Healthcare: The worst part of living in America

Fewer than half of Americans rate the quality of U.S. health care as excellent or good. Only 12% say it is handled extremely or very well. Americans have similar views about health care for older adults. The public gives even lower marks for how prescription drug costs, the quality of care at nursing homes, and mental health care are handled, with just 6% or less saying those health services are done very well in the country. Can it ever be improved?

People with horrible diseases are being denied treatment by their insurers while they make billions. This means people are suffering; for some, it means they’re staring at the end of life. While appeals go on and on, thousands suffer.

Two years after the pandemic, healthcare worker burnout and staffing shortages are plaguing hospitals nationwide. Prescription drug prices, especially for new drugs, are out of control, and when you go to the hospital, you’re liable to get a bunch of bills you thought insurance would cover in the mail.

Patients are burned out. Nurses are leaving the profession. Doctors are demoralized. In the meantime, the people not sick or tending to sickness — the corporate middlemen in charge of insurance companies, private hospitals, doctor practices, and pharmaceutical companies — are feasting.

New York Times

Pharma is a business whose sole purpose is to maximize profits

A new Amgen Inc. lung cancer treatment, Lumakras, carried a hefty price tag when it came out in 2021: $17,900 per patient monthly. Just over a year later, in December 2022, a second drug for the same type of cancer, Krazati from Mirati Therapeutics Inc., had an even higher price: $19,750 a month—a 10% premium.

According to the WSJ, “as drugmakers face rising pressure to rein in repeat or annual price hikes on existing drugs, new brand-name medicines are coming to market with ever-higher price tags on day one. Previously, companies would carefully consider whether to crack significant price barriers when launching a drug, like $5,000 and then $10,000 monthly. Many new cancer and rare disease drugs routinely exceed those price thresholds, often at over $20,000 monthly.

Drugmakers say the prices reflect the clinical benefits the new drugs provide for patients. The companies say most people don’t pay list prices because they offer rebates and discounts to employers, pharmacy-benefit managers, and insurers. And companies often provide assistance to help defray out-of-pocket costs for patients.  We know that’s 10% Grade A bullshit.

Two new cancer drugs approved in the U.S. in January—Eli Lilly & Co’s Jaypirca for mantle-cell lymphoma and Stemline Therapeutics Inc.’s Orserdu breast-cancer treatment—each cost at least $21,000 a month, or more than $250,000 for a full year of use.

Among the other factors fueling high launch prices is the drug industry’s increased focus on developing new medicines for diseases with small patient populations, like genetic disorders and certain cancers, drug-price researchers say.

Companies have long justified high prices for such “orphan” drugs because there are fewer patients from whom to generate enough sales for a return on costly research-and-development investments. Now, such drugs make up much of the industry’s output. In 2022, 54% of new drugs approved by the FDA were for rare diseases, versus 33% in 2012, according to the agency.

Hospitals receive $1 out of every $3 spent on health care, and the United States is projected to spend about $1.3 trillion for hospital care alone in 2019. Hospitals collectively boast a margin of 8 percent, a level higher than margins in the pharmacy or insurance industries. Across America’s acute care hospitals, total revenues exceeded expenses by more than $64 billion in 2016, according to a Center for American Progress analysis. However, experiences among individual hospitals vary, and about one-quarter of for-profit and not-for-profit hospitals lost money in 2016.

U.S. residents with average hourly earnings must work 504 hours to cover a typical hospital stay. A hospital stay costs $2,873 a day, but the average stay is 4.6 days. Workers who make $26.22 hourly (the national average) would need more than 500 hours if they owed the entire bill.

The cost of a typical hospital stay is up 98% since 2004. The jump drops to 35% when adjusted for changes in hourly earnings over time. In 2004, the typical hospital stay cost 374 hours of work.

And it’s getting worse.

For many years, KFF polling has found that the high cost of health care burdens U.S. families and that health care costs factor into decisions about insurance coverage and care seeking. These costs also rank as a top financial worry. This data note summarizes recent KFF polling on the public’s experiences with healthcare costs.

  • About half of U.S. adults say they have difficulty affording health care costs. About four in ten U.S. adults say they have delayed or gone without medical care in the last year due to cost, with dental services being the most common type of care adults report putting off due to cost.
  • Substantial shares of adults 65 or older report difficulty paying for various aspects of health care, especially services not generally covered by Medicare, such as hearing services and dental and prescription drug costs.
  • Healthcare costs often prevent people from getting needed care or filling prescriptions. About a quarter of adults say they or a family member in their household have not filled a prescription, cut pills in half, or skipped doses of medicine in the last year because of the cost, with larger shares of those in households with lower incomes, Black and Hispanic adults, and women reporting this.

I keep waiting for some brave person to step forward and say, “enough is enough,” and demand that Congress do much more to fix American healthcare but, it hasn’t happened except for Mr. Cuban’s attempt to lower generic drug prices.

For-profit healthcare is broken and beyond repair. The CEO of AbbVie just took home a paycheck of over $60 million while people have to decide whether to buy their drugs or food. America’s number one problem continues to be healthcare.