Fix Our Broken HealthCure System

by Margaret Anderson, COO, FasterCures
An ever-evolving economic crisis continues to challenge our U.S. and global leaders. The marathon search for solutions is approaching sprint speed and yet, we are surprised at how hardly anyone has turned to leveraging our greatest strength: human capital as part of the answer.

The 20th Century’s greatest achievement was the increase in life expectancy. This fueled the growth and increased the productivity of our economy and allowed nations worldwide to build wealth. The 21st Century presents us with the opportunity to not just leverage the extension of life but to also improve the quality of life. Instead of taking this opportunity head-on, we shy away from investing in human capital, the one resource we have an abundance of, even as we know that doing so will yield immense returns for generations to come.

Along with the moral imperative to conquer disease and relieve suffering comes the economic reality that illness and its costs are debilitating to our economy. According to the Centers for Medicare and Medicaid Services, the U.S. spent $2.1 trillion on healthcare in 2006, more than $7,000 per person. For all the intellectual and financial capital flowing through our healthcare system, there remains a formidable list of diseases for which there are no cures or even meaningful treatment options. Treating disease is not only the right thing to do to save lives; it is the right thing to do to save our economy.

Consider that the elimination of cancer as a cause of death and suffering is worth more than $50 trillion to the US economy. If we can do this, we would greatly add to the growth of our economy, productivity, and quality of life, making up for the financial assets we may have lost in the last 90 days, and preventing further loss in years to come. Yet our national investment in cancer research is going down and is nowhere near commensurate with the costs we bear or the gains we could expect if we made progress in curing cancer.

If President-elect Barack Obama cares about fixing America’s broken healthcare system, he needs to think about fixing the broken healthcure system.

Research!America released a report last week that showed 73 percent of Americans believe research is a solution to rising healthcare costs, and yet, out of every dollar we spend on health, we invest only 5.5 cents in research. It takes 15 years to develop new medical treatments. But we know that the thousands of people diagnosed with a deadly disease today cannot wait 15 years. We created a research enterprise system at the National Institutes of Health (NIH) whose central organizing principle was the study of human biology. This brought enormous breakthroughs in the fundamental knowledge necessary to understanding, preventing, diagnosing, and treating many diseases. But our ability to translate exciting new discoveries into products that can help patients is severely lagging behind the pace of discovery.

If President Obama cares about improving America's standing around the world, he needs to make good health our most important export. Global health is not just for ex-presidents. Our global diplomatic strategy should include directing resources to finding cures for global diseases.

Reorienting our medical research enterprise to cure diseases will pay-off in dividends far greater than health outcomes alone. It is one of the critical pieces needed to rebuild America’s global standing. Diseases transcend national borders and trump domestic policy agendas.

We need to immediately begin creating a medical research system for the 21st Century, one that will focus on curing diseases. To do so would require the right leaders are in the right positions at the right time.

We need strong, capable individuals at the helm of government agencies with bold, nearly-impossible missions. Presidential appointments need to rest on credentials, not connections. With Former Senate Majority Leader Tom Daschle (D-S.D.) holding the top post at the Department of Health and Human Services, other officials with equal gravitas and expertise need to be in place protecting the health of all Americans, providing essential human services, and effectively managing an annual budget of over $700 billion dollars (representing almost a quarter of all federal dollars). We need and expect the right leader to steer the vast NIH enterprise down the path of finding cures, accelerating the pace of over 38,000 research projects nationwide, and managing 27 separate health institutes and centers. We need and expect a formidable FDA Commissioner ensuring the safety of foods and cosmetics, and the safety and efficacy of drugs and devices; products which represent almost 25 cents out of every dollar in U.S. consumer spending.

Among the tasks at hand, these leaders will have the opportunity to:

1. Transform the existing fragmented, bureaucratic research infrastructure into a collaborative network.
2. Ensure that the ultimate goal of all scientific research is to improve health and cure disease.
3. Highlight the critical role patients play in the search for cures and incentivize patient participation in research.
4. Ensure that the nationwide health information system being built can improve patient care and enable medical research.
5. Transform the NIH Intramural Research Program (IRP) to focus on translational research.
6. Support efforts to build capacity and improve effectiveness at the FDA.
7. Develop a responsive system for reviewing and funding research that will identify the most promising areas of scientific exploration in terms of their potential to contribute to improved human health and well-being.
8. Encourage innovative, integrated, and information-based research approaches and new models of research funding.

As President-elect Barack Obama turns his attention to reforming our healthcare system, he, too must nurture our healthcure system. Only if we translate promising scientific research into new treatments will we have any hope of reducing healthcare costs, productivity losses, and human suffering.
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A Manhattan Project to Replace the Moon Shot

by Greg Simon, President, FasterCures

Next summer I have my fortieth high school reunion. (Ouch!) I haven’t decided whether I’ll go. To be honest, I’m not sure I want to be trapped for a few days talking about what happened forty years ago. I always cringe when I hear "Glory Days," the Springsteen song about a guy stuck reliving his high school achievements the rest of his life. I’ve had a lot of good fortune in my life since high school and there’s a lot to talk about; the problem is I don’t feel comfortable talking about it around people who only want to talk about the "glory days."

