Increased Prevalence and Severity of Type II Diabetes is a Major Threat to Our Country's Health and a Significant Driver of Health care Expense
Mount Sinai CEO Kenneth L. Davis, MD advocates action by patients, physicians and policymakers to orchestrate change.
Increased prevalence and severity of Type 2 diabetes is a major threat to our country's health and a significant driver of healthcare expense," said Kenneth L. Davis, MD, President and Chief Executive Officer of The Mount Sinai Medical Center in New York in an Aspen Ideas Festival interview with Richard Besser, MD, Chief Health and Medical Editor at ABC News. "Patients, physicians and policymakers must act in order to change behaviors and orchestrate change."
"Some drivers of health care costs are under our control, like what we eat and how much we exercise," said Dr. Davis. "We must look at issues such as the increased sugar consumption and the amount of sugar in processed foods. The answer lies in public policy changes that will affect change in our behaviors."
Speaking on the topic of "What Is Healthcare Going to Look Like in 25 Years" on June 30, Dr. Davis also described current and future medical breakthroughs. "Parents who use in vitro fertilization can now decide which embryo to implant, based on genetic sequencing of each embryo in order to help prevent the risk of various diseases such as breast cancer and Alzheimer's," he said. As for the future, Dr. Davis predicts major breakthroughs in cancer and foresees the day when "clinicians will be able to inject cartilage into the knees of patients, made from their own stem cells, in order to avoid joint replacement."
As a researcher who conducted the proof-of-concept studies that led to the approval by the U.S. Food and Drug Administration of three drugs for the treatment of Alzheimer's disease, Dr. Davis called for the reform of patent laws to increase incentives for pharmaceutical companies, and to extend market exclusivity. "We must align public policy with a business model that will support the development of new drugs," said Dr. Davis. Noting that a new deadly virus has emerged in the Middle East, Dr. Davis says that incentives must be provided to pharmaceutical companies to avoid epidemics and protect us. Market exclusivity must also be created for innovative compounds that can deal with the nation's most devastating conditions for which there is no preventive treatment such as Alzheimer's disease and the consequences of Type 2 diabetes.
In the interview with Dr. Besser, Dr. Davis also addressed:
- Mount Sinai's investment in Big Data: "Through the use of algorithms and supercomputing, we can look at your genome in a way we first used a microscope to look at bacteria, or used a telescope to understand astronomy. We are in the midst of a sea change of discovery, and the understanding of the human genome will help us prevent, treat and conceptualize disease in a way that has never been done before," said Dr. Davis. For example, Mount Sinai researchers, in collaboration with scientists from around the world, have examined brains of patients with Alzheimer's, and a control group. Using supercomputers, the researchers discovered that a network of genes involved in the inflammatory response in the brain is a crucial mechanism in driving Alzheimer's disease.
- Privacy of genetic information: When Dr. Besser pointed out that there are currently no laws protecting people whose genetic information is released against discrimination by providers of life insurance, disability insurance, and long-term care insurance, Dr. Davis said, "We need these protections in the law." Dr. Davis urged individuals "to make sure your genetic information will not be used by others" and emphasized that Mount Sinai researchers do take precautions to de-personalize databases with genetic data.
- The Supreme Court's ruling not to allow companies to patent genes: Dr. Davis called the ruling "a good decision for science moving forward and for the public." He added, "I do not want it to inhibit companies from conducting research and developing therapeutics."
- Healthcare reform: "The ACA (Accountable Care Act) was designed to give more patients access to care," Dr. Davis said. "We need to move beyond trying to repeal the ACA and, instead, work on improving it. We also need to look at ways to pay for the increasing costs of healthcare." Dr. Davis described how Accountable Care Organizations, including a large one at Mount Sinai including more than 22,000 patients, coordinate care for patients to improve health and help avoid unnecessary emergency-room and hospital visits.
- Funding cuts to academic medical centers: Noting that Mount Sinai in New York ranks among the top 20 medical schools in terms of National Institutes of Health (NIH) funding per researcher, Dr. Davis said that 62 percent of patients treated by Mount Sinai received Medicare and/or Medicaid. As the country and states reduce reimbursements to medical centers for care, and financial margins for providers like Mount Sinai shrink, Dr. Davis questioned "what's left for innovation." Dr. Davis explained that most drug discovery originates in medical centers, while drug development comes from pharmaceutical companies. Funding cuts by government to academic medical centers "are hurting one of the great engines of innovation," Dr. Davis said.
