The cost barrier to healthcare

  • One quarter of Americans say either they or someone in their family has skipped necessary medical care because of the cost.
  • Older Millennials (ages 27-36) are more likely to forgo care due to cost.
  • 56 percent say they’re either very or somewhat worried that they might not have affordable health coverage in the future.

One quarter of Americans say either they or someone in their family has skipped necessary medical care because of the cost and more than half worry about not being able to afford health insurance.  Welcome to for profit healthcare.

According to JAMA ” [inlinetweet prefix=”” tweeter=”” suffix=””]in 2016, the United States spent nearly twice as much as 10 high-income countries on medical care and performed less well on many population health outcomes.[/inlinetweet] Contrary to some explanations for high spending, social spending and health care utilization in the United States did not differ substantially from other high-income nations. Prices of labor and goods, including pharmaceuticals and devices, and administrative costs appeared to be the main drivers of the differences in spending.

In addition, research shows that for a substantial fraction of Americans, [inlinetweet prefix=”” tweeter=”” suffix=””]a trip to the hospital can mean a permanent reduction in income[/inlinetweet]. Some people bounce right back, but many never works as much again. On average, people in their 50s who are admitted to the hospital will experience a 20 percent drop in income that persists for years. Overall, income losses dwarfed the direct costs of medical care.

While prescription drug prices continue to be the hot button topic for the media little attention is being given to hospital costs and the power of insurers.  Someone, for example, who goes to the hospital for an emergency can find that they have to pay hundreds or thousands if the doctor that helped them doesn’t take their insurance.

The upcoming midterm election and future presidential election are going to be, in large part, focused on healthcare costs.  PhRMA is already lobbying with record levels of dollars and is prepared to fight anything that could potentially benefit patients and benefit pharma.

Change is coming, but will pharma be ready?  Some pharma companies have already started to lay off people and cut back on R&D.  My guess is that there is a lot more coming because as we know most pharma organizations only focus on short term results not long term strategic direction.