When Vice President Biden announced that he would not seek the Democratic nomination for president, he made clear that he intends to use his remaining 15 months in office to help drive a national commitment to end cancer.
“If I could be anything, I would have wanted to have been the president that ended cancer, because it’s possible,” the vice president said.
He’s right – it is possible. While more than half a million Americans will die this year from over 100 types of cancer, we’re entering a new decade of medical discovery, one in which we’ll see breakthroughs that will gradually bring these numbers down.
Fortunately, we’re on the right track. From 1991 to 2010, the cancer death rate for men and women dropped by 22 percent. Imagine if we could get this number to 40 or 60 percent (or higher).
Unfortunately, however, the U.S. spends approximately three trillion dollars on health care every year ($157 billion on cancer alone) and, despite our system being the envy of the world, people with cancer and other debilitating diseases aren’t getting the results they need and deserve. Ironically, the focus increasingly is not on the patient and what is in his or her best interests.
According to the Centers for Disease Control and Prevention, one out of four adults had two or more chronic health conditions in 2012. Diabetes cost the nation $245 billion that year. Heart disease cost more than $440 billion. Furthermore, these amounts don’t factor in loss in productivity or the irreparable impacts on families, children and communities in every state and district across the country.
Beyond chronic disease, deductibles are going up, co-pays are going up and we’re moving further away from clear solutions to help bring costs down – human and financial.
Here’s a proposal: what if we put everything on the table — the full expenditure pie, if you will — alongside a simple proposition to treat and cure costly diseases. In some areas, we’re vastly underserving America’s seniors and most vulnerable while wasting resources on administrative matters and duplicative services. Insurance is an equally challenging area for far too many Americans as it has become confusing and burdensome. Hillary Clinton’s recently proposed $250 monthly limit on out-of-pocket prescription drug costs under the ACA is an example of a policy idea that will help minimize harm to the consumer.
To date, much of the focus has been on medications that treat cancer, cystic fibrosis and high cholesterol, among other costly conditions. However, for decades, spending on medications has amounted to approximately ten cents on the dollar compared to medical procedures and hospital care. We should have a practical conversation on drug prices, but we need to go beyond and focus on health care costs broadly.
By no means am I suggesting that straight spending cuts are the answer. In fact, it might turn out to be just the opposite (in the near-term, at least), and we need to take a careful look at how we shift the national mindset from reacting to disease prevalence to proactively preventing and treating it. In many ways, we’re losing the long-term game by viewing health care through a political or “good vs. bad” lens. Let’s not forget that disease is the enemy first and foremost.
What is the lynchpin of any proactive strategy? In short, new discovery. From health care to energy to high tech, we’ve all heard about the promise of innovation and the broader possibilities if only we would make it more of a priority. However, I’d make the argument that medical discovery is near the bottom of the list as it relates to the public’s innovation awareness generally because we can’t imagine a world without it.
In the last century, new discoveries have helped raise average U.S. life expectancy from 47 years to 78 years. They save lives and help chronically ill patients avoid expensive hospitalizations and emergency room visits. The Congressional Budget Office has recognized the increased use of prescription medicines in Medicare as a way to reduce the use of medical services and save costs.
If we are to develop cures for different types of cancer, as well as tackle disease head on, we don’t have the luxury of waiting for the next wave of discoveries. We need to proactively seek them. However, doing so requires leadership on the part of industry, academia, government, and individual patients, making a point to fully understand our nation’s health care woes and design a proactive mindset with patients and society writ-large in mind.
It’s an exciting time in medicine, but we lack a practical strategy for using it to our advantage. We’re long overdue to develop one.
Howard Dean, MD is the former Governor of Vermont and a former candidate for President. He is a senior advisor with Dentons. Views here do not necessarily reflect the firm or its clients.