Dr Robert Dubois Discusses Addressing Healthcare Spending

The destination is to get to a point where we can spend our healthcare resources more wisely so that patients get the care they need and we all get the type of innovation that we really want, said Robert Dubois, MD, PhD, chief science officer and executive vice president, National Pharmaceutical Council.

Trascript (slightly modified)

What do you think are the most important questions that currently need to be addressed in the conversation about healthcare spending?

I think there’s a number of important questions that need to be addressed regarding healthcare spending, and I think there’s tier 1 questions and tier 2 questions. The tier 1 questions are really the high-level ones: How much do we want to spend on healthcare in the United States? And then, how do we allocate those dollars? So those are the high-level questions.

Then underneath it is where it gets to be difficult. It’s what I like to call the third rail questions: should we be spending more in preventive care than actual treatment? Should we be spending different amounts on end-of-life care or on the elderly versus the younger folks? Should we be spending the same amount on cancer care that we do today, or should we allocate those resources differently? That’s the second-tier questions, and those frankly are the really tough ones, but unless we address those, we really won’t come up with any solutions.

What will the consequences be for the US economy if unchecked healthcare spending is not addressed?

Too often we say the problem is drug spending or the problem is hospital consolidation raising the cost of going into the hospital. That’s looking at things individually and finger pointing. What we need to do is not just look at the costs of these services, but also the benefits. So, what’s the cost of hospital care, and what are the benefits? What are the costs of medications or devices or surgery, and what are the benefits?

Only by looking at those side by side can we decide, “You know, I think we’d be better off reallocating some of our resources, which are currently being spent on things that are not high value, and shifting those dollars towards things that in fact are high value.”

We are on a journey, and the journey really is to begin to talk about these kind of things, but the destination isn’t just to talk. The destination is to get to a point where we can spend our healthcare resources more wisely so that patients get the care they need and we all get the type of innovation that we really want.