Courage, Kay Bailey Hutchison on the women who helped shape texas. Thats at 8 45. And on cspan3s American History tv, daughters of civil rights leaders and a segregationist share their memories of the Civil Rights Era at 8 30. Youre watching cspan2 with politics and public affairs. Weekdays featuring live coverage of the u. S. Senate. On weeknights watch key Public Policy events and every weekend the latest nonfiction authors and books on booktv. You can see past programs and get our schedules at our web site, and you can join in the conversation on social media sites. Ibis with sanchezserrano is author of a recent book analyzing the Worlds Health care problems. He claims Global Health care problems are based on a lack of access to safe and Affordable Medicines and not due to lack of good Health Insurance. He spoke to an audience at the New York Public Library in late august about the causes and solutions for the World Health Care crisis. As well as his thoughts on u. S. Health care reform. This is an hour and a half. [applause] good evening, everybody. I would like to thank you very much for taking the time out of your busy schedules to come and listen to this lecture, and i would like to give a special thanks to mrs. Deborah harris for her kind invitation to be here. It has been a very crazy schedule for me because i have been traveling in different parts of the world presenting my book and my ideas. I actually do have a scientific background in genetics as well as Business Management and Public Policy, so this has been advantageous in actually understanding Better Health care, but also the scientific part of it. I would also like to thank very much mr. Daniel moran from switzerland who was the person who sponsored this research, six years of my life. And it was funny because when i was working on this in the beginning i was working on biotechnology, about finding ways to develop better drugs. And health care was not the priority at that point. But then as i continued to travel and to speak with many experts all over in the United States, in latin america and and in europe, i found out that health care is something so complex that it depends on medicines even though the generallyassumed idea is that the issue is Health Care Insurance. So it was a six years project of my life in which i dedicated completely to this project, and i am very glad that i have the opportunity to share this knowledge not only with scientists and physicians, but also with the general population, and in that way i think that is what a book should be about. It should be about informing the general population and sharing with them the findings, because those are the ones who are generally affected by the problems of health care. And with that, i would like to start my lecture. Patients were in a veryies docile position. And i think that the internet has done a lot of positive things in that because we have a very informed and more educated patient population. So this is a wonderful opportunity for all of us right now. What im going to be talking about would be, first of all, i will be talking about the Health Care Crisis, Global Health care crisis. Because this is a problem that is not only exclusive to the United States, it is worldwide. I will be talking about what are the costs of this Health Care Crisis and also once i have covered the causes, i will delve a little bit into the pharmaceutical industry. I will try to make all the effort to explain everything in detail, so whenever you guys have questions, please, do not be afraid, because i will try to be very clear and very basic about this. I will be speaking about the Different Solutions on what is required for health care to be resolved and finally, some conclusions. Something that i wanted to mention from the very beginning is that i will be focused mostly on the Global Health care crisis, and as part of that Health Care Crisis comes the United States. So first of all, we need to define when we read the newspapers, when we listen to the news and as we get older, we are always concerned about our health. And this has been a big issue in the United States not only through the president obama administration, but also before that. So people talk about a Health Care Crisis, people talk about having access to health care and medicine, but what is it really . A Health Care Crisis is basically a financial crisis. And by financial i mean that there is not enough money, there are not enough resources to provide a 21st century person access to two important aspects. One of them is health Care Services, and the other one is pharmaceuticals. And this is an issue that gets complicated because as we have made many conquests in terms of technology and medicine, people live now longer, but also we have a demographic explosion. So what that means is that now these resources are very, very limited worldwide. So it gets more and more difficult, more competitive to have access not only to health care, but to other issues as well. And when it come toss the political level comes to the political level, health care has to fight with other important issues such as the pension plans, and that is an issue which is going on globally. So not only in the United States, it is worldwide. So what are the levels of the manifestation of the Health Care Crisis . First of all, the economic aspect and why economic . Because as time passes by, governments and people are spending more and more money on health care. That is an issue which has created a lot of tension in the United States. It is creating a lot of tension in latin america, in europe and also in the rest of the world. From a clinical perspective, and also there are other problems because nowadays it is very difficult for doctors to develop drugs which are safer. I mean, there is not a single drug, there is not a single medicine which is 100 safe to people. So we are finding an increase in resistance not only to antis that have been antibiotics that have been developed in the last 50 years, but also chronic ailments are showing resistance, and this is happening all over the world. There is another element here which is a pharmaceutical element, and it has become more and more difficult for the pharmaceutical industry to come up with new drugs. And so the drugs that are currently available have reached a point which they are very good, and they are very hard to improve, so it costs more and more all the time to come up with better and more efficient drugs. We have, also, the political dimension in which it becomes more and more difficult for politicians to come up with policies to address these issues. So what this creates is a problem in the sense that many of these politicians take rush measures, rush oils in order to policies in order to appease people and keep them quiet rather than thinking in the long term on how to solve the problems which are happening all over the world. And sociological has a great importance because from the social point of view we, for the first time, have a population which is getting more sick and are sicker. And then that is an issue because from the Economic Perspective it is very, very difficult to have a sick population or a population which is unhappy about what is happening in terms of their health and their health care. So what parts of the world are affected by this health care . In general, we think of the United States because this country has had Health Care Problems for decades. And also in terms of that, we also think of the developing world. But, actually, the reality is that there is not a single country in the world that at present does not have Health Care Issue of one sort or another. So it is affecting the United States, canada, latin america, europe, asia, africa. So this is a global issue, and it is very important to go over each one of these systems. There are benefits and also there are problems, in order to understand what are the causes of this Health Care Crisis and also how we could solve them. Let us discuss about, first of all, north america because, obviously, i am in the United States right now, and we are in new york, so well start with the United States. And it is very funny because in general, people think that everything in the United States is perfect, that everybody here is rich, that life is wonderful. And the reality is that the United States has a lot of problems right now, and they are affecting everybody. So i think that people outside should start learning more and visit more the United States to learn that people really sometimes have to struggle here too. So in general, the United States is a Health Care System which is the most privatized in the entire world, yet half of the Health Care Spending is financed by the government through medicaid and medicare. So what is happening is that despite the fact that the United States is spending more than 17 of its gdp on Health Care Spending right now compared to 5. 