DDP 2010 Panel: Assessing the Impact of Healthcare Reform on Payment, Reimbursement and Innovation

Moderator: Ian Morrison
Internationally known Futurist, Future of Healthcare and the Changing Business Environment and author, Health Care in the New Millennium: Vision, Values, and Leadership The Second Curve and Future Tense: The Business Realities of the Next Ten Years
Sally C. Pipes, President and Chief Executive Officer, Pacific Research Institute and Author, Miracle Cure: How to Solve America’s Health Care Crisis and Why Canada Isn’t the Answer and The Top Ten Myths of American Health Care: A Citizen’s Guide
Michael J. Ruggiero, Senior Director, Government Policy & External Affairs, Astellas Pharma US, Inc. Peter J. Pitts, President, Center for Medicines in the Public Interest and Advisor, Obama FDA Transition Team

Is health reform dead?
Understanding healthcare is like unraveling an onion, full of layers and tears. The President made a commitment to healthcare reform. He’s increasing the role fo government in the healthcare system, it currently owns 48%. It’s looking to increase it. It isn’t currently dead, according to the panelists, there are lots of things going on behind doors.

Our country’s leaderships doesn’t know if healthcare reform is dead or not. It’s a continuum rather than a series of options. They look to fix the Senate bill and pass it. A bill may be presented, just scaled back. Healthcare is a part of culture, intertwined with the fabric of society. Healthcare policy is not healthcare reform. Some of the biggest issues we have to tackle (infrastructure, value, etc.), have nothing do with actual reform. Innovation in how hospitals are paid, happens regardless no matter what happens to the current passage of the healthcare bill.

How do we achieve quality healthcare? 1) Patient centered solution 2) Increasing Role for government from 48% to nearly 100%. We would move more towards a Canadian healthcare system.

What about multiple tier systems for healthcare?
Canada isn’t the best compression for where the US should get its healthcare from. Holland, France and Germany tend to be the best compression for where US should go. There are rules for the insurance market. Should the US copy Holland? One panelist believes a lot of people look to organize the US healthcare system. As a policy person, it’s difficult to translate the rules. The other panelist believes that all of the systems are undergoing cost control issues. The French system has been facing cost increases, they’re looking at putting people into healthcare education systems. The HMO was making the decision, instead of the patient. However, they’re not making their decision. We need our own healthcare system that suits the needs of America, not the needs of another country. We are world renowned in world for healthcare treatments and devices, we can’t forget that when looking to reform healthcare.

The Drug Delivery industry can help this situation by making it easier to take their medication. That is what they can do to help healthcare reform.

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DDP 2010: Explore Insights and Perspectives on Healthcare Reform and its Impact on Innovation and Reimbursement in the Pharmaceutical Industry

Ian Morrison, Internationally known Futurist, Future of Healthcare and the Changing Business Environment and author, Health Care in the New Millennium: Vision, Values, and Leadership The Second Curve and Future Tense: The Business Realities of the Next Ten Years

Every health system in the world is a compromise. They all have flaws. The US has the worst, possibly because we spend twice as much on healthcare than any other nation. Why the difference? The fallacy of excellence – we have great hospitals and technology, but lack in other areas. Can we fix it? Culture is part of the problem. Policy management and the payment system are part of what the problem is in American system.

The average American family cannot afford the average cost of healthcare. The reform to change this is now in jeopardy due to the election of Sen. Brown in Massachusetts. If people are required to buy healthcare, they will be those who cheat the system. The problem with reform is with the stakeholders, most who are onboard with the compromise. Who does the public blame for the problems in the healthcare system? The answers are Pharma and Health insurance.

Extreme right and left feelings have killed reform. Total costs will rise at a slower rate because no coverage expansion subsidized by the government. Rates are going up, no matter what, by 8%. This is without healthcare reform. Could it switch either way? This will result in small businesses getting out priced, just like it has been over the past few decades. There’s no way to balance a budget with a country which has no taxes. The people with the best health plans in America are teachers and firefighters….and those at Goldman Sachs.

Where are we headed? If we stay where we are, generic substitution for drugs will increase. In the 25% of people who are taking injectibles, they don’t take the right amount of medicine due to the current cost. What does this mean for Pharma? Coverage, in Obama’s current plan, would be expanded to cover more drugs. Cost shifting will continue, and it will result in individuals using more generics.

Pharma will have to change the way it does business over the next few years. Value will also have to be demonstrated to the customer at the end.

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