Posts Tagged ‘FDA’

The healthcare reform bill being presented by our current administration follows the same thought process as the European and Canadian socialized programs; they are pessimistic with respect to advancements to healthcare and human nature.  In both cases, the focal point is on lowering costs through mandating lower pricing from healthcare providers.  Don’t believe me?  See this quote from Chris Jennings, a health policy expert from the Clinton administration when they were pushing HillaryCare (he is currently assisting the new administration).

“…the power of the public option would come from government’s ability to present doctors and hospitals with a stark choice: accept lower reimbursements or lose access to large numbers of patients.”

So let’s take a step back and think about this.  By wanting to attack the problem of rising costs and lack of complete coverage, our government believes that the best way is to force providers to take less for their goods and services.  In doing so, you will start a cycle of less people going into the field of medicine (since it’s harder to make a dollar doing doctor stuff versus being an electrician) and reduce the future advancements (as capital will go to those areas that offer more promise).

So, I would like us to think optimistically and produce solutions that allow for, and leverage, advancements.  Here are some of my wishes for a reformed healthcare industry.  These ideas are not original to me but those that I have seen presented by others that I find valuable for us to pursue.

1.  Mandate coverage (similar to auto liability as mentioned by a friend) with the intent to offset costs that may be taxing to the healthcare system when costs are pushed to the hospitals and doctors through bad debt (this would be, in my mind, meant to cover the big, expensive stuff like cancer, emergencies, etc), and that it would be delivered through private insurance companies.  This would not be preventative care coverage as I see that as a choice of the individual.  It is an individual’s responsibility to maintain ones health.

2.  Privatize Medicaid by slowly adjusting income qualification levels to be location based (a $44,000 AGI in rural Indiana is completely acceptable to live on, whereas $44,000 in NYC, Boston would not). One way to do this would be for the federal and state governments to go through a bidding process with nationwide insurers, keeping some control.  [The reason I find this important is the amount of expense and inflexibility placed into the system that produces no productive end.  This comes from speaking with hospital administrators and medical professionals that spend upwards of 20% of revenue trying to conform to outdated govt regulations]

3.  Offer a government sponsored (though privately administered) major disability plan (similar to the re-insurance industry) that would act as a supplemental to a regular plan for those with pre-existing conditions.  The way I see it working, it would allow a private insurance contract to be more accurately priced for the chronically ill (as the maximum distribution would be known as the government plan would kick in above some level) for the more preventative care side of healthcare as well as the risks of new ailments.  This would only be offered to those with pre-existing conditions. Also administered through private insurance companies that would have to compete every few years for the business.

4.  Stimulate competition amongst the 1,500 insurers by allowing them to cross state lines, setting the federally mandated standard level of care at the lowest coverage currently offered by the states.  See this study for some good detail.

5.  Reform malpractice laws and payouts.  Having a penalty of $50,000,000 with half of it going to the lawyers is not an effective way of ‘teaching the doctor/hospital a lesson’.  With malpractice insurance composing 15%+ of a procedure’s cost, one needs to rethink how we penalize them for making mistakes or true malpractice.

6.  Don’t allow unlimited tax deductions for health insurance expense, and make the tax code fair (eliminate the favor of deductions given to big businesses).

7.  Revert the FDA back to its original mission: test the safety of new products.  It has turned into an averaging mechanism, where we are getting to more tailored drugs as we refine the technology yet the FDA will not approve based on averages over large samples.  If they were to go back and approve based only on safety, it would allow doctors more flexibility to tailor treatment to the needs of the individual, removing the limited accessibility of potentially helpful drugs.  (from conversations with pharmas, given the genome project, we can invent drugs to target specific DNA types but have problems getting through FDA as they are incapable of setting up useful (and economical) clinical trials (all due to their archaic definition of drug effectiveness)).  With FDA clinical trials representing more than 50% of the drug development costs, this would positively impact the development cycle, both in speed to drug and volume of treatments.

I’m not an athlete but I do know that the best way to slow down during a race is to turn your head and look at your competitor.  I hear many say that, in the end, it is a race against yourself so push hard and focus on the finish line.  I wish someone would give that advice to our current government.  From our Supreme Court Justices referencing international laws to our current administration looking to Europe for healthcare reform, I see so much time being spent looking at those behind us.

Did I offend anyone?  Sorry, but for those readers outside the US, I hate to be the one to tell you that your nation’s progress toward individual freedom lags the US (there may be argument from Singapore, Australia, NZ, and a few others, but I feel comfortable in defending my statement).  I can’t take credit for it, it’s just a fact that the US fought for independence from tyranny in the late 1700′s and has led the movement against oppression since.  This is the part of the world where those desiring freedom of expression, freedom to succeed or fail, freedom to think as an individual, freedom to pursue unlimited success, etc have come for centuries.  The US has grown to be the largest economy very quickly due to the relatively low barriers placed in our way by the whimsical acts of authoritarians.

So, why is our current administration looking to those that lag for ideas on how to advance our society?  Does Tiger Woods look to the golfer in 30th place and try to copy his swing?  Does Bill Gates try to copy the strategy of the executives of Kodak, Digital Equipment, NCR, or Unisys (for those that aren’t into technology history, those are all failed tech companies)?  No, they are the laggards, the losers.

Whomever was the one to propose the single-payer healthcare plan (aka the government-option, aka co-op plan, aka socialized medicine) should have been laughed out of the room immediately for suggesting something that those that are losing talent (brain drain of UK in the 80′s), that grow much slower than us (Europe GDP has been anemic compared to ours), and that offer little in advancement of personal freedom (class segmentation in UK, France, India) have adopted.  The response should have been “Are you nuts?  Why do we want to go backwards?  We (the nation) have fought long and hard to obtain and maintain our individual rights and you want to suggest we take a step back?  Oppression is oppression no matter what name you give it.  Get Out!”

So, my recommendation to our government, look forward, not backward.  Advance freedom, don’t rescind it.  Leverage the skill and knowledge base that collectively makes up our healthcare society rather than alienating it and risk losing it.

http://wcbstv.com/health/cheerios.general.mills.2.1007986.html

Of course, a little sugar or honey makes them so much better…