More Bold Thinking Is Needed To Transform Healthcare

It takes big ideas and visionary leadership to transform an industry as complicated as healthcare. Both of those were on full display at the recent Aspen Ideas: Health 2023.

Nearly 1,000 attendees, including practitioners, researchers, business leaders, and policymakers, came together to discuss ways of elevating and accelerating bold approaches to better health for all. The 10th annual meeting zeroed in on 10 big ideas for healthcare, including:

• The potential to make genetic alterations reversible and temporary, allowing for more informed decisions on safety, therapeutic effect, and to personalize strategies such that we can have “a new gene like a pair of jeans,” said Renee Wegrzyn, Director of the Advanced Research Projects Agency for Health, part of the National Institutes of Health
• The need to lower the cost of screening in oncology and expand coverage in the US given the rising number of cancer patients and increasing out-of-pocket expenditures, according to Troy Tazbaz, Director of Digital Health at the Food and Drug Administration
• The opportunity to stop the healthcare worker shortage by listening to workers, a revolutionary, but simple way of ensuring our largest sector by the number of workers have their needs met, particularly after the stress they were under during COVID-19, said Iman Abuzeid, CEO of Incredible Health

As a 2023 Aspen Health Fellow, I saw these ideas coalesce into “3 Big Ideas” across sessions, all of which was underscored by a recognition of the persistent impacts of COVID-19 and the continued need to address health equity.

Health Innovation Alongside R&D

Research can generate transformative, high-impact, biomedical, and health breakthroughs across medicine. In cancer, innovative technology, like harnessing immune systems using T-cells and NK-cells, cancer vaccines, and AI for drug discovery, are allowing us to attack new targets and treat and cure in different ways. “This is a transformative age for cancer, like none other,” Selwyn Vickers, President, and CEO of Memorial Sloan Kettering Cancer Center, declared.

But cost remains one of the greatest threats to these therapies. We need to innovate how therapies are designed, delivered, and discovered, to reinvent not just treatment, but how we deliver care. As “It’s a fragile model, and solutions are complex,” which necessitates the need for rethinking the business model, and the need for policy, particularly in areas like Medicaid expansion, Peter Pisters, President of The University of Texas, MD Anderson Cancer Center, explained.

Technology may help us get there — via concepts like in silico trials, off-the-shelf cell therapies, and the rise of AI — but without major innovations in how we deliver and pay for care, we will continue to have disparities in health equity, which will impact our ability to produce excellent data, research, and outcomes.

Novel Financing in Healthcare

One shift in healthcare financing has been the explosive growth of private equity and venture capital. We witnessed historic levels of investment in 2021, exceeding $200 billion, more than 5x of what was invested in 2010. But as Alan Weil, Editor-in-Chief of Health Affairs, and a panel moderator, noted, there are three elements to consider: Why is this shift happening, what is the role of private equity, and what are the effects?

In many ways, the movement of private equity is a response to other ongoing trends in the healthcare ecosystem, like consolidation, which aim to reduce costs via economies of scale.

Investors claim that the role of private equity is as a financing mechanism, among many others, like self-funding, venture capital, or public markets, that allow for growth. This may in turn expand access to care, drive innovation, and create efficiencies in the market.

Critics argue that if values aren’t aligned with the underlying business, private equity can drive consolidation in healthcare, taking advantage of gaps in the regulatory frameworks, particularly around lack of price transparency, which can drive poor outcomes for some providers or patients.

Related to the growth of private equity and venture capital has been the rise in different voices being able to influence decisions, including areas like women’s health. “It’s important to spread out the funding because different entrepreneurs think about different communities,” Maria Velissaris, Founding Partner of SteelSky Ventures, asserted.

Policy and Leadership Matter

Transformation of our healthcare system does not just exist in R&D or financing. As we’ve seen over the years, public health and health policy play a major role, too.

Twenty years ago, under the George W. Bush administration, the federal government established the President’s Emergency Plan for AIDS Relief, with allocations exceeding $110 billion. Dr. Anthony Fauci, former Director of the National Institute of Allergy and Infectious Disease, and Dr. Bill Frist, former US Senator and Senate Majority Leader, described how a “vision and a need” drove leadership and bipartisan support to act on one of the most devastating diseases in our recent history.

Then a panel of three leaders of the Health and Human Services Department — Alex Azar, Kathleen Sebelius, and Xavier Becerra — described some of their proudest moments heading the department. For Azar, who was secretary under President Donald Trump, it was Operation Warp Speed during the COVID-19 pandemic. Sebelius, who served under President Barack Obama, said it was “the ability to participate in the ACA” and for Becerra, the current secretary, it was developing “the 988 suicide and crisis lifeline intervention,” much like 911 exists for emergencies.

Across the board — these were tremendous steps forward in health policy, in managing pandemics, and in expanding coverage — all of which required bold leadership and a willingness to see what others often think impossible.

To learn more contact Matthew Weinstock, Senior Editor, Health and Life Sciences.