"Visions of World Benefit & Global Responsibility: Perspectives of McGill Students

Thursday, August 9, 2007

The Cry for a New Health Care Approach

It is not impossible for one person to change the world. Anyone can start with a dream but what is needed is the perseverance to follow it through. There are many problems in the world that are hard for one person to accomplish alone. The proper solution would either require everyone to work together to correct these problems or for one person to dedicate himself to one problem and correct it. If each person engaged in the latter solution and dreamt of correcting a problem it is to be expected that the world would become a better place. If I were to focus on one problem it would be that of health care on the global scale. Inadequate health care distribution is one of the greater problems that plague modern society as the technology and resources are readily available but cannot be provided to everyone. Due to the inequality of wealth distributed globally, there are countries that can afford health care and provide it to their citizens, countries that cannot afford it, and countries that can afford it but choose not to provide it to their citizens. Countries such as Canada, England and Paris provide free health care to all citizens with lowered or no costs related to medication. 3rd world countries cannot afford health care for all citizens due to the lack of funds and infrastructure and rely on the charity and aid of developed countries. Looking at the United States of America, a country that proclaims itself as being one of the wealthiest in world, a privatized health care system and high medication cost reign. The inconvenience of such a system is depicted in Michael Moore’s recent documentary Sicko.

The lack of global health care translates directly into the loss of life of millions of people annually. Disease brings forth violent death. We throw around the term “world peace”, but could the notion of a peaceful life and death be attained?

My vision and mission would be to provide the lacking health care to many countries that desperately need it. To help create the infrastructures that are lacking, set up a functioning system, train people, provide affordable medication, etc. The vision is broad but so is the problem. I am not the only person to dream of global health care; it is one of the noblest thoughts where many have failed. Canadians are fortunate enough to live in a country where free medicare is provided to every citizen (and this is since 1966 when the Medical Care Act was implemented under the Lester B. Pearson government). With this being said, change has already occurred at home and it is time to bring it to our neighbors.

It is my belief that universal health care for all can only be achieved by the initial contribution of the major pharmaceutical companies.

This spreading of universal health care has always been a passion of mine; I would not be studying in a medical field if it was not passionate about it. I have acquired an enormous amount of knowledge in the medical sciences but have concluded that the tools provided by this field are not sufficient: the world cannot be changed from the inside of a lab. The solution can come from the lab, but the man who controls the lab financially makes the decisions on how it is used. Is his allegiance to the share or stake holders? I want to become the man who hold the decision making power because I know where my allegiances lie; my goal is to create an organization based on the 3 p’s with a particular focus on people. To create this organization I must be in control and managers hold the decision making power; managers have the ability to control expenses and to some extent revenue. This is due to patents which limit the types of drugs available on the market and allow pharmaceutical companies to set the prices how they see fit. Consumers argue that patents are anti-competitive and allow for price inflation, the companies argue that they help cover research costs. I believe that there exists a middle point which managers should aim for. My vision is to strive for that point.

The objective of formulating a strategy is to reach the desired goal (the ultimate goal). The goal is to provide universal health care to all by regulating costs related to health care. However, before discussing a business strategy, it is important to outline a personal strategy. The personal strategy consists of gathering all of the tools necessary to position myself where I need to be. Firstly, I plan on finishing my bachelor in Microbiology and Immunology in order to get a full understanding of the body and immune system. This is critical for pharmaceuticals and health care as it enhances my knowledge of the problem and serves as a reminder of how necessary health care is and why it is needed. Secondly, I plan on pursuing an education in management so I can increase my leadership and decision making skills. This will provide me with the proper tools to work in an organization which I can adequately lead and direct to accomplish my goal. Thirdly, I plan on working hard to gain experience crucial to becoming the leader needed to accomplish the task at hand.

