American People's Online Health Summit

AMERICAN PEOPLE'S ONLINE HEALTH SUMMIT

Center for Health Transformation

 

An ongoing, online Summit with the American People to discuss solutions to transform our country’s healthcare system.

 

Featured topic today Tuesday February 23, 2010

 

21st Century Personalized Health: Accelerating Scientific Discovery and Innovation

Why is supporting and protecting scientific discovery and innovation so important to assuring all American’s have access to quality healthcare that will be available, affordable and appropriate?

The health care system in the USA will deliver state of the art care that is appropriate for the needs of each individual and will do so at the lowest possible cost.

 

To create an integrated health care system across the domains of discovery, development and delivery so that there is constant innovation and rapid availability of integrated solutions that will eradicate disease and preserve health. The last half of the 20th century has witnessed astounding progress in science and technology that is elucidating the genetic and molecular mechanisms responsible for disease. These discoveries are transforming medicine, enabling the development of rational interventions that can be tailored to the needs of each individual patient and will predictably achieve the desired outcome of restoring and preserving health.

In view of such progress, our current efforts should be directed not at reforming our 20th century health care system, but rather transforming its function and structure into a 21st century health care system that will be: Personalized, Predictive, Preemptive (preventive), and Participatory.

Create a heath care system whose components will enable every American to be confident their health care will be: Available, Affordable, and Appropriate.

Make Research a Centerpiece in Reform

“If you think research is expensive, try disease.” In that simple phrase, advocate Mary Lasker (1901-1994) summed up the case for investing more in the future of health and health care. Because the nation’s elected officials, with the enthusiastic support of the public, responded to that wisdom, Americans’ life expectancy increased dramatically in the second half of the twentieth century, and the U.S. became the global leader in life sciences. Just as most American families can point to research as the “game-changer” in protecting the health—and often the very life—of someone near to them, our nation can point to research for an estimated 50-fold return to our economy. But our once-undisputed lead is now forecast to end (see Battelle and Georgia Tech reports). This means new businesses and jobs will be created elsewhere, not here. So why aren’t we making research more of a centerpiece, instead of an after-thought, when we talk about health care reform?  According to polls commissioned by Research!America, 71% of the American public says research is part of the solution to containing health care costs, not part of the problem.  The public supports stronger investment in research; our President and the Congress should act on their behalf.

 

Mary Woolley is President and CEO, Research!America

Make Room for Science, Discovery

At the M. D. Anderson Cancer Center, we see the sickest patients with the worst prognoses. Health care reform is a very important topic to our institution and one that we think about daily.  What should health care reform include?

It's crucial that any measure of health care reform provide an opportunity for new science and discovery. There are many hospitals in this country that are focused more on research and academic endeavors. We must ensure that the health care reform agreed upon doesn't do away with the academic/research segment of our health care system.

Fifty years ago, childhood leukemia (ALL) was essentially a death sentence with only a 4% survival. Today, it's one of the most curable cancers in our armamentarium (75-80% survival) thanks to the devotion of generations of scientists and physicians who wouldn't give up.

Funding this research wasn't cheap and it took a lot of faith before breakthroughs began to emerge. But today, what parent who has a child being treated for ALL wouldn't say those resources weren't well spent? What active, productive, happy adult who was cured of ALL would say the benefits to society weren't worth the costs?

Our goals must include support for outstanding health care delivery and continue our quest for the best biomedical science in the world.

Raymond DuBois, MD, PhD is Provost and Executive Vice President of The University of Texas MD Anderson Cancer Center

Stimulate Economy and Reform our Nation’s Health Care System

The United States has the best health care system in the world and it has given patients unlimited access to the latest treatments and experimental procedures that exist today.  These trial treatments and new procedures often lead to scientific discoveries that ensure quality health care for Americans.  The more leeway doctors are given to perform these innovative tests without government interference, the higher the chances of finding cures and solutions to the many health problems who affect millions across the globe.

The Democratic health care plan will not stimulate our economy; it will squash innovation and strictly limit the quality of care we so highly enjoy.  This is the wrong prescription for the American people, who have so adamantly rejected this plan.