Well, I hate to say it, but America is stuck at its own fortieth reunion, talking about past glory days – I’m talking about landing a man on the moon forty years ago, my senior year in high school.

How often have you heard in the past election campaign, or at meeting after meeting on healthcare, education, technology innovation, whatever, that what this country needs is another moonshot, a commitment to do something hard and inspirational? And for a special bonus, don’t forget to mention the Manhattan Project when you really want to inspire people to do something hard.

Right. What we need to do to cure cancer or fix our broken schools is to lock a group of Hungarian, German, and Russian immigrants in a gym under a football field, put them under the dictatorial command of a General and not let them out until they develop something that can end life as we know it.

Is this the best we can do? Have we accomplished nothing since the Bomb and the Apollo projects? Have we been wandering in a desert of underachievement for the last forty years, or are we just metaphor-deprived?

Let me take a different tack. Have you ever noticed that nearly all the metaphors we use in daily life originated in 18th century sailing terms?

• "We stayed ‘til the bitter end." (The end of the anchor cable attached to the "bit.")
• "He was three sheets to the wind." (Sheets are the ropes that haul the sails, three sheets flying mean you are out of control.)
• "I gave him quite a start." (To "start" someone on a ship is to strike them with a whip, or worse to get them moving and working.)
• "He has lost his bearings."
• "The campaign fired back with a full broadside." (I’ve long advocated for the America’s Cup to require cannon battles during the race. Anyone can learn to sail, but can you sail and fire a broadside at the same time?)

None of these terms retain their original meaning, they are now shorthand for situations or conditions.
When I worked for Vice President Gore, he gave a commencement speech at MIT devoted exclusively to the poverty of modern metaphors to represent our lives. (We did two all-nighters on that speech, but that’s a different story.) His point is just as true today; for all of our innovation in science and technology that has transformed our daily lives, we have not found a way to replace the metaphors we inherited from our grandparents’ grandparents. (Somehow, "My hard drive crashed" still doesn’t trump "It took the wind out of my sails.")
So, how do we …uh…chart a different course? Are we doomed to be linguistically lost at sea, rudderless and unmasted by a lack of imagination? Or can we damn the torpedoes of inertia and go full steam ahead with a wind of new metaphors at our back, flowing with a creative current of concepts to a bright shining shore? Whew.

First, let’s leave high school. We can no longer ride the moonshot to glory, and those scientists we need for another Manhattan Project can’t get work visas. Where can we look for inspiration? Let’s leave the world of rockets and bombs and look at life.

It’s 2008 and so far, we have defined life in the 21st Century in terms of having everything instantaneously and simultaneously. We want speed (10 seconds to open an attachment?!). We multitask (ITunes, YouTube, instant messaging, Facebook updates, all while watching CNN’s split screens). We live in communities connected by social networks (are the 2,489 friends really your friends?).

And yet, when speed matters most and its consequences are measured in terms of lives saved, we’ve gotten complacent. It takes 15 years to develop new medical treatments. If living longer and having a better quality of life are not enough to spur us into making this a national priority, where can we look for inspiration? What will it take for us to focus on curing diseases?

We need a moonshot equivalent in the life sciences. Until then, any metaphors we should consider?

FasterCures President Gregory C. Simon Joins President-Elect Obama’s Transition Team

FasterCures president Gregory C. Simon, former Chief Domestic Policy Advisor to Vice President Al Gore, has been named by President-elect Barack Obama to his transition team.

Simon is part of the team reviewing the Department of Health and Human Services (HHS). He brings experience and expertise in biomedical research policy, knowledge of the transition process, and close familiarity with the mission of HHS and its 11 operating divisions, including the National Institutes of Health and the U.S. Food and Drug Administration.

“I am honored to join President-elect Obama’s HHS transition team to help ensure that the important work of the agency continues to move forward seamlessly,” said Simon. “HHS touches the lives of millions of Americans every day in its quest to protect the health of all Americans and provide essential human services,”

Greg Simon is president of FasterCures, a center of the Milken Institute formed in 2003. Simon’s leadership has positioned FasterCures into an organization valued and recognized for catalyzing systematic change in the process of discovery and development of new therapies for deadly and debilitating diseases. In October 2008, Nature Medicine named Greg one of 10 influential people to watch in biomedical policy and noted that he is among a “handful of influential people who quietly help keep the wheels of biomedical science turning.”

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About FasterCures
FasterCures / The Center for Accelerating Medical Solutions is committed to saving lives by saving time in the research, discovery and development of new treatments for deadly and debilitating diseases. FasterCures, as a center of the Milken Institute, is nonpartisan, nonprofit and independent of interest groups. For more information, visit www.fastercures.org.