Health Care: Why it Really Costs So Much

Republicans are learning a hard lesson. Passing bills and filing lawsuits to try and defeat the Affordable Care Act (ACA) isn’t easy. Coming up with a comprehensive health care plan that will benefit most Americans is hard. In fact, republicans recently failed to get enough votes to pass an Affordable Care Act replacement plan.

“Can’t someone reel in the cost of pharmaceuticals?” Melisa Masters is a 47-year-old Colorado realtor who is diabetic with high blood pressure and neuropathy. She doesn’t have health insurance and often can’t afford needed medication.

“It scares and angers me that my life will be shorter and my quality of life will be less … there are days I can’t walk. I have no insulin, blood pressure medication, or pain therapy,” she said.

Masters is not alone. A new Gallup poll shows 10.9 percent of Americans do not have health insurance. Sounds bad. Keep in mind, since Gallup started tracking insurance nine years ago, more people than ever are covered. And the rate of people without insurance fell 6.2 percent since the ACA, also known as Obamacare, went into effect.

That does not mean Obamacare cured all of our health-care ills. Far from it. Here is what we know.

When it comes to health care in America, we are in trouble. Study after study shows the U.S. spends the most on health care worldwide, while being outranked in quality time and time again. The Commonwealth Fund found the U.S. ranks dead last overall in health care quality among the top 11 industrialized countries. Worldwide, the World Health Organization puts us at 37, right behind Costa Rica. At the same time, a recent study done by the Organization for Economic Co-operation and Development found the U.S. spends two and a half times more for health care than most other developed nations.

“A coherent system that covers everybody is cheaper than the fragmented, incomplete, crazy-quilt U.S. health care system that leaves millions with no coverage,” said T.R. Reid, a health care advocate, best-selling author, and Chairman of the Colorado Foundation for Universal Health Care.

He said whether we are looking at Obamacare or the GOP’s newly proposed American Health Care Act, the bottom line is the major winners will always be, “the Big Four insurance companies, big pharma, and for-profit hospital corporations. It’s their bottom line.”

Figures from the Center for Responsive Politics (CRP) and the Federal Election Commission support Reid’s claims. During the last election, the pharmaceutical and health care industry donated an accumulated amount more than $15 million to candidates Hillary Clinton, Jeb Bush, Bernie Sanders, Donald Trump, Ted Cruz, Chris Christie, Marco Rubio, and John Kasich.

Last year alone, Pfizer, one of the largest pharmaceutical companies spent more than $10 million lobbying Congress. And both sides of the aisle benefit. When Obamacare was being debated, a record $273 million was spent lobbying our representatives and senators in Washington.

It worked.

Obamacare provided critical concessions that allow companies to keep drug prices high. Remember the outrage when a two-pack of EpiPens jumped from $100 to $600? Or when the cost of an often life-saving HIV/AIDS drug jumped from $13.50 to $750 per pill?

Congressional hearings were held. Threats were made. Then presidential candidate Donald Trump called the executive who raised the price “a spoiled brat.” What’s happened since? Nothing. Drug prices are still high.

Will President Trump succeed in lowering them? He says he will. At the same time, his transition team includes lobbyists who represent some of the biggest pharmaceutical companies in the world. These drug companies have given millions to key lawmakers, including $200,000 over the last two years to each of the two Republican congressmen spearheading Trump’s new health care bill, according to MapLight.

To be fair, the CRP shows Hillary Clinton received more drug money than any other presidential candidate, and MapLight reports even Senator Bernie Sanders has taken campaign donations from pharmaceuticals.

MapLight also lists Senator Cory Gardner (R-CO) having received $127,050 from big pharmaceuticals since he began his bid for Senate. He was elected in 2015. MapLight doesn’t list Senator Michael Bennet (D-CO) having received money directly from drug companies, but during the same election period, the CRP reports he received $291,317 from pharmaceuticals and health products. Neither Colorado senator responded to requests for comments on this story.

Even with Obamacare expansion, millions remain uninsured. In 2012, the Supreme Court ruled states did not need to participate in the law’s Medicaid expansion requirement that would have insured more lower-middle-income families. Right now, nearly 29 million Americans are uninsured, and The Congressional Budget office estimates that will double under the GOP’s proposed plan.

Why is that important? Study after study shows people without health insurance often die from treatable diseases because they couldn’t get care until they were too sick. Figures over the last 10 years range from 22,000 to 45,000 unnecessary deaths every year.

What’s the answer?

Reid believes we should take a page from other industrialized nations, especially those that outrank us in quality. “The most important step for fixing U.S. health care would be to make a national commitment to universal health care.”

While doing research for his book The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care, Reid visited 15 industrialized democracies around the world to see what is working and what isn’t.

“The fairest and most cost-effective way would be Medicare for everybody. Medicare is a single-payer system that is the most efficient and the most popular health insurance scheme in the U.S. Systems like Medicare work in various countries around the world,” Reid said.

One of the world’s leading health care authorities, Harvard professor William Hsiao said higher taxes to pay for universal care would still be lower than what people pay in insurance premiums, deductibles, and copayments. But he told Physicians for a National Health Program that, “no country can control costs unless it has a health care system operating as a whole.” This includes health care providers and financers. For instance, all financing, from billing to payments, would be unified. That not only cuts down on administration costs, it also makes it easier to detect and eliminate fraud.

“No American should suffer at the expense of drug and insurance companies and their huge profits.” Masters said affordable health care can’t come soon enough. For her, high-cost treatments are simply out of reach.

“My meds cost over $1,500 a month. The cost of drugs to sustain life is ridiculous,” she said.