Is healthcare too profitable to be fixed?

QUICK READ: The American healthcare system is too damn profitable for any reasonable reforms. If we don’t address this issue head-on when will we?

According to The NY Times, “HCA Healthcare is one of the world’s wealthiest hospital chains. It earned more than $7 billion in profits over the past two years. It is worth $36 billion. It paid its chief executive $26 million in 2019.  HCA executives warned that they would lay off thousands of nurses if they didn’t agree to wage freezes and other concessions.

A few weeks earlier, HCA had received about $1 billion in bailout funds from the federal government, part of an effort to stabilize hospitals during the pandemic.

This should make you very angry. It’s your tax dollars that are being misused while CEO’s laugh all the way to the bank. Hospital costs have been rising every year and more and more hospitals are being taken over by big corporations whose goal is profits.

On the pharma side money is leading to excessive costs for healthcare as well.

The Food and Drug Administration has approved five generic versions of Humira, the world’s biggest-selling drug with global revenue of $20 billion. AbbVie, Humira’s manufacturer, kicked off 2020 with a price increase in excess of 7 percent on its mega-blockbuster brand-name treatment, which is used to treat rheumatoid arthritis, psoriasis, and Crohn’s disease.

Good luck trying to find them though. In the meantime, AbbVie is raking in the cash for Humira. Price increases followed total Humira price hikes of 19 percent during 2017 and 2018, according to a survey by the nonprofit Institute for Clinical and Economic Review, which deemed the increases unjustified.

Humira has built a patent fortress around their product to protect their ability to continue their monopoly pricing. The CEO of the company is being compensated by the profitability of Humira.

Gilead is set to make a small fortune with Remdesivir for COVID-19 even though the supporting research shows a marginal improvement in patients who were given the drug. At $5,000 a treatment it could wind up bringing a lot of dollars to Gilead.

The U.S. spends more on health care as a share of the economy — nearly twice as much as the average OECD country — yet has the lowest life expectancy and highest suicide rates among the 11 nations and it’s very profitable.

But because it’s so costly and profitable a record 25% of Americans say they or a family member put off treatment for a serious medical condition in the past year because of the cost, up from 19% a year ago.

While ASCO had some great news on new cancer drug trials the subject of the cost of cancer is still not being openly debated. The financial costs of cancer are high for both the person with cancer and for society as a whole. The Agency for Healthcare research and Quality (AHRQ) estimates that the direct medical costs (total of all health care costs) for cancer in the US in 2015 were $80.2 billion

How can we address these challenges?

1ne: We need to simplify the healthcare payments for drugs. The list price of a drug doesn’t mean a thing because every middleman has his hand out and wants a piece of the pie. Insurers and PBM’s need to be more transparent.

2wo: Set profit limits on key players. OMG, are you suggesting that capitalism doesn’t work? Yes! Lobbying has ensured that politicians will make decisions based on what’s best for them and their re-election not what’s best for society.

3hree: Shareholders need to be more vocal about CEO salaries. No healthcare CEO should make $28 million period.

4our: Simplify the process to qualify low-income people for the drugs they need.

5ive: Fight litigation designed to prevent generics from reaching the market. It has to stop it makes drug companies richer and keeps patients paying for branded drugs.

6ix: The FDA and insurers need to stop approving me-to drugs.

Maybe we need not-for-profit hospitals and insurers while eliminating PBM’s. It won’t be easy to face the army of lobbying money but we can’t continue down this path anymore. Wanted..a politician with the guts to say that our healthcare system is broken and needs to be torn down.