Milken Institute
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Changing our health-care priorities: Incentivizing prevention and cures
By: Milken Institute
April 26, 2010
Health reform legislation is a positive step toward providing more Americans with insurance, but there's a big omission: The law doesn't do enough to promote prevention, innovation and cures. In a session moderated by CNBC's Maria Bartiromo, panelists discussed taking a broader and more holistic approach to what the concept of health care really means.

At least 70 percent of health spending goes toward preventable diseases, most of which are caused or made worse by lifestyle choices. Obesity is linked to several serious medical conditions i? 1/2 from heart disease to cancer i? 1/2 and its consequences are grave.

Every imperative to lose weight is there. But obesity presents an accumulation of complex socioeconomic factors that influence lifestyle choices. For example, in many communities, especially urban neighborhoods, options for healthy choices are limited, not easily affordable, or in some instances, completely unavailable making healthy choices difficult or impossible.

Prevention, said Wayne Gattinella of WebMD, is a "concept without a champion." Health insurers, pharmaceutical companies and even health-care providers are just not incentivized to promote it. Jay Gellert of Health Net said it's time to wage a war against obesity, the same way we fought the war against smoking. According to Gellert, "right now, we are fighting this war with squirt guns."

Ardis Hoven of the American Medical Association called for educating the public in a meaningful way and ensuring that available information is trustworthy and reliable.

Quickly woven into the conversation were the likely suspects of the ever-expanding waistline i? 1/2 Pepsi, Coca-Cola, McDonalds. Are they to take the brunt of the blame? Perhaps. But the larger question remains: Who's in charge of helping Americans improve their lifestyles, make healthier choices, and enhance productivity?

All panelists underscored that collaboration across sectors i? 1/2 health, policy, business i? 1/2 will be key.

The other side of coin is finding real cures for disease, said Michael Milken, chairman of the Milken Institute and FasterCures. Breakthrough cures will pay tremendous dividends, but we will have to channel capital correctly and streamline the process of translating discoveries into treatments. Milken cited the successful management of polio in the 1950s, and urged policymakers to learn from history.

David Brennan, CEO of AstraZeneca said that it's "about the art of what's possible." The pharmaceutical industry has been treatment-oriented, and for most diseases, there's limited understanding of prevention.

America's leadership in medical innovation is now being challenged on a global scale, and the U.S. should look to science parks in China, a biopolis in Singapore and better science and math education in Asian nations to find best practices. Innovation will thrive in an environment where it's appropriately incentivized and rewarded.

Milken noted that if the U.S. continues to misallocate resources significantly, our future in science will be in question. "What are we as a government going to stand for?"


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