"Unhealthy Medicine: All Breakthrough, No Follow-Through"

Read the full essay by Steven H. Woolf in the Sunday Outlook section of The Washington Post. (January 8, 2006)

"We tend to view medical advances -- the breakthroughs that produce better medications, technology and procedures -- as the front line in the war on disease. They capture the media's attention; we marvel over the technological wizardry and the ingenuity of scientists; and to the afflicted, each advance gives hope of a cure. The federal government invests billions of dollars in this enterprise, and competition for better products drives the highly lucrative pharmaceutical and medical device industries.

"But the promise of a cure requires an additional step: Patients must receive the treatments promptly and properly. This step requires a well-functioning system to deliver care, which our country lacks. We spend far more money on inventing new treatments than on research into how to deliver them. Last year, Congress gave $29 billion to the National Institutes of Health, most of it to devise better treatments. The smaller federal agency responsible for solving problems with the delivery of health care, the Agency for Healthcare Research and Quality (AHRQ) , received only $320 million. Starkly put, for every dollar Congress allocates to develop breakthrough treatments, it allocates one penny to ensure that Americans actually receive them."