Monday, July 16, 2018

What next for health care costs?

This is Joseph

I read with great interest this article by Edward Murphy on US health care costs.  The bottom line was quite interesting:
In March, three researchers from the Harvard T. H. Chan School of Public Health published a study in JAMA analyzing the well-known reality that the United States spends dramatically more on health care than other wealthy countries. They compared the US, where health care consumes 17.8 per cent of gross domestic product, to 10 comparable nations where the mean expenditure is 11.5 percent. Despite spending much less, the other countries provide health insurance to their entire populations and have outcomes equal to or better than ours. The researchers found that this inefficiency gap is primarily driven by two characteristics of the US system: the high cost of pharmaceuticals and inordinate administrative expenses.
It is not in the interest of huge profit-making corporations to restrain the overall cost of the US health care system. In fact, their interest is served by driving health care expenditures higher. When combined with the spending analysis provided by researchers, the financial data disclosed by public corporations point to a path that the country must follow to make our system more coherent and less costly. Any progress will require driving down pharmaceutical pricing and reducing administrative costs imposed by middlemen. We are not doing that yet but, ultimately, we must. 
This is an evergreen topic given that health care is expensive and there is a sense that it doesn't have quite the overall outcomes that you'd expect.  If it was just that a wealthier country spends more on health to get better outcomes, then I would say that the market was functioning effectively.  It's unclear to me that being wealthy means an interest in higher administrative costs, although I guess hedge funds might be an example of this phenomenon.

This is relevant because there is a real issue with laws to regulate health care, both in terms of payments and the laws themselves.  I see this as the end of the idea of a regulatory framework for the private marker (the affordable care act) and a prelude to a pivot to some other approach. I am waiting to see who might provide leadership on this front.  What is the vision of the Trump administration on health care policy and cost containment?  How are they going to tackle this difficult and nearly intractable issue?

Curious minds are waiting for the other shoe to drop and see what the new plan is

Postscript:  And in case you think these high profits are needed for innovation, Noah Smith has a great tweet here

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