Submitted by Mike Mahler (not verified) on May 17, 2008 - 10:31pm.
While the issues of health care costs and comparative effectiveness are complex issues by nature, I think we're looking too much to complex solutions as opposed to low cost measures that can be implemented quickly. All these major proposed plans, which often include 300+ million dollar Comparative effectiveness research centers and millions more in annual funding, do not appear to recognize resources which we already possess.
From a health care cost standpoint spending hundreds of millions, most likely annually, to attempt to determine the most cost effective treatments seems to me like robbing Peter to pay Paul. I just do not see the health care savings exceeding the costs of these proposed centers, and if they do it would be insignificant compared to the increased spending. Just researching and developing these proposed models would be a huge expense. Even if there is a moderate degree of success, will physicians have their hands tied in choosing the best treatments for their patients when they are the ones liable for the outcome? We already have too few physicians in our country, and those we have are often considering new careers due to the rapidly developing number of regulations and other red tape now associated with practicing medicine. They currently see more patients then any other time in our history and they're compensation for services continues to be reduced.
There are solutions much more beneficial to our system that not only cost less, but the cost is redirected from institutional entities to our most vital health care resource, the doctors. The problem is not with our capitalist system, it's with the sharing of information in a technological age that invites revolutionary methods of achieving this very end. The FDA's job is to make sure a medical device or pharmaceutical is safe for use. It's up to the companies to identify market needs and trends prior to taking a risk on spending the money in research and development of a new approach. These drugs, devices and techniques are in use across the nation after FDA approval. If we have physicians share results on the patients they have treated with these drugs, devices and techniques the results will speak for themselves. Let the doctors determine which of these is the most effective based on positive patient outcomes and share these results nationwide. Ideally these proposed millions of dollars should go to them so they can see fewer patients and report on outcomes. Let medical products gain market share based on positive results as opposed to which companies have the largest marketing budget and sales forces. If medical companies lose hundreds of millions of dollars because their product didn't stack up to the competition, they'd pay more attention to what they chose to bring to market. Let the doctors weed out the treatments that don't produce the results. They have the data on hand,and they should be paid for the time to assemble and produce it. It's much better then spending money on an institution that may or may not produce results, after they have developed their models, held countless meeting to make a single decision, jumped through hoops, and the pencil pushers have dotted the i's and crossed the t's. More bureaucracy is not the answer.
Finally, let's take a look at cost. The huge majority of medical companies are publicly traded and their financial information can be viewed by anyone. This is true almost true for all companies across the board, check it yourself. The largest expense is not research and development, not manufacturing, not even the companies profit margin, it is administration, sales and marketing. Almost all these companies spend 10% on research and development, 28% on manufacturing, 10% taxes, 18% profit margin, and yes, 34% on administration, sales and marketing. While yes all these companies need administrative employees and this portion is good for the economy. What is not good for health care is the $50+ billion spent annually on sales and marketing. While pharmaceutical companies have for years ran expensive DTC TV-ads we are now seeing medical device companies following suit. Zimmer corporation spent $600-800 million on a six month TV ad campaign promoting their total joints. The average sales rep annually costs a company $200,000 (Pharmaceutical rep) and $180,000 (medical device rep). TV ads, high pressure sales tactics, expensive aesthetically appealing marketing materials.... a doctor choosing a medical treatment is not the same as a consumer purchasing cookware, why do we treat them the same. Not to mention this system is highly inefficient, ineffective and fiscally irresponsible. Doctors need a centralized source to become notified of available products/techniques, a place to research them, and a peer review feature so they can compare patient outcomes and together determine the best treatment protocols for their patients.
We need to organize the doctors to take control of medical product information, comparative effectiveness research, and invite them to take an active roll in reducing health care costs by taking stands in areas where they can have an effect on reducing health care costs.
Analyze the system and unite physicians to take necessary steps. The sales and marketing point was just one example. Don't spend more money, add more regulations and bureaucracy, it just doesn't work for the good of anybody. Doctors are smart people, they know more then anyone the crippling effects of the current health care trends, they will help if given the right formats and platforms.
Doctors, if you read this, you're in greater jeopardy then ever of losing your right to treat your patients based on your years of education and experience. There are voices out there, support those voices, help build those platforms and take a stand to improve our nations health care. Don't leave it to the control of government, health insurance companies,or other non-physician oriented organizations. It will not be good for anyone.
