What is driving the cost of health care?

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Articles - May 2013
Monday, April 29, 2013

New technologies

The U.S. is renowned for health care innovation, and new medications, devices and techniques have revolutionized standard practices many times over in the last quarter century. However, newfangled technologies have a price. Portland-based HemCon Medical Technologies, for example, developed a novel type of bandage formulated using the substance chitosan, derived from shrimp, which rapidly stops bleeding on the battlefield and beyond. The fact that HemCon became Oregon's biggest corporate bankruptcy of 2012 after being sued for patent infringement illustrates that stakes are high in health care technology. Companies spend many years developing products, investing millions, awaiting FDA approval and fending off litigation. So if and when brand-name drugs or medical devices finally hit the market, prices must be inflated way above manufacturing costs to cover all the R&D, marketing and intellectual property fees before patents run out or the technology becomes obsolete.

These demands fuel medical inflation. In 2012, Portland-Salem’s consumer price index (CPI) for medical care was 262 points above CPI for all other items, and it has greatly surpassed U.S. medical care CPI since 2007. Prescription drugs are one of the fastest growing among medical care CPI components, and Oregonians have been heavier-than-average drug consumers. In 2011, Oregonians per capita filled 13.3 retail prescription drugs at pharmacies, versus 12.1 across the county, according to the Kaiser Family Foundation.

Health care companies will continue to face battles bringing products to market, and it’s unlikely patients’ hunger for better drugs and technologies will be sated anytime soon. But if consumers can become more cognizant of the costs of their care — even as an employer or insurance company foots the bill — they might aid its cost-effectiveness.

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Editor's Letter: Power Play

January-Powerbook 2015
Thursday, December 11, 2014

There’s a fascinating article in the December issue of the Harvard Business Review about a profound power shift taking place in business and society. It’s a long read, but the gist revolves around the tension between “old power” and “new power” as a driver of transformation. Here’s an excerpt:

Old power works like a currency. It is held by few. Once gained, it is jealously guarded, and the powerful have a substantial store of it to spend. It is closed, inaccessible, and leader-driven. It downloads, and it captures.

New power operates differently, like a current. It is made by many. It is open, participatory, and peer-driven. It uploads, and it distributes. Like water or electricity, it’s most forceful when it surges. The goal with new power is not to hoard it but to channel it.

The authors, Henry Timms and Jeremy Heimans, don’t necessarily favor one form of power over another but merely outline how power is transitioning, and how companies can take advantage of these changes to strengthen their positions in the marketplace. 

Our Powerbook issue might be viewed as a case study in the new-power transition. This annual book of lists provides information on leading businesses, nonprofits and universities in the state. Most of the featured companies are entrenched power players now pursuing more flexible and less hierarchical approaches to doing business. Law firms, for example, are adopting new technologies and fee structures to make legal services more accessible and affordable.

This month we also take a look at a controversial new U.S. Securities and Exchange Commission rule requiring public companies to disclose the median pay of workers, as well as the ratio between CEO and median-worker pay. 

Part of the 2010 Dodd-Frank financial reform law, the rule will compel public companies to be more open about employee compensation, with the assumption that greater transparency will improve corporate performance and, perhaps, help address one of the major challenges of our time: income inequality.

New power is not only about strategy and tactics, the Harvard Business Review authors say. “The ultimate questions are ethical. The big question is whether new power can genuinely serve the common good and confront society’s most intractable problems.”

That sounds like a call to arms. Or a New Year’s resolution. Old power or new, the goals are the same: to be a force for positive change in the world. Happy 2015!

— Linda


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