Posted 5/7/12 on The Health Affairs Blog
A recent spate of commentaries on the continuing health spending moderation raise an important policy question: If the cost curve is well and truly bent, why are we investing so much of our policy energy on bending it further, when the more pressing problem is the declining percentage of Americans that can afford our health system’s astronomical costs?
Health spending the past two reported years (2009 and 2010) have grown in the high 3 percent range, the lowest growth rates since Dwight Eisenhower’s last year in office (1960), five years before Medicare.Medicare’s actuaries have pointed to the recession as a root cause. Yet even Medicare spending growth has subsided to about 5 percent in 2010, a development hard to attribute to recession since so few Medicare patients have first-dollar cost exposure. This analyst’s extensive industry contacts suggest no spending rebound in 2011 and 2012, despite an aging population and fee-for-service’s pernicious volume-increasing incentives in full force.
Continue reading “Barking Up the Wrong Tree: Affordability, Not Cost Growth, Is The Real Policy Challenge”
Posted 4/06/12 on Managed Care Matters
Rep. Paul Ryan (R WI) and the House Republicans are touting their budget as fiscally responsible and prudent. What Mr Ryan conveniently forgets, or more likely avoids, is this:
Eight short years ago he – and his GOP buddies – passed the single largest entitlement program since Medicare – the Medicare Part D drug benefit – with no dedicated financing, no offsets and no revenue-generators – the entire future cost –which is now around sixteen trillion dollars [see page 148] – simply added to the federal budget deficit.
According to Bruce Bartlett writing in the Fiscal Times, “By 2030, Part D alone will cost taxpayers 1 percent of GDP.”
Continue reading “The GOP Budget, Fiscal Responsibility and Part D”
Brian Klepper and Shannon Brownlee
Published 3/29/12 in the New York Daily News
Obamacare had its days in the Supreme Court this week, and the justices’ decision could have sweeping consequences for the individual mandate provision in the Patient Protection and Affordable Care Act, and maybe even for the fate of the law itself.
Yet whatever the court decides, we will still be stuck with a problem that this contentious law was not likely to solve on its own: an out of control health care industry that threatens the stability of the U.S. economy and the federal government’s ability to deal with our long-term debt.
Continue reading “The Right Rx for Better Health Care: Rise Up to Challenge the Industry’s Lobbying Power”
Posted 3/26/12 on Cracking Health Costs
We’re seeing a trend. The FDA approves a stent without proper testing. Death and complication rates with the new stent increase, the FDA is force to review it.
Remember the controversy over drug eluding stents?
According to an article in the WSJ by Thomas Burton, the so-called Stryker stent…aka the Wingspan device… is increasing rates of death of patients who have received them. Following protocol a panel has been convened. According to the WSJ article, “The FDA had asked the outside panel to advise it on what to do in the wake of a large study last year showing more strokes and deaths in patients with the Wingspan device than among those whose condition was treated using drugs.”
Further, “Researchers in the study concluded the rate of stroke in the patients who got the Wingspan device was ‘substantially higher than the rates previously reported
with the use of the Wingspan stent.’ ”
This is yet another reason for patients to be cautious in agreeing to a stent, and another reason employers need to consider favoring clinics who practise strict evidence-based medicine constructs.
There’s a shift in power in health care moving away from providers and suppliers like pharma and medical device companies, toward patients and payers. This is the new health world according to Ernst & Young‘s latest Progressions report called, The third place: health care everywhere.
What’s underneath this tectonic shift is the need to bend that stubborn cost curve and address public health outcomes through behavior change. E&Y says look for new entrants, like retailers, IT companies, and telecomms, to be part of the solution beyond traditional health care stakeholders. These participants will be part of both delivery of care services and play an ever-important and -growing role in “value mining,” which E&Y defines as the use of data mining to determine the value of health interventions. THINK: comparative effectiveness through a lens of value-for-money and you get the picture.
Continue reading “Superconsumers and Value Mining: Health Care’s Uber-Trends Driving Care, Everywhere”
Posted 3/06/12 on The Doctor Weighs In
This post was inspired by Kathryn Johnson, Western Regional Council Member of MedShare, a friend, and a most wonderful connector of people.
Today, I drove over to San Leandro, California, the San Francisco Bay Area town where I went to high school. I wasn’t there to reminisce, however. I was there to visit one of the most innovative medical charities in the country, MedShare.
MedShare’s Western Region Executive Director, Chuck Haupt welcomed a small group of visitors to MedShare’s 32,000 square foot West Coast facility by framing the need that the charitable organization is meeting. He showed us a video of the birth and death of a baby born to an HIV positive mom in Lesotho (Southern Africa). The baby was born limp and in respiratory distress. In the US, a newborn like this would have been rushed to the neonatal ICU (NICU), intubated, placed on a respirator and then be expertly cared for by a highly trained medical team, with a NICU nurse devoted just to her. This Lesotho baby was rushed to a nurse already caring for seven other sick babies who were receiving oxygen from a jerry-rigged device that allowed oxygen from a single tank to be shared with other babies in distress. This newborn died because there was not enough tubing to share the O2 with an eighth.
Continue reading “MedShare – Recycling Medical Supplies for the Good of the World”
Published 2/16/12 in The Fiscal Times
The drug industry usually defends the high price on drugs – the latest cancer therapies are tipping the scales at $100,000 a year – by pointing to the large sums it spends on research and development. It is true that drug firms spend alarger share of their revenue on R&D than most other industries, typically anywhere from 15 to 20 percent of sales. And Eli Lilly ran a Super Bowl ad claiming the cost of developing a new drug has now risen to more than $1.3 billion.
Continue reading “The Fiction Behind the Cost of New Drugs”