Talking Points: 23 January 2023

A quick roundup of the issues driving the healthcare reform conversation.

Item of the Week

Week in Review

DELAYED CARE Record-high number of Americans put off medical care last year due to cost.

Quick takeaway: According to new survey data released by Gallup, the percentage of people in the US who reported postponing medical treatment because of how much it cost hit 38 percent in 2022 – the highest amount recorded in the 22 years that the organization has tracked the number.

Further context: Last year’s figure represents a 12 percent increase from the previous year.  For context, the previous high was last observed in 2014 and again in 2019 and was 33 percent, while the average percentage of patients delaying care over costs from 2001 to 2021 was 29 percent.

What it means: Of concern, 27 percent of respondents said the treatments they skipped were for “very” or “somewhat” serious conditions.  Foregoing essential medical care not only carries with it serious consequences, but can compound the costs of treatment in the long run.  This is especially problematic for lower-income households, who were twice as likely to report delaying care for a serious medical condition.

MEDICAL DEBT The pandemic put a dent in the number of people with medical debt in the country.

Quick takeaway: The number of Americans in families having problems paying medical bills decreased by more than 10 million people between 2019 and 2021, a 3.2 percent decline.

Further context: According to researchers, the combination of COVID relief legislation and the dropoff in doctor visits, elective procedures, and outpatient care during the early stages of the public health crisis, all came together to soften the blow of medical debt.

What it means: Despite the improvement, medical debt remains a critical factor in overall debt in the US.  And, as recent reporting shows, hospitals continue to aggressively pursue patients for unpaid medical bills, deploying tactics such as lawsuits, debt collection, and negative reports to credit agencies.

Rx LAUNCH PRICE The median annual launch price of new prescription drugs surged past $220,000 last year.

Quick takeaway: As recently touched on, 2022 was a banner year for the pharmaceutical industry, with the annual median launch price of new medicines coming in at just over $222,000.

Further context: While the second half of last year saw drugmakers curb their excessive appetites, bringing new products to market bearing a median launch price of just shy of $194,000, the damage had already been done during the first half of the year, which saw these companies establish a record-high for their products, with a median launch price of $257,000 – significantly higher than the $180,000 set over the same period in 2021. 

What it means: Stakeholders were quick to raise the alarm, pointing out that these excessively-high launch prices were merely the continuation of a trend that saw launch prices for new drugs increase by 20 percent from 2008 to 2021.

MEDICARE ADVANTAGE Enrollment in the Medicare Advantage (MA) program hits a new high-water mark.

Quick takeaway: As teased last week, the MA program has now enrolled over 30 million American seniors, eclipsing last year’s number by approximately 2 million beneficiaries.

Further context: With nearly half of all eligible beneficiaries now choosing MA plans over traditional Fee-for-Service (FFS) Medicare, stakeholders highlight the program’s ability to offer eligible seniors better services, better access to care, and better value, which is why so many of them continue to choose MA over FFS Medicare.

What it means: In the last 15 years, MA enrollment has more than doubled, growing from just under 20 percent to nearly 50 percent today.  In fact, in several states, including Florida, California, and New York, more than half of beneficiaries are already enrolled in MA plans.  Further:

• 94 percent of senior voters with MA are satisfied with their coverage
• 93 percent of senior voters would recommend MA
• 4 out of 5 senior voters say it’s important that federal lawmakers and regulators protect the MA program

Spotlight