Merrill Goozner is an award-winning journalist and author of “The $800 Million Pill: The Truth Behind the Cost of New Drugs” who writes regularly at Gooznews.com.
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From the Health Affairs blog: “One of the most important lessons that has come out of the current “reform” process is the enormous power of the medical industrial complex and their large financial contributions and armies of lobbyists to block any significant cost containment.”
— Alain C. Enthoven
For those not familiar with Enthoven’s work, the Stanford health economist is considered the father of the health maintenance organization, and is a long-time critic of the medical industrial complex. I was drawn to his blog post this morning because he takes aim at Atul Gawande’s false assumption that the pilot programs in the health care bills will, over time, hold down costs. The New Yorker writer arrived at his conclusion without considering the fact that organized providers have undermined every previous pilot project aimed at making health care more efficient and cost-effective.
“The farmers were willing partners, the medical industrial complex is not,” Enthoven writes. “Physicians complain that doing the right thing costs them money. The incentives in today’s dominant payment model are oriented to doing more, spending more, using more complex methods when simpler methods would do just as well for the patient.”
His solution to cost-control is giving consumers the power to drive the system via Sen. Ron Wyden-style voucher plans. The train is long gone from the station on that one (although, ironically, the Senate bill has a voucher program pilot project). No matter. The article is well-worth reading for the insights it brings to the cost control battle that is sure to follow in the wake of this bill.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