If our Democratic leadership wants to stimulate our economy – they need to scrap this proposal altogether.  Republicans have solutions and we are ready to come together with our colleagues and have real discussions and negotiations on how to simultaneously stimulate our economy and reform our nation’s health care system.  We can do this without putting our middle class families and small business owners through the ringer, and then hanging them out to dry.  At a time when one out of every 10 people is unemployed, our President’s proposal for health care reform will hurt those who need our help the most while stifling the innovation that is so renown to the United States.

Congressman Phil Gingrey (GA-11) represents the 11^th District of Georgia and has been a practicing OB/GYN physician for over 26 years.

Prevention, Intervention and Innovation

In today’s challenging global marketplace, America’s best competitive advantage is our proven ability in the area of science and innovation in terms of capturing value for investors, improving our balance of trade and most importantly, helping patients around the world.  There is no other area in which we currently have such a clear and commanding lead and at the same time, so many opportunities are right at our doorstep if we have the will, the right policies and the funding with which to capture these enormous opportunities. 

There are several keys to our capturing these opportunities and providing the value that they represent.  First, America needs to lead in intellectual property protection.  Patents are the lifeblood of innovation.  We need to provide certainty when it comes to the high risk endeavor of life science innovation and investment.  Rather than debate technicalities, we need to provide data protection of at least 12 years and after those 12 years, open the marketplace to all comers. 

Second, we need to continue to strengthen America’s science education programs.  We simply aren’t attracting the numbers of talented young people to go into science as a career compared to our competitors, particularly in Asia.  We are woefully understaffed in both quantity and quality of science teachers at the elementary and secondary level.  If we don’t address this “talent pipeline” ultimately our innovation pipeline will run dry. 

Third and very importantly, we need to encourage collaboration.  America is the envy of the world when it comes to biomedical research largely due to the partnership between government (NIH), academia (our university medical schools and teaching hospitals) and the private sector (pharma and biotech) all working together.  We need to be fast and flexible in technology transfer to allow the collaboration to deliver the fruits of this partnership in a more timely and efficient manner.  There is no better current example than in the field of oncology where as we move to personalized medicine, where cancer patients will be given based on their genotype, specific new agents often in combination that will either put the cancer in remission or provide a real cure.  We must expedite the discovery, development and delivery of these remarkable new agents to the patients who can’t afford and shouldn’t have to wait one day longer than necessary. 

In summary, it is in the area of science and medical innovation where America has both the opportunity, and I would say responsibility, to lead the world.

The three key points to focus on in the current debate on health care costs are:

1. Prevention – Let’s incentivize organizations and individuals to practice healthy behaviors, i.e. The Gold Standard of the CEO Roundtable on Cancer.
2. Intervention – Start by encouraging annual health physicals and waive co-pays for medicines as it keeps people out of emergency rooms and hospitals.
3. Innovation – This is still the best ROI of any investment we can make.

Robert “Bob” Ingram is retired former CEO GlaxoWellcome, Founder of CEO Roundtable on Cancer and currently General Partner Hatteras Venture Partners which invests in early stage life science.

Research is the Foundation of All New Advances in Medicine

Without sustained investment in biomedical research and innovation to better understand and treat disease, the long-overdue reforms being debated today aimed at achieving access for all patients will have its limits. Swift action on comprehensive health care reform is vital to the future health of this country. However, access to ineffective care is not the reform we all envision.  Improving the understanding of existing medical options, as well as sharp focus on development of the therapies of tomorrow, should be a pillar of much-needed health care reform. 

 

For the past century, research has been the foundation of all new advances in medicine – from the discovery of penicillin to today’s targeted cancer therapies. Without research, new vaccines and new cures will not be developed, and the costs of health care will remain unacceptably high for American families.

 

Twenty years ago the mapping of the human genome was unthinkable at the outset. But its successful completion demonstrates the power of innovation and collaboration to make the impossible, possible. Continued biomedical research is crucial for improving the quality of life of Americans, and eliminating the physical, emotional and financial burden of disease.