My business plan is broken into short to long terms strategies and goals. My short term strategy is to first appropriately analyze the situation at hand. This means assessing which countries need the most help, which countries can contribute the most, and the relative degrees to which the these countries can be aiding and aided; before jumping into a project it is best to know which direction to take. Another short term goal would be to amass enough funds to begin research and cover expenses and salaries. It is also important to be competitive enough in terms of salaries to recruit top researchers. The short terms goals pertain mostly to infrastructure and analytical matters. Medium term goals would be to continue developing products and patent them as well as increase the company’s infrastructure. The development of new products ensures that the company is viable in the eyes of the shareholders; the development of analogs of older products ensures that many types of medication relieving multiple ailments can be sold by the company. Patents stop other companies from making generic versions of the medication and therefore from generating profit from their own version of the product. Patents would solely serve this purpose and would not be used to over inflate prices. Long terms goals would be to provide this medication at an affordable cost by selling products at cost at 3rd world countries and selling them to developed countries at price where profits generated would create enough revenues to ensure that the company is self-sustaining. This is done in case shareholder interest is diminished at this point; the organizational structure could then shift towards a non-profit organization (where sales revenues would cover expenses) if possible. Since pharmaceutical companies and health insurance companies own hospitals in the U.S.A. perhaps the same could be done in 3rd world countries, lower wages would keep costs low and would ultimately benefit their own population. Plants and labs could also be established in 3rd world countries due to low wages. This would keep costs low and once again benefit their own country. Educational aid could also be provided in order to better train people in the health and medical research sector. The long term goals and strategies aim to aid countries in becoming self-sustaining.

Critical success factors include acquiring new shareholders (initial funding), increasing profit margins (positive cash flow), employee satisfaction (good researchers and motivated workers), intellectual capital (research and patents), product development and corporate sustainability. These are all themes and concepts that can be found throughout the strategic plan and are necessary to ensure the success of the vision.

It is said that the rich get richer and the poor get poorer. In an asset point of view this holds true; wherever money regulates the decision making power of the world this is the case. This relationship can be seen between people within one country and even between countries. The problem with health care is that everyone needs it so there is potential for profit (with exploitation) to be made and this profit making potential occurs all throughout life. Life is a stepwise process: the first step is birth, the second is living (pleasure and pain) and the third is death (disease). These are the three steps that every human being is sure to go through so there is always potential for profit. The health care system deals with each step and can therefore be used for a tool of exploitation. Health insurance companies have the opportunity to cash in on the potential to contract sickness, hospitals have the opportunity to cash in on ailments that are occurring and pharmaceutical companies have the opportunity to cash in on ailments that need treating. The three pillars of the health care system that depend on each other. The problem arises when these companies are not governmentally controlled as in the American structure; governments usually have to pick up these high costs through taxation. Hospitals are at a disadvantage as medical equipment is costly and the incidence of everyone getting sick at some point of their life is very close to 100%. Health insurance companies are at a disadvantage as they must pay for these high medical fees and in order to be profitable they must refuse insurance as well as treatment. The only organization to truly benefit is the pharmaceutical company; research may cost millions but patents ensure that their drug is the only one to be purchased; the enormous research cost, after all, only occurs once for a pharmaceutical company. If there is truly one company that could permit itself to “play fair” with the stakeholder it is the pharmaceutical company. This is why I believe a successful way to pursue global universal health care would be via a pharmaceutical company.

There are many initiatives that exist around the world such as Doctors Without Borders and the Red Cross that try to provide care and supplies to 3rd world countries but they are confined by limitations due to funding. The first Non-Profit pharmaceutical is the Institute for OneWorld Health founded by Dr. Victoria Hale. They are currently developing medication for visceral leishmaniasis, diarrheal disease, malaria and Chagas disease. They are of course making progress but typically rely on donations as a source of revenue. My ideal model would incorporate a self-sustaining model in 3rd world countries but a profit based (lower profit margins than most pharmaceuticals) model in developed countries (as elaborated previously). Profits could then be redirected from developed countries to 3rd world countries. I believe this would be a more realistic model than the traditional NPO approach that is often idealized. I believe the self-sustaining model is a positive step towards concretization.

Rome was not built in a day, but we did build it eventually.


My obsession with affordable medication actually arose from mathematics. Suppose the cost of developing and manufacturing enough medication for 100 million people for one treatment totaled 100 million dollars, each person would end up paying 1$ per treatment to cover the cost. Now assume that our development cost is covered for our next batch and therefore now costs 10 million dollars to produce another round of treatment for 100 million people, the cost is now of 0.10$. Now assume that we wanted to develop 10 new drugs that would cost 1 billion to develop (total); we would then have to only charge 10.10$ to cover the cost of research and manufacturing. The importance of this calculation is to demonstrate how easily the cost of development can be covered; some prescriptions can cost upwards of 120$ when they can be amply reduced.

The numbers in this example might be exaggerated but if you were to come up with other ratios I am sure you would come to a similar conclusion. This is of course not the case for every drug on the market but it is for the majority.



Sicko (2007). Michael Moore, The Weinstein Company, Lionsgate

World Health Organization ,The World Health Report 2000. pp.215 (http://www.who.int/whr/2000/en/)

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