The healthcare system in the United States has been slowly collapsing over the past 30 years, according to Bradford Kirkman-Liff, professor of health policy and biotechnology at the W. P. Carey School of Business. In a video interview conducted in collaboration with The Communications Institute, Kirkman-Liff explores the sources of pressure on the system, including the impact of large numbers of patients who are uninsured and the cost of pharmaceuticals. The prospects for reform, however, are clouded by what Kirkman-Liff calls the divisiveness of the national discussion.

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The soaring cost of prescription drugs is a major concern in the United States, but drugs in one important category -- biopharmaceuticals, or drugs produced through biotechnology -- actually do not cost more in the United States. Michael F. Furukawa, assistant professor in the School of Health Management and Policy at the W. P. Carey School of Business, and his co-author found that while the United States is by far the biggest user of biopharmaceuticals, the prices for these drugs in the United States are comparable to those in a broad range of countries.

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In the event of a disease outbreak or bioterrorist attack, public health officials must make decisions about how to allocate finite medical resources -- decisions that impact the spread of the disease and the number of lives lost. Ajay Vinze and Raghu Santanam, both information systems professors at the W. P. Carey School of Business, wondered what might be the best way to allocate critical resources in such scenarios. They realized that, viewed from a business perspective, the public health system is actually a very large and complex supply chain -- in many ways even more intricate than the highly developed supply chain of an enterprise like Wal-Mart.

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As more and more states begin targeting insurance reform, the costs and problems they face become increasing evident. Still, the current system of health-insurance coverage in the U.S. has been "crumbling for 30 years," says Bradford Kirkmann-Liff, a professor in the School of Health Management and Policy at the W. P. Carey School of Business. In part two of Knowledge@W. P. Carey's coverage of state health care initiatives, Kirkman-Liff joins his colleague, Marjorie Baldwin, director of the health-management school, in offering ideas on reforms that could protect the 45-million Americans without health insurance safety nets.

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If interest in the movie "Sicko" is any indication, insurance woes are moving to the forefront of public concerns. Will we soon see real reform that gives the 45-million Americans with no insurance coverage a safety net? Probably not, according to W. P. Carey School health care experts Marjorie Baldwin and Bradford Kirkman-Liff.

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Today's health care leaders are constantly challenged with the seemingly incompatible goals of improving patient care while developing strategies to reign in skyrocketing costs. Among the many cost-reduction ideas batted around the industry, one of the most promising -- yet often overlooked -- areas is supply management. Recent research by Professor Eugene S. Schneller of the School of Health Management and Policy at the W. P. Carey School, examined the PPI purchasing and standardization efforts of 25 major U.S. hospitals.

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Since their first appearance some 20 years ago, "hospitalists" -- doctors who manage patient care during a hospital stay -- have assumed an increasingly complex role in the healthcare system. Conversely, the attempt by the AMA to address a nursing shortage by the creation of a bedside care worker called the "registered care technician" was a short-lived and unsuccessful experiment. Professor Eugene Schneller of the School of Health Management and Policy at the W. P. Carey School, examined the successful hospitalist movement and the failed RCT implementation in a chapter for the recently-published "Managing Change in the Public Services."

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Research co-authored by marketing Professor Rajiv K. Sinha of the W. P. Carey School of Business shows that the later in life people start smoking, the more likely they are to quit. And, the longer people wait to light up, the more likely it is that they never will smoke at all. But those who take that first puff early in life are most likely to be doomed to a lifelong addiction. "Our findings support the congressional move to further limit cigarette advertising, as they provide evidence that targeting youth has the potential of converting 'never smokers' to 'forever smokers,'" Sinha says.

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