Columns and Commentary from Michael Levin, Integrator Editorial Adviser
Michael D. Levin
Founder, Health Business
Strategies
Michael Levin
Michael is a cross-over professional. His
business
insights are deeply steeped in conventional pharmaceuticals and
medical technology, formed through a first career which included a
stint as a
vice president with Baxter Healthcare. For most of the last decade,
Michael
has held executive positions with natural products companies including
Tyler Encapsulations and Cardinal Nutrition. He has a passion for the
development of the integrated health care industry, seeing that if
people aren't making much money that growth will be slow! Michael has
been quite
useful on both natural product quality issues and on the potential cost
savings from better integration of natural therapeutics. To contact Michael:
Michael D. Levin, Founder Health Business Strategies 12042 SE Sunnyside Road Clackamas, OR 97015 503-753-3568 (direct) 503-698-7565 (fax)
Integrator adviser and columnist Michael Levin read the brief in the August 2014 Integrator Round-up entitled"Hospital group begins
campaign promoting its role disease as an economic engine."The
subject is an organization of U.S. hospitals and academic health
centers, the Coalition to Protect America's Health Care (CPAH).
The organization was created to protect economic life as hospitals know
it. Their strategy leads with calling attention to the jobs they create
and their economic impact on communities. I questioned whether this
strategy is ethical of nominally "healthcare" organizations. Levin, the
founder of theHealth Business Strategies consultancy,
dives into CPAH and share details: over $14-million of marketing and
lobbying revenues from 2011-2013. He particularly notes the role of
academic health centers in this self-protective work.
Healthcare business strategist and Integrator columnist Michael Levinwas one of the earliest players in the integrative health field who sought to focus attention on the importance of establishing the business case for integration and inclusion. With a background as an
executive in both Pharma and natural products companies, Levin's early
focus was on pharmacy substitution strategies. Business models were
needed to require payers to explore. Here Levin speaks to another sort of business model, this time extolling a direction that is outside the box of the payment system.
No one doubts whether the
Bravewell Collaborative's new mapping study added useful understanding
of the nation's health system-sponsored and academic health
center-sponsored integrative clinics. But do these thumbnails, reports
and tables on these 29 clinics capture what the title suggests: Integrative Medicine in America: How Integrative Medicine is Being Practiced in the United States? I posed the question. Here are responses from: public health acupuncturist and researcher Beth Sommers, MPH, LAc, PhD; holistic
medical doctor Bill Manahan, MD; Integrator columnist Michael Levin;
rehab specialist and past American Association of Medical Acupuncturists
board member Mitchell Prywess, MD; an anonymous integrative MD;
National University of Health Sciences president Jim Winterstein, DC;
and senior editor of the Textbook of Functional Medicine Sheila Quinn. I conclude with my own speculations on what might be different in community-based integrative medicine.
Correction: Dr. Roger
Rogers after whom the Dr. Rogers Prize is named is alive ... Bill
Manahan, MD on pain treatment, CAM and the IOM pain blueprint ... Janet
Kahn, PhD on key Integrated Healthcare Policy Consortium language in the
National Prevention Strategy ... Ann Fonfa comments on sham acupuncture
in the IOM blueprint ... Jean Keating, PharmD speaks up for independent
pharmacists ... Glenn Sabin offers an informed patient's view on
Freedman's Atlantic article ... Jim Winterstein, DC speaks to a value in the term "alternative medicine" ... Jennifer
Olejownik, PhD on the current state of integration ... Chris Foley, MD
and Stephen Bolles, DC on "patient-centered care" and "code-centered
care" ... Michael Levin of Health Business Strategies on the
characteristics of Primary Care 2025 ... Lon Jones, DO and Common Sense
Medicine weigh in on the future of primary care ... Lisa Rohleder, LAc
offers a useful rant against protective guild behavior
The
stories of patients arriving at doors of
integrative practitioner offices with avoidance of prescriptions as
their
motivation are legion. In an earlier column, Stephen Bolles, DC
challenged the move of credit rating firm FICO into drug adherence
monitoring in part for its failure to appreciate what may be called
positive non-adherence. In this exchange, Integrator columnist
Michael Levin notes the substantial estimates of harm from
non-adherence. His take is friendlier toward FICO's intent. Bolles
responds, and Levin replies. It's a complicated exchange in which
paradigms collide. I add a couple comments.
