Curing Bureaucratic Health Care

 

Curing Bureaucratic Health Care

When the House voted to repeal the employer mandate and the individual mandate in Obamacare a few weeks ago, I wrote that we would look back on it as the beginning of the end of Obamacare. Only 12 percent of Americans favor implementing the individual mandate next year. People understand the law is unworkable.

I also challenged House Republicans to begin hearings on real opportunities to improve health care once the centralized bureaucratic model of the left finally falls.

A big part of their focus should be cures. A confluence of medical breakthroughs means that in the not-too-distant future we may be able to cure many of today’s most common diseases, changing how long we live, how well we live and how independently we live. For individual Americans, the value of reaching this breakout is tremendous.

It also has huge implications for government. Health is such a big part of what the government does these days -- between Medicare, Medicaid, and dozens of smaller programs and regulatory agencies -- that curing the most common diseases will necessarily transform government as a result.

If, through cures, we can reduce to trivialities the real human problems which motivated many of our largest programs, we will be in a whole different world from the one we are now debating. The problems we face in Medicare, Medicaid, health insurance coverage, and even Social Security will look completely different, if they aren’t solved entirely.

Consider just one disease: Alzheimer's. A few years ago I was privileged to serve on the Alzheimer’s Study Group. We discovered that this disease alone is estimated to cost taxpayers and citizens $20 trillion from now to 2050. Anyone who has had a family member or friend with Alzheimer's knows that this cold number understates the human pain and the human exhaustion that are integral to helping an Alzheimer's patient. But you can also imagine how quickly the fiscal cost of millions of Alzheimer’s patients adds up.

Simply understanding Alzheimer's enough to postpone its onset by five years could cut those costs in half because it is largely (though not entirely) a disease of the elderly.

You can probably think offhand of five other medical conditions like diabetes and heart disease that will cost taxpayers trillions in coming decades.

Almost nothing we could do to save taxpayers money can compare with curing the most common and expensive diseases. That’s because cures can dramatically reduce the cost of healthcare and of sustaining people in the later years of their lives. In fact, achieving that breakout might be the most powerful step we can take toward balancing the federal budget in the long term.

The opportunity to cure so many diseases is growing out of the interaction of four separate but parallel revolutions which could reinforce and magnify each other in ways few of our political leaders seem to understand.

The four great areas of breakthroughs are genetics, regenerative medicine, advanced brain diagnostics, and big data for health analysis.

Let’s consider each one separately.

First, the genetics revolution is creating waves of new insights into how bodies (human and otherwise) work. We are still in the early stages of discovering and applying this knowledge, but over the next two decades this area alone will yield tremendous breakthroughs in curing diseases. Even more exciting, it may lead us to an ability to anticipate diseases and “turn them off” before they start. This potential for understanding is what lead my friend and former commissioner of the FDA Dr. Andy von Eschenbach to believe we could cure cancer within 15 years. The genetics revolution could also help us develop new levels of prenatal care to preempt certain genetically driven birth defects.

Second, regenerative medicine is in the takeoff stage of becoming a genuine source of cures. Within a decade we could begin to routinely replace whole organs by taking your own cells and growing a new one for you. To achieve this, however, we will need profound change at the Food and Drug Administration.

Third, as the example of Alzheimer’s suggests, advanced brain diagnostics is probably the greatest opportunity we have to truly transform the quality of life for tens of millions of people. Our brains are one of the most complex systems we know of. Breakthroughs in understanding the brain could make great strides in curing autism, Alzheimer's, Parkinson's, mental health problems, and a wide range of other conditions. These mental conditions have the potential to distort our lives as decisively as any physical condition. Depression alone is a major contributor to total health costs, as depressed individuals are much more likely to manifest other illnesses.

And fourth, “big data,” the ability to collect and analyze huge amounts of information, has enormous implications for health research. As we develop more and more electronic health records, we will have the ability to aggregate a huge amount of data and analyze it. Electronic epidemiology will become a very powerful source of health information.

These breakthroughs are real. The question for government is whether it will hinder them, as it’s doing now, or accelerate them, which it could do even while spending less than it does today.

House Republicans should begin hearings to learn how we can use these breakthroughs to cure many of the most common health problems we face today.

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