Bringing Surgical Precision to Public Policy

November 20, 2012
1:15 pm

Following an election that left the White House, the U.S. Senate and U.S. House in the same hands, even the most ardent opponents of the Patient Protection and Affordable Care Act (PPACA) are calling off wholesale efforts to erase the law from the books.  As Congressman Phil Gingrey (R-GA) told The Hill newspaper, “It would be pointless, in my opinion, to have a vote on repeal of PPACA.”

That doesn’t mean, however, that the legislative surgeons should refrain from picking up their scalpels and performing detailed actions to improve the health reform measure.

A good start was explained in an op-ed in Politico, co-written by health industry leaders including C.R. Bard CEO Tim Ring, a member of the Healthcare Leadership Council.  In the op-ed, the authors explain that it is essential for Congress to repeal the scheduled excise tax on medical devices for both economic and healthcare reasons.  The tax is applied to device company revenues, not profits, and thus will be a heavy financial burden that is already having an impact on jobs.  (Stryker, a major manufacturer of joint replacements and other healthcare products, announced this week it will have laid off five percent of its global workforce by the end of 2012)

As Ring and his colleagues point out, though, the tax will also have an adverse impact on medical innovation.  They wrote, “If the device tax goes into effect, the march of medical innovation will be inhibited and patient access to the next generation of medical technology won’t be realized…small businesses often suffer losses in the early years of operation when they are investing in research and development on new products.  Paying a sizeable new tax while incurring traditional startup-driven losses will be more than many small businesses can bear.”

I would go further and suggest that Congress examine all of the taxes and fees being applied to healthcare sectors by PPACA to determine how they can affect the course of medical innovation, the nation’s role as the global leader in medical breakthroughs, and the state of job growth during these fragile economic times.  That re-examination must extend to scheduled provider cuts, particularly if acquisition of health insurance by currently uninsured Americans does not take place at a pace that lawmakers envision.

The war over PPACA’s existence may be largely over.  The effort to improve it hasn’t even gotten well underway.

Dr. Noseworthy’s Invitation

November 14, 2012
10:10 am

Now that the smoke has cleared and the 30-second ads have (thankfully, to many) left the airwaves until the next election cycle, it’s time for policymakers to refocus their attention on the daunting challenges facing our nation — addressing our healthcare system’s cost, quality and sustainability challenges certainly not the least among them.

In that vein, Congress, the President and key players in the Obama Administration would do well to accept an invitation from Mayo Clinic CEO John Noseworthy.

Dr. Noseworthy, the day after the election, publicly invited our nation’s leaders to work with Mayo to address the healthcare problems that he insists, correctly, still remain even with the Patient Protection and Affordable Care Act in the process of implementation.

As Dr. Noseworthy said, “Care for patients is fragmented, reimbursement inequitable and imprecise.  An uncertain economy, challenges of an aging population and the federal deficit have combined to put even greater pressure on our nation and the country’s not-for-profit healthcare organizations.”

Mayo’s invitation is a needed reminder that a number of forward-thinking healthcare providers in the country are doing a remarkable job containing cost increases, achieving greater efficiencies and still improving healthcare quality through innovation.  It’s one thing to write and read policy papers.  It’s another level of understanding altogether to visit these providers, meet with their leaders, physicians and nurses and accelerate a process of extrapolating many of their successful approaches to the healthcare system at large.

In developing their plans for 2013, Washington, D.C.’s leaders should schedule ample time to get out of town, visit the nation’s most effective healthcare organizations and develop a vivid picture of what the future of American healthcare can and should be.

Medical Innovation is Alive and Well

November 02, 2012
1:52 pm

When it comes to medical innovations, misconceptions persist.  That innovation drives higher health care costs, that it consists largely of “me too” advances that add little to existing healthcare tools and treatments, that innovation is confined to just the pharmaceutical and medical device industries.

Anyone who visited the Cleveland Clinic’s annual Medical Innovation Summit this week would have those misconceptions quickly dispelled.

One of the highlights of the Summit is the announced selection, by an expert panel, of the top ten new healthcare innovations expected to emerge in the coming year.  This year’s list underscores both the vibrancy and diversity of what’s developing in various healthcare sectors.  The list includes:

•    A handheld device that dermatologists will be able to use in their offices to scan a patient’s skin lesions and compare them immediately to an online database of more than 10,000 types of melanoma and skin diseases.

•    Bariatric surgery for diabetes patients that, based on trials thus far, creates a likelihood that patients will be free of diabetes and have reduced blood pressure and cholesterol levels.

•    Femtosecond (meaning one-quadrillionth of a second) laser surgery for cataract patients that is more predictable and accurate than conventional surgery using blades.  This bladeless approach requires less time within the eye, reducing the possibility of inflammation.

•    The Medicare Better Health Rewards Act of 2012, a measure that the Healthcare Leadership Council has strongly supported, that encourages greater wellness among seniors by creating financial incentives to participate in wellness checkups and taking steps to improve their overall health.

The full Top Ten list can be found here.

A Chicago Tribune article about the new innovations is found here.