Why is Health Care and Medication so Expensive in the US?

Like most chronic illnesses, we manage with daily regiments of medication that keep our symptoms under control. Without their medications, most people would have a lower quality of life or even be at risk of fatal complications. These medications are both life-saving and life-destructing because costs continue to rise each year in the United States. Medications can end up costing people more than just a month's salary. This article is meant to engage the patient community in an issue that affects their well being directly, and empower patients through knowledge of the system they are a crucial part of.

How does the healthcare system work?

Healthcare in our country is like any other for-profit industry; a commodity is sold to a consumer to generate capital for the enterprise. So let's break down what those components are:

Commodity

A useful or valuable thing to a population of consumers. In this case, medication and treatment.

Consumer

A person who purchases goods or services for personal use. In this case, we the patients.

Capital

A term for financial assets including resources, technology and monies. In this case that would be money.

Enterprise

A company, business, organization or other purposeful endeavors. In this case, the pharmaceutical companies.

Healthcare is one of the largest industries in the United States. In the last fiscal year, the US healthcare industry generated $3.65 trillion making up just under 18% of the country’s entire GDP. The US spends more money than any other country, ever, on healthcare; yet as a country, make no mistake, we are no healthier for it.

The patients support that system

If you were to place patients in a hierarchy of who benefits most from the current system, we would be near the bottom of the current system. As chronic illness rates continue to rise in the United States, the demand for medication and treatment grows alongside. Without patients buying medication, the prices would fall, but that is not something a patient can do. So, in this system, the Enterprise and the consumer are co-dependent. We as the consumers are definitely undermined in this relationship, unlike other countries' healthcare systems, the United States operates in a way that holds patients in a constricting vice.

Why is insulin so expensive in the United States?

From insulin to albuterol and eyeglasses to HIV medication, patients in the United States will go to other countries to have their prescriptions filled. Why is this? Why is the same insulin medication 10x the price in the United States compared to Canada? (Goldman, 2019) Well, most other countries have boards that determine the reasonable market price for a medication, considering the costs to make it, the cost of labor and a reasonable profit margin. The US government does not assert the same control of drug prices that Canada, Mexico, the UK, and other European countries have. Instead, drug prices are set and raised based on the manufacturer's decision.

As a result, US drug companies boast some of the highest drug and treatment prices in the world; vindicating these bankrupting prices with the cost of research and development. While it's true that clinical trials can cost tens of millions of dollars, why is insulin so expensive? Insulin was invented in Canada and the patents were sold for a few dollars with the intention that prices would never be out of reach for the consumer. Yet, the same insulin medication, Humalog, costs $32/vial in Canada and $300/vial in the US. (Goldman, 2019) Consequently, while pharmaceutical executives have some of the highest salaries in the country, a 2005 study reported 46% of bankruptcies in the US are caused by outstanding medical conditions and medical debt. (Krulick) Chronic illness, medication prices, debt, and bankruptcies have all increased since then and we, as the consumers are holding that burden more than ever.

What can patients and consumers do?

Right now, it seems like drug companies are abusing our dependency on medication to generate enormous profits. Typically, market prices are held in check by the consumer's willingness to pay; if prices get too high, people stop paying. Unlike other commodities, medication is not something we can simply stop buying and boycott because of high prices. We have a biological dependency on these medications, but our willingness and even ability to pay is wearing thin.

The best thing we can do is educate ourselves as to why we are paying so much, and hold the drug manufacturers accountable for their impact on our financial stability. Also, research different alternative systems to what's in place; there are many being proposed. We should actively discuss and advocate for what we believe will make a change. As unionized consumer-patients, we can have a voice against a system that is currently working against us. We have a right to health and our health should not be exchanged for our financial stability any more than it already has.