Technology in healthcare will explode between now and two years

Member of Parliament Arno Rutte motivated for good and affordable care We walk out of the historic study room in a bit of a hurry Arno Rutte inside the VVD wing of the House of Representatives building. It's campaign time, the run-up to the elections. “We have to keep a close eye on the time.” The next appointment is firmly in the agenda. The situation in which we start our conversation is a bit stressful. Such is the work of a parliamentarian. It is all the more remarkable how quickly we get into a thoughtful conversation that is really about essential matters of life. It's professional if you can switch so quickly and it shows your drive. What drives the now almost forty-five-year-old Groningen resident, singer of the Rock 'n Roll band 'Harige Harry & the Ladyshavers', to be politically active as a Member of Parliament? It is Arno Rutte's personal story. “About ten years ago my life was turned upside down. My younger brother and my father both died of cancer shortly after each other. And I lost my job due to a reorganization at my employer, the court. That was a 'hard reset' for me. In any case, I wanted to commit myself to healthcare and started working for health insurer Menzis. Now I come from a political background and from that background I became a member of the municipal council of the city of Groningen. I was then invited to stand as a candidate for the House of Representatives in an unelectable position, I thought. To my utter surprise, I was also chosen. I have now been here for four years and am high enough on the list to be re-elected.” Which is what happened. With his legal background, Arno appears to be able to put his 'care egg' to good use in The Hague. “I am very motivated for quality in healthcare, which we must be able to continue to pay for. The fact that I can commit myself to that here and now makes me grateful.” How are we doing in the Netherlands? “Things are moving very quickly in the Netherlands in the biomedical sector. We have a lot of high-quality knowledge, for example in the field of biomarkers. Such specializations of our research institutes and companies are also not so easy to move. We may not realize enough how good we are, even in Groningen where I live. In the Netherlands we don't actually have any real 'big pharma' companies, but we are taking very big steps in research, diagnostics and drug development. I do think we should be a little less careless with patents. New companies are acquired too quickly or sell licenses too easily. Before you know it you are paying twice, first for the research and then for the product that is then marketed by someone else. This way you don't get enough ROI, Return on Investment. By the way, I see, for example, at Brightlands in Maastricht that there is a very targeted search for local entrepreneurs to develop value themselves by setting up companies. I feel more for this path. Our universities should start thinking more enterprisingly.” The fact that we do not make much of what we can public is also evident from the fact that the parliamentary healthcare specialist appears not to know a recently large Dutch pharmaceutical company such as Synthon. Understandable, because this is a company that has developed completely outside the purview of government financing. How does this Rutte view the role of health insurers? “Of course I also know that sector because I worked in it myself. What I see is that problems that are attributed to the health insurer often lie more with the health care provider. For example, eight years ago, remote home care was started. They wanted the insurer to pay for this. But it became too expensive because home care providers wanted to offer this in addition to and not instead of regular work. The problem was then 'framed' as if the health insurer did not want it. Often the biggest problem is the implementation of an innovation. Introducing a new working method is experienced as 'too complicated'. We don't have an innovation deficit, we have an implementation deficit. Healthcare providers have to get to work here. Suppliers of medical technology can certainly play a role in this.” Moreover, Arno Rutte acknowledges and recognizes the problem of poorly matched revenue models, for example when health insurers scour the global market for the cheapest disposables if the price of equipment is determined on the basis of expected turnover from the associated consumables. “I see more pain points in the market. The Da Vinci surgical robot is so unique that there is no alternative supplier. That slows down innovation, especially if you have to buy a very expensive new operating arm for such a device after ten uses. Yet I expect that between now and two years the implementation of technology in healthcare will explode. There is such a shortage of people who can work in the sector that it is inevitable. Moreover, with the available people, we want to focus on real human contact with patients. The drivers of innovation are now the aging population and the associated tightness in the labor market.” Arno points to FHI member companies such as Philips and Siemens as examples of suppliers that respond to what is needed. “For example, the 'Hartwacht' app, a 24-hour telecardiologist for heart patients, via smartphone or tablet. This is monitored by Sionsberg hospital in Dokkum. Such proven effective, patient-friendly innovations must be rolled out more quickly throughout the Netherlands.” How does MP Rutte view the linking of patient databases for research and clinical studies, the Health RI initiative? “Totally in favor. There is of course a privacy issue, but my experience is that patients almost always say 'share my information'. Doctors sometimes want to go further than the laws and regulations allow, but on the other hand, the resistance is sometimes somewhat theoretical. There is much to be gained by sharing information. But we must prevent everything from ending up on the street. Care is the first requirement.” In this context, Arno refers to 'Informed Consent', the arrangement whereby a doctor is obliged to provide a patient with all kinds of information in advance about a proposed treatment for which the patient's consent is required. The Life Lines project is also well known within FHI, in which biological material and data from many people are stored for reference over many years. “You should always actively ask people if they want to participate. Then the choice is theirs.” We almost automatically arrive at the topic of 'medical ethics and technology'. “I see that as a major issue for the future. We are aware of the discussion surrounding the NIP test, the prenatal test for hereditary conditions such as Down syndrome. Now we are testing for five or six factors. We know that it is possible for up to 70 different possible conditions. But it is very questionable whether that is desirable. Also current is the relatively young CRISPR technology to replace genes in embryos. This is a tremendously hopeful technique that can prevent very serious and life-threatening diseases. But the same technique can also degenerate into choosing eye color or gender. I therefore see a major and important task for the legislator, to properly determine what is permitted and what is not.” Suddenly it's time for the next appointment. We quickly make an agreement that Arno will participate in the FHI federation conference, provided that the parliamentary agenda allows this of course. But that won't be too bad as long as there is no new cabinet yet. The second appointment is for a company visit to FHI members. To be continued so, in many ways…