Making the cost case. A decade ago, now Integrator
adviser and columnist Michael Levin and I connected on this theme.
Levin's passion for the topic was, and remains, informed by experience
of conventional medical stakeholder perspectives, in part due to his own
background as executive with pharma, medical devices and more recently,
with supplement companies. Presently a consultant to the field, Levin
published his first Integrator column in January 2007 and has
fashioned 20 columns and short commentaries since. His contributions are
frequently stimulated by news items that underscore the importance of
the economic argument for integrative and wellness practices. A second
regular theme relates to issues surrounding natural products. Levin's
value to the Integrator is less visible but also considerable in
the numerous news items and studies he has sent my way through the
years. It is a pleasure to make his contributions visible.
October 26, 2010
A
nice mix of themes and responses here: Michael Levin on the
Seely-Herman research on cost savings of whole practice ND care for
Canada Post employees; AHMA president David Forbes, MD on the NCCAM
priorities; short notes on the
Georgetown-Bastyr relationship promoted by Adi Haramati, PhD; Barney
Holmes on biases relative to alternative medicine in Wikipedia; Carlo
Calabrese, ND, MPH on what "CAM" fields have in common according to
Wikipedia; Community Acupuncture Network co-founder Lisa Rohleder, LAc,
AOM educator Steven Stumpf, EdD and AOM student Leah Taylor on the
incomes of licensed acupuncturists as reported by the National
Certification Commission for Acupuncture and Oriental Medicine, plus a
brief note from an anonymous naturopathic physician who believes that
her profession has a similarly challenged economic perch. I comment on
the link between Levin/Forbes and the income discussion.
September 2010
The National Institute of Complementary Medicine
(NICM), established with seed funding provided by the Australian
Government and a New South Wales governmental agency has published a recent report
that found cost effectiveness for most of the handful of therapies
examined. The agency sent a September 13, 2010 press release entitled Economic report finds complementary medicine could ease health budget. Integrator columnist and adviser Levin, in his commentary, notes that "If the presenteeism and absenteeism costs of low-back pain are averted, the benefits from acupuncture would double."
A
disturbing new report from Medco documents the growing use of major
pharmaceuticals in the treatment of children. Use with childhood chronic
diseases is highlighted with a particular area of concern the drug
treatment of Type 2 diabetes associated with childhood obesity. Integrator
columnist Michael Levin, a healthcare consultant with Health Business
Strategies, seizes on the report's recommendation that "health plans
actively promote lifestyle change." Levin urges the right integrative
medicine entrepreneurs to step up to a potentially lucrative business
opportunity.
March 6, 2010
The "McCain Bill,"as it quickly became known, has stirred
up a furor in the integrative practice and natural products communities.
Practitioner, consumer and industry interests are peppering their lists
with alerts about a proposed bill which they argue will increase
regulatory burden, limit access to supplements and significantly
increase costs. US Senator John McCain used the Senator floor to take on
the arguments of his opponents. Major league sports are backing McCain.
The proposal is called the Dietary Supplement Safety Act of 2010. Here
are links to key viewpoints followed by a critical analysis from Integrator
columnist Michael Levin whose professional career spans executive
positions in big Pharma and the supplements industry. He offers a useful
regulatory strategy by focusing on the narrows of the production river.
(Note: At publication time word arrived that McCain was backing down.) More October 26, 2009
Passage of a bipartisan amendment from US
Senators John Ensign (R-NV) and Tom Carper (D-DE) has elevated a debate Integrator
columnist Michael Levin has repeated brought to these pages. To change
behavior, in Levin's view, "education rarely works, economics usually
does." The Ensign-Carper amendment allow health plan costs to be cut by
as much as 50% for those who engage healthy behaviors. Some unions and
major disease-based organizations are opposed. Employers tend to support
the direction, as Kenneth R. Pelletier, PhD, MD(hc) and Sean Sullivan,
JD, each share. A tremendous discussion has been kindled on the Washington
Post site. Levin lays out what he believes are significant
opportunities for the integrative medicine community. Where are you on
this issue of patient engagement, habit change, healthcare economics and
public policy?
