Event Tackles Health Spending

A kick-off event hosted by Health Affairs https://www.healthaffairs.orgg and the National Pharmaceutical Council www.npcnow.org was held at the National Press Club February 1, 2018 to discuss “Health Spending: Tackling The Big Issues”.

Alan Weil JD, Editor-in-Chief, for Health Affairs discussed Health Affair’s new multi-year project tackling “Health Spending.” The plan is to explore the level and growth rate of health spending, distribution of spending, and how to improve value of care.

He explained, “Aggregate health spending of $3 trillion may seems abstract but the need for changes in how much or how we spend healthcare dollars is very important. However, with limited resources available to spend on healthcare, many factors must be discussed and taken into consideration.in order to give critical thought about our current allocation of resources.”

According to Robert Dubois PhD, Chief Science Officer and Executive Vice President, for National Pharmaceutical Council, “Several questions need to be answered. We have to ask how much to spend and for what? Should healthcare resources be shared equally? Are prices too high for surgery, devices, hospital stays, and drugs? How can we afford to invest in future treatments? Has health spending begun to crowd out other social determinants that are needed in the community?

He discussed how developing new technologies and treatments can run up the cost of healthcare. “Recently, a newly approved CAR-T cell therapy was able to achieve long term remissions and a possible cure for a pediatric form of previously fatal leukemia. It’s a one-time treatment but it comes at a high cost. There is no doubt that we need access to this type of technology but on the other hand, we really don’t know how to address the high costs involved in treatment.

As he continued to say, “Remarkable new treatments will transform lives. However, they are likely to have substantial near term costs but with the already high level of current spending and the inability so far to reduce waste, financial constraints may preclude their adoption.”

Anitabh Chandra PhD, Malcolm Wiener Professor of Public Policy at Harvard University, stressed how the government plays a big role in delivering healthcare but at the same time, is a direct drain on government revenue.

He said, “Spending on healthcare depends on providing value but providing good value can increase spending. Serious discussions need to take place on how to squeeze out fraud and waste and importantly, who to cover and what to cover”. As he stated, “There is simply no one answer.”

David Cutler PhD, Otto Eckstein Professor of Applied Economics at Harvard, suggests, “If we would reduce administrative costs in our system, the system would improve in this country. He also suggests, that people should shop around for medical services which can work with some private insurers as some private insurers will back down when challenged.”

A panel moderated by Alan Weil opened with Leslie Greenwald, PhD, Vice President Research Strategies, at RTI Health Solutions, giving details on her thoughts on how the U.S compares against the rest of the world in terms of GDP spending for healthcare.

On the same panel, Craig Mitton, Professor in the School of Population and Public Health in the Faculty of Medicine, at the University of British Columbia, sees the delivery and financing of healthcare in terms of lessons learned from other countries in the world. As an economist researching healthcare spending, he has detailed data on healthcare spending in OECD countries in relationship to how much the U.S. is spending.

Carrying on the panel discussion, Amber Barnato, Professor of Health Care Delivery at Dartmouth Institute for Health Policy & Clinical Practice located at the Dartmouth Geisel School of Medicine Institute, talked about her vast experience in palliative medicine and discussed issues related to health spending and value when dealing with end of life issues.

Last December, Alan Weil announced that with support from the National Pharmaceutical Council, Health Affairs will publish a series of papers featuring “Health Spending” on the “Health Affairs Blog”. More traditional empirical analyses will appear in the Journal while the blog will provide an opportunity for commentary, policy proposals, criticism, and much more.

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