Opinion

The Great Debate

In determining healthcare cost, one size doesn’t fit all

Peter Pitts– Peter Pitts is president of the Center for Medicine in the Public Interest and a former FDA Associate Commissioner. The views expressed are his own. –

As part of its healthcare reform bills, Congress is calling for a more aggressive use of comparative effectiveness research (CER). What does this mean? Is comparative effectiveness the same thing as cost effectiveness?

No. There’s a big difference.

Cost effectiveness research is what The United Kingdom’s National Institute for Health and Clinical Excellence (NICE) does. NICE uses a measure known as a Quality Adjusted Life Year (QALY) to assess whether or not a treatment is cost-effective or not. If providing an additional year of life costs more than $50,000 — the average price of a fully-loaded Land Rover — NICE won’t recommend that treatment.

For example, NICE’s preliminary decision was that four new kidney cancer drugs — Torisel, Avastin, Nexavar, and Sutent — should not be reimbursed by the National Health Service (NHS) because, despite clinical evidence that these drugs can actually help, they weren’t “cost effective.”

Currently, the only available treatment for metastatic renal cell cancer is immunotherapy. This halts the disease’s progress for just four months on average. But if a person isn’t a candidate for immunotherapy, or the treatment doesn’t work, that’s it. They have no other treatment options.

Europe borrows from Peter to lend to Peter

jamessaft1(James Saft is a Reuters columnist. The opinions expressed are his own)

Europe’s experiment in borrowing from Peter to pay Peter argues for a slow economic recovery with a low ceiling.

Data released by the European Central Bank on Monday showed that the supply in money is growing at best haltingly and that loan growth to euro zone households and businesses is at its lowest since records began.

Annual loan growth to the private sector slowed to 1.5 percent in June from 1.8 percent in May while the broader measure of money supply growth hit 3.5 percent.

China and the world economy

gerard-lyons Dr. Gerard Lyons is chief economist and group head of global research, Standard Chartered Bank. The views expressed are his own.

The world is witnessing a shift in the balance of power, from the West to the East. This shift will take place over decades, and the winners will be:
- Those economies that have financial clout, such as China
- Those economies that have natural resources, whether it be energy, commodities or water, and will include countries, some in the Middle East, some across Africa, Brazil, Australia, Canada and others in temperate climates across, for instance, northern Europe
- And the third set of winners will be countries that have the ability to adapt and change. Even though we are cautious about growth prospects in the U.S. and UK in the coming years, both of these have the ability to adapt and change.

China is at the center of this shift.

The scale and pace of change in China is breathtaking. Against this backdrop of dramatic change, let me look at China’s impact on the global economy, especially in the aftermath of the financial crisis.

Driven to drink by marijuana laws?

(Bernd DebusmannBernd Debusmann is a Reuters columnist. The opinions expressed are his own)

Tough marijuana laws are driving millions of Americans to a more dangerous mood-altering substance, alcohol. The unintended consequence: violence and thousands of unnecessary deaths. It’s time, therefore, for a serious public debate of the case for marijuana versus alcohol.

That’s the message groups advocating the legalization of marijuana are beginning to press, against a background of shifting attitudes which have already prompted 13 states to relax draconian laws dating back to the 1930s, when the government ended alcohol prohibition and began a determined but futile effort to stamp out marijuana.

How dismally that effort has failed is not in doubt. Marijuana is so easily available that around 100 million Americans have tried it at least once and some 15 million use it regularly, according to government estimates. The U.S. marijuana industry, in terms of annual retail sales, has been estimated to be almost as big as the alcohol industry — $113 billion and $130 billion respectively. On a global scale, marijuana is the world’s most widely used illicit drug.

Where the healthcare debate seems bizarre

healthcare-globalpost

global_post_logoMichael Goldfarb serves as a GlobalPost correspondent in the United Kingdom, where this article first appeared.

