BioPerspectives

Apr 30, 2010

Milken Institute Global Conference Points to Missed Opportunity in Health Reform: Wellness and Prevention

  • On Monday April 26, a panel of executives and leaders, including financier and philanthropist Michael Milken, moderated by CNBC anchor Maria Bartiromo convened to discuss health reform in a session 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 that 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, instead of 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 such issues during healthcare reform since 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. Some references were made to China, pointing out that they are already controlling obesity albeit in a heavy-handed way. Longterm 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.

    Additional key points included the need for innovation to drive healthcare reform. For example, major innovations in the past were statin drugs for treating cardiovascular disease and the polio vaccine, which eradicated a major disease. Although $65 billion 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 being eliminated.

    In summary, healthcare policymakers are narrowly focusing 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 to advance medical research while altering destructive lifestyles that contribute to disease.


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