Table of Contents
- Executive Summary
- Strategic Considerations
- Stakeholder Implications
- A Conundrum Wrapped in an Enigma
- Health Care Rationing by Any Other Name
- Why Health Care Reform Is Necessary
- Staggering Impacts of Health Care Demographics
- Shifting Disease Patterns
- Society' s Expanding Expectations
- Expensive New Medical Technologies
- Health Care Economics 101
- Why Health Care Reform Has Failed
- Buying Your Way Out of Trouble
- Increasing Effi ciencies
- Invisible Hand of the Market
- Rationing by Stealth, Not by Fiat
- Insuring Only Healthy Patients
- Limiting Access Among the Elderly and to New Treatments
- Determining a Person' s Worth and Adopting Futile Care Approaches
- Rationing: Do Not Resuscitate
- Ascendancy of the Gray Panthers
- Requisites for Chronic Disease Care
- Added Strains from Preventable Illnesses
- Iatrogenic Illnesses in the United States
- Iatrogenic Illnesses in the United Kingdom
- Nosocomial Infections
- Modifying Health Care Demand
- Factors Driving Demand
- Upstream Prevention
- Educational Programs Aimed at Behavior
- Incentives for Changing Behavior
- Herd Immunization
- Environmental Disease Burden
- Behavioral Changes to Address Quality of Care
- Evidence-Based Medicine and Value for Money
- Technology Assessments to Determine Value
- Problems with Quality-of-Life-Adjusted-Year Thresholds
- Real and Assumed Value of New Medical Technologies
- The Concept of Care: Lifestyle Choice or Illness?
- The Bottom Line
Tables:
- 1. The Accelerating Aging of the Population and the Decline in the Rate of
Population Replacement
- 2. Current Vaccine-Preventable Diseases
- 3. Select Infectious Disease and Cancer Vaccines in Late-Stage Development
or in Registration, August 2007
- 4. High-Mortality Diseases with Environmentally Modifi able Factors
- 5. The 90% Solution: Saving 100,000 Additional Lives Annually in the
United States by Increasing the Use of Preventive Services
- 6. Select Lifestyle Drugs That Do Not Treat or Prevent Illness
- A. Tyrosine Kinase Inhibitor Treatment Costs and Medicare Prescription
Drug Plan Coinsurance Requirements
Figures:
- 1. A Growing Rift Between the Ability to Fund and the Capability to
Provide Health Care: Four Trends from the Late 1980s
- 2. Waste and Overconsumption in Both Private and Public Systems Due to a
Silo Approach to Health Care as Opposed to Holistic Health Care Management
- 3. A World Pharma Market Dominated by Annuity Drugs Offering Symptomatic
Treatment for Chronic Diseases
- 4. Preventable or Modifi able Health Care Risk Factors
- 5. Proactive, Not Reactive, Health Care
- A. Tyrosine Kinase Inhibitor Cost Controls Used by Private Health Care
Plans
Expert Commentary:
- U.S. Health Care Rationing and Cost Containment of Targeted Therapy Drugs
Used for Cancer Treatment
Expert Featured:
- Marcus Hoyle, analyst, Onkos, Decision Resources, Inc.
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