Valuing Health Care: Improving Productivity and Quality

64 Pages Posted: 20 Apr 2012  

Kenneth J. Arrow

Stanford University - Department of Economics

Kamran Bilir

University of Wisconsin - Madison - Department of Economics

Shannon Brownlee

New America Foundation

Robert M. Califf

Duke University - School of Medicine

Bob Cook-Deegan

affiliation not provided to SSRN

Frank L. Douglas

Ewing Marion Kauffman Foundation

Paula Ehrlich

Drug Discovery Center of Innovation

Stephen H. Friend

Sage Bionetworks

David Gratzer

Manhattan Institute for Policy Research

Scott E. Harrington

University of Pennsylvania - Wharton School

David A. Hyman

Georgetown University

Brink Lindsey

Cato Institute; Ewing Marion Kauffman Foundation

Robert E. Litan

Ewing Marion Kauffman Foundation; AEI-Brookings Joint Center for Regulatory Studies

Susan M. Love

Dr. Susan Love Research Foundation

Ernest Ludy

EGL Advisors/The Ludy Family Foundation

Lesa Mitchell

Ewing Marion Kauffman Foundation

Benjamin Moulton

Harvard University - Department of Health Policy & Management; Informed Medical Decisions Foundation

Dominique Pahud

Ewing Marion Kauffman Foundation

George Poste

Arizona State University

Franklyn G. Prendergast

Mayo Clinic Center for Individualized Medicine

George L. Priest

Yale University - Law School

Arti K. Rai

Duke University School of Law; Duke Innovation & Entrepreneurship Initiative

Jonathan Rauch

Brookings Institution

Barak D. Richman

Duke University - School of Law

Carl J Schramm

Syracuse University

Peter H. Schuck

Yale University - Law School

Gregory C. Simon

Pfizer, Inc.

Joseph M. Smith

West Wireless Health Institute

Dane Stangler

Ewing Marion Kauffman Foundation

John E. Tyler III

Ewing Marion Kauffman Foundation

John Wilbanks

Ewing Marion Kauffman Foundation; Sage Bionetworks

Date Written: April 2012

Abstract

This report addresses a deceptively simple question: How can the productivity of American health care be substantially improved? Productivity, in lay terms, is the ratio of output to inputs. A more colloquial rendition of the question might be: how can we get a lot more bang for our health care buck?

By design, we have brought together a varied assortment of ideas and suggestions, illustrating the messy, grab-bag nature that effective changes often need to take. Yet our proposals do fall (albeit with some overlap) into four broad categories, which structure the recommendations section of this report.

Harnessing information: how systematically gathering and sharing data can unlock knowledge that produces systematically better choices. The key here is to incentivize a new corps of data entrepreneurs to collect and analyze existing medical data to discover and then disseminate the use of new therapies.

Improving research: encouraging more collaboration across institutions and funding more translational research (aimed at “translating” basic scientific discoveries into medicines and therapies).

Legal and regulatory reform: modernizing medical malpractice systems, removing counter-productive restrictions on health insurance premiums, and streamlining new drug approvals.

Empowering patients: there are large benefits of giving more power to the people who matter most — patients — to make informed decisions about their own care.

The ideas here are not new, though many of them are familiar only to the cognoscenti. To the contrary, we have sought ideas that have showed promise in the field, and then attempted to set them in a context that exploits the adjacent possible.

If this report can focus more minds in the health policy community and general public on finding and implementing those changes, in everything from clinical practices to regulatory structures, it will have succeeded.

From the Kauffman Task Force on Cost-Effective Health Care Innovation.

Keywords: health care, health, policy, productivity, regulation

Suggested Citation

Arrow, Kenneth J. and Bilir, Kamran and Brownlee, Shannon and Califf, Robert M. and Cook-Deegan, Bob and Douglas, Frank L. and Ehrlich, Paula and Friend, Stephen H. and Gratzer, David and Harrington, Scott E. and Hyman, David A. and Lindsey, Brink and Litan, Robert E. and Love, Susan M. and Ludy, Ernest and Mitchell, Lesa and Moulton, Benjamin and Pahud, Dominique and Poste, George and Prendergast, Franklyn G. and Priest, George L. and Rai, Arti K. and Rauch, Jonathan and Richman, Barak D. and Schramm, Carl J and Schuck, Peter H. and Simon, Gregory C. and Smith, Joseph M. and Stangler, Dane and Tyler, John E. and Wilbanks, John, Valuing Health Care: Improving Productivity and Quality (April 2012). Available at SSRN: https://ssrn.com/abstract=2042644 or http://dx.doi.org/10.2139/ssrn.2042644

Kenneth J. Arrow

Stanford University - Department of Economics ( email )

Landau Economics Building
579 Serra Mall
Stanford, CA 94305-6072
United States

Kamran Bilir

University of Wisconsin - Madison - Department of Economics ( email )

Madison, WI 53706
United States

Shannon Brownlee

New America Foundation ( email )

Washington, DC USA 20009
United States

HOME PAGE: http://newamerica.net/user/218

Robert M. Califf

Duke University - School of Medicine ( email )

United States

Robert M Cook-Deegan

affiliation not provided to SSRN

Frank L. Douglas

Ewing Marion Kauffman Foundation ( email )

