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No Time for Complacency

May 31, 2013
2:31 pm

Washington, D.C. has long had a tendency to avoid decisive action until crises make continued delays untenable.  This being the case, there should be a great sense of joy and relief in the Nation’s Capitol over the Medicare Trustees pushing the projected date of Medicare insolvency two more years into the future, to 2026.

That would, of course, be the wrong way to look at this issue.

Whether it’s 2024 or 2026, the fact remains that Medicare insolvency is still where it shouldn’t be, on the foreseeable horizon.  And with the number of retirees rapidly climbing and utilizing, on average, three dollars of healthcare services for every one dollar they paid in payroll taxes during their working years, the Medicare status quo is no more sustainable today than it was before the Trustees Report was issued.

(A side note here:  Yes, there are those who will insist that insolvency is not really all that catastrophic, that there will still be sufficient revenues to pay 85 or 90 percent of benefit obligations and, anyway, Congress would never allow Medicare to fail in meeting beneficiary needs.  I have no doubt this is true, but assurances like these gloss over the actions that would be necessary in order to make up for this financial shortfall – higher taxes, greater burdens on beneficiaries, further cuts in payments for Medicare services, or some combination of all of the above.)

Treasury Secretary Jack Lew was correct in saying today that we need to act sooner rather than later to address Medicare’s financial challenges.  The longer we wait, the more draconian the remedies in trying to forestall insolvency.

And it remains true that solutions are right in front of us.  The Medicare Part D program continues to be incredibly successful in keeping federal costs well below projections and in keeping medications highly affordable for seniors.  Medicare Advantage plans are achieving health outcomes superior to the conventional Medicare fee-for-service program.   What these two programs have in common are a reliance on consumer choice and competition to drive value, the same components that are central to the Affordable Care Act’s health insurance exchanges.

As we discuss Medicare’s future, it only makes sense to examine how the lessons learned from these already-existing success stories can be utilized to ensure healthcare security for future generations.

So, as we examine the 2013 Medicare Trustees Report, let’s focus not on the fact that insolvency is delayed by two years, but at the fact we’re still talking about insolvency at all.  Then, let’s begin the discussion on how to remove that prospect from the imminent horizon.

When Sand Gets in Your Eyes

May 07, 2013
2:06 pm

I’m pretty certain that no one has ever successfully made the case that life-changing advances in modern medicine have come as the result of physicians and researchers keeping their heads buried in the proverbial sand.

Yet, a guest op-ed in the Wall Street Journal last month suggests exactly that approach.  The head of a major healthcare organization wrote that patients are at risk for “potential harm” unless physicians completely stop participating in collaborative relationships with the healthcare industry.  He added that the 7,000 physicians in the medical group he heads were banned from engaging in any consulting arrangements with pharmaceutical or medical device companies.

So this is the ideal future of American healthcare?  An environment in which the companies that make lifesaving medicines and technologies can’t communicate with the brightest doctors who will use those innovations and whose insights can make them better?

God help the patients of the future if that philosophy becomes the accepted standard.

There is a superb opinion piece published today on The Atlantic website in response to the Wall Street Journal guest op-ed.  It’s written by Dr. David Shaywitz, an adjunct scholar with the American Enterprise Institute and a strategist with a San Francisco-based biopharmaceutical company (not a Healthcare Leadership Council member company).  I recommend you read Dr. Shaywitz’s writing in its entirety, but I wanted to pull two quotes from it that are worth highlighting.  The first:

“To advance even a solid idea requires, ideally, close communication between industry and outside experts: university researchers, who often developed the science and understand it the best; practicing clinicians, who can describe where the medical needs are the greatest, and what properties an ideal therapeutic would have; and patients, of course, who understand better than anyone else what they need, and where existing approaches may fall short. We should strive to cultivate, not demonize, these sorts of interactions.”

And at the conclusion of his piece:

“Drug development is far too important, and far too difficult, for anyone to do by themselves. To have even a fighting chance, stakeholders — pharma companies, university researchers, clinicians, and patients — need to work together, and collaborate as if our future health depends upon it. It probably does.”

This is a one-sided argument.  In an environment in which chronic disease is on a path of rapid escalation, we need to constantly develop new and better technologies and biopharmaceutical therapies to advance wellness and prevent serious illness.  Talented physicians should be part of this process in a principled, transparent, independently-minded fashion – one that we’ve addressed through the National Dialogue on Healthcare Innovation.

This will do far more for patients than a head buried in sand.