40 Suprising Facts About The Medical & Healthcare Industry in the USA

As the United States is one of the wealthiest nations in the world, you might expect it to have one of the best health systems. Unfortunately, researchers have found time and again that the country’s massively expensive healthcare industry falls short in several respects. Despite having a health care price tag far higher than every other nation, the U.S. does not have the highest life expectancy or the best infant mortality rate. American doctors and patients alike report dissatisfaction with everything from the cost of healthcare and the complexity of billing to the long waits for appointments and the short doctor-patient interactions. “The current COVID pandemic has only emphasized the gaps and failings of the U.S. healthcare system,” says Susy Salvo-Wendt, Summit Healthcare Regional Medical Centre telehealth specialist. Read on for the 40 most shocking facts about the current medical industry.

In 2019, the U.S. spent $3.8trillion, or $ $11,582 per person, on healthcare, the Centers for Medicare & Medicaid Services (CMS) reported. That’s an increase of 4.6% from 2018.
In the U.S., healthcare spending accounts for 17.7% of the Gross Domestic Product (GDP), or the total value of goods and services produced by the entire nation for the entire year, according to the Centers for Medicare & Medicaid Services.
The per capita price of healthcare per year is higher in the United States than in any other nation in the world, according to National Public Radio (NPR). America spends nearly 2.5 times as much per person as the United Kingdom does, despite having comparable wealth and a lower life expectancy.
Almost two-thirds of that $3.3 trillion cost – 64% – is paid for by American tax dollars, and that amount is growing. A study by the American Journal of Public Health predicts that taxpayers will shoulder 67.3% of the burden of healthcare costs by the year 2024, Physicians for a National Health Program
As it is, health care taxes are higher in the United States than in any other country in the world – even those with universal healthcare programs, according to Physicians for a National Health Program. The full amount of health care taxes American taxpayers cover includes government programs such as Medicare, Medicaid and the Veterans Administration as well as tax subsidies and the cost of private health insurance for public employees.
Though opponents of a single-payer system have long cited cost as an obstacle, findings published in Lancet show the opposite is true. Switching from the current model of numerous public and private insurers to a Medicare for All model would save the United States 13% annually. In raw numbers, that’s $450 billion a year.
What makes healthcare so expensive in America? Rather than mere overuse of medical services, a study published in the Journal of the American Medical Association found that the high cost of medical treatments and procedures is what makes healthcare expenditures twice as costly in the U.S. than in other wealthy countries, The Washington Post
Americans see their primary care doctors less often than they did a decade ago. Adults under 65 made nearly 25% fewer visits to primary care providers in 2016 than they did in 2018, according to National Public Radio. In the same time, the number of adults who went at least a year without visiting a primary care provider increased from 38% to 46%.
Administrative costs currently make up a major chunk of healthcare spending, especially in America. In fact, healthcare administrative spending accounts for 8% of the GDP in the U.S., or more than $1.485 trillion if looking at 2016 data. The cost of healthcare administration in other nations is just 3% of the GPD, on average, according to healthcare revenue news source RevCycleIntelligence.
Administrative spending is particularly problematic in United States hospitals, where it makes up about 25% of total hospital spending and accounts for hundreds of billions of dollars in healthcare spending annually, The Commonwealth Fund The percentage of total hospital spending devoted to administration is highest in for-profit hospitals, followed by non-profit hospitals, teaching hospitals, and finally public hospitals. Outdated reimbursement and reporting methods are a big part of the administrative cost, says Salvo-Wendt. “Reimbursing in bundled payments instead of itemizing each service or component would produce instant savings of administrative costs.”
Inflated pharmaceutical prices are another huge factor in the steep cost of healthcare. Americans spend an average of $858 per person on prescription drugs, according to Vox. That’s about twice as much as people in Australia spend on prescriptions. It’s three times the amount paid by people in The Netherlands.
