Missed Opportunity in Health Reform-Wellness and Prevention

On Monday April 26 a panel of executives  and leaders including Michael Milken, moderated by CNBC anchor Maria Bartiromo convened to discuss Health Reform in a session focused on “Prevention and Cures”. The primary focus of the discussion was the need for government policy and health reform to address “wellness” and chronic diseases such as diabetes. Healthcare Reform that has recently been enacted into law is “uneconomic” and has put prevention and wellness on the “back-burner” even though unhealthy living represents a major  cost to society. A lingering concern is that we are a few years away from price setting of medical products and services.

The panel drilled down on nutrition and obesity. Although consumers would prefer to have an “obesity pill” to treat their poor diet and junk food consumption the panel felt there needs to be a national “war on obesity “similar to the successful model used to combat cigarette smoking. Better education and a well communicated campaign led by the government in a broad collaboration could shift priorities toward wellness not just treatment and “rate setting” by payors. The economics of getting the right food and exercise must be broadly communicated to the public,  led by physicians at the local level. Progress will be incremental not breakthrough.

Legislators may have avoided political issues with healthcare reform as obesity can be traced in part to the junk and fast food industries where offerings have become “supersized”. Some have floated the idea of taxing soda and junk food but of course this got little political support even though high taxes in combination with education works in curbing tobacco use. Long term we have to deal with poor diet and lack of exercise as it relates to obesity and diabetes. Alcohol and substance abuse are another social cost that needs to be addressed in Health Reform.

Some additional key points were made such as the need for innovation to drive Health Reform. For example major innovations in the past were the “statin drugs” for treating cardiovascular disease and the polio vaccine which eradicated a major disease. Although $65B is spent on R&D each year, it is becoming more difficult to find major cures. The drug industry is now consolidating with more than 100,000 jobs eliminated.

Some references were made to China pointing out that they are already controlling obesity although in  a heavy-handed way. About 70% of all scientists in medical research are Asian. Singapore was offered as a model for medical research excellence  driven by government.

In summary,healthcare policymakers focus narrowly on costs and care for the sick with discussions of insurance coverage. A more holistic view of healthcare needs to be taken with the twin strategies of cures and prevention-advancing medical research while altering destructive lifestyles that contribute to disease.

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