Medical Device Daily Washington Editor
NEW ORLEANS – It would be difficult to come to almost any kind of healthcare conference and not talk about overall trends – past, present and future.
Ian Morrison, PhD, who bills himself as a “healthcare futurist,” was the plenary session speaker Thursday morning at Heart Rhythm 2005, the 26th annual scientific sessions of the Heart Rhythm Society (Washington).
An author and consultant specializing in long-term forecasting and planning focused on healthcare, Morrison detailed positives and negatives (backed by a wide variety of data from different sources) about the U.S. healthcare system and what these trends portend for the future of medicine in America.
He had good news to share for the device sector.
In a recent survey of American satisfaction of different industries, respondents placed “a very high value” on medical devices and equipment such as pacemakers and stents, Morrison said.
“People appreciate the value they get from devices,” he said. That’s certainly a positive given that public sentiment is completely opposite for pharmaceuticals. “Pharmaceutical companies are right up there with tobacco companies as the most despised in America,” he added.
While that news is encouraging, it should be taken with a grain of salt.
Morrison said people surveyed had a basic knowledge of pharmaceutical companies, their names and their products. Overall, the public that doesn’t know many specifics about device companies.
“The general public has no clue who the device companies are,” he said. Even if they did, he predicted their impression probably still would be more favorable than that for drug companies.
One of the few pharmaceutical areas that has received “anything close to a ringing endorsement” from the American public, he noted, has been generic prescription drugs.
Overall, Morrison said the approach to healthcare in developed nations shares certain values, such as government responsibilities, equity, and universality.
Compared to most countries, however, the U.S. has slightly different healthcare values. The role of government as a healthcare provider is not as universal, and Americans care more about volunteerism.
“And you’re on the verge of paranoid about monopolies,” said Morrison, a native of Scotland, who now lives in California, by way of Canada. “But Americans love technology and innovation.”
The love of technology comes with a price, he suggested.
“Countries outside the U.S. have done fairly well when it comes to reducing costs,” he said. “This speaks to concerns about what we are getting for the enormous premiums we in the U.S. are paying, compared to other countries.”
By his numbers, U.S. healthcare costs are 15% of our gross domestic product. Roughly 23% of all healthcare charges in America are related to administrative costs, “making it among the most inefficient in the world,” Morrison said.
It also increases the numbers of uninsured – 45 million people this year, and 56 million by 2013, he predicted.
Some people assume that because the technology is better, it must cost more.
“That seems intuitive, but there are other factors at work here,” Morrison said. “There is something in the middle. There must be value, quality and results. Technology by itself is not enough, though it is a great environment for drug and device companies.”
He called the quest for value “a common thread,” no matter where you live.
One of the more recent popular catchphrases in healthcare is “pay for performance.”
The Centers for Medicare & Medicaid Services (Baltimore) recently has initiated some physician practice-based pay-for-performance programs.
The programs have sparked some controversy from critics who charge that physicians shouldn’t need money as an incentive to provide better care. Proponents argue it is a better way to get value out of a system that pays for service, no matter the outcome.
“That is an idea that is increasing globally,” Morrison said.
He noted that true performance must be a combination of access and quality. When compared to other English-speaking countries such as Australia, Canada, New Zealand and the UK, the U.S. has the worst healthcare satisfaction scores, with low marks in such categories as quality of emergency care, patient-doctor relationships and access to primary care.
The U.S. does score better on access to medical records and time to elective surgery.
“That’s the hallmark of the U.S. system,” he said. “You can find a specialist at the drop of a hat.”
Much of the onus for driving change will fall to consumers, and healthcare will have to respond as any industry would to stay in business and survive.
“As we shift more of the burden to consumers, delivering and demonstrating value will be increasingly important,” Morrison said. “The reasons Americans haven’t had a raise in the last 10 years, on average, is because so much extra is going toward healthcare.”
There has been three years of double-digit growth in insurance premiums. “That is an astonishing and unsustainable trend,” he said.