September 27, 2009
In a recent column in the New York Times,
author Michael Pollan pits big
food vs. big insurance, arguing
that the elephant in the room in healthcare reform is obesity, and that
the solution comes to slimming down. Integrator columnist
Michael Levin finds in Pollan's perspective evidence that key
characteristics of current insurance reform efforts create financial
incentives that support investment in integrative practices. One
wonders, with Pollan, whether "Washington can summon the political will
to take on
and reform a second, even more powerful industry: the food industry."
Yet Levin's argument is clear that we may be seeing changes that could stimulate investment
in therapeutic approaches which support habit change. Will these changes incentivize insurers to
finally invest
significantly in health creation?
Did you know
that Pepsico is threatening to move all its operations out of New York
if the state passes a "sin-tax" on soda pop? Integrator columnist
Michael Levin recognized in this story that the giant firm has a rather
strong perspective on whether economic incentives can be a powerful
stimulus for behavior change. Levin uses the story to wade into
questions raised in a recent British Medical Journal article on
what it will take for people to make healthy decisions. Fascinating
piece. Levin invites you to weigh in on the topic. More
Integrator
adviser and columnist Michael Levin reports on a recent California
action, under Proposition 65, against 56 dietary supplement companies.
The issue is a level of lead in their products which required informing
their customers. Levin uses the column to remind clinicians and
administrators of the importance of vigilance of supplement
manufacturers about the extent of their quality control plans. The
story was brought to Levin's attention through Michael McGuffin and the
American Herbal Products Association. More ...
Integrator
adviser and columnist Michael Levin often speaks to us from the
discomforting chasm between the aspirations of integrative medicine and
current realities regarding the natural healthcare products which most
integrative practitioners prescribe in their offices. Here, Levin
focuses on "economic adulteration" of dietary supplements in the recent
story of melamine contamination of infant formulas which caused
sickness and death in China. What are the integrative practitioner's
responsibilities in raising the bar? More ...
The big medical
news just after Independence Day was that, following new American
Academy of Pediatrics recommendations, thousands of children will soon
be dependent on statins for cholesterol management. Integrator
columnist Michael Levin muses on this news together with a virtually
unnoticed whole system, integrative Mayo Clinic study which found that
lifestyle, supplements, diet and yoga or Tai chi not only lowered
cholesterol but also weight and who knows what other positive outcomes.
Are statins parenting replacement therapies? More ...
Integrator columnist
Michael Levin recently had occasion to read a series of reports,
prepared by the internationally-known health care consulting firm, The
Lewin Group. The subject: possible cost impact of pro-actively using a
few dietary supplement interventions for a handful of conditions. The
outcomes were compelling. Levin argues that this kind of work, funded
by the dietary supplement industry, exemplifies forward thinking
collaborative effort needed to advance the integrative and natural
health fields. The story of this strategic funding will be familiar to
chiropractic. More ...
Integrator columnist Michael Levin
shares intriguing outcomes of a healthcare survey from the Deloitte
Center for Health Solutions. The authors examine opinions and practices
of over 3000 consumers, identifying use of alternative healthcare
services as a key identifier of behavior across a series of consumer
types. The six types range from "content and compliant" to "out and
about" (the most significant alt-med users) to "shop and save." Current
complementary medicine use represents a fraction of the openness
expressed by these consumers. Paul Keckley, PhD, co-author
and director of the Center was formerly the head of integrative
medicine planning for Vanderbilt University. Levin is correct: there is
much here to ponder about integrative care and the changing nature of
the healthcare consumer.More ...
Integrator columnist
Michael Levin, founder of Health Business Strategies, is a long-time
promoter of integrative medicine strategies that challenge the often
costly, unsafe and quality of life-damaging interventions promoted by
Big Pharma. So when Levin, who has been an executive with both pharmaceutical
and dietary supplement firms, saw the new AARP report on drug price
trends pre and post the implementation of the Medicare Drug Benefit, he
analyzed it both for what Pharma had already extracted, and for what
integrative medicine might. Here is Levin's brief report and view of
opportunities. More ...
February 18, 2008
Most
integrative practitioners and consumers have some awareness that
various forms of certification of product quality are increasingly available to natural
products firms. Integrator
adviser Michael Levin looks into the dependability of such
certification. He begins with a comment from Alan Greenspan on trust,
then goes down the rabbit hole into issues surrounding United States
Pharmacopoeia, Concumerlab.com and the major supplement manufacturer
Leiner. It's a fascinating and sobering journey. More ...
