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Healthcare is an asset, not an expense

There is something Rotten in the U.S. Healthcare system

The republicans had eight years to come up with something better than the Affordable Care Act (ACA). None of the proposals honor the commitment that Donald Trump made during his election. Instead, the proposals includes 1) defunding of preventive care, which will drive up costs, 2) repeal of important provisions that ensure that people with pre-existing conditions can afford a plan 3) Redefinitions of what healthcare is to a point where important care no longer is included driving up out of pocket cost 4) Increase of cost for the elderly who needs healthcare the most.

I am in support of more effective healthcare; however, the inconvenient truth is that the U.S. healthcare system is three times (3X) as expensive per capita compared to the single payer healthcare systems in Europe, which cover EVERYBODY, with comparable outcomes.

Furthermore, providing healthcare enables patients to be active, hold jobs, and pay taxes.

"I am always surprised to hear healthcare being a cost. It’s an asset that enables patients to survive, to continue contributing to society, and thereby pay taxes"

In other words, the United States could provide healthcare for ALL with the existing budget by making structural changes. 

Here are a couple urgent changes which could provide a more cost-effective healthcare system in the United States:

  1. Remove any economic incentives for doctors for writing drug prescriptions and create economic incentives for outcome = health
  2. Enable Medicare to negotiate with drug providers to lower drug prices (drugs are three times (3X) more expensive in the United States compared to single payer systems which negotiate those prices).
  3. Accelerate PEMA regulation which changes the payer codes for diagnostics from a cost-based system to a value-based system. Diagnostics are not attractive investments because they don't get reimbursed the same way as drugs!
  4. Change the patents laws so companies can invest in diagnostics. Right now, we can't get patents issued on our innovations.
  5. Support streamlining of the FDA approval process of new treatments based on real-life data rather than structural clinical trials. Clinical trails do not reflect how the drug will work in a real-life situation. 
  6. Improve access to experimental drugs and drugs approved in other indications when existing standard of care don't work. Next generation diagnostics can assist in determining much for efficient treatments; however once that data exists, hurdles still remain for getting access to those drugs either from a regulatory or a payer perspective.

Medicare pays the doctor six percent (6%) of the cost of the drug and this is a "perverse incentive": It makes doctors economically incentivized to write drug prescriptions - and choose more expensive drugs. This is in steep contrast to the Stalk laws which makes it illegal for diagnostic companies to provide economic incentives to doctors to use diagnostics. Next generation diagnostics can predict responses to drugs. The inconvenient truth is that only one out of four cancer drugs prolong life! We are wasting $75 billion out of the $100 billion we spend on cancer drugs every year globally 

I do believe that a commercial system can work in the United States; however, the current system is not outcome/value based, and that needs to change.

Here are a couple urgent changes which could provide a more cost-effective healthcare system in the United States:

  1. Remove any economic incentives for doctors for writing drug prescriptions and create economic incentives for outcome = health
  2. Enable Medicare to negotiate with drug providers to lower drug prices (drugs are three times (3X) more expensive in the United States compared to single payer systems which negotiate those prices).
  3. Accelerate PEMA regulation which changes the payer codes for diagnostics from a cost-based system to a value-based system. Diagnostics are not attractive investments because they don't get reimbursed the same way as drugs!
  4. Change the patents laws so companies can invest in diagnostics. Right now, we can't get patents issued on our innovations.
  5. Support streamlining of the FDA approval process of new treatments based on real-life data rather than structural clinical trials. Clinical trails do not reflect how the drug will work in a real-life situation. 
  6. Improve access to experimental drugs and drugs approved in other indications when existing standard of care don't work. Next generation diagnostics can assist in determining much for efficient treatments; however once that data exists, hurdles still remain for getting access to those drugs either from a regulatory or a payer perspective.

Medicare pays the doctor six percent (6%) of the cost of the drug and this is a "perverse incentive": It makes doctors economically incentivized to write drug prescriptions - and choose more expensive drugs. This is in steep contrast to the Stalk laws which makes it illegal for diagnostic companies to provide economic incentives to doctors to use diagnostics. Next generation diagnostics can predict responses to drugs. The inconvenient truth is that only one out of four cancer drugs prolong life! We are wasting $75 billion out of the $100 billion we spend on cancer drugs every year globally

I do believe that a commercial system can work in the United States; however, the current system is not outcome/value based, and that needs to change.

Being Danish I am intimately aware of the benefits as well as downside of a single payer system which does not implement novel technology with the same enthusiasm as the US system.

Obamacare was a plaster on a problem that needs a root canal, however I am confident that it can be improved and surpass any single payer system granted that the right changes are made. The current AHCA proposals does not do that.

The Trump Healthcare proposals reduces cost by reduce care and limit access for some of the Americans that need it most.

Gitte Pedersen

CEO and co-founder

Genomic Expression