 

While increased access is vital, in order for health reform to be truly meaningful a continuous commitment to discovery is needed so we can understand how to prevent disease in the first place.

 

We should undoubtedly do more to prevent the diseases where known preventative measures exist, and Congress deserves whole-hearted support for their reform efforts in making this a top priority. However, many life threatening diseases, like Alzheimer’s and Parkinson’s and several of the most lethal cancers like brain, pancreatic and ovarian, currently have no known preventive mechanism and many diseases have no viable treatment options. Expanding access when there are few successful treatment options provides little hope for patients afflicted by these diseases.

 

As the health care discussion continues, we must generate policies aimed at encouraging and supporting science and continue to stimulate biomedical research and innovation in the United States.

 

Ellen V. Sigal, PhD, is Chair & Founder of Friends of Cancer Research, a non-profit organization that pioneers innovative public-private partnerships, organizes critical policy forums, educates the public, and bring together key communities to overcome the barriers standing between patients and the most promising cancer treatments. www.focr.org

Health Care Reform Should Start with the Interests of the Patient First

At US Oncology we believe that health care reform should start with the interests of the patient first. With this in mind, we developed our Principles for Reforming Cancer Care in an attempt to focus heath care reform on the goal of attaining the highest-quality cancer care for our patients.  At US Oncology we have embraced the information technology revolution and have harnessed it not only to provide the best quality care for our cancer patients but to provide a foundation and a new direction for health care reform that we hope will benefit all of medicine.

 

We have focused on introducing cutting-edge tools to our cancer patients and cancer care providers that have been proven to facilitate the highest-quality care while eliminating unnecessary care and its associated costs. These concepts have been extremely successful in the private-sector and have not surprisingly caught the attention of a bipartisan group of Congressional health care reform leaders who would like to better-align the incentive structure of the Medicare program through the use of specialty-specific accountable care organizations (ACOs).    

 

Under the specialty-specific ACO concept, services would still be billed under fee-for-service, but the members would join to coordinate care for their shared Medicare patients with the goal of meeting and improving on quality benchmarks, and because ACO members are held jointly accountable for this care, they would share in any cost savings that stem from the quality gains. US Oncology has begun to offer and implement a platform we call Innovent Oncology for just this purpose, and we are proud of a recent study that shows that it can produce significant savings while maintaining high-quality care.

 

The keys to success within the Innovent Oncology program are the following:

• Level I Pathways, which are evidence-based guidelines developed by oncologists that re-direct the wide range of treatments driving tremendous disparities in oncology care today into more precise, clinically proven treatment options directed through our health information technology platform known as iKnowMed;

• Through our patient support services, Innovent Oncology enables oncologists to proactively manage a member’s disease between office visits with regular outreach to the patient and focused education specific to his or her condition;

• Advance Care Planning facilitates open, frank conversations between the oncology care team and the patient and his or her family regarding disease progression and documentation of patient treatment preferences, including palliative care and hospice.

We hope the concept of specialty-specific ACOs will allow products such as Innovent Oncology to flourish not only within the field of cancer care, but within all fields of medicine. Efficient cancer care requires an advanced approach that integrates services and aligns incentives for consistent care delivery across the cancer care continuum. By allowing physicians to develop evidence-based guidelines for treatment of various diseases while providing patients with more control over their care is a good first step towards finally embracing the health information technology revolution that has thus far passed-by the house of medicine.  

Dr. Lloyd Everson is Vice Chairman of the Board of Directors of US Oncology, Inc.  He is a well known leader in oncology, and has been active in private practice, academic medicine, research, and administrative medicine throughout his career.

A World of Difference

Read my op-ed with Mayor Bloomberg. Cancer isn't just emotionally devastating. New research shows that the global economic toll is huge. But it doesn't have to be that way.

 

LIVESTRONG

 

Lance Armstrong is Founder and Chairman of LIVESTRONG. Lance Armstrong, a champion cyclist and cancer survivor, established his Foundation before he knew whether he would survive his own cancer.  Photo by Elizabeth Kreutz.