I don’t know if anyone would argue with the statement that healthcare in the US is expensive. It’s more than that, though; it’s staggeringly expensive. It’s existentially expensive – healthcare is such a huge part of our national spending that it threatens our way of life.
Around 18% of the US’s outsized Gross Domestic Product gets spent on healthcare each year, even after the waning of the COVID-19 pandemic. The pressure for maintaining profits (about 11% of the $4.3T we spend a year on healthcare is profits for the various industry members, mostly going to care providers, pharma companies, and insurers) is pushing providers to run leaner. That’s contributing to the real tragedy in this situation, which is that for all we pay (almost $13,000 per person annually, two times the average spending of our economic peer nations), our health outcomes and access to care are among the worst of similarly developed countries. As provider profits soar (projected to rise 27% between 2019 and 2024), their staff are increasingly overworked (around 7.5% of healthcare jobs are unfilled) and underpaid (healthcare industry pay was 3% higher than the average all other industries in 2013; by mid-2019 it was 0.5% lower).
People are increasingly putting off care because they can’t afford it and when they do finally seek it out, waiting months for an appointment. All of these are ingredients in the toxic soup that’s combined to drop US life expectancy at birth from an already-poor 78.8 years in 2019 to 76.1 in 2021 (and that’s the combined number – the life expectancy for males is down to 73.2 years. Gonna be a lot of lonely grandmas out there).
So if we can all agree this isn’t how we want things to be, what’s to be done about it? There are lots of ideas out there (I like David Cutler’s here) and like all things these days, the debate has become increasingly partisan. We do have lawmakers working across party lines to secure affordable, available care for their constituents (Sens. Sanders and Marshall have a great example with their Bipartisan Primary Care and Health Workforce Act), but gridlock and the massive war chests of the insurance and pharmaceutical lobbies mean that these efforts generally don’t go anywhere. I hope that changes someday, but while we’re waiting for legislative relief there are some common sense changes we can make to get back on the right path.
I grew up in a household led by care providers: my parents are a physician and a pharmacist with 90 years of medical experience between them. Among other things, they taught me that simple answers are often the best; if you have a viral infection, the best treatment is generally hydration and rest rather than pills. And based on their experience, there are a couple things we could do to improve the healthcare landscape in America, one for each of their areas of expertise:
End direct-to-consumer advertising for drugs. Pharma companies spend over $8B a year on direct-to-consumer advertising, and since these companies are all making a profit, all of that cost is covered by their charges to those same consumers. Americans pay more than 2.5 times what our economic peers pay for drugs, but that’s not the whole story: we pay over 3.4 times as much for name-brand drugs, and we actually pay less than others for our generic drugs. And while it doesn’t always make sense to do something because everyone else is doing it, it’s pretty telling that direct-to-consumer drug advertising is only legal in two countries in the whole world. This savings may only be a drop in the bucket against $4.3T, but we could provide a lot of care to underserved communities with eight billion dollars.
Move back to primary care as our main interactions with providers. 40 years ago, around two-thirds of doctor’s visits for Americans 65 and older were with primary care providers, with the remaining third being with specialists. 10 years ago, that ratio had flipped. This has two negative effects: specialty care is more expensive, so this contributes to driving up the cost of care, and communities that are more dependent on specialty care have worse health outcomes. This is one of those things that make sense anecdotally (my father moved from primary care to a hospitalist role years ago because of economic pressures, a story told over and over around the country, and he regularly laments the drop in the quality of care he can provide now because he’s not familiar with the histories of his patients) and are borne out by research. The bill from Sens. Sanders and Marshall attempts to address this, and I hope it succeeds.
Times are tough now. Care is expensive and hard to get, workers are stressed and underpaid, and health outcomes are trending in the wrong direction. We have some huge problems in front of us, but we don’t need to solve everything at once; every little thing we can do to move the needle back in the right direction helps. At Extract, we can help by reducing the amount of time and energy your teams spend processing documents. Our automated solutions can reduce costs and improve the quality and completeness of the data going into your medical record system. Talk to our team today about how we can help you.
About the Author: Alex Albrecht
Alex Albrecht is a member of the Professional Services team at Extract Systems. He spent a decade as a global learning and development leader and has also worked as a product manager, system administrator, trainer, product support specialist, and serviceability engineer. When he’s not adding to that list, Alex enjoys coaching sports, spending time in the kitchen with his family, and wrestling with his tiny brown Shih Tzu.