Comparative effectiveness
While the issues of health care costs and comparative effectiveness are complex issues by nature, I think we're looking too much to complex solutions as opposed to low cost measures that can be implemented quickly. All these major proposed plans, which often include 300+ million dollar Comparative effectiveness research centers and millions more in annual funding, do not appear to recognize resources which we already possess.
From a health care cost standpoint spending hundreds of millions, most likely annually, to attempt to determine the most cost effective treatments seems to me like robbing Peter to pay Paul. I just do not see the health care savings exceeding the costs of these proposed centers, and if they do it would be insignificant compared to the increased spending. Just researching and developing these proposed models would be a huge expense. Even if there is a moderate degree of success, will physicians have their hands tied in choosing the best treatments for their patients when they are the ones liable for the outcome? We already have too few physicians in our country, and those we have are often considering new careers due to the rapidly developing number of regulations and other red tape now associated with practicing medicine. They currently see more patients then any other time in our history and they're compensation for services continues to be reduced.
There are solutions much more beneficial to our system that not only cost less, but the cost is redirected from institutional entities to our most vital health care resource, the doctors. The problem is not with our capitalist system, it's with the sharing of information in a technological age that invites revolutionary methods of achieving this very end. The FDA's job is to make sure a medical device or pharmaceutical is safe for use. It's up to the companies to identify market needs and trends prior to taking a risk on spending the money in research and development of a new approach. These drugs, devices and techniques are in use across the nation after FDA approval. If we have physicians share results on the patients they have treated with these drugs, devices and techniques the results will speak for themselves. Let the doctors determine which of these is the most effective based on positive patient outcomes and share these results nationwide. Ideally these proposed millions of dollars should go to them so they can see fewer patients and report on outcomes. Let medical products gain market share based on positive results as opposed to which companies have the largest marketing budget and sales forces. If medical companies lose hundreds of millions of dollars because their product didn't stack up to the competition, they'd pay more attention to what they chose to bring to market. Let the doctors weed out the treatments that don't produce the results. They have the data on hand,and they should be paid for the time to assemble and produce it. It's much better then spending money on an institution that may or may not produce results, after they have developed their models, held countless meeting to make a single decision, jumped through hoops, and the pencil pushers have dotted the i's and crossed the t's. More bureaucracy is not the answer.
Finally, let's take a look at cost. The huge majority of medical companies are publicly traded and their financial information can be viewed by anyone. This is true almost true for all companies across the board, check it yourself. The largest expense is not research and development, not manufacturing, not even the companies profit margin, it is administration, sales and marketing. Almost all these companies spend 10% on research and development, 28% on manufacturing, 10% taxes, 18% profit margin, and yes, 34% on administration, sales and marketing. While yes all these companies need administrative employees and this portion is good for the economy. What is not good for health care is the $50+ billion spent annually on sales and marketing. While pharmaceutical companies have for years ran expensive DTC TV-ads we are now seeing medical device companies following suit. Zimmer corporation spent $600-800 million on a six month TV ad campaign promoting their total joints. The average sales rep annually costs a company $200,000 (Pharmaceutical rep) and $180,000 (medical device rep). TV ads, high pressure sales tactics, expensive aesthetically appealing marketing materials.... a doctor choosing a medical treatment is not the same as a consumer purchasing cookware, why do we treat them the same. Not to mention this system is highly inefficient, ineffective and fiscally irresponsible. Doctors need a centralized source to become notified of available products/techniques, a place to research them, and a peer review feature so they can compare patient outcomes and together determine the best treatment protocols for their patients.
We need to organize the doctors to take control of medical product information, comparative effectiveness research, and invite them to take an active roll in reducing health care costs by taking stands in areas where they can have an effect on reducing health care costs.
Analyze the system and unite physicians to take necessary steps. The sales and marketing point was just one example. Don't spend more money, add more regulations and bureaucracy, it just doesn't work for the good of anybody. Doctors are smart people, they know more then anyone the crippling effects of the current health care trends, they will help if given the right formats and platforms.
Doctors, if you read this, you're in greater jeopardy then ever of losing your right to treat your patients based on your years of education and experience. There are voices out there, support those voices, help build those platforms and take a stand to improve our nations health care. Don't leave it to the control of government, health insurance companies,or other non-physician oriented organizations. It will not be good for anyone.