Envisioning 2.0

Sen. Tom Daschle has called for Americans to host and participate in health reform “house parties” and health industry insiders have responded to his call. In a clear signal that they want a seat at the health reform table, insurance companies have urged executives and consumers to participate in one of the 4,200+ meetings Americans will be having across the country during the upcoming holiday break. According to the New York Times:

“The meetings, originally envisioned as a way to make good on Mr. Obama’s commitment to “health care reform that comes from the ground up,” could thus turn into living-room lobbying sessions involving some of the biggest stakeholders in the health care industry.”

Some Obama advisers are afraid that health industry advocates will attempt to “pack” the meetings with supporters. However, others, including a prominent member of the Obama transition team, are less concerned.

It is clear that insurance companies are very worried about Obama’s pledge to create a parallel public insurance framework that will take all comers, regardless of age or disease status. However, managed care companies are not sure why Obama needs to set up another system. In a major concession, America’s Health Insurance Plans, an industry trade group, has signaled that managed care companies are willing to cover all who ask for insurance – if the incoming President pledges to institute an individual mandate for all Americans. In this case, all adults would be required to enroll in an insurance plan.

However, with health costs steadily increasing and the national debt approaching $1 trillion, it is unlikely that Obama and Daschle will accede to this request without taking steps to curb medical inflation.

It will be interesting to see whether the house parties bear fruit and how the health insurance industry will adapt to Obama’s reform efforts. However, it’s very likely that everyone won’t get what they want.

Please note: This will be my last post for the year, as the holidays are approaching.  I’d like to thank everyone for taking the time to read this blog and I wish all of you a merry and bright holiday season and New Year! I’ll see you all in January 2009.

Given my age, some might look at me and wonder why the topic of end of life care would be important to me.  However, it is. I see my elders aging and (since witnessing the September 11th attacks first-hand) contemplate my own mortality regularly.  This is why I am happy to support the Engage With Grace project.

According to USA Today, Engage With Grace is designed to make “one of life’s most difficult discussions easier by boiling it down to five talking points on a single, easily e-mailed and linked slide that can be shared during business events, long car rides and family dinners.”

Before learning about this project, I have had conversations with my loved ones about developing a living will.  It’s hard to contemplate the end of my life, but it is a worthwhile conversation to have.  Take the time to download the Engage With Grace slide and share it with others you care about.  Together, we can improve end of life care so and make it as positive as humanly possible.”

Over the past few years, attacks on pharmaceutical industry direct to consumer (DTC) advertising have steadily increased.  Once critics blasted it for increasing sales of medications that have limited usefulness.  Today, these individuals have been joined by some within and without the industry who have suggested that it is not a very effective marketing tactic.

I am very used to seeing scathing critiques of DTC advertising, but I must admit I was a little shocked when I learned that the CEO of Roche Pharmaceuticals, William Burns, said it was the “single worst decision for the industry.”  I have not been able to locate Burns’ full remarks, but his statement made me wonder whether:

o    Roche is going to discontinue its DTC advertising:  Perhaps not as commercials featuring Sally Field are currently appearing on television

o    If Roche is going to aggressively experiment with other marketing channels that help it build robust and authentic connections to patients

Somehow, I think that unless the FDA bans DTC advertising – which is unlikely – we are going to see companies continue to use it.  Although some may doubt its effectiveness, commercials do have their uses.  In crowded disease areas like osteoporosis, advertising can do a good job alerting people to new medications.  Roche likely believed that advertising about Boniva made sense because it only needs to be taken once a month unlike other osteoporosis drugs.

Despite Burns’ critique, I expect DTC advertising to be with us for a long time to come.