[ExI] Longevity Dividend Course OP-ED Assignment 07 ptB

Morris Johnson mfj.eav at gmail.com
Fri Jun 6 19:18:30 UTC 2008

Telemedicine delivered electronically by linking  the physician live (ex;
from India by point to point broadband uplink) to a telemedicine rural or
urban Saskatchewan site for  medical consultation  interactivity service
access is a way to bring increasing speed, power and efficiency to service
capacity  while  reducing per patient costs for medicare.  Internet based
"surgery by wire" is  soon to become commercially available. Use of this
technology enabled model to maximize doctor's capability to operate, by
spreading all the doctors over all the patients globally is logical .

If the rich assume the risks of "beta testing" deregulated leading edge
technology  that may be occasionally dangerous and lethal instead of wildly
efficacious  this reduces the time from discovery to generic mass marketing
and cheap broad availability of healthcare innovations for the middle class
and poor who depend

on Medicare?  Micheal Moore in "Sicko" dramatizes the "6/94 moral hazard
gap" of a mixed public private medical delivery system trying to deliver
"fairness".  "Sin Taxes" represent a prepayment of a future deductible  due
to high risk behavior.  Conversely I propose the  notion of a "capped" tax
deduction/credit  for documented expenditures for planned preventative
health measures. Public coverage of the cost of "Individual Health
management plan" creation , monitoring  and implementation by appropriate
individually chosen health professionals can be funded by spending a portion
of the current value of the projected future risk reduction dividend.

In Saskatchewan  economic calculations are done behind closed doors and
medical criteria for drug coverage are created.  I propose , for
pharmaceuticals a system-wide  proposal to buy drugs on an "efficacy-based
pricing" model.  By that I mean the value of the disease to be treated or
cured  would differ from patient to patient based on medical criteria.
the number of people in each criteria /group by a "progressive bid"  price
for the drug based on the value of the same drug for use in treating each
different criteria  would create an average  composite per dose value for
the public payor to cover.  Currently if for example , a high cost
anti-cancer drug is available, a medicare committee decides how many doses
at the market price the province will buy and sets out to analyse the
statistics to see what criteria would allow just the right number of
prescriptions to use up that estimated budget for that particular drug.  That
is not fair, or ethical but is a worldwide accepted practice.  A model where
all possible customers are served is more desirable.  If the cost is
negotiated between drug company and medicare using the "efficacy based
pricing" matix all medically necessary prescriptions can be covered.  The
drug company benefits as well as the maximum number of sales for high cost
drugs X "efficacy value"  will maximize its ability to extract gross revenue
overall.  All non-Sask Health Card customers pay the Manufacturer's
Suggested Retail Price  independent of this so the market is not distorted
or skewed.

I have not even touched on methods to enhance future health in order to
reduce future costs and increase current service availability to ensure
Medicare  sustainability.  This will be covered in the next piece on

You may send your feedback attention "Pharmer Mo" at
extropian.pharmer at gmail.com
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