Kudos to the WaPo for publishing two great articles today on some of the biggest problems in our healthcare system. First,
part one of a series on Medicare outlining the billions of dollars we waste every year due to outdated financing rules. Advances in healthcare information technology and a better understanding of
disease management in the last ten years have given us the tools to fix much of this disfunction, but making these changes will require a dose of political will we do not currently possess.
For healthcare policy wonks like myself this is not news, but this series is exactly the kind of thing required to get people calling their Congressional reps (if anything will). Perhaps when we are finally faced with raising payroll taxes significantly to fund Medicare for old sick babyboomers, Congress will suddenly get religion on Medicare reimbursement reforms.
The second article focuses on the
pharmaceutical industry's bribing of physicians, to the tune of an average $6K a year for every doctor in the country. Vermont tried to do something about this with legislation requiring the disclosure of pharma reps' gifts to docs (just like campaign finance disclosure requirements). Of course, the pharmaceutical industry got the bill watered down to the point they can drive their aircraft carrier through the loopholes. In addition to the author's excellent recommendations for better legislation on this issue, I've got one to add from the healthcare IT geek peanut gallery:
1) Set up a data model that uniquely identifies each medical provider by their DEA number
2) Pharm companies are required to electronically submit an
XML formatted report of all their gifts to medical providers on a periodic basis
3) The state health department publishes a website that incorporates all the data submitted by the Pharm companies and allows John Q. Public to easily look up how many thousands of dollars his doctors are accepting in bribes (and for which drugs)
Using XML formatting and open source web application tools, a system like this could be easily and inexpensively set up and then made available to other state health departments. Once installed, it would not be a significant administrative burden for the health department -- the data would be updated automatically because of the XML formatting. Depending on how the Pharm companies are currently tracking their bribes, it might be an administrative burden for them (something I wouldn't lose much sleep over).
By the way, I'm all for the pharmaceutical industry making money. I just think that when they spend twice their R&D budget on marketing, they don't have a leg to stand on when they threaten us with inferior drugs if we dare mess with their blessed status quo. (
In 2002, the top 10 US pharm companies spent 31% of revenue on marketing compared to 14% on R&D).