4801 Rockhill Road
Kansas City, MO 64110-2046
United States
8169321204 (Phone)

Paula Ehrlich

Drug Discovery Center of Innovation ( email )

PO Box 13032
Research Triangle Park, NC 27709
United States

HOME PAGE: http://www.ddcoi.org

Stephen H. Friend

Sage Bionetworks ( email )

1100 Fairview Ave. N.
Mailstop M1-C108
Seattle, WA 98109
United States
(206) 667-2102 (Phone)
(206) 667-2062 (Fax)

HOME PAGE: http://sagebase.org

David Gratzer

Manhattan Institute for Policy Research ( email )

52 Vanderbilt Ave.
New York, NY 10017
United States

Scott E. Harrington

University of Pennsylvania - Wharton School ( email )

3641 Locust Walk
Colonial Penn Center
Philadelphia, PA 19104-6358
United States
215-898-9403 (Phone)
215-573-2157 (Fax)

HOME PAGE: http://scottharringtonphd.com/

David A. Hyman

Georgetown University ( email )

Washington, DC 20057
United States

Brink Lindsey

Cato Institute ( email )

1000 Massachusetts Avenue, N.W.
Washington, DC 20001-5403
United States

Ewing Marion Kauffman Foundation ( email )

4801 Rockhill Road
Kansas City, MO 64110-2046
United States

Robert E. Litan (Contact Author)

Ewing Marion Kauffman Foundation ( email )

4801 Rockhill Road
Kansas City, MO 64110
United States

AEI-Brookings Joint Center for Regulatory Studies

1150 17th Street, N.W.
Washington, DC 20036
United States

Susan M. Love

Dr. Susan Love Research Foundation ( email )

16133 Ventura Blvd 1000
Encino, CA 91436
United States
310-828-0060 (Phone)
310-828-5403 (Fax)

HOME PAGE: http://www.dslrf.org/

Ernest Ludy

EGL Advisors/The Ludy Family Foundation ( email )

Sausalito, CA

Lesa Mitchell

Ewing Marion Kauffman Foundation ( email )

4801 Rockhill Road
Kansas City, MO 64110-2046
United States
8169321109 (Phone)
8169321430 (Fax)

HOME PAGE: http://www.kauffman.org

Benjamin Moulton

Harvard University - Department of Health Policy & Management ( email )

677 Huntington Avenue
Kresge Building
Boston, MA 02115
United States

HOME PAGE: http://www.hsph.harvard.edu/faculty/benjamin-moulton/

Informed Medical Decisions Foundation

40 Court Street
Suite 300
Boston, MA 02108
United States

HOME PAGE: http://informedmedicaldecisions.org/about-us/our-team/staff/communications-outreach-policy/

Dominique Pahud

Ewing Marion Kauffman Foundation ( email )

4801 Rockhill Road
Kansas City, MO 64110-2046
United States

HOME PAGE: http://www.kauffman.org

George Poste

Arizona State University ( email )

Mail Code: 9908
1475 N. Scottsdale Rd. SkySong - Suite 361F
Tempe, AZ 85287
United States
(480)727-8662 (Phone)

HOME PAGE: http://www.casi.asu.edu/

Franklyn G. Prendergast

Mayo Clinic Center for Individualized Medicine ( email )

200 First Street SW
Rochester, MN 55905
United States
(507) 284-4081 (Phone)
(507) 281-9349 (Fax)

George L. Priest

Yale University - Law School ( email )

P.O. Box 208215
New Haven, CT 06520-8215
United States

Arti Kaur Rai

Duke University School of Law ( email )

210 Science Drive
Box 90362
Durham, NC 27708
United States

Duke Innovation & Entrepreneurship Initiative ( email )

215 Morris St., Suite 300
Durham, NC 27701
United States

Jonathan Rauch

Brookings Institution ( email )

1775 Massachusetts Ave, NW
Washington, DC 20036
United States

Barak D. Richman

Duke University - School of Law ( email )

210 Science Drive
Box 90362
Durham, NC 27708
United States
919-613-7244 (Phone)
919-613-7231 (Fax)

Carl J Schramm

Syracuse University ( email )

900 S. Crouse Avenue
Syracuse, NY 13244-2130
United States

Peter H. Schuck

Yale University - Law School ( email )

P.O. Box 208215
New Haven, CT 06520-8215
United States

Gregory C. Simon

Pfizer, Inc. ( email )

235 East 42 Street
New York, NY 10017
United States

Joseph M. Smith

West Wireless Health Institute ( email )

10350 North Torrey Pines Road
La Jolla, CA 92037
United States

HOME PAGE: http://www.westwirelesshealth.org/

Dane Stangler

Ewing Marion Kauffman Foundation ( email )

4801 Rockhill Road
Kansas City, MO 64110-2046
United States
816-932-1044 (Phone)

John E. Tyler III

Ewing Marion Kauffman Foundation ( email )

4801 Rockhill Road
Kansas City, MO 64110-2046
United States
816-932-1293 (Phone)

John Wilbanks

Ewing Marion Kauffman Foundation ( email )

4801 Rockhill Road
Kansas City, MO 64110-2046
United States

Sage Bionetworks ( email )

1100 Fairview Ave. North
Seattle, WA 98109
United States

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