Obama moving quickly on health care?

President-Elect Obama has proposed significant changes to the U.S. health care system. Senator Baucus recently unveiled a 104 page health care reform plan. Aspects of the Baucus plan are strikingly similar to the Obama health care reform proposals. Some pundits have suggested that the Baucus plan may encourage an Obama Administration to move quickly on a comprehensive health care reform agenda and avoid some of the missteps that extinguished the Clinton Administration’s reform efforts.

However, a deteriorating economic climate may hamper or slow any comprehensive health care reform efforts. In fact, the economic climate may require that an Obama Administration initially concentrate on incremental change rather than sweeping reforms. Whether reform efforts are incremental or sweeping, it is likely that the State Children’s Health Insurance Program, Medicare sustainable growth rate formula, health information technology, and payments to Medicare Advantage plans will be among the early agenda items.

Michael Apolskis JD
Michael G Apolskis PC, Health Care Law, Chicago Area

Obama playing ball with Healthcare?

Whether reveling in victory or agonizing in defeat, if you thought we'd have a hiatus between now and the inauguration you've likely come to your senses. Obama will be pursued like no other president-elect before to provide immediate policy for our multiple problems, particularly the economy. In addition to a lame duck, we now have a duckling. As Reid and Pelosi dip their toes reluctantly into the economic mess, a bailout seems in the works for the auto makers. But the question is whether Paulson/ Bush will support one, and more specifically one that Obama - through Reid and Pelosi- may tie to developing vehicles with greater fuel efficiency and reducing layoffs. Outcome based bailouts? Obama is smart enough to use the immediate crisis in this industry to drive forth programs that fit his strategic environmental and social agendas, particularly with Bush feeling legacy pressure.

What might this mean for Healthcare? Although we are seeing health insurance demand greater accountability and experimenting at the margins with patient results, it is still a system that primarily rewards visits and procedures rather than outcomes. Some have said healthcare reform will take a backseat to the economy. But I suspect within the first several weeks of the new Obama administration he will move forward with a program for universal healthcare- even offering it as a means of creating jobs and helping a struggling economy. But will he provide a blank check to the existing structure by enrolling millions of uninsured-one way or the other- into what many believe is an increasingly expensive, broken system? Or will Obama leverage the economic crisis and demand for universal healthcare to create a path for substantial change in the delivery of care and payment methodology. Watch the auto industry for clues as to how sharp his elbows will be on the Healthcare court.
Doctor Steve

VC going to seed?

Several of the VCs and Private Equity groups I maintain contact with are in desperate exit mode. "Everything is for sale" I was told with the emphasis on SELL. IPOs are almost non-existent; big pharma is overpaying for compounds and companies because they have no pipeline.
Article in The Scientist titled "Biotech Faces Investment Downturn" was of interest- although investment was up in the 3rd Qtr compared to same in '07, they reported that was going to decrease significantly in the 4th and much would be placed in existing companies to keep them afloat until exits could be generated.
http://www.the-scientist.com/daily/2008/10

Maybe this will be the case- but what about the pipeline? Tech transfer and development is not stopping- the grant money was given out months ago and it ain't going back. The clock is ticking on any IP and patents- delayed investment is money lost. The time needed to move forward with clinical studies is relatively fixed or actually lengthening in hot areas such as oncology and CNS. In the past VC and PE kept stepping up the size of their investments as money poured in. VC strove to be PE and PE wanted bigger and more secure companies for investment. Why? Was it because without additional due-diligence capacity the number of deals was not increasing, just the size ? Or was the money just more risk adverse? Or was the increasing volume of preclinical development producing little of quality? ie more money chasing the same number of good candidates and therefore needing higher quality because of the increasing amounts they wish to invest?
BUT- Could we now see a return to seed and early stage funding? Will the 'Valley of Death' become more verdant ? As the existing biotechs with limited pipelines become less valuable with each passing month and the number of smaller deals available picks up, perhaps we are on the cusp of an explosion of start-ups and some real innovation.