I have fallen behind trying to keep up my reporting on meaningful health care research. Here are a few studies worth noting.
Specialty drugs, particularly for cancer, have very high price tags and add enormously to total health care spending. These drugs are generally infused or injected, and do have expensive development and manufacturing processes, but the profit margin sought by drug companies, through use of patents, is just abusive. That is bad enough, but when these drugs are administered in a hospital inpatient or outpatient setting, this study finds that these despicable institutions mark up the price by as much as two to six times what they pay. That is right, price markups of over 100% are very common. There is absolutely no justification for this, none whatsoever, except greed by health systems which are supposed to be non-profit and by their executives who are paid as though they are running public, for-profit companies. (JAMA Article)
Health care costs a lot in the US because, as noted in the just above reference, everyone is trying to make a lot of money. Drug companies, hospitals and their executives, and physicians. I don’t think the average American knows how much a physician makes. According to this survey, the typical physician has this annual compensation, by specialty–orthopedics $557,000; cardiology $490,000; urology $461,000; dermatology $438,000; oncology $411,000; surgery $402,000 and ER $373,000. Primary care doctors are the front line of trying to keep people in good health, so of course we pay them less–a family medicine physician $255,000 and pediatrics $244,000. The rate of growth of compensation accelerated in the last year, as so much money was thrown around in health care. The survey has a number of slides with other interesting information about physician compensation. (Medscape Survey)
And here is some research from UnitedHealth Group, the country’s largest insurer, on what conditions account for the most health spending in employer health plans. As I would expect, cancer is first at 15% of total spending. Cancer has become a chronic disease in many cases. That is followed by musculoskeletal, which includes all of orthopedics, at 13%, cardiovascular at 9%, gastrointestinal at 7% and neurological at 6%. For the country as a whole, dementias are actually becoming the leading source of spending, particularly for Medicare and Medicaid. the report includes a little detail on where the spending is within these categories. (UHG Report)