Saum Sutaria, M.D.

I don't know that the healthcare system as it stands today is going to solve our cost problem. that's driven by the factors I just described. It's certainly not going to change materially our outcome problem. Tinkering with the different parts of the system, we might be able to affect cost. The outcome problem is a more fundamental problem.

I don't know that the healthcare system as it stands today is going to solve our cost problem. that's driven by the factors I just described. It's certainly not going to change materially our outcome problem. Tinkering with the different parts of the system, we might be able to affect cost. The outcome problem is a more fundamental problem.

By the way, it gets back to this issue. The border is a healthcare issue. It just is. You can't escape it. Everything ties back in one form or another to healthcare.

By the way, it gets back to this issue. The border is a healthcare issue. It just is. You can't escape it. Everything ties back in one form or another to healthcare.

That is right. And I think you can't underestimate the power. I think, by the way, choice sort of fits in a broad framework of access. If you have enough access points and they're differentiated, that allows choice.

That is right. And I think you can't underestimate the power. I think, by the way, choice sort of fits in a broad framework of access. If you have enough access points and they're differentiated, that allows choice.

I mean, there are probably 15,000 pharmaceuticals available today in one form or another. Some of them are repeats, but my point is there's a lot of choice.

I mean, there are probably 15,000 pharmaceuticals available today in one form or another. Some of them are repeats, but my point is there's a lot of choice.

Why is that is one of the questions that I think comes up. So I think, first of all, I agree with you. We cannot underestimate the power of choice. I mean, we learned that in the 90s with managed care when it was quite constraining. And by the way, as I said before, that system lowered healthcare inflation. It only proved it for a short time because the backlash was so vicious against it.

Why is that is one of the questions that I think comes up. So I think, first of all, I agree with you. We cannot underestimate the power of choice. I mean, we learned that in the 90s with managed care when it was quite constraining. And by the way, as I said before, that system lowered healthcare inflation. It only proved it for a short time because the backlash was so vicious against it.

And I don't think we can go back there. Politically, even from the standpoint of not politically, but just the way the system has evolved to create more options and more choice, it will be difficult to go back there. Limited supply-side constraints, I think, at this stage, have and are becoming a part of the dialogue. As I said, Medicare sets prices for doctors and hospitals.

And I don't think we can go back there. Politically, even from the standpoint of not politically, but just the way the system has evolved to create more options and more choice, it will be difficult to go back there. Limited supply-side constraints, I think, at this stage, have and are becoming a part of the dialogue. As I said, Medicare sets prices for doctors and hospitals.

They probably will start doing so for certain drugs. Okay, it's purchasing power. And one could argue that in some ways that's a form of supply-side constraints.

They probably will start doing so for certain drugs. Okay, it's purchasing power. And one could argue that in some ways that's a form of supply-side constraints.

I think we have to avoid looking at extremes.

I think we have to avoid looking at extremes.

Well, I would say this. I don't think the people who are talking about this in a rational way in terms of actual pricing, which is not you or me really in terms of the policy, I don't think anybody's saying let's bring it down to the average of the OECD, et cetera, from where drugs are priced.

Well, I would say this. I don't think the people who are talking about this in a rational way in terms of actual pricing, which is not you or me really in terms of the policy, I don't think anybody's saying let's bring it down to the average of the OECD, et cetera, from where drugs are priced.

The question is, are there ways to start to curb the inflation rate of price and actually rationalize some group purchasing capability? I think that the challenge with accepting the extremes is it will only fuel the discussion of innovation will stop. Nothing will happen any further. And that's not going to happen.

The question is, are there ways to start to curb the inflation rate of price and actually rationalize some group purchasing capability? I think that the challenge with accepting the extremes is it will only fuel the discussion of innovation will stop. Nothing will happen any further. And that's not going to happen.