EPI: 20 Is Healthcare A Business

EPI: 20 Is Healthcare A Business

August 16, 2019

Current health news: How optimism is linked to longer and better sleep

According to a 2016 report by the Centers for Disease Control and Prevention, about 1 in 3 U.S. adults fail to get adequate sleep, escalating their risks of many chronic diseases.

A study of young and middle-aged adults found that individuals who were more optimistic tended to be better sleepers. More than 3,500 people ages 32-51 were included in the study sample. The participants included people in Birmingham, Alabama; Oakland, California; Chicago; and Minneapolis. 

Participants’ levels of optimism were measured using a 10-item survey, which asked them to rate on a five-point scale how much they agreed with positive statements such as “I’m always optimistic about my future” and with negatively worded sentences such as “I hardly expect things to go my way.” 

Participants reported on their sleep twice, five years apart, rating their overall sleep quality and duration during the prior month. The survey also assessed their symptoms of insomnia, difficulty falling asleep and the number of hours of actual sleep they obtained each night. Participants also came in for sleep studies for three consecutive days a year apart. 

Results: Individuals with greater levels of optimism were more likely to report that they got adequate sleep, slumbering six to nine hours nightly. And they were 74% more likely to have no symptoms of insomnia and reported less daytime sleepiness.

“Choose to be optimistic, it feels better.” – the Dalai Lama


So why is optimism linked to better health outcomes? Comment on our IG or FB post or on youtube comments, we usually hang out there to engage with you guys. 


The Healthcare For All Idea

It is crazy to think about a term called bankruptcy. We hear it thrown around and we usually think of someone that poorly manages their spending and money.

You have been misled. The number one cause of bankruptcy in the United States is due to medical expenses. It’s been that way since 2007. 

People are filing for bankruptcy because they cannot afford their medical bills, this includes people with insurance. As we know, most of the time our insurance does not cover 100% of the costs so we are stuck paying out of pocket. 


Why is healthcare so expensive?

How much does the US spend on healthcare? 

In 2017 the US spent over 3.5 Trillion on healthcare and is estimated it will be around 6-10 trillion in 2020. That is over $10,000 per person. The average 1st world country spends about half of that. With that price tag, we should be having the best healthcare outcomes right? We currently have the 11th best healthcare system and its for a premium price.

  • Administrative costs.
    • We do not have one system. It seems that each medical group or system have their own way of doing things, different programs with different structures. Communication between these programs costs money. 
      • Privacy and security between systems.
      • Billing and payment processing.
      • Recruiting, hiring, and managing employees.
    • Price negotiations. It costs money to decide who pays for what at what price.
    • All the choices we have with healthcare correlates with complexity and adds to cost. 
  • Americans are less likely to see a doctor.
    • Many times people go to the Er while they are sick instead of going to their clinic.
    • We tend to not think about our health until we fall ill.
    • Prevention does not get a lot of attention.
    • There is a small to no profit margin for companies to promote prevention. Think about it. The best way to lose weight is by changing your diet and exercising. No one is marketing that. Companies market weight loss pills and products that you have to dish out money for.
  • Drugs, tests, and services.
    • MRIs, x rays, Ct scans, surgeries all cost more in the US.
    • Drug prices have minimal regulation and are inflated compared to other countries.
  • Physicians have a fear of getting sued
    • they over-order tests, diagnostics, and overprescribe.
  • Marketing
    • Medications and devices are sold to you and physicians. Companies spend money so you can see their product and they also spend money so your physician will use their product.
  • There is no transparency
    • We have hidden costs in healthcare. There is no set price for a pacemaker or any other devices. Your bill reflects a package, not individual care, devices, or medications. We don’t know what the cost will be until after.


Is Universal Healthcare A Good Idea?

We thought Obamacare would be a big help but that was unable to tackle the big prices and soaring out of pocket costs. It did, however, open up the insurance market for uninsured people however the costs are now the issue.

Bernie’s Medicare for all

Out of all the Democratic Presidential candidates, Bernies Sanders seems to have the most popular health care plan on the Democratic Party Side.

Bernie introduced the Medicare For All Act of 2019, which calls for significant healthcare reform to improve patient care, reduce costs, and provide healthcare to everyone.  Proving that single-payer universal healthcare is no longer considered a “radical” idea, his bill has been cosponsored by 14 of his Democratic colleagues in the Senate. 

Medicare For All is a universal healthcare system, where everyone is covered for all necessary health services, with no deductibles or copays.  All healthcare providers and doctors will be in the network. Medicare for All will pay healthcare providers for visits, tests, and procedures according to a set schedule of prices.

