university school of medicine, the ceo of children's national health system, and the head the memorial sloan-kettering cancer center. they discussed hospital capacity, the opioid crisis and obesity in the u.s. david rubenstein is a cofounder of the carlyle group and the current president of the economic club. he moderated the hour-long discussion. [inaudible conversations] >> can have your attention, please. can everybody you meet your attention, please. thank you. thank you. everybody, please continue eating eat very, very quietly. this is being televised on c-span and so we do want any extraneous noise, so thank you very much. two announcement i should abate earlier. one of our event sponsors the united banks rick, thank you very much. [applause] and our new member breakfast is next tuesday april the tenth at the intercontinental hotel, and please, members were interest in attending, you're welcome. let me introduce our distinguished panel. to my immediate left, paul rothman. paul is the ceo of johns hopkins medicine. is also the dean of the johns hopkins medical school, a native of queens. he went

cancer center, did work at the university of pennsylvania medical school and he became the head of sloan-kettering in . his wife is also in the family business. she is a cancer researcher. very distinguished. kurt neumann. kurt has the distinction of being a member of our club. well andan athlete as was a base for player in high school. [laughter] he made a mistake and went to the university of north carolina but he has atoned for that by going to duke eccles school. [laughter] he works at the children's hospital -- brigham children's hospital in boston. came to the children's hospital which are will celebrate its 150th anniversary. is children's hospital achieved by the joseph robert surgical center. he is been a part of the children's help system since 2011. his wife is also in the family business. she is a neonatal nurse practitioner. ask you the first question. when you go to a cocktail party, and do people say i have this pain here, the think i need to see a doctor? is it cancer? do people ask you this all the time? >> occasionally. >> mostly by me. i you want to help people so think that is

last week, memorial sloan-kettering's drug pricing lab reported research or made the suggestion that should 340b hospitals be required to provide charity care totally just 1% of their patient revenue, 9% of 340b hospitals would no longer be eligible for 340b. that is if they provided just 1% of their rev fenue for charity care. secondly, i'll point out that if you say the way the business model works is that the more expensive the drug, the greater the discount if the hospital is not returning that discount to the pay or, to the patients or federal government, this he get a bigger spread with a more expensive drug. now, miss maxwell i think i've seen evidence that the incentive is for the 340b program to use the more expensive medicine because again, that increases their spread. is that reasonable and do you agree with that. >> you know, the work of the ig has not touched on that particular issue. our focus has been primarily. >> let me ask dr. draper. >> we have done a report in 2015 that looked at pled care part b drugs in the 340b program and that work we found that it the 340b ho

peter bach, who studies the cost and value of drugs at memorial sloan kettering in new york, to look into acthar for us. what got his attention is that by 2015, medicare was spending half a billion dollars a year on acthar. tens of thousands of dollars per vial-- not for weeks, as with babies, but for years. is there any evidence that these drugs are effective for the diseases that seniors are taking it? >> bach: i mean, none that the food and drug administration would consider convincing. >> stahl: so the food and drug administration has not approved the drugs for these diseases? >> bach: so, the approval for these drugs predate any standard of evidence that we use today. >> stahl: the f.d.a. approved the use of acthar to treat these chronic conditions in 1952, when drug companies were only required to demonstrate a drug's safety, not its efficacy. >> bach: and more important, there's many other drugs that work, that are really quite inexpensive. >> stahl: why did doctors prescribe acthar for these diseases, if there's something cheaper? >> bach: many of the doctors who prescribed a

university school of medicine, the ceo of children's national health system, and the head the memorial sloan-kettering cancer center. they discussed hospital capacity, the opioid crisis and obesity in the u.s. david rubenstein is a cofounder of the carlyle group and the current president of the economic club. he moderated the hour-long discussion. [inaudible conversations] >> can have your attention, please. can everybody you meet your attention, please. thank you. thank you. everybody, please continue eating eat very, very quietly. this is being televised on c-span and so we do want any extraneous noise, so thank you very much. two announcement i should abate earlier. one o

and parents to stay in school in atlanta and i commuted back and forth every other friday to sloan ketteringlanta in spelman and you were going back and forth for cancer treatment. they said why don't you give up school. you said, no, i'm not going to do that. >> you, dr. sampson davis, you were 17 years old and thought you would rob drug dealers. you were the getaway driver. what was it you thought you could do? >> i thought we could get away. >> you didn't get away. at 17 you think you're going to je juvenile detention. instead you were handcuffed. that changed your life how? >> when i was arrested i realized i had to change my life and with me, it was p to me. it was with the stuff i had inside of me. i didn't have to search it and seek it out. i possessed it. it was a matter of me activating it. >> sharlee, what does that mean, the stuff, you have it in side you? >> we believe it's inner fortitude, this you're born with. it's resilience, you know. >> grit. >> grit, exactly. and it's that -- a lot of people don't realize they have it. like i didn't. when we first did this project, he was

the rates of colorectal cancer are skyrocketing up 51% and i spoke to the experts at memorial sloan-ketteringre in their 20s and 30s. now, it's important to say most still occur over the age of 50 but they're watching this trend. when you recommend increased testing you have to take into account costs, other risks versus benefits but the reason behind it is that we know that if you catch colon cancer early, that can save lives and let me show you what i mean. if you imagine this as the colon, okay, no tumor there, no polyp, no obstruction. when a cancer starts to grow, it has to get really, really big to completely block off the lumen or inside of the intestine at times before starting symp m sympto symptoms. if you screen people with either colonoscopy or other tests, you can catch it early. >> do we know why the rates increasing. >> that's the thing. terry, does it have something to do with diet and obesity? it's not really clear. we know that there are other factors that increase the risk of colin cancer, family history, certain genetic mutations. polyp, inflammatory bowel disease, increas