By Sy Mukherjee
May 16, 2018

The National Institute for Health Care Management (NIHCM) Foundation on Monday had a wide-ranging panel on transforming health care in the United States, touching on complex issues like drug pricing, the barriers to (and fuels for) health care innovation, and what the future of American medicine will look like. Panelists at the Washington, D.C. event included Memorial Sloan Kettering Cancer Center’s Peter Bach, Blue Cross and Blue Shield of North Carolina’s Patrick Conway, former CMS Administrator Gail Wilensky, GuideWell and Florida Blue’s Patrick Geraghty, NIHCM Foundation’s Nancy Chockley, and one Clifton Leaf of Fortune.

It would be difficult to condense this all-star crew’s presentations into a single email. But NIHCM has conveniently made their slides available to the public. And I’d like to touch on just a few overarching highlights from a nuanced, in-depth conversation.

Wilensky, a widely-respected health care economist and former government official, broached one of the most significant big-picture questions about medicine in her presentation: Is the private or public sector better at nudging progress?

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“In almost all of those instances, it’s not a matter of which is better… They both have relative strengths, and there are cases where the other is stronger,” she said. “For very large-scale changes, it’s very hard for the private sector to pull that off in a way that government can do. But if you’re talking about new products, new payment models, commercializing new products as a strategy, generally speaking, the private sector is able to do that much more easily.”

Wilensky went on to note that “only government can produce large changes on a very specific timeline,” pointing to the examples of massive population health surveys that only the public sector is suited to undertake and innovation spurred by groups like DARPA. But she also stressed the fluidity of the enterprise—for instance, artificial intelligence development began in the public sector, but the funding was so sporadic and unreliable that it had to move to the private sector to really take off, Wilensky said.

Peter Bach, who leads Memorial Sloan Kettering’s Center for Health Policy and Outcomes, presented equally thought-provoking ideas about high drug prices, including whether or not the health care industry is right to cheer President Trump’s recent speech on curbing prices. “My group focuses on the weeds… It’s difficult to know if Wall Street’s got this right. The question is whether or not there’s going to be follow through on these things,” said Bach.

You can flip through all of the group’s PowerPoint presentations here (there is a lot to dig through).

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