Searching for a Cure

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Articles - July/August 2014
Friday, July 11, 2014

The Big Pill

The Oregon coordinated-care solution seeks to align hospital and doctor incentives. “Everybody has looked out for themselves. That’s the way the system was built,” observes Davidson. “Breaking down those walls, you have hope for creating a system that’s incented to do less with less.”

There’s one problem: Not all the walls have come down. Drug companies and medical-equipment manufacturers, for instance, remain outside the purview of reform, despite the fact that their products are huge drivers of health care costs. “Oregon hospitals and physicians have bought into this concept, but drug companies and medical-equipment manufacturers clearly have not — and they threaten to sink it,” says Dannenhoffer.

He points to a $1,000 pill: a new hepa­titis-C drug he calls useful but ridiculously priced. “It’s hard to live within a 3% or 4% increase a year when some of the component costs are going up at a far greater rate.”

Long-term care providers, too, have managed to avoid transformation. “They negotiated a great political deal to not be included,” Davidson notes.

But health care reform is inherently political and therefore requires compromise. “We can’t let the perfect be the enemy of good,” says Davidson. “Drugs aren’t in. Durable medical equipment’s not in. Long-term care’s not in. And we need to have policy conversations about adding them in. But we had to do something to get everybody in the same tent.”



 

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