In America, the health care debate is about to come to a boil. President Barack Obama has put pressure on both houses of Congress to pass versions of his flagship domestic legislative program prior to their August recess.

Good luck.

Opponents are filling the airwaves with the usual litany of lies, damned lies and statistics about socialized medicine and the twin nightmare of bureaucratically rationed health care and high taxes amongst allies like Britain, France and Germany. So here is a brief overview of health care in some of Europe’s biggest economies: Britain’s National Health Service is paid for out of a social security tax. Services are free at the point of provision. No co-pay, no reimbursement. The budget last year was 90 billion pounds (about $148 billion). That makes the average cost per person about 1,500 pounds ($2,463).

The three urban myths of healthcare reform

Peter Pitts– Peter J. Pitts is president of the Center for Medicine in the Public Interest and a former FDA associate commissioner. The views expressed are his own. –

When it comes to healthcare reform, as Aldous Huxley said, “Facts do not cease to exist because they are ignored.”

Three of the most common “urban myths” of American healthcare are that:
1. The lower life expectancy in the U.S. “proves” the total inadequacy of our system;
2. There are 47 million uninsured Americans — proving the inequity of our system; and
3. We spend “too much” on health care — proving the wastefulness of our system.

Healthcare reforms warnings from France and Canada

healthcare-combo– Brian Lee Crowley is the founding president of Atlantic Institute for Market Studies (AIMS), a public policy think tank in Canada (pictured left) and Valentin Petkantchin is director of research at the Paris-and Brussels-based Institut économique Molinari. The views expressed are their own. –

President Barack Obama’s package of heathcare reforms – mandatory health insurance, public health option and increased federal government financing – is being sold as preserving independent high quality care and choice for patients while keeping down costs. Taxpayers and patients in both Canada and France know better.

Unfortunately, our experience is that once the government gets its nose in the healthcare tent, not only is spending not contained, but health care professionals lose their freedom to practice. Left with few choices, patients face shortages and waiting lists.

The gender gap in personal finance

womenmoneyIt’s not surprising that men and women handle their personal finances differently. Yet, data collected by the employee benefits company Financial Finesse shows that men trump women when it comes to managing their wallets.

Out of the 3,500 U.S. workers polled, 90 percent of men said they pay their bills on time each month compared to only 74 percent of women. Also, 71 percent of men said they have a handle on their cash flow so they spend less than they earn each month, while only 53 percent of women could claim the same.

Manisha Thakor, a Houston-based finance expert for women, explains that women tend to be less educated in personal finance.

The real lesson of CIT

Agnes Crane – Agnes T. Crane is a Reuters columnist. The views expressed are her own –

Sometimes a failed lender is just a failed lender.

The relatively small size of CIT Group is a big reason the middle-market lender is headed to the wood chopper as soon as Friday. But the lender’s decision to move aggressively into the world of risky lending and not regroup when troubles in the credit markets first emerged is a classic case of bad decision-making and bad timing striking the mortal blow.

Indeed, one should resist the temptation to draw broader conclusions from a CIT bankruptcy in a world where the government is saving some banks and leaving others to languish.

The Ugly American and other stereotypes

Bernd Debusmann- Bernd Debusmann is a Reuters columnist. The opinions expressed are his own -

What happened to the Ugly American, the one with the loud shirt and the loud voice, expecting the natives to speak English? Has he been shouldered aside by the Arrogant French?

That’s the conclusion one could draw from a survey this month of 4,500 hotel owners around the world who rated the French the world’s worst tourists, bad at foreign languages, arrogant and tight-fisted. Spaniards, deemed noisy and messy, came second in a field of 27. Americans ranked 9th on the list of the top 10 best.

The survey, commissioned by the online travel agency Expedia, ranked travellers in nine categories, from cleanliness to generosity in tipping, and provided food for thought on a long-running debate on an unresolved question: to what extent do national stereotypes correspond to reality?

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