I've ended up on the email distribution list of seemingly every marketing/communications vendor and market research outfit around.  I have chosen to stay on many of these lists mainly because, when I have time read their emails, they sometimes contain interesting or even provocative information.

This morning is a case in point. 

One firm has issued a brief report, Doctor-Patient Discussions About Healthcare Reform.  Pulling from its collection of physician-patient interactions recorded during the first nine months of the year, the firm discovered that "Physicians are more likely than patients to initiate discussions about healthcare reform during in-office visits."  Their data also shows:

• Physicians are far more likely to use the term "socialized medicine" than any other term, such as "universal health care," "national healthcare," or even "healthcare reform"
• Both physician and patient attitudes toward healthcare reform were overwhelmingly negative
• The prevailing fear is that proposed reforms would increase costs and decrease the quality of healthcare by limiting physician and patient options
• Interestingly, physicians and patients were also likely to express frustration with insurance company intervention in healthcare delivery, with a sizeable number of physicians confiding in patients that frustration from insurer intervention makes them regret becoming healthcare practitioners  

Curiously, physician-patient dialogue on healthcare reform peaked back in February, according to this data, but September and October are not accounted for, and one would expect this discussion would have significantly ramped up (I know my Dr. brought up the issue, unprompted, in my last visit).

From the information provided, there is no way to know details about the underlying data.  But if their information is correct, it is certainly concerning.  Healthcare reform ultimately is about the patients and their doctors.  For reform to be successful, they've got to believe it will work.

A piece in this weekend's New York Post ("Shutting off the miracle-drug spigot") reminds us of the extraordinary stakes at play in the current healthcare debate, particularly when it comes to continued investment in pharmaceutical innovation.

Suggesting that some in Washington "are out to cut health-care costs at the expense of the research-intensive (as opposed to generic) pharmaceutical industry," it rightly points out:

 

.... Yet drugs often improve the span and quality of life in a remarkably cost-effective way. Innovative new drugs have helped many patients avoid costly hospitalization, for example. From 1980 to 2000, the number of days in the hospital per 100 people fell from 129.7 to 56.6, a drop of 56 percent--so that Americans avoided 206 million days of hospital care in 2000 alone, according to Medtap International, which provides health economics and outcomes-research services.

Our industry's promise to provide patients with the best care and therapies possible is built on a huge investment in innovation--$65 billion in 2008.  We recognize that this innovation is meaningless unless we are equally committed to ensuring access to our medicines.  So just as health care reform must broaden that access, it must also reflect the fact that our medicines help people 'do more, feel better and live longer,' as echoed in our corporate mission.  That is, they are implicitly part of the solution, and that critical piece is only made available through continued investment in cutting edge scientific research.  

The article continues, "even after drugs are approved for marketing, only about three in 10 now recoup their development costs."  This means, we make a lot of bets--smart, informed bets, but there is risk nonetheless.  As the Senate takes up consideration of their healthcare reform legislation, when it comes to innovation, patients deserve the best. We cannot afford to roll the dice.

(Image courtesy of Wikipedia.)

Health reform took a step forward yesterday as the House of Representatives released a new healthcare reform bill, H.R. 3962 Affordable Health Care for America Act.

When announcing the new bill, Speaker Nancy Pelosi (D-CA) compared the measure to the creation of Social Security in 1935, and to the 1965 enactment of Medicare and Medicaid.

The bill clocks in at an incredible 1,990 pages demonstrating that a 21^st century overhaul of America's health system is no small task. Support among House Democrats for the new bill seems to be growing, but House Republicans remain opposed. The bill could hit the House floor for consideration as early as November 5.

To learn more about how a bill becomes a law, click here.

(Image courtesy of the The American Constitution Society for Law and Policy.)

My local Sunday paper included two unrelated pieces that really bring home the complexity, breadth and diversity that is implied when we talk about our "healthcare system."

