Beyond drug prices: Healthcare industry challenges

The American healthcare industry is facing unparalleled challenges. An aging population, physician burnout, and lack of trust in government healthcare agencies are part of a huge problem that can’t be solved with bigger budgets.

While the media focuses on the high cost of prescription drugs, the healthcare industry deals with many problems. For example, the average doctor’s appointment wait time in 2022 was 26 days, 24% higher than in 2004. According to the Association of American Medical Colleges, the US could have a deficit of between 37,800 and 124,000 doctors by 2034. One of the reasons for that is the growing US population. The US Census Bureau estimates that the population will grow to 423 million by 2050.

It’s not hard to understand why this is happening. 62.8% of physicians had at least one manifestation of burnout in 2021, compared with 38.2% in 2020, 43.9% in 2017, 54.4% in 2014, and 45.5% in 2011. These trends were consistent across nearly all specialties. Among those with physician burnout, 60 percent say too many bureaucratic tasks, such as charting and paperwork, are to blame. About a third say that the “computerization of the practice” or the rise of electronic health records (EHR) contributes.

But help may be coming for patients.

Health insurance has contributed significantly to the sharp rise in core inflation, which strips out volatile food and energy prices, to 6.6% in September from 6.3% in August and 5.9% in July. Health-insurance prices rose 28.2% from a year earlier in September, the sharpest increase in the index’s history going back to 2006, as measured by the Labor Department’s consumer-price index. That added less than 0.4 percentage points to September’s rise in core CPI.

Omair Sharif, the founder of Inflation Insights LLC, estimated the health-insurance index would decline 38% by September of next year from this past September. That would mean health insurance would go from adding around 0.38 percentage points to the 12-month increase in core inflation as of last month to subtracting about 0.42 percentage points by next September, Mr. Sharif said.

Health insurance costs may decrease because patients have caught up on services they put off because of the pandemic. As patients get caught up, there is less of a need to have expensive procedures done. However, the biggest challenge is the aging population. People 65 and older spend nearly twice as much of their total expenditures on healthcare costs when compared with the general population, even with 94% of this age group being covered by Medicare.

The CDC is trying to change, but politics remains in the way.

The CDC’s new push to get information about health crises out faster to Americans is already running up against its limited authority, congressional inaction, and the agency’s own entrenched culture. The CDC’s inability to compel states to share information about disease outbreaks is getting in the way of the effort, said Walensky, who added that the agency needs more money from Congress to draw in new talent and train the public health workforce to speed up the information flow to the public.

The CDC risks repeating the mistakes it made during the pandemic, in which millions did not have the clear, real-time information they wanted to protect themselves from a virus that has killed more than a million Americans. Public trust in the agency has plummeted over the last three years; a further decline would mean even fewer people are listening to the government when another deadly Covid-19 wave hits or a dangerous new disease emerges.

Trump hurt the CDC.

A Congressional report detailed the Trump Administration’s systematic—and often successful—efforts to compromise the scientific integrity of the Centers for Disease Control and Prevention’s (CDC) coronavirus response to serve the former President’s political goals. Evidence obtained by the Select Subcommittee documents how Trump Administration officials usurped control of CDC communications and blocked public health officials from providing accurate information about the coronavirus to the American people; installed political operatives who sought to downplay the seriousness of the pandemic and retaliated against career officials who contradicted Trump Administration talking points; overruled scientists to weaken multiple CDC guidance documents and to exploit and counteract CDC’s public health authorities to achieve political goals; attempted to manipulate the content and block the publication of CDC’s scientific reports and destroy evidence of such political interference; and diverted taxpayer money away from CDC to inject overtly pro-Trump slogans into public service announcements about vaccines.

Concerns in the administration and among public health experts that the agency is too slow to publish critical data have dogged the agency throughout the pandemic. It often took days — sometimes weeks — for the CDC to post infection rates and deaths. That’s partly because the CDC’s system to collect state and local health data is outdated and unreliable. Dozens of states still gather lab results via fax machine and snail mail, delaying the time it takes public health officials to log the information into the electronic data system and send it to the federal government.

Sharing data faster also carries a risk outside the embattled agency. Americans may get public health information sooner, but they also have to stay tuned in case that information proves to be different or wrong, a condition that has the potential to exacerbate the mistrust millions of Americans have developed of federal health officials during the pandemic.