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'

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Why Flu Shots Rarely Match the Current Flu, and Why You Should Get One

As any science guy recognizes, evolution is a fact of life. If an environment is inhospitable to a population, that population dwindles and another prevails. Flu shots are designed every year to prevent the premier emerging strains that are likely to become dangerous, either through virulence in the body, or…

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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.

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In Light of the GOP’s new Health Care Proposal, it’s Time to Rename the GOP as the “Social Darwinist Party.”

In light of the GOP's "solution" to the "problem" of Obamacare, it's time to simply and clearly declare that the GOP has become (and should be renamed) the "Social Darwinist Party." Addressing the cries of the Super Rich ("I want even more money") is no solution at all to the medical crises many of us face. I realize and recognize the frustration of the GOP that people who are lazy and/or who repeatedly make bad decisions resulting in being poor should not be able to mooch off the rest of us. But what about those who have worked hard and have been laid off by downsizing, and now earn $10/hour? What about people who are doing their best after being raised by dysfunctional families and/or "taught" at dysfunctional schools? Should they really be told that health care is totally out of their reach? I'm lucky that I am a 60 year old man who can afford to pay the market rate of $900/month for a $6,000 deductible ("Bronze") health care policy with Anthem for me and my teenage daughter. It was the best deal I could find this year. But there are good hearted hard-working people who are paid minimum wage, meaning that they gross about $1,500 a month for full time work. After Social Security taxes, if they were to pay $900/month for health insurance (and then all the co-pays and deductible) they would have NOTHING left on which to live. NOTHING. The GOP solution, I assume, is to have these people (many of whom voted for Trump) begging for health care at hospital doors, with many of them eventually dying in the streets. Is the GOP then going offer block grants to cities to help clean up the bodies of sick and dying people on the sides of streets? Obamacare was an flawed attempt to balance the many competing interests at play. But it was an attempt. It was far better than the GOP proposal, which is essentially, "If you can't come up with a LOT more money than minimum wage will pay you, then into society's scrap heap you go!" We can do better than Obamacare. We can do a LOT better than the current GOP proposal. It's time for single payor, a solution used by almost every other industrialized country.

Continue ReadingIn Light of the GOP’s new Health Care Proposal, it’s Time to Rename the GOP as the “Social Darwinist Party.”