- Educating new doctors: Dr. Davis says health care providers are going to need new skills as they move forward in a new era of healthcare reform. As a result, the Icahn School of Medicine at Mount Sinai teaches "team building" as a way to encourage students to develop strategies together. In a revolutionary first-in-the-country move, the Icahn School of Medicine has also eliminated MCAT exams and traditional pre-med requirements such as organic chemistry, for half of the incoming medical school class, who are admitted as sophomores. Through Mount Sinai's FlexMed program, entering students are admitted into one of three areas: Humanities; Computational Sciences and Engineering; or Biomedical Sciences. Medical students are also assigned role models, "super clinicians" with decades of experience who are "more sensitive, extroverted. With a couple of hours a week over two years, it begins to rub off."
To watch a webcast of Dr. Besser's interview with Dr. Davis held Sunday, June 30 in Aspen, Colorado, go to: http://www.aspenideas.org/session/what-health-care-going-look-25-years. For a transcript, please contact firstname.lastname@example.org.
At another panel, Dr. Davis spoke on "What's Holding Back Medical Progress?" Other panelists included Anthony Coles, MD, Chairman and CEO of Onyx Pharmaceuticals; Margaret A. Hamburg, MD, Commissioner of the Food and Drug Administration; Moncef Slaoui, PhD, Chairman of Research and Development at GlaxoSmithKline. Moderator: Elliot Gerson, Executive Vice President at the Aspen Institute. Dr. Davis expressed opinions on topics including:
- Sequestration: When the federal government cuts funding for medical research, one result is that often only more "conservative" science is funded, Dr. Davis said. When flights were delayed as a result of sequestration and cuts to the Federal Aviation Administration, that "was turned around immediately," Dr. Davis said. "The impact on what may be the best science is dramatic," he added, "but the flights are on time."
- Failed clinical trials: Agreeing with other panelists that there is value in more transparency around failed clinical trials and sharing of that data, Dr. Davis said that there is new and "important learning from genomics." Researchers "need to go back" to again observe failed trials to "identify people who were great responders." By identifying those patients' biomarkers, "genomics will give us a key" to what therapeutics work for patients with different genetic profiles.
To watch a webcast of the panel on what's holding back medical progress held Sunday, June 30, go to: http://www.youtube.com/user/AspenInstitute?v=yfXKWruwpI4.
"Can We Afford Our Health?" was another panel Dr. Davis participated in which was moderated by Kevin Vigilante, Senior Vice President of Booz-Allen Hamilton. In order to cut health care costs, Dr. Davis called for administrative simplification, incentivizing advanced directives for end-of-life care and changes in patent law so Big Pharma could be realigned with academic medical centers as a source of discovery. Other panelists include Peter Orszag, PhD, former Director of the U.S. Office of Management and Budget under President Barack Obama, and Robert Rubin, former U.S. Secretary of the Treasury under President Bill Clinton.
Dr. Davis also gave his insights on how medical centers manage to stay afloat in the current environment where margins are shrinking. "As technology marches on, our expenses increase while our revenues decrease," said Dr. Davis. "As a result, medical centers must cross subsidize for the services they perform. But a margin is needed for innovation in biomedical research, otherwise the research pipeline will run dry."
To watch a webcast of the "Can We Afford our Health" panel held on July 1, go to: http://www.youtube.com/user/AspenInstitute?v=NkszfSINGD0
The Aspen Ideas Festival was held in Aspen, Colorado, from Wednesday, June 26 through Tuesday, July 2, 2013. Mount Sinai is the first medical center to sponsor the Festival, now in its ninth year. The Festival gathers transformational thinkers and leaders from the United States and around the world to discuss their work, the issues that inspire them, and their ideas. Presented by the Aspen Institute and The Atlantic magazine, the Festival is unique in its dedication to dialogue and exchange, and in its commitment to bringing ideas to the public at large
For updates on Mount Sinai's activities in Aspen:
- Use a mobile device to visit the Mount Sinai/AIF web page at www.mountsinai.org/aspen
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About The Mount Sinai Medical Center
The Mount Sinai Medical Center encompasses both The Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai. Established in 1968, the Icahn School of Medicine at Mount Sinai is one of the leading medical schools in the United States. The Icahn School of Medicine is noted for innovation in education, biomedical research, clinical care delivery, and local and global community service. It has more than 3,400 faculty members in 32 departments and 14 research institutes, and ranks among the top 20 medical schools both in National Institutes of Health (NIH) funding and by U.S. News & World Report.
The Mount Sinai Hospital, founded in 1852, is a 1,171-bed tertiary- and quaternary-care teaching facility and one of the nation's oldest, largest and most-respected voluntary hospitals. In 2012, U.S. News & World Report ranked The Mount Sinai Hospital 14th on its elite Honor Roll of the nation's top hospitals based on reputation, safety, and other patient-care factors. Mount Sinai is one of just 12 integrated academic medical centers whose medical school ranks among the top 20 in NIH funding and by U.S. News & World Report and whose hospital is on the U.S. News & World Report Honor Roll. Nearly 60,000 people were treated at Mount Sinai as inpatients last year, and approximately 560,000 outpatient visits took place.