The mission of Prognosis is to explore the nexus at which healthcare policy meets healthcare practice and how one affects the other. This blog makes readers more aware of the innovations taking place in healthcare delivery, financing and technology and the types of public policies that will encourage further progress.
Healthcare In Focus is a public education initiative of the HLC, created to promote a constructive dialogue about the state and future of American healthcare.
There’s an inherent problem with most news media coverage of the healthcare industry. The companies, the products, the processes and the issues surrounding them are so complex that it’s difficult to fully grasp an understanding of an industry in a two-minute TV news report or a 500-word newspaper story.
That’s why I have to give credit to USA Today. This week, the newspaper devoted more than an entire page to an interview with Abbott Laboratories CEO Miles White, who was speaking at a USA Today-sponsored forum at Michigan State University. In an interview, Miles gave his views and perspectives on a panorama of issues. It’s a piece well worth reading because Miles makes important points on, for example, why the differentials on what people in different countries pay for drugs should be treated as an international trade issue. Among some of the highlights:
Miles White on different pricing for pharmaceutical products around the world…
“In most countries around the world, when we seek licensure of our product, there’s negotiation with the government over the price of that drug. It’s a government-run health care plan in France, Germany, etc. And they’ll just impose a price decrease. We have not much to say about it.
“People will say to me, isn’t the U.S. consumer subsidizing the availability of drugs in the rest of the world? You know what? That’s true. The issue isn’t something a consumer can manage. It’s a trade issue that governments have to manage.
On the industry providing medicines to people in need…
“I’ve never sat in a meeting where we looked at a drug and somebody said, ‘But, gee, we can’t make money on it because it’s only for poor people.’ We happen to have one of the leading (anti-HIV) drugs in the States, and we provide it either free or below cost. And we developed heat-stable forms of it so (in poorer countries), it didn’t have to be refrigerated. We do have a social obligation to balance with our financial obligations.”
On the next major pharmaceutical challenges…
“I have a particular passion and focus on Alzheimer’s and diseases of dementia. There’s just so much scientifically that we don’t know, and we can know. And because so many of those patients are institutionalized for there are, if we can find ways to solve that, we not only (improve) quality of life for the patient, but we also prevent the medical system from being burdened by enormous cost as we age.”
On partisanship in Washington, D.C…
“I’m as disgusted as anybody with what I see as the inability of Washington to be collaborative. I think, ‘Why don’t you guys put down all of your Republican and Democratic shields and arms and uniforms and think about this on behalf of the American public, setting ideology aside here?” Because most of us are in the middle.”
The U.S. healthcare system takes no shortage of criticism. Often, these criticisms fall into two camps. There are those of us who believe that the United States has one of the strongest, most innovative health systems in the world, but we need delivery and payment reforms to increase value as well as insurance reforms and subsidies to strengthen accessibility. There are others who see the U.S. ranking well below dozens of other countries’ health systems and that we’re inherently condemned to this inferiority unless we begin taking steps to model ourselves after the government-run systems of Europe.
As we consider these two views, it’s good to get a little perspective. That perspective is brought to us from the Times of London.
The Times recently reported an appalling instance. Cost-cutting to meet government budget requirements took priority over providing hospital patients even basic, decent care. Doctors and nurses “stopped providing safe care because they were preoccupied with government targets and cutting costs.” This negligence and maltreatment led to the deaths of between 400 and 1,200 patients at this one hospital alone between 2005 and 2008. Read more
We hear it all the time. It’s a nonstop drumbeat. Healthcare in the United States is too expensive and too low in quality compared to other countries. Critics are constantly citing the World Health Organization which, in its most recent rankings, said the U.S. ranks 37th in overall healthcare performance.
In reality, though, what kind of healthcare do Americans receive? And would we really trade what we have for what is offered to citizens in other nations.
Dr. Mark Constantian, a reconstructive surgeon in New Hampshire, investigated that question and shared his conclusions in the Wall Street Journal last week. Dr. Constantian found that, when it comes to the factors that patients and healthcare consumers care about the most, healthcare in this country stacks up pretty well. Read more
In November, NewYork-Presbyterian Morgan Stanley Children’s Hospital celebrated the 25th anniversary of pediatric heart transplantation. In 1984, the Hospital’s surgeons performed the world’s first successful heart transplant to a 4-year-old boy. Since then more than 350 children have received new hearts at the Hospital.
Twenty-three years ago, one of those fortunate children was 12 year old Christy Farley. In a CNN article today, Farley of Hasbrouck Heights, New Jersey said “Not a day or minute goes by where I don’t think about how lucky I am just to be here, I thank God every day when I wake up that I woke up.”
With her new heart, Farley has been able to have the life experiences of graduating from college to become a nurse and she recently gave birth to her daughter, Analise. Farley said that “As a child I learned that having a transplant would make me better, and my job was to get better. So that’s what I focused on. Of course, there’s always fear. If I get sick, if I get the flu, a million things go through my mind. Now, I look at more positive things and how successful I am.”
This news story reminds us of what medical innovation means to society’s happiness and future. Doctors at NewYork-Presbyterian Morgan Stanley Children’s Hospital have given Christy Farley and many others a second chance at life.
When he was a United States Senator, Barack Obama cosponsored legislation to allow the importation of prescription drugs into this country. White House Chief of Staff Rahm Emanuel was a champion of importation in the U.S. House of Representatives.
It’s very telling then that the Obama Administration yesterday threw a bucket of cold water on efforts in the Senate to attach a drug importation amendment onto health reform legislation. Dr. Margaret Hamburg, head of the U.S. Food and Drug Administration, sent a letter to Senator Sam Brownback (R-KS), saying that it would be “logistically challenging” to try to guarantee the safety of any prescription medications entering our borders from other countries. Dr. Hamburg notes, accurately, that the FDA can’t oversee the safety of foreign supply chains. Read more
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