2 in the 1960s tells a lot about this difficulty. So the Health Care Costs have soared here for many decades. And then even though it is spending more in terms of money spent, it has the highest infant mortality rate, it is the country in which people have the lowest life expectancy, and in the next graph, next table i will show that. And also the amount of healthy americans at the age of 55 is low or than in other countries. Lower than in other countries. So one of the characteristics of the United States is that here we, the United States does not have price control for drugs, so this creates a lot of problems. And the fact that people because of the baby boom generation and also the increasing longevity, it is also atexting the Health Care System. Affecting the Health Care System. So before obama signed the health care act, there was about 46 , 46 million americans without Health Insurance. So that has created a lot of pressures in order to cover those people, and so the point of the obamacare would be to reduce those amounts. But this is very complex, and i will get a little bit into that. So one of the other issues that the United States has as a limitation is that there are many unhealthy habits here in terms of food, lack of exercise, and all of those things have an impact. Even stress, too, have an imact in the quality of impact in the quality of the life of people. What happens is when it comes to 65, many people have to suffer a lo hot of chronic ailments because of those issues. So in this table where as we could see here in terms of the infant mortality rate, we compared the United States with other industrialized nations. This has one of the, has the highest infant mortality rate. In terms of the amount per capita spent on health care, the United States is the highest. This terms of the amount of in terms of the amount that is spent by the government or subsidized by the government, it is also the highest. And also in terms of quality of life in general. So this is a big issue when a countrys spending so much money, but then the results are not seen. And that is quite preoccupying. So at present in the United States what is happening with the Patient Protection and and Affordable Care act of 2010 or obamacare, one of the things that have come out of that is that there will be a coverage, extension of coverage to about 30 million americans, and then the strategy of that comes to make available for them Health Insurance through, basically, a market. And one of the preoccupying things about this strategy is that it is worried about containing costs. So does this really represent a way forward for health care . And i will get back to that question later on as we examine other countries and also as we talk about the different causes for this problem. So as i mentioned earlier, the United States has no price controls, and that is a big issue because for many, many years this has been a debate here. And the issue is that because the United States is the leading country in terms of science and technology and also in pharmaceutical development, then that issue has great repercussions all over the world as well. Because if something is very expensive here, then chances are it is going to be expensive elsewhere, and people will not be able to afford that. And another characteristic of the United States system is that after all these conversations and all the implementation of all these reforms started, what has been happening then is that the deductibles and also the out of pockets have increased at least three times in the last five years. And then there have been other increases in health care that actually are straining the system. And this situation is only going to change, because regardless of whether people are going to be insure what is coming in the future is whos going to pay for the medicines that all of these people are going to need especially for diseases like cancer. And i will get back to that point. We see in the United States there is always a debate, okay, adopting a canadian system, a universal health care land. And if plan. And in many ways, this is something that one should always take very seriously because everybody should have of access to at least basic health care coverage. Everybody should have access to medicines. Everybody should have the best health care possible. Now, there is an issue here in terms of the cultures too. I mean, the United States has a culture and a history which is different from canada and from the rest of the world, and the mentality here is such that people want the best options for them. People fight for their rights. That mentality doesnt easily exist in other countries. So what is happening now is that when we talk about the universal Health Care System, canada has it, but then despite the fact that there are a lot of people covered by a universal health care because it is a one single payer by the government, then we run into high efficiencies. We have a lot of problems in terms of people waiting to be attended, that there are waiting lists of six, eight months, and during that time one hears a lot of people having their ailments complicated or dying. There is a lot of dissatisfaction in terms of getting access to the best medicines. So even the canadian Health Care System which have been proposed to be imitated here in the United States has a lot of problems, and it would be in many ways, i think, naive to think to implement that system in the United States because the histories are very different, and the mentalities too. People here want the best that they can. And that mentality not like that in other countries in which people basically take what they are given. So there we find an issue. So there are a lot of problems in the canadian system. So if we go back to europe, we find a similar situation in which people are always saying that the grass is greener on the other side. And what is happening in europe many people say, oh, i went to france, and i was attended there, and it was free, or i didnt pay for this in this country and everything. But if we look into this, nothing is really free. What happens is that people are paying this Health Care System from their own money, with tax, the taxes that they pay. So nothing is really free. So while they could see free could be something quite complicated because economically then all these countries are spending more and more money. So they have a limited budget, and that limited budget, the Health Care Part is consuming more so that if the health care is consuming more, then they have less police, less teacher, i mean, they have to sacrifice then the quality of other areas within the economy. And that is really not good. So what is happening in europe is that for many decades the europeans Health Care System have tried to create a safety net for people so that everybody i