Alan Sager is a professor at the Boston University School of Public Health, School of Medicine, where he has taught since 1983. His courses on health finance, planning, and administration have won eight awards and he received the School’s teaching prize in 1998. With his colleague, Deborah Socolar, he directs the Health Reform Program (www.healthreformprogram.org). He has testified six times before congressional committees on urban hospital closings and prescription drug reform, and before eight states’ legislative committees on various topics.
A 2004 study showed that importing prescription drugs from Canada might not lower drug makers’ profits or their abilities to finance research. In 2003, a report showed that the new Medicare prescription drug benefit bestows substantial windfall profits on drug makers.
His January 2002 minority report to the Massachusetts health care task force repudiated the option of raising ever more health care money to finance business as usual. It called on state government to stabilize each needed hospital, and asked each stakeholder to consider the core needs of the others in order to shape a health care peace treaty.
His September 2001 U.S. Senate testimony demonstrated that current U.S. prescription drug spending is almost sufficient to finance all needed medications. A combination of lower prices, higher volumes, and guaranteed revenues for drug makers would win affordable medications for all Americans without harming drug makers’ research or profits—at an incremental cost of about $9 billion annually.
A December 2000 study assessed causes of hospital financial distress in Massachusetts. It recommended immediate and targeted relief to financially distressed hospitals. It also called for state government to identify which hospitals are needed to protect the health of the public, and to assure that all such hospitals are paid enough to provide high-quality care, as long as they are operated efficiently. Earlier research predicted hospital bed shortages and found that hospital closings did not save money.
Dr. Sager is updating a study of the closing of urban hospitals. This work, begun in 1973, has followed 1,200 hospitals in 51 cities over 65 years. More efficient hospitals have been more likely to close. Hospitals located in minority neighborhoods have been significantly more likely to close or relocate. (Major league baseball teams located in minority neighborhoods were also likelier to relocate.) In 2000-2002, Dr. Sager studied the importance of preserving D.C. General Hospital. In 2003, in connection with Los Angeles County’s proposal to close Rancho Los Amigos National Rehabilitation Center, he has investigated the capacity of other hospitals to serve Rancho’s patients.
In 1979, Dr. Sager designed a “time banking” method of mobilizing voluntary aid for disabled citizens. It allows individuals to volunteer to help others when convenient. Contributed time would be banked. Those who had helped others could receive aid when needed by trading their banked time for the time of a new volunteer. Banked time could also be pooled to provide long-term care insurance.
Alan Sager holds a B.A. in economics from Brandeis and a Ph.D. in city and regional planning (specializing in health care) from MIT. He is a trustee of Waltham Hospital.
Isn't it time we stopped paying such high prices for prescription drugs?
ASK THIS | September 20, 2004
The big question regarding prescription drugs isn't whether the U.S. can afford universal coverage. We can. It's: Why are we letting drug makers charge us so much for so little – and how much longer will we let it go on?
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