Food For Thought: Questions to Get You Thinking About the State and Cost of Healthcare

With the 2016 Presidential Race keenly imprinted on our minds, fresh from the stark remarks of Donald Trump or Hillary Clinton’s fierce promises, everyone should be asking themselves some serious questions; for instance, “if this person were elected, how would my healthcare change?”

We never know what the future holds, nor do we know who will be elected. However, we do know this: our present state of health, good or bad, will not remain forever – and on that inevitable day when we (and/or a loved one) are ushered into an emergency room or health care facility, we need to know what’s going on. What is the likelihood that our present quality of healthcare will deteriorate? Will it improve? What is the future of tomorrow’s healthcare, should one of these candidates be elected? And most importantly – are any of these healthcare platforms fiscally feasible, given the large amount of government debt? It’s a question that I, among other budding health care economists, would love to examine.


Let’s meet some of the candidates… 

Before we can tackle any of these larger questions, we need to analyze the platforms of a sample of candidates. It’s interesting to note that while the majority of these candidates are suggesting similar ideas (the need for universal health care, health as a human right, etc.), they are arguing against one another.1 Here’s an infographic from The New York Times about one of the Republican debates; it summarizes the candidates’ criticisms of each other and members of other parties.

Source: The New York Times

The top row represents the candidates at the debate. The bottom row shows at whom the comments were targeted. The bigger the arrow, the more comments. Clearly, Obama and Clinton were the biggest targets of verbal opposition at the debate.15

The democrats have also been keen to criticize their fellow contenders as well as members of other parties. Here are some well known-names in this race: Donald Trump, Carly Fiorina, Ben Carson, Hilary Clinton, Bernie Sanders, and Martin O’Malley.

Here's a snapshot of some of the democratic presidential candidates (Source: CBS News).

Here’s a snapshot of some past and present democratic presidential candidates.16

According to ontheissues.org, we can infer that the majority of candidates just want to make sure that health is indeed a human right and that they do the best they can towards achieving that goal.1 However, while our quality of healthcare in America might seem adequate, when compared to other economically similar nations, it is clear that our access to healthcare is not. Other nations, such as Norway, for example, have been recently praised for their efficient healthcare systems.3


The State of Global Health and Important Costs to Consider

If we look at this chart of healthcare in 11 different countries, the U.S. seems to be ranking dead last in some of these categories — another indication that our system is not as efficient as it could be.4

Source: The Commonwealth Fund, 2014

The U.S. does not rank as well as the other nations in most of the categories.17

Speaking of debt, just how much of it is the U.S. dealing with, comparatively speaking? Is it bad enough that spending on healthcare will further cause a sufficiently drastic rise in debt? Before spending, it is always prudent to measure just how much we will need to spend and how much we can spend — thus, we need to first look at how much we owe. The government debt to GDP ratio currently sits at a whopping 96 percent.5

That figure does not seem extremely optimistic, but this is when we look to our hopeful candidates — can they achieve the impossible? Can they lower costs while increasing access? Well, that’s what they all claim.


What’s going on with drug prices? 

Medicine Costs

Drug prices are increasing rapidly.18

Hilary Clinton says drug prices are too high, and she plans to lower them. According to a recent Reuters article, Hilary claimed “allowing Medicare to negotiate prescription drug prices would be one of her ‘highest priorities’ if she becomes president.” 6 Furthermore, she has said that she aims to “rein in” the big pharmaceutical companies.6 While this will indeed reduce the cost of medication for the average consumer, what could this do to the overall spending of the country? Hopefully, not much, if we assume only private spending (that is, spending by consumers) will be affected.

Again, though, we have to ask, what exactly, or how will Medicare be “negotiating” prescription drug prices? Will Medicare coverage pay for some of that drug coverage? If that’s the case, then once again, government spending will increase — and debt might increase along with it. However, drug prices are increasing rapidly — that’s very much so a fact.6

Some of these medications are used very commonly. The Epi-Pen for example, is used to treat anaphylactic shock reactions against the autoimmune allergy response. Almost anyone with a food allergy will always have one.7

Doxycycline, a powerful antibiotic, is used to treat bacterial infections, and although today infectious diseases are no longer as large a concern as they once were, antibiotics are being overprescribed and misused — so antibiotics are definitely being consumed.8

Benicar is a high blood pressure medication.10 According to the CDC, about 1 in 3 Americans has high blood pressure.9

Benicar is an example of a hot medication whose prices are skyrocketing.11 So Hilary Clinton definitely has an important point when she says drug prices are rising — but it is up to us all to make sure we are asking the hard-hitting questions about what government intervention in drug prices might do and what the opportunity cost is for the economy in the long run. However, the opportunity cost might be worth it to curb such steep price increases with policy if the quality and access to the medications will increase efficiently and significantly — so there’s some food for thought.