As of August 2020, the most expensive drug in America is Myalept, a drug used to treat leptin deficiency. A month’s worse of this drug costs $71, 306 per month, according to research from GoodRx. Myalept is known as an “orphan drug” because it’s intended to treat a rare disease.
Long wait times are often cited as a downfall of universal healthcare systems but wait times in America have reached a new high, too. The average time to make a physician appointment as a new patient in 15 major U.S. cities is now 24 days, up 30% in just 3 years (2014 to 2018) according to physician recruiting firm Merritt Hawkins.
Once you do get to see the doctor, don’t be surprised if you’re rushed out of the exam room before you get all of your questions answered, according to healthcare staffing agency Staff Care. Studies show that 41% of ophthalmologists spend just 9 to 12 minutes with a patient, and 13- to 16-minute appointments are the norm for 40% of cardiologists, 37% of paediatricians, 35% of urologists, 35% of family physicians, 34% of obstetricians and gynaecologists and 30% of otolaryngologists.
The average length of the portion of a doctor appointment in which the patient actually sees the doctor is up from previous years, rising by about 12 seconds per year, according to Reuters. However, 60% of physicians report dissatisfaction with the amount of time they spend with their patients, athenaInsight Many doctors now spend more time on paperwork than seeing patients, and a primary care physician who spends 5 minutes of face-to-face time with a patient will spend another 19.3 minutes, on average, working on that patient’s electronic health records (EHRs).
Patients, too, are unhappy with the care they receive during those brief interactions with their doctors. Healthcare communications company West Corporation reported that 25% of patients don’t feel that their provider cares about them as an individual and nearly 20% aren’t convinced their doctor is focused on improving their health – even though 93% of doctors strongly agree that patient satisfaction is important.
Preventable medical errors kill about 22,000 patients a year, according to research from the Yale School of Medicine. That’s much less than a previously reported number of 250,000 deaths a year where medical error is to blame.
Part of the reason for these long wait times and short appointments is due to a nationwide shortage of physicians that is only getting worse. A report by the Association of American Medical Colleges predicts that, due to population growth and specifically growth of the elderly population, the physician shortfall in the U.S. could reach 121,300 by the year 2030.
The problem isn’t a shortage of people wanting to be doctors, but rather, too few opportunities for training. Medical schools have increased class sizes by 30% since 2002, but federal funding for residency training – an essential step in the process of becoming a practicing physician – has not increased since 1997, according to Inside Higher Ed.
Students who make it into medical school pay a lot of money for the privilege of eventually becoming a doctor, with medical school students in the class of 2019 graduating with an average of $201,490 in student debt, according to the Association of American Medical Colleges as reported by Nerd Wallet. That’s an increase of 2.5% from 2018.
Physician is a high-paying career, and American doctors have some of the highest salaries worldwide, with general practitioners earning an average of $185,000 and surgeons earning $306,000 annually, according to MLive Media Group.
If doctors aren’t the ones bringing in more money than they could possibly need, where is the money going? Insurance chief executive officers (CEOs) earn an average base salary of $584,000, hospital CEOs earn $386,000 and even hospital administrators earn more than a general doctor, with an average base salary of $237,000, MLive Media Group
If your health insurer denies your claim or treatment, you have very little time to act. Appeals to Medicare must be filed within 90 days in the most lenient states, with even shorter deadlines in some states, and many insurers and healthcare providers will turn over unpaid medical bills to collection agencies after just 60 days, the AARP
Denied health insurance claims are a major problem for patients in America. The Kaiser Family Foundation found that ACA marketplace plans denied about 17% of in-network claims in 2019.
Major health insurance companies have faced legal trouble over their claim denial practices. In February 2018, the insurance commissioner of California announced plans to investigate Aetna’s coverage denial practices after a former medical director of the insurance company admitted that he never once looked at a patient’s medical records when deciding whether to deny claims over the three years he worked in the position, according to CNN.