There is no question that the holistic, naturopathic, Oriental, chiropractic and integrative medicine professions are in bed with pharmaceutical companies ... natural
pharma, that is. The question is, how is this relationship best
effected? Put differently, can these professions avoid the pitfalls of
the MD-Big Pharma marriage and take advantage of each other's
strengths? In this third column in an ongoing series on the topic begun
by David Matteson, Integrator adviser Michael Levin - who has
held executive positions for both Big Pharma and natural products firms
- weighs in on the issue. More ...
September 7, 2007
Integrator Adviser Levin on Dietary Supplements and the FDA's cGMPs: What Defines "Quality?" - a 2nd Look Integrator adviser Michael Levin continues with his analysis and commentary on the current
Good Manufacturing Practices (cGMPs) finally published by the US Food
and Drug Administration. In this take, looks at how the industry and
the FDA have defined "quality" and finds out they are not aligned. What
does this mean for practitioners and consumers? Levin brings it all
home for ginger lovers with his analysis of a July 2007 action on
imported ginger by a California regulatory agency. He credits AHPA, the
herb industry organization, for its demand that the FDA set the bar higher, and offers a forecast. More ...
August 24, 2007
The
story on the success of a group-focused services clinical strategy for
a Chrysler employee population led by Robert Levine, PhD, for Henry
Ford Health Systems (HFHS),
prompted Lisa Rohleder, LAc, with the Community Acupuncture Network
(CAN) to stimulate a dialogue and real-time link with Levine in the CAN
Blog. The HFHS outcomes promoted Adrian Langford, who runs a
patient-focused program with a Medicaid population with Alternative
Medicine Integration Group to comment on what promotes the positive
patient outcomes. Taylor Walsh wonders at the use by Karlo Berger, ABT,
LMT, of "collective healing" to describe some of the power of these
setting ... In other notes, the COCSA-AMI relationship stimulated a
note from COCSA executive director Janet Jordan ... Chris Huson, LAc
opens a dialogue about a suggested integrated pathway for asthma and
Rik Cederstrom , DC, responds to another attack on supplements by
author Michael Hurley, this one broadcast for Medscape plus comments from Michael Levin. More ...
August 3, 2007
The natural
products industry in the United States has a boatload of stories of
businesses started in homes and garages that grew to become dominant
players. The Current Good Manufacturing Practices (cGMP) for dietary
supplements document recently issued by the FDA promises to significant
change the terrain. What effect will it have on the industry? Integrator adviser
Michael Levin addresses this topic in Part 2 of his analysis of the
cGMPs. Levin also addresses questions regarding his first article which
were raised by Michael McGuffin, executive director of the American
Herbal Products Association. More ...
July 14, 2007 - Bastille Day
After a
12 years of unsteady and politicized process, the US Food and Drug
Administration last month finally issued its new Good Manufacturing
Practices (GMPs) for dietary supplements. Integrator advisor Michael Levin is making his way through the 831 pages of the GMP document. In this Part #1 filing for the Integrator,
Levin reveals a strange conceptual approach to GMPs which will allow
companies to make claims that sound equivalent (ie, "we follow GMPs")
which actually give the consumer no information about the quality of
the products. For those wishing to know more about the likely impact of
the GMP on consumers and manufacturers, a September 13-14 conference
led by Loren Israelsen and
the United Natural Products Alliance will explore the full meaning of
the new GMP. More ... May 9, 2007
Another recent Integrator post
reports outcomes of a survey of media coverage of dietary supplements
in 2006. The outcomes were not pretty for the industry. Integrator
editorial adviser Michael Levin noted two recent reports, both on chondroitin, which might
explain some of that negativity. Levin, who has held executive level
positions for both Big Pharma and supplement companies, focuses on a
Consumerlab.com quality and potency study and an efficacy study in the Annals of Internal Medicine. Is there a useful pattern emerging? More ...
January 20, 2007
On January 16, the New York Times
published an essay by supplement-bashing author Dan Hurley entitled
"Dietary Supplements and Safety: Some Disquieting Data." Michael Levin,
an Integrator advisor who has held executive level positions in
both pharmaceutical and dietary supplement companies, immediately
researched Hurley's core assertions and discredited them. Here is the
full letter to the editor which Levin has shipped off to the New York Times.
Are clear thinking and accuracy of interest to this staid daily? Truth
is presently again a casualty in Hurley's war against supplements.
