In employer-based health plans, the average deductible for a SINGLE person is over $1,500, according to Kaiser — 3 times higher than it was a decade ago. The trend toward increasingly high deductibles means families struggle to afford their care, even with insurance.
Chronic disease management is a must when shifting to value-based care! The Milken Institute reported that the total costs in the U.S. for direct health care treatment for chronic health conditions totaled $1.1 trillion in 2016—equivalent to 5.8% of the U.S. GDP.
Chronic diseases also lead to indirect costs—lost income and reduced economic productivity—for the individuals suffering from the conditions, their family caregivers, and the overall economy. When the indirect costs of lost economic productivity are included, the total costs of chronic diseases in the U.S. increased to $3.7 trillion, equivalent to 19.6% of 2016 GDP—i.e., one-fifth of the U.S. GDP.
This trend is expected to get worse as an estimated 83.4 million people in the US will suffer from 3 or more chronic diseases in 2030 compared to 30.8 million in 2015.
Opponents of the Affordable Care Act have been busy. In the midst of several headline-making events on other issues, the Trump administration has instigated two major efforts to effectively do what Congress could not do earlier this year — repeal Obamacare.
The result is a laundry list of warnings for all health care consumers, not just those who buy insurance on the ACA exchanges. The moves are a return to the bad old days before insurers had to adhere to standard regulations that protected consumers from paying insurance premiums, only to find coverage wasn’t there when they needed it.
Here’s a closer look at the latest changes to the health insurance marketplace: [Article]
They are the most-trusted profession in America (and with good reason). They are critical to patient outcomes (especially in primary care).
Could the growing army of nurse practitioners be an answer to the doctor shortage? The data say yes but — big surprise — doctors’ associations say no.
To find out more, check out the podcast from Freakonomics: “Nurses to the Rescue!”
That hasn’t always been the case. America was in the realm of other countries in per-capita health spending through about 1980. Then it diverged.
It’s the same story with health spending as a fraction of gross domestic product. Likewise, life expectancy. In 1980, the U.S. was right in the middle of the pack of peer nations in life expectancy at birth. But by the mid-2000s, we were at the bottom of the pack.
The cold war on Obamacare is having an effect. The uninsured rate has begun to creep back up since Trump became president. After several years of major declines under Obama, the uninsured rate has grown from 10.9 percent to 12.2 percent, according to Gallup. It’s not hard to imagine, in just one Trump term, that we could see half of the gains made under the ACA, which led to 20 million Americans being newly covered, erased.
Poll after poll shows the public wants this assault on the ACA to stop. After all this time, the program remains at a record level of popularity. Fifty percent approve, even as the administration badmouths and undercuts it.
Mostly, Americans want this assault on their ability to care for their families to end so we can begin the process of building back what has been allowed to erode. Americans want to pay less, not more, for health insurance. They don’t want insurance companies to be given unlimited authority again.
They want to see Medicaid strengthened, not weakened. They want the basic dignity of being able to afford medication and an end to the constant fear that grips so many that if they get sick, they will lose everything.
Americans didn’t want last year’s war on Obamacare, and they don’t want this new cold war either.
The actual prices hospitals charge private health insurers are closely guarded trade secrets. But a widely circulated health economics paper, which received some new updates, uses actual claims data from three national insurers to show the inner workings of how hospitals get paid.
The bottom line: Hospitals make a lot of money off patients who get their health coverage through their jobs, and hospitals with little or no competition have the power to set their rates at will.
When rural hospitals close, their communities often lose their biggest employers and closest access to health care, struggling to stay afloat in the aftermath. And that’s happening a lot as the health care industry keeps consolidating — 83 rural hospitals have closed since 2010, according to the North Carolina Rural Health Research Program
The impact: This is happening now in rural Missouri, where Community Health Systems is shuttering a 116-bed hospital. Axios spoke with some of the hospital employees who are losing their jobs. They are sad, angry and concerned about what will happen to their community.
One of the laws of health care baked into the heads of every policy analyst is that health care spending almost always rises much faster than GDP. Except it hasn’t really been doing that since 2010, and the gap between health spending and GDP growth is projected to continue to be small through 2026.
What we don’t know: The cause. We don’t know why the gap has closed (experts disagree and emphasize different factors), and we don’t know if the narrowing is permanent or if the gap will widen again.
The United States is exceptional in that it does not regulate or negotiate the prices of new prescription drugs when they come onto market. Other countries will task a government agency to meet with pharmaceutical companies and haggle over an appropriate price. These agencies will typically make decisions about whether these new drugs represent an improvement over the old drugs — whether they’re even worth bringing onto the market in the first place. They’ll pore over reams of evidence about drugs’ risks and benefits.
The United States allows drugmakers to set their own prices for a given product — and allows every drug that’s proven to be safe come onto market. And the problems that causes are easy to see, from the high copays at the drugstore to the people who can’t afford lifesaving medications.
What’s harder to see is that if we did lower drug prices, we would be making a trade-off. Lowering drug profits would make pharmaceuticals a less desirable industry for investors. And less investment in drugs would mean less research toward new and innovative cures.
There’s this analogy that Craig Garthwaite, a professor at Kellogg School of Management who studies drug prices, gave me that helped make this clear. Think about a venture capitalist who is deciding whether to invest $10 million in a social media app or a cure for pancreatic cancer.
“As you decrease the potential profits I’m going to make from pancreatic cures, I’m going to shift more of my investment over to apps or just keep the money in the bank and earn the money I make there,” Garthwaite says.