About half of all denied claims that are challenged or appealed ultimately end up being covered – but only when policyholders put in the time and energy to fight the denial, the Los Angeles Times
Just under half – 49% – of Americans get their health insurance through their employer, according to the Henry J. Kaiser Family Foundation. Another 19% of Americans are insured under Medicaid, 14% under Medicare, seven% under non-group plans and two% under other public insurers, while nine% of U.S. citizens remain uninsured.
For both workers and companies, employer-sponsored health insurance is costly. For 2018, employers paid an average of $10,000 per employee to cover 70% of the cost of health insurance, leaving workers with a price tag of about $4,200 for the remaining 30% of the expense, CNBC
The older you get, the more you will be forced to spend on healthcare. A couple retiring at age 65 in 2018 will spend $280,000, on average, on medical costs throughout their retirement, not counting the expense of over-the-counter medications or the cost of living in a nursing home, CBS News
Fears over not being able to afford health insurance or medical care are among the top reasons why Americans are delaying retirement. From 2000 to 2016, the number of Americans 65 and older working full-time or part-time rose by six% to include almost 9 million people, according to the Pew Research Centre.
Given the high cost of medical care, it’s hardly a shock that patients are drowning in medical debt. Almost 20% of American households have delinquent medical bills that affect their credit report, according to NBC News. Having medical bills in collections makes it more difficult for patients to engage in other economic activities, such as purchasing a home or securing a loan to start a business.
Even with health insurance, patients in the U. S. have a hard time affording their medical care. About one in five working-age Americans with health insurance, and more than half of those without health insurance, reported having trouble paying their medical bills in the last year, according to S. News & World Report.
Nearly 60% of Americans surveyed support a Medicare for All program, according to Business Insider. Those in favour of Medicare for All include 75% of Democrats, 58% of registered Independents and 36% of Republicans, though Republican support jumps up to 64% when discussing an optional expanded Medicare program, also referred to as “Medicare for Some.”
Interestingly, Americans show more favour toward Medicare for All healthcare initiatives than they do toward these efforts when they are labelled as “single payer,” most likely due to the popularity of the Medicare program, STAT
The last 20 years have seen the cost of medical care increase about 70% faster than the rate of general inflation as measured by the Consumer Price Index (CPI), the Research Division of the Federal Reserve Bank of St. Louis Healthcare inflation dropped to a historical low after 2010 but is again on the rise as of 2018, according to Bloomberg.
Despite the arguments of political opponents to the contrary, premium increases had been going on for decades before the passage of the Affordable Care Act, also known as Obamacare. In fact, the average rate of yearly premium increases decreased after the law was passed in 2010, according to Forbes.
One of the most important and most popular changes to the health insurance landscape brought about by the passing of the Affordable Care Act was the prohibition against denying patients health insurance, or charging them more, if they had pre-existing conditions. Research shows that 27% of Americans in the 18 to 64 age group have what would have been considered a “declinable medical condition” before the Affordable Care Act took effect, and in some regions, the percentage of patients with pre-existing conditions rises to nearly four in 10, the Henry J. Kaiser Family Foundation
It’s not just health insurance premiums, but also deductibles, that keep on rising. In 2018, the average deductible was $3,000 for a gold-tier family plan, $8,000 for a silver-tier family plan and $12,000 for a bronze-tier family plan, according to USC Annenberg’s Centre for Health Journalism.
Pre-tax flexible spending accounts (FSAs) are often touted as the answer to high out-of-pocket medical costs, but many FSAs have “use it or lose it” rules. FSA holders lose $50 to $100 per year on average, CBS News reported, but since you’re allowed to contribute up to $2,650, you could risk losing thousands of dollars if you don’t spend your FSA money in time.
In studies, the artificial intelligence (AI) technology used in some online health services for preliminary screening before connecting patients with a doctor actually outperformed real physicians in terms of reaching an accurate diagnosis, CNN AI technology correctly diagnosed conditions in 81% of patients, compared to a 72% average for accurate diagnoses among real physicians over a five-year period.

40 Suprising Facts About The Medical & Healthcare Industry in the USA

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