothing new – but from the outset, it was clear that this coughing fit was different. This one had a sense of urgency to it. My wife and I both got up to come to Ben’s aid.
We held Ben. We encouraged him to relax and to catch his breath. He settled somewhat, but there was still something wrong with his breathing. It was raspy and labored. Of the many ails we’ve tended to since becoming parents, this was the first time that one of our children was having a difficult time breathing. Needless to say, it scared the hell out of us. I got dressed.
By 2:45 AM, I was backing my car out of the garage with Ben in the back seat. My wife stayed home to be with our other son (Kedrick, 18 months old) – who was thankfully still asleep in his crib – but Benjamin and I were on our way to the emergency room. I hated all 15 minutes of that drive. Ben was in a reasonably cheerful mood, but his breathing remained labored for reasons unknown. I prayed for his safety as I sped down the highway.
We arrived at the ER around 3:00 AM. As soon as we set foot inside the doors, I immediately felt some relief. We’re in the right place. People here can help my son. But what was ahead for Ben? Why was he laboring to breathe? How serious was his problem? What treatment would he require? How quickly would his condition improve? My parental anxiety was still swinging in full force.
Thankfully, there was no line to meet with the intake nurse. We sat right down with her and gave her our basic information. She directed us to a triage room for initial analysis. After a few more questions and a little prodding and poking, the nurse admitted us into the ER for treatment.
We were led to another room. I sat down in a chair, and Benjamin – still in his PJs, wrapped up in a fleece puppy blanket we brought from home – sat in my lap. Less than a minute later, a physician’s assistant came into the room and took a seat on the bed next to us. Hands folded, cool, calm, and collected, he gave us an immediate diagnosis: Benjamin had croup, “an infection of the upper airway, which obstructs breathing and causes a characteristic barking cough.” And he had an action plan to bring Ben some serious relief.
Benjamin would first receive a dose of ibuprofen to bring down the slight fever he was running. Second, he’d be given Decadron, a dexamethasone steroid “used to treat severe inflammation” that would be mixed with grape juice to make it easy for Ben to ingest. Third, Ben would be given Micronefrin, an epinephrine which “works by relaxing muscles in the airways to improve breathing.” He’d receive the Micronefrin by means of a nebulizer, which would turn the liquid Micronefrin into a breathable mist.
If the action plan worked as expected, Ben would enjoy relief within 10 minutes after starting this treatment, and we’d be on our way home in about an hour. Relief hardly begins to describe the depth of my emotion upon hearing his words.
Treatment went exactly as planned. Benjamin was back to his normal self in almost no time at all. We left the ER a little after 4:30 AM and were each back in bed – exhausted but relieved by our emergency adventure – by 5:15 AM. Benjamin slept in until 9:00 AM, and given the circumstance, I was unashamed to do the same.
Reaping the Fruits of Liberty at the E.R.
As I reflected on the entire ordeal during the day on Thursday, I realized just how fortunate my family was live in the time and nation in which we do. Healthcare and health insurance aren’t perfect in America – and debates about how to improve our systems will rightfully continue – but no matter where you stand on particular proposals, let us all resolve to agree on at least one thing: liberty in the healthcare industry should be strengthened and embraced. It clearly improves our well-being as patients and rewards those who develop ways to make our lives better.Liberty in the healthcare industry should be strengthened and embraced. Click To Tweet
Just consider these three ways in which liberty positively impacted my family’s experience last week:
1. Improved Methods to Treat Croup
Croup has been treated in different ways throughout history. Back in the 1960’s, croup was treated by placing children in “croupettes” – small, intimidating, clear plastic tents – which were then filled with a cold mist. Yikes. And in extreme cases, a tracheotomy might be performed because “the art of [tracheal] intubation had not yet been mastered.” Double yikes!
But a question arose: did the croupettes work? Liberty incentivized and empowered interested parties in the free marketplace to test the effectiveness of the tents. Two studies “failed to show the benefit” of the tents, so their use diminished.
New ideas continued to be evaluated. In the 1970s, emergency rooms began exercising liberty to evaluate the use of nebulized epinephrines (like the Micronefrin my son received) to treat croup. Emergency rooms found such treatment to “be helpful in preventing hospital admissions” resulting from croup – and the effective practice spread voluntarily throughout the healthcare industry.
Interested parties in the healthcare industry further exercised liberty to put the use of steroids (like the Decadron my son received) to the test for the treatment of croup. Were steroids effective? How were they most effectively delivered? Which steroid(s) were most effective? All of these questions were evaluated because economic liberty incentivizes interested parties to evaluate them – both morally and financially – to the great benefit of suppliers and patients alike.