The first, a reprint from the Washington Post, reported the challenges involved in transitioning to a fully digitized system.  The benefits of improved "health IT" products including electronic medical records have been well-documented and are one element of health-care reform that enjoy support across the political spectrum.  Indeed, we're on record here as boosters.  Yet, the article notes:

But such bipartisan enthusiasm has obscured questions about the effectiveness of health information technology products, critics say. Interviews with more than two dozen doctors, academics, patients and computer programmers suggest that computer systems can increase errors, add hours to doctors' workloads and compromise patient care.

Talk about a punch in the gut.  It is right, however, to keep immediate expectations in check.  As the article says, we should not expect digital health records to be an overnight "cure-all" for systemic inefficiencies in our system.  And it is particularly critical that as new technologies are rolled out, the very end users they are supposed to help - doctors and their patients - are consulted and listened to.  Any system that inhibits physician productivity and their precious time with patients will be a non-starter.

The second article that caught my eye was a thoughtful "community view" essay by a leader of the local hospice and palliative care network.  She writes knowingly about "end-of-life" care and the importance of honest, candid discussions among patients, their family members and health providers about how individuals want to spend their last days.  She cites data showing 98 percent of families saying they would recommend hospice to others facing end-of-life decisions.

My take-away from these two very different stories:

1. We are blessed to have so many incredibly talented people involved in every aspect of our health care system.
2. That "system" is innately a human one--no amount of technology nor mechanization can ever replace the primary role of loving, caring, committed human beings who every day are focused on making people well or easing their pain.  And we should be doing everything we can to support them.

In a new poll by National Public Radio, the Kaiser Family Foundation, and the Harvard School of Public Health, 71 percent of people surveyed felt Congress was paying too little attention to what average Americans think about health reform. On the heels of contentious town hall conversations with constituents and legislators this past summer, this is an interesting finding.

In the same poll, 51 percent of people felt interest groups played a constructive role in carrying out changes to our health care system and it was important to have them on board with the legislation. The survey also indicated drug makers were among the least trusted interest groups and some respondents went so far as to say drug makers were primarily to blame for the current problems facing health care.

The fact is no one group is responsible for the problems plaguing our system.  Ours is made up of many diverse organizations, some public, some private, some for-profit, and some non-profit, all of whom comprise a U.S. health care system that provides the most advanced medical care available in the world. But for the many Americans who are uninsured or underinsured, access to health care can be sporadic and inadequate. Improvements are needed in the quality and affordability of care for all Americans so our system can sustain itself over the long-term.

A key driver of health costs is poor management of chronic disease. Accounting for 75 percent of health care spending in this country, more than half of all Americans suffer from one or more chronic diseases, many of which are manageable and preventable. We can improve health outcomes and reduce the increase in overall health care costs if our system includes the appropriate incentives to:

·         encourage wellness and prevention

·         manage costly chronic diseases more efficiently, and

·         maintain strong incentives for continued medical innovation to meet costly unmet medical needs such as Alzheimer's disease

If you are part of the 71 percent who feels your voice isn't being heard in the health care reform debate, don't sit idle. Call your elected officials in Washington, D.C. and tell them you want comprehensive health care reform that focuses on prevention and management of chronic disease and encourages medical innovation. There is no better time to pick up the phone.  

Congress will soon be back to work on healthcare reform and we will again be working for passage of comprehensive reforms that ensure every American has access to first-class healthcare.  We share the concerns of many Americans, as mentioned before, that legislation approved by the House Energy and Commerce Committee is unfortunately not headed in the right direction.

A bill passed by that committee includes a public plan option, run by the federal government, that would use a one-size-fits-all national drug formulary to control prices.  Our principle concern is that this would in turn greatly reduce a doctor's discretion and a patient's access to necessary medicines.  There is no requirement in the bill that the public plan have experts or physicians involved in determining what medicines would be included in the formulary or that it ensures adequate access to a sufficient number of medicines in each class.

The Veterans Affairs drug formulary and Medicaid drug coverage suggest how access and options could be restricted if this public plan is enacted into law.  The VA covers far fewer drugs than Medicare Part D, the prescription drug benefit enacted in 2006. 

Any healthcare reform must be rooted in a commitment to giving more Americans better access to healthcare.  For us, limiting access to potentially life-saving medicines is not an appealing option, and not in the public interest.  

