A moment of reckoning has arrived.
In the United States, we spend about $3.5 trillion, or $10,739 per person, on annual medical care, or roughly 20 percent of our nation’s entire economic output. About 10 percent of these healthcare outlays are for prescription drugs, a line item that alone accounts for about half of what we spend on national defense. And of the $329 billion we spend collectively on prescription drugs, a typical family of four spends nearly $5,000 per year out of pocket to pay for them.
This spending isn’t likely to taper off anytime soon. Each day, 10,000-plus baby boomers sign up for Medicare, the federal health insurance program that was launched in 1966 when a typical American lived to be 70 years old. Today, the life expectancy of an average American at retirement age is 13 years longer.
Here’s the hard truth: Our current trajectory is unsustainable. As a result, we’re going to have to develop new ways collectively to propose and work through deeply complex policy and political issues. Why? Because the ways of the past don’t work very well. Remember the “death panel” soundbite a little more than a decade ago as the country was gearing up for the Affordable Care Act debate? Or the “Harry and Louise” ad campaign 25 years ago? Exactly — the message was messy.
We recently had a preview of the difficult discussions to come. About five years ago, a promising new drug came online for hepatitis C, a potentially life-threatening disease that affects 2.4 million people in the United States. It was a game changer. But there was only one catch: It cost $1,000 a pill. In the first year after the drug’s release, Medicare spent $4.5 billion on it, unquestionably changing the lives of those affected by the disease, their loved ones and their communities.
But it also set off a fierce debate in the medical community. In a 2016 blog post, the Mayo Clinic urged a nuanced approach in considering these new treatments: “Most patients with HCV cured with new drugs — but at what price?” According to one Mayo physician cited in the piece:
“It’s an extremely difficult decision to tell patients they have to wait on therapy because the price is too high. All the interested parties have to come together and voice their concerns in order to arrive at a common-sense solution. Doctors, patients, pharmaceutical interests and the third-party payers have to engage in a dialogue to arrive at a national strategy that will lead to broad coverage of these effective new agents.”
These vital national discussions are the reason we’re launching American Healthcare Journal. Once a month, we’ll post the latest big ideas from the politicians, policy makers and industry decision makers who are charting the future of the U.S. healthcare system. We’re hoping to moderate a discussion about what’s working and what isn’t — and how it can be fixed. In this inaugural issue, we’re honored to include thought leaders from Susan G. Komen and Rep. Robin Kelly (D-Ill.).
We’re also closely following the 2020 presidential election, but not in a way you’ll see anywhere else. We’re not interested in the simplistic horserace stories, the mud-slinging or show-business circuses that national campaigns have become. Plenty of other publications do that.
Instead, we’re offering our own take, such as launching our 2020 Healthcare Scorecard, an online feature that tracks where all of the presidential candidates stand on important healthcare issues like Medicare for All and government negotiation of drug prices.
We hope you enjoy and value the discussion.