America’s Costly Health Care System Can be Fixed

The Medicare Hospital Insurance Trust Fund that American workers and employers pay into is projected to become insolvent in 2028, according to the latest Medicare trustees’ report.  President Biden has proposed some fixes in his budget for fiscal year 2024 that include higher payroll taxes for the wealthy and prescription drug reforms.  He claims his plan will keep the trust fund solvent until sometime in 2050.  Drug companies, of course, are pledging to fight efforts to lower drug prices, including those already passed in the Inflation Reduction Act. 

Not to worry though, even if the president’s proposals do not become law, Congress will find some way to keep Medicare solvent in the short term.  But our current health care system is not sustainable longer term and that will only delay the inevitable.  The best solution for the future is to significantly reduce health care costs – and not just for drugs.

Prescription drug costs are killing people, literally.

Mavenclad, a multiple sclerosis drug, has a list price of $194,000 a year, according to a February New York Times article.  One lady’s Medicare co-pay is $10,000, but she can’t afford that and neither can most families.  Biden’s Inflation Reduction Act will cap out-of-pocket costs for Medicare patients like her at $2,000 annually — but not until 2025.  Research suggests, however, that large numbers of patients abandon their prescriptions when faced with $2,000 in payments. 

The median annual price of a new drug was around $180,000, in 2021, according to researchers for Brigham and Women’s Hospital in Massachusetts.  Still, new drugs aren’t the only problem.  In the last few decades, drug companies have hiked the prices of many older medications like blood cancer drug Revlimid, which costs three times more today than when it was introduced in 2005. 

The prices for insulin, however, are even more shocking.  This drug has been around for over 100 years and, depending on the type, only costs between $2 and $10 to make per vial, according to Verywell Health.  But that vile can cost consumers between $50 and $1,000.  For all types of insulin, Americans pay 10 times more on average than all other countries.  Some diabetics rationing their insulin have died.

Ely Lilly projects that it will spend $8 billion on drug research in 2023.  I believe Congress must find a way to effectively reimburse companies like Lilly for research so they can’t use these costs to justify the exorbitant drug prices they charge to Medicare and consumers.

Why less costly and sustainable health care systems are desperately needed.

An estimated 98 million Americans cut spending on things like food and rent, or borrowed money, to cover healthcare costs, according to a West Health and Gallup 2022 survey report.  And high costs caused 26% of U.S. adults to either delay care or avoid purchasing prescribed medicine.

Other large, wealthy countries spent, on average, about half as much per person ($6,100) on health care in 2021 as the U.S. ($12,900), according to the Kaiser Family Foundation.  Yet, life expectancy is lower in the U.S. than other wealthy nations, while about 60% of American adults have a chronic disease and around 10% of the population doesn’t have health insurance. 

Health care costs are a factor causing gross inequality in medical outcomes.  The death rate of college-educated – and likely wealthier – Americans with cancer is 90.9 per 100,000 per year, according to Dr. Otis Brawley, a Johns Hopkins University professor of oncology and epidemiology.   The rate is 247.3 for patients with a high school education or less.  And I suspect this is also the case with other life-threatening diseases.

America’s population is aging and half of its current five-year-olds will likely live to be 100, according to a recent National Geographic article. 

Universal health care, like many other wealthy nations have, could have prevented an estimated 338,000 U.S. deaths and saved $105.6 billion in health-care costs during the first two years of the coronavirus pandemic, according to a June 2022 report by the National Academy of Sciences USA.

The possibilities for Artificial intelligence (AI) in health care are almost endless.

Radiologists will increasingly be examining x-ray, CT, MRI, and PET images in 2023 that have been first evaluated by AI machines, according to an article in Wired.  An exciting new capability of AI will allow untrained patients with a smart phone to acquire high-quality scans of their organs, which can be interpreted by AI algorithms.

Smart watches are already able to detect abnormal heart rhythms and this year these capabilities will be extended to preliminarily diagnose other conditions, like skin lesions and urinary tract infections.     

I am confident that AI can use a combination of patient’s medical history and various CT, MRI and/or other images to diagnose numerous health issues, effectively and safely prescribe drugs and so much more.    

Voters must support solutions to fix our health systems.

My first career in information technology helped me understand that AI machines will require large, accurate quantities of personal medical data in order to fully transform America’s health care system.  Personal data collection, however, creates significant privacy concerns that must be addressed.

I believe, however, that only dramatic, paradigm shift proposals – like those suggested above – can make America’s health care systems less costly, more effective and sustainable long-term.  I intend to support organizations that will help voters understand the need for these solutions and politicians who will vote for them.

About eeldav

I am a retired corporate attorney who has lived in both Europe and Asia. While working my responsibilities took me to over 40 countries in Europe, the Middle East, Africa and Asia.
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