Maria Bartiromo talks health care at Cleveland Clinic
— -- There has been much talk recently that America is on the decline. That we have lost our edge in innovation and growth, as emerging economies such as China, Brazil and India grow much faster than the U.S. A recent study by the Kaiser Foundation said medical innovation gains will increasingly come from Asia in the coming years. So I went to one of the leading health care institutions today, the Cleveland Clinic, and caught up with leading cardiologist and surgeon Dr. Steven Nissen to talk about health care, innovation and robots, which are increasingly being used throughout health care and technology. Our conversation follows and has been edited for clarity and length.
Q: Where is America in terms of health care innovation? Why are we seeing this gravitation away from America?
A: I don't think we're declining, The rest of the world is catching up. The finest medicine in the world is practiced in this country. We spend more than everybody else does, and that's a problem, but I think we also offer more. The clinical outcomes for patients in the U.S., for any disease, tend to be better in America than almost anywhere else in the world.
Q: There's a lot of debate over devices and drugs being stalled. Some say the U.S. Food and Drug Administration is dysfunctional.
A: Everybody likes to pick on the FDA, and I've been known to do that myself. But the problem is not regulatory. The difficulty is that we are victims of our own success. We have developed classes of drugs in cardiovascular medicine that have revolutionized patient care. The statin drugs to lower cholesterol, now taken by 25 or 30 million Americans, have lowered the risk of heart attack, stroke and death substantially. The drugs that we have for high blood pressure, like ace inhibitors, many of which are now generic, we've had 20 years of an extraordinary run. We've reduced the age-related mortality in cardiovascular disease by 50%. There's no other field of medicine where we've done as well. And so it's harder now to innovate because the easy things have been done, and the bar is higher.
Q: Some investors say the real innovation in America is coming from technology — the iPad, the iPhone — not biotech, not medical technology. Why?
A: I can't agree with that. The leaders in the world are American companies. There are other companies in other parts of the world that are innovating, but we're still the envy of the world when it comes to medical technology. Things like the magnetic resonance imagers and the CT scanners, a lot of those are being developed and made in the U.S. I don't think we've lost our luster.
Q: How do we get health care costs to stop rising?
A: We have to be more disciplined about doing things that benefit the patient, rather than the physician. We have very perverse incentives. The way our payment system works is if you put more stents on coronary arteries, you make more money. If you do more studies, you make more money. The physicians are largely well-intentioned, but the incentives are driving over-utilization. You're twice as likely to get a CAT scan in the U.S. as you are in most Western European countries. You're twice as likely to have a heart catheterization. Our population isn't that much different.
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