Private health insurers can offer coverage for services not covered by Medicare For All, such as elective cosmetic surgeries. In the Medicare For All system, every American would be automatically enrolled in the healthcare plan — Medicare For All. Healthcare providers and facilities would continue to be independent private practitioners. They would be paid by the healthcare plan.

The government wouldn’t be in control of everything. Some things would still stay private. Everyone opts-in and your hospital, doctor visits, tests, etc would be covered. Certain things that wouldn't be covered like cosmetic surgery or certain drugs would cost extra for coverage. 

How will we pay for this?

Of course, there would be tax, a healthcare income tax for all. Some people will end up paying more and others less. The numbers are still in the works. 

We already pay so much for insurance and medication, it increases every year. If Bernie's team can find a good medium for the cost it would be well worth it.

If we have a single-payer healthcare system we can cut many costs from administrations and negotiations. We would also see a decrease in the cost of medication.

 

Prescription Drugs & Drug Manufacturers

Healthcare in the U.S. is about twice as expensive as it is in any other developed country. If the $3 trillion U.S. healthcare sector were ranked as a country, it would be the world’s fifth-largest economy, according to consumer reports.

How Much Does it Cost to Develop One Drug?

Drug prices reflect years of research, development and clinical trials. It takes 10-12 years to design, develop, and secure approval of one medication. The long road from initial idea to approval comes with significant investment and risk.

Investment: One successful drug can cost up to $2.6 billion to bring to market.

Risk: 90% of drug development programs fail, and 90% of biopharmaceutical companies do not make a profit. 

Our government subsidizes drug research. Certain research agencies and pharmaceutical companies can get paid by the government to do research. When research shows a drug is effective and suitable for the market the company can produce and sell it. The company also determines the price. If you think about it, the drug company got paid by the government to do the research and now control the price of the product.

Whether we planned it or not, whether we admit it or not, or whether we like it or not, our healthcare system is a business that has become about making money.


Insulin

The cost of insulin has been skyrocketing. Insulin treatment for a type 1 diabetic has increased from $12,467 in 2012 to $18,494 in 2016 and is even greater now. Many times these individuals are stuck rationalizing insulin or turning to older forms of insulin due to cost, which leads to poor blood sugar control, recurrent hospitalizations, other chronic health problems, and death.

Humira

Humira is an immunosuppressant drug It can treat arthritis, plaque psoriasis, Crohn's disease, and ulcerative colitis.

Humira is an especially popular medication right now. In 2015, patients all around the world spent $14 billion on Humira prescriptions — that’s roughly the size of Jamaica's entire economy.

 

Let’s say your doctor appointment is happening in the United Kingdom. There, your Humira prescription will cost, on average, $1,362. If you’re seeing a doctor in Switzerland, the drug runs around $822.

But if you’re seeing a doctor in the United States, your Humira prescription will, on average, run you $2,669.

Regulation on prescription drugs?

The United States is exceptional in that it does not regulate or negotiate the prices of new prescription drugs when they come onto the market. Other countries will task a government agency to meet with pharmaceutical companies and negotiate 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.

The United States allows drugmakers to set their own prices for a given product — and allows every drug that's proven to be safe to come onto the market. The United States has no government panel that negotiates drug prices. Each health care insurance plans all across the country negotiate its own prices with drug makers separately. 

Let's say you have discovered a new drug and you want to sell it in Australia, Canada, or Great Britain. You have to set up meetings with regulatory bodies that evaluate two things: whether the country wants to buy your drug and how much they’ll pay for it. These regulatory bodies usually reject drugs when they don’t think they provide enough benefits to justify the price.

How much does the hospital pay for prescription drugs?

Hospitals markup brand-name drugs nearly 487 percent, according to a study performed by The Moran Company and commissioned by the Pharmaceutical Research and Manufacturers of America.

The study examined the charges and reimbursement rates for 20 brand drugs made available through the "Magellan Rx Management Medical Pharmacy Trend Report: 2016 Seventh Edition." Researchers calculated units per claim values by dividing commercial hospital cost-per-claim data by cost-per-unit data and calculated the hospital charge per claim from the 2015 Medicare 100 percent Outpatient Standard Analytic File.

ResultsThough the markup does not reflect the actual cost insurers pay for the drugs, the study found that even after negotiations with insurers, hospitals receive over 2.5 times what they paid for the drugs.

 

References

https://news.illinois.edu/view/6367/801754

https://feelthebern.org/bernie-sanders-on-healthcare/

https://www.consumerreports.org/cro/magazine/2014/11/it-is-time-to-get-mad-about-the-outrageous-cost-of-health-care/index.htm

http://www.themorancompany.com/wp-content/uploads/2017/10/Hospital-Charges-Report-2017_FINAL.pdf



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