Advanced economies typically spend about 10% of GDP on keeping their citizens in good health, a share that is rising as populations age. America’s profit-riddled healthcare-industrial complex consumes 17% of GDP, equivalent to $3.6trn a year. That is unsustainable. However, changes are slowly being implemented that could lower healthcare costs.

Sixty percent of employees in a recent survey reported experiencing healthcare cost increases that outpaced inflation in the past three years, and 63 percent expect that trend to continue, signaling potential cost challenges in the future. Right now, annual raises are being neutralized by increasing healthcare insurance premiums. If pharma wants to retain people, they may have to develop a solution to lower healthcare insurance premiums.

A 2015 Commonwealth Fund brief showed that — before the major provisions of the Affordable Care Act were introduced — the United States had worse outcomes and spent more on health care, primarily because of greater use of medical technology and higher prices, compared to other high-income countries. The United States ranks last overall, despite spending far more of its gross domestic product on health care. The U.S. ranks last on access to care, administrative efficiency, equity, and health care outcomes but second on care process measures.

The value of health literacy extends far beyond the boundaries of COVID-19. Education leads to fact-based empowerment, and an educated healthcare consumer can be a potent change agent. Poor health literacy is one of the reasons why life expectancy is lower in Republican-led states, and the problem has been growing worse for decades. The highest rates for covid-19 deaths and murders are found mainly in red states.