Disrupting the Healthcare System

This morning I attended a conference titled “Disruption and Innovation in Healthcare 2.0“ at Washington University in St. Louis. I was humbled at how well informed and nuanced the speakers were. They included Alex Gorsky (CEO of Johnson and Johnson), I certainly learned a lot. My main concern is that the ability to understand the complexity of the health care system is well beyond the ability of most people. The simplistic positions of our politicians are a great disservice to our country. For example, it is absolutely clear that our health care system is NOT a functional market, meaning that the Ayn Rand/Free-Market conservatives are deceiving us when they claim that all we need to do is “get government off our backs” to fix healthcare. I admire that progressive politicians are calling for universal access (something that almost all developed countries have, but not the U.S.). That said, how do we square that universal access with the need to incentivize future innovations, in addition to ongoing care? Any big changes to the current system could have disasterous ramifications.

The stakes could not be higher. To the extent we are tempted to implement broad new changes, we need to keep in mind (as one of today’s speakers said), “This is not a dress rehearsal. It’s the real deal.”

[On the right] Johnson and Johnson CEO, Alex Gorsky

The speakers somberly delivered the following shocking information: There is currently no payment model for many current (and anticipated) extremely expensive curative therapies. Thus, people who can be CURED of horrific diseases will languish under the status quo because we can’t figure out how to give them more than palliative treatment, even when palliative treatment is sometimes more expensive in the long run. I dare you to read previous sentence a few times and then shrug and try to convince yourself that we, as a country cannot do better.

Here’s another fact was mentioned several times today: 75% of our health care budget is the result of bad choices made in early life by individual Americans. Preaching at people to get their act together shouldn’t offend reasonable people. For instance, urging that children should eat healthier food should be applauded, even though some conservatives ridicule Michelle Obama’s urgings in that direction. But what about more? To what extent should we, must we, put some skin in the game for people who are actively self-destructing their bodies? I think we need to seriously look at some low-hanging fruit and make some people uncomfortable for their own well being and for the greater good of the United States. The overall health of the United States is most definitely a public good. The ill-health of any of us affects all of us.

These issues are ultra-complex, highly nuanced, in addition to being critical important. Anyone pretending otherwise should be promptly yanked off the political stage.

Here’s more information about this event. It was being video-recorded and hope that it will be made available to anyone interested in these issues. “2nd Annual Olin Business School Healthcare Symposium: 'Disruption and Innovation in Healthcare 2.0'

Continue ReadingDisrupting the Healthcare System

Resisting Wars of Discretion Could Save Lives at Home

Our belief in war as a solution to our foreign policy issues, despite the lack of clear objectives and confirmatory metric of "success," is hemorrhaging the U.S. budget. Where are the voices of politicians demanding that we justify this annual military spending by pointing to real life successes?

In the meantime, many Americans are going bankrupt in an effort to get the necessary medical care to stay alive (2/3 of all bankruptcies). Others simply give up and die.

Continue ReadingResisting Wars of Discretion Could Save Lives at Home

Out-of-Network Medical Insurance Hell

What Happens When You Don’t Pay a Hospital Bill? This article in the Atlantic gives detailed accounts. Every day you wake up not needing a hospital, you need to give gratitude. Where are all of the free-marketers when this rampant out-of-network bullshit is destroying people's lives. The government is not causing this, but it could offer solutions. Desperate and unconscious people WITH health insurance should not be unwittingly signing up for lives of harassment and economic destitution when they enter hospitals seeking medical care.

Continue ReadingOut-of-Network Medical Insurance Hell

The cost of asthma inhalers in the United States compared to other countries

I'm traveling abroad, a trip centered on teaching law school for a week in Istanbul. On the way out of the U.S., I had an asthma attack while walking through the perfume area of a Duty Free store in Atlanta. I had an inhaler, but it was getting low (my inhaler is the red Albuterol inhaler on the left. It costs about $70 or $80 WITH the insurance price. My first stop overseas was in Beirut, Lebanon, where I entered a pharmacy without a prescription. They didn't have Albuterol but the pharmacist sold me the Lebanese equivalent called Salres. Total price was $5. When I arrived at Istanbul Turkey, I visited a pharmacy and paid less than $2 for their equivalent, "Butalin," the one in the middle Again, no prescription needed, and the pharmacist assured me that this was an equivalent prescription. I am now in Madrid. Yesterday, I visited a pharmacy here, no prescription, and they sold me the "equivalent," the inhaler on the right. Price was 2.5 Euros (about $2.85). I spoke with the pharmacist in Spanish. I told her that in the United States, my inhaler costs about $80 with the insurance rate, $300 without. Her immediate reaction was shock at the price. The she became angry, and asked "What do children do when their families cannot afford the medicine?" I told her that I don't know, and that it is a terrible situation and that there is no excuse for it.

Continue ReadingThe cost of asthma inhalers in the United States compared to other countries

What Ails the United States Beyond Health Insurance Reform

According to this article from the conservative leaning National Review, the current debate needs to be much broader than health insurance. Who could possibly disagree with that? The article includes a stunning graph tracking middle-age mortality, and a even more stunning video-mapping of the increasing obesity across the US. Here's a haunting quote by the author, David French:

As Congress debated Obamacare repeal, I had lunch with a local critical-care doctor who seemed oddly indifferent to the outcome. His is a world dominated by addiction. “If it weren’t for addicts,” he says, “I wouldn’t have a job.” The intensive-care unit is overrun with people addicted to drugs, to alcohol, to food, and to tobacco. Insurance matters to the economics of the hospital, but it doesn’t matter so much to the quality of its patients’ immediate care or to their ultimate health outcome. They’re killing themselves, and the best health care and the most luxurious “Cadillac” health plans won’t stop their slide into oblivion.

Continue ReadingWhat Ails the United States Beyond Health Insurance Reform