Our hometown Phillies happen to be on a major tear these days, hitting their stride right as we enter the critical run-up to October.  When things go well, they go very well indeed as with yesterday's amazing triple-play by second baseman Eric Bruntlett.

Leading the hated NY Mets 9-7 in the bottom of the ninth inning, Bruntlett made a triple play to end the game ...by...him...self.

This is only the second time a major leaguer has made this play unassisted.

Bruntlett's historic play provides us an opportunity to shamelessly plug another triple play, but one that can't be pulled off single-handedly.

This one is about healthcare (natch) and it is the triple play we believe must serve as the fundamental basis for any changes we make to the current health system in our county.

Our triple play--a triple solution, really--rests on healthcare reform that focuses on the PREVENTION of chronic diseases that come with such extraordinary costs; enhances and broadens ACCESS to treatments for the right patients at the right time; and ensures continued investment in INNOVATION so that our country continues to provide cutting edge treatment and care.

That is a gameplan where everyone will win.

(Photo courtesy of US FWS)

The U.S. House of Representatives recessed last Friday for the month of August and the U.S. Senate plans to recess this Friday. Prior to their departure, the House Energy and Commerce Committee approved a health care reform plan that has raised concerns among many Americans. 

A USA Today/Gallup poll shows that only 26% of Americans believe health care reform will improve their personal medical care and only 21% believe it will expand their access to health care.  That's unfortunate when the purpose of health care reform, which GSK supports, is to increase access to better health care for Americans while lowering the costs.  The poll showed that only 18% of Americans believe a new health care reform law would reduce their personal costs.  Clearly, many Americans aren't happy with their first glimpse of where Congress is leading health reform.

While a House committee hustled to approve a health reform plan before the August recess, the Senate has moved much slower and does not plan to release any of the details of their negotiations.  Whether you agree with the House's eagerness to show America that progress is being made or you think the Senate is taking the right approach by moving slowly and more methodically, everyone agrees that something must be done to improve our country's health care system.  It is expected that Members of Congress will hear a lot about health reform from their constituents over the August break.  Let's hope they come back to Washington in September ready to debate and ultimately pass a reform bill that increases access, lowers costs, and promotes innovation.

A recent Harris Poll of 1000+ adults showed that scientists and doctors ranked alongside firefighters as the occupations most respected by the American public.  It seems to me this is good news that demonstrates our country has its head on right.  (Ironically, despite the 24-7 barrage of celebrity info - we'll, actually, maybe because of it -- the numbers were not as promising for actors with only 15% of respondents affixing prestige to that job.)

These results brought to mind a Health Care Blog post I'd seen sometime back.  The post, "Innovation + Economics: Keys To Successful Health Care Reform," by Dr. Albert Waxman, makes the point that increased investment in healthcare technology is essential to seizing an opportunity to create a "new healthcare economy."

Dr. Waxman, who in addition to running a venture capital fund also serves as New Mexico's Healthcare Commissioner, bemoans the lack of investment in healthcare innovation:

This morning, HHS Secretary Kathleen Sebelius addresses the Weight of the Nation Conference. 

According to presentations from the conference, more than two thirds of American adults--and almost one out of every five American children--are obese or overweight.   This is shocking to me.  Obesity raises the risk of heart disease, some cancers, and stroke, and is the single biggest predictor of diabetes.   

A new report that Sebelius cited in her remarks states that obesity costs our health system as much as $147 billion a year, almost double since the last time the CDC calculated it in 1998.

"To put that figure in perspective," she said, "the American Cancer Society estimates that all cancers combined cost our health care system $93 billion a year.  So ending obesity would save our health care system fifty percent more dollars than curing cancer."

This is an epidemic, but it isn't treated as one.  We are all responsible--from individuals making smart food choices for themselves and their families, to making cities safer and more walkable and bike-friendly, to educating students about nutrition and making physical education a requirement in schools.  That's just off the top of my head. 

The War on Obesity doesn't have the same resonance as some of the other health wars we've waged, but it is a war we must win--for our health and for our national wallet.