Domestic Healthcare Costs

So now that we have analyzed a democratic candidate’s take on healthcare policy, let’s turn to the Republican side. Ben Carson, a physician, has stated he plans on replacing Obamacare with something altogether new. According to the New York Times: the federal government currently spends, on average, more than $11,000 per year for every Medicare beneficiary, around $1,900 for an average child, around $12,000 for an average disabled beneficiary in Medicaid, an average of more than $3,200 for middle-income people subsidized through the new Obamacare exchanges, and about $2,200 in forgone taxes for people covered through the employer system.12

Medicare is essential, but is certainly not inexpensive for the government. Ben Carson has said that he plans on using a universal healthcare system.12

Here’s an infographic showing where we stand currently in terms of healthcare spending:

Source: (source: http://wrm5sysfkg-flywheel.netdna-ssl.com/wp-content/uploads/2012/09/US-Healthcare-Spending-Infographic.png)

The U.S. spends a lot on healthcare, but how much of it is efficient?14

If we remember correctly, Bernie Sanders has said that he too would implement a universal healthcare system. Bernie has specifically stated that he would use a sort of “Medicare for All” type of system.13


Universal Healthcare: To Pay or Not to Pay

Here’s a map of countries across the world that use universal healthcare. Notice that the U.S. is one of the only developed economies not having universal healthcare.12 The countries in green have universal healthcare.12 The countries in grey do not have universal healthcare.12

Source: http://wrm5sysfkg-flywheel.netdna-ssl.com/wp-content/uploads/2012/09/US-Healthcare-Spending-Infographic.png

Healthcare is a human right, but how many countries have Universal Healthcare?14

However, as the New York Times eloquently puts it, “altogether, the average American’s health care costs more than $9,200 every year, though not even Bernie Sanders, who recommends a single-payer health care system, suggests the government ought to pick up the entire bill.”12

So just who is going to pick up this giant bill? And that’s one of the toughest — and undeniably — the scariest, most important questions of all.

Hopefully, you now have enough “food for thought” and can mull over this question.


Citations

  1. Health Care: 2016 contenders’ views. (n.d.). Retrieved January 31, 2016, from http://www.ontheissues.org/Health_Care.htm#Headlines
  2. Parlapiano, A. (2015, August 6). Republican Debate: Analysis and Highlights. New York Times. Retrieved January 31, 2016, from http://www.nytimes.com/live/republican-debate-election-2016-cleveland/
  3. Norway. (n.d.). Retrieved January 31, 2016, from http://www.commonwealthfund.org/topics/international-health-policy/countries/norway
  4. U.S. Ranks Last Among Seven Countries on Health System Performance Based on Measures of Quality, Efficiency, Access, Equity, and Healthy Lives. (n.d.). Retrieved January 31, 2016, from http://www.commonwealthfund.org/publications/press-releases/2010/jun/us-ranks-last-among-seven-countries
  5. Central government debt, total (% of GDP). (n.d.). Retrieved January 31, 2016, from http://data.worldbank.org/indicator/GC.DOD.TOTL.GD.ZS
  6. Clinton: Medicare drug-price negotiations a top priority. (2015). Retrieved January 31, 2016, from http://www.reuters.com/article/usa-election-clinton-medicine-idUSL1N12T2QP20151029
  7. EpiPen injection : Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD. (n.d.). Retrieved January 31, 2016, from http://www.webmd.com/drugs/2/drug-20017/epipen-injection/details
  8. Schwartz, B., Graber, C., Diep, B., Basuino, L., Perdreau‐Remington, F., & Chambers, H. (2009). Doxycycline, Not Minocycline, Induces Its Own Resistance in Multidrug‐Resistant, Community‐Associated Methicillin‐Resistant Staphylococcus aureus Clone USA300. Clinical Infectious Diseases CLIN INFECT DIS, 48(10), 1483-1484.
  9. (2015). Retrieved January 31, 2016, from http://www.cdc.gov/bloodpressure/
  10. Benicar oral : Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD. (n.d.). Retrieved January 31, 2016, from http://www.webmd.com/drugs/2/drug-63173/benicar-oral/details
  11. Hot Drugs Show Sharp Price Hikes in Shadow Market. (n.d.). Retrieved January 31, 2016, from http://www.bloomberg.com/news/articles/2015-05-06/diabetes-drugs-compete-with-prices-that-rise-in-lockstep
  12. Sanger-katz, M. (2015). Ben Carson’s Health Care Plan: New and More Confusing. Retrieved January 31, 2016, from http://www.nytimes.com/2015/10/28/upshot/ben-carsons-health-care-plan-new-and-more-confusing.html?_r=0
  13. Bernie Sanders on Healthcare. (n.d.). Retrieved January 31, 2016, from http://feelthebern.org/bernie-sanders-on-healthcare/
  14. Misfit | References. (n.d.). Retrieved January 31, 2016, from http://misfit.com/references
  15. http://www.nytimes.com/live/republican-debate-election-2016-cleveland/ — >Same as 2
  16. Election 2016: What’s at stake in the first Democratic debate. (n.d.). Retrieved January 31, 2016, from http://www.cbsnews.com/news/whats-at-stake-at-first-democratic-debate/
  17. U.S. Ranks Last Among Seven Countries on Health System Performance Based on Measures of Quality, Efficiency, Access, Equity, and Healthy Lives. (n.d.). Retrieved January 31, 2016, from http://www.commonwealthfund.org/publications/press-releases/2010/jun/us-ranks-last-among-seven-countries
  18. Then and Now: The cost of prescription drugs [Digital image]. (n.d.). Retrieved January 31, 2016, from http://www.ahipcoverage.com/wp-content/uploads/2014/11/THEN_NOW_FINAL-01_Small.jpg
Shriya Jamakandi

Co-Editor-in-Chief.

Shriya Jamakandi is a sophomore majoring in Economics and Community Health with a minor in Finance. In her spare time, she enjoys reading the Wall Street Journal and has a keen interest in tech start-ups and financial markets.


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