As is seen in the history of croup treatment, liberty in the healthcare industry incentivizes and empowers its members to develop best practices organically. And that’s really important. You can’t make good determinations in any industry – let alone in an industry as important as healthcare – from an ivory tower.
If you’re interested in learning more about this particular subject, I discussed the importance of liberty in healthcare innovation with Dr. Peter Clagnaz in May of 2016. Listen to our conversation here!Liberty in the healthcare industry incentivizes and empowers its members to develop best practices organically. Click To Tweet
2. Development of Medications and Technology
As I mentioned, my son received three drugs last week to treat his croup: ibuprofen, Decadron, and and Micronefrin. These drugs didn’t just magically appear in this world. They were developed by people who embraced individual liberty to study new ideas and economic liberty to develop new products for marketplace introduction.
Ibuprofen was patented in 1962 after ten years of testing, experimentation, failure, and disappointment. Its creator, Dr. Stewart Adams, knew he was on the right path when his developing product “cured his hangover ahead of an important speech.” Today, it’s one of the most popular painkillers in the world.
Decadron was approved by the Food and Drug Administration in 1958. At the time of its approval, the drug was produced by Merck & Company. Today, multiple companies offer the same drug (dexamethasone) under different brand names, including Ozurdex, Maxidex, and Baycadron. (Bonus economic lesson: this marketplace competition keeps the price of dexamethason low!)
Micronefrin is a brand of epinephrine (also known as adrenaline) which is manufactured by Bird Medical. Adrenaline is, of course, found in the natural world – but that doesn’t mean that Micronefrin “magically appeared” in this world. Scientists around the world began to study adrenaline in the late 1890s and early 1900s. These scientists’ efforts were paired with drug manufacturers’ efforts to bring epinephrine to the marketplace. The drug “was once prepared using adrenal glands of animals, but is now produced synthetically” – all thanks to the power of liberty.
And, of course, my son’s Micronefrin was administered by means of a nebulizer – a piece of technology thousands of years in the making. Ancient Indians, Egyptians, and Greeks all experimented with inhaled therapies. Modern nebulizers exist because individuals have exercised their liberty for centuries to explore and improve nebulization science and technology.
Other examples of the beneficial technology which surrounded my son and me in the ER last week are too numerous to list in full. Computers, software, monitoring and examination devices, textile materials developed for the medical industry – heck, electricity, light bulbs, even the cleaning solution used to mop the floors and keep the place sanitary – the list goes on and on! Literally every product seen in that ER was developed by humans who exercised their liberty to explore ideas and develop new goods. And my family directly benefited from it all last week.
3. Available Doctors, Physician’s Assistants, Nurses, and Support Staff
Finally, not to be overlooked were all the persons working in the ER last week. Doctors, physician’s assistants, nurses, and support staff all exercised their individual liberty to pursue their careers. Each of those wonderful people working in the ER last week (presumably) have a passion for helping others in need, and they chose to exercise their individual liberty to turn that passion into a career. They are “doing their thing” in life!
But surely it’s not all coming up roses for them. All those persons working in the ER that night made sacrifices to be there. Each of them invested significant time, energy, and resources to pursue education. Some spent years of their life pursuing highly advanced degrees. Each of them was working third shift. Clearly, each of them could have pursued an easier, more luxurious career path – yet each of them chose to work in that ER, and subsequently to provide my family help exactly when my family needed it. Rightfully, each one of those persons will be compensated for their choices and sacrifices. They provided great value to my family last week, and we are happy to provide great value (i.e. money!) in return. Such is the ethical nature of economic liberty: value is traded for value in the free marketplace.Such is the ethical nature of economic liberty: value is traded for value in the free marketplace. Click To Tweet
Striking A Balance
As Milton and Rose Friedman beautifully identify in their book Free to Choose, there are two ways to organize society: voluntary cooperation and command. In simplest terms, voluntary cooperation is liberty; command is government. All societies embrace some of both methods for social organization. The amount of freedom enjoyed by a society is determined only by the balance struck between the two.
So what is the “perfect balance” to strike in the healthcare and health insurance industries in America? I don’t know. But I do know this: my family’s personal experience at the emergency room last week says that a balance struck in favor of liberty is the right thing to do in American healthcare.
In what ways has liberty served you and your family well in the healthcare industry? Has it failed you elsewhere in the industry? Please share your thoughts in the comments below!