Sales Rep Wanted: Government Experience Required, AHRQ and Health Reform Legislation

We are going to place this week’s blog entry in the “Did not know, and had no idea, how did I miss that one” file. Health care reform legislation and how it affects business has been a common topic over the past few months. Much of the conversation has been a one way street it seems with Washington calling the shots, our legislators arguing for or against the changes, and then the changes coming down anyway. The business population has worked to impact and influence with calls, letters and emails to Washington, and I would submit that now is the time to trust and verify that the needs of business with regard to health care costs are truly being addressed.


Robert Goldberg writing for The American Spectator relates that the House Republicans plan to cut $360 million in health reform funding in this year's budget as part of the retooling of the health care legislation. What was a light bulb moment in reading the article is that Goldberg writes that the current Obama Administration will be spending $100 million to run an ad campaign and hire a sales team to push the health reform legislation to thousands of doctors. Very interesting. It is one thing when private industry hires a sales force to market, PR, and sell a product, but now we have the US Government using a sales force (with cars and expense accounts) to convince doctors that government health guidelines are the way to go. Time will tell, but I am certain this will not be a simple “Buy War Bonds” message as was seen in World War II.

The most expensive part of the roll out of a product as you know is the sales and marketing component. I find this idea very compelling, as I work in the detail representative world and I know firsthand how challenging it can be to develop a credible support relationship with busy physicians. Access in many groups is not only limited but closed due to regulations with industry and research. Will the government sales representative adhere to those same guidelines? Even more telling will be the understanding of the monitoring of the Government Health care representatives. Will Government sales reps be tied to the same messaging, regulation and liability that private industry subscribes too? Will these healthcare representatives receive the same high level of technical training, sensitivity and diversity training, training on product and disease state management, and will they be required to sign detailed codes of conduct? What will the customer service and quality management goals look like? If recommendations are adhered to, and the patient suffers some adverse effect, will the company behind the message, in this case the US Government, be held accountable? After all, it is the US Government, not a publicly traded company, so what is the planned process for checks and balance?

According to the article, the home of this marketing machine is the Agency for Healthcare Research and Quality (AHRQ). It has a planned budget of nearly $1 billion. AHRQ is mentioned in the health reform legislation frequently, is responsible for determining what preventive services we get, what health care "quality" is, what should be cut from Medicare and what new technologies should be paid for. According to Dr. Carolyn Clancy, AHRQ’s director, consideration will be given to directives, guidelines, and placement of reminders into electronic health records. An additional 50 million will be spent on comparative effectiveness research (CER). Dr. Clancy has been the director of AHRQ since 2003, almost as long as AHRQ has been in existence.

CER is promoted as information about what are the most medically and cost-effective treatments, drugs, and medical devices. Pharmacoeconomics research is not new to the healthcare industry, but again, time will tell if the government research is held to the same standards as that in the public sector. And how do you manage the FDA in this conversation? Should another government agency validate the work of another government agency, or should there be some element of input from private business?

If healthcare is a component of the bottom line of your business, or if you receive healthcare coverage support from your employer, I would suggest that you keep a sharpened eye on these developing conversations.