What are the ethical considerations regarding the price that pharmaceutical companies charge for medications, and how are those charges passed on to pharmacies and hospitals/clinics? 
Posting about advocating for cost-effective health care­­­­­­­­ from In All Things - an online hub committed to the claim that the life, death, and resurrection of Jesus Christ has implications for the entire world.
http://inallthings.org/healthcare-costs-in-the-u-s

Van De Griend, Kristin

English

Dordt College

Digital Collections @ DordtFaculty Work: Comprehensive List2-17-2016Healthcare Costs in the U.S.Kristin Van De GriendDordt College, kristin.vandegriend@dordt.eduFollow this and additional works at: http://digitalcollections.dordt.edu/faculty_workPart of the Christianity Commons, and the Medicine and Health Sciences CommonsThis Blog Post is brought to you for free and open access by Digital Collections @ Dordt. It has been accepted for inclusion in Faculty Work:Comprehensive List by an authorized administrator of Digital Collections @ Dordt. For more information, please contact ingrid.mulder@dordt.edu.Recommended CitationVan De Griend, Kristin, "Healthcare Costs in the U.S." (2016). Faculty Work: Comprehensive List. Paper 459.http://digitalcollections.dordt.edu/faculty_work/459Healthcare Costs in the U.S.Abstract"What are the ethical considerations regarding the price that pharmaceutical companies charge formedications, and how are those charges passed on to pharmacies and hospitals/clinics?"Posting about advocating for cost-effective health care from In All Things - an online hub committed to theclaim that the life, death, and resurrection of Jesus Christ has implications for the entire world.http://inallthings.org/healthcare-costs-in-the-u-s/KeywordsIn All Things, health care, United States, Christian stewardshipDisciplinesChristianity | Medicine and Health SciencesCommentsIn All Things is a publication of the Andreas Center for Reformed Scholarship and Service at Dordt College.This blog post is available at Digital Collections @ Dordt: http://digitalcollections.dordt.edu/faculty_work/459Healthcare Costs in the U.S. inallthings.org /healthcare-costs-in-the-u-s/Kristin Van De GriendI have taken omeprazole (prescribed by a physician) since I was 16 years old. During graduate school, I hadstudent health insurance and utilized the student pharmacy. The pharmacy charged my insurance $249.10 permonth, which insurance paid most of, and I had to pay $58.22 co-insurance. Initially, it seemed the healthcaresystem was working in my favor because I paid a fraction of the cost, until I compared it to the over-the-counterprice (OTC) for omeprazole at $14.There are multiple issues in this small example of how we should examine our healthcare system with a critical eye,keeping in mind that we are called to practice good stewardship of our resources. First, what are the ethicalconsiderations regarding the price that pharmaceutical companies charge for medications, and how are thosecharges passed on to pharmacies and hospitals/clinics? Research and development, including failure to get drugsapproved, is cited as the main reason for the price of prescription drugs.1 How have we arrived at a system where apharmacy charges $249.10 for a generic medication? Initially, I thought it might be that the pharmacy was small andlacked the leverage to negotiate lower prices with pharmaceutical companies, so I called retail pharmacies in thearea. They all charged at least that much or more and recommended that I purchase the medication OTC. Second,why is our healthcare system set up in such a way that the insurance company routinely pays the pharmacy almost$200 on my behalf for this generic medication?Financially, I was left with little choice but to purchase my medication OTC. Because of this I also had the option tostop being seen by my physician for the medication. It was tempting because I would save money on office visit co-pays and co-insurance. This is also a shortcoming of our healthcare system, because the prescription was for ahistory of recurring bleeding ulcers. How many other Americans have faced the same decisions and made thechoice to abstain from seeking medical care because they could treat themselves cheaper somewhere else forpotentially serious diseases?Hospitals and clinics, as well as long-term care facilities, charge similarly high prices for services. When we think ofthe cost of healthcare, we often think of the price that consumers (patients and our government) pay for services.However, there is also a cost to healthcare from a provider perspective, which is the cost to produce these services.When hospitals have to purchase expensive technology to provide state-of-the art care, the hospital or clinic needsto charge patients with each use of those diagnostic and surgical tools. In order to keep emergency departmentsstaffed 24 hours per day with highly qualified providers and sophisticated equipment, a threshold of revenue must bemet to continue to offer this level of care and to offset the costs the hospital incurs due to uncompensated care.2In 2014, the US spent $3 trillion on healthcare, including hospital visits (32%), physician and clinical care (20%),prescription drugs (20%), and other expenses. Private health insurance covered one-third of these costs; Medicarewas the second highest payer, followed by Federal and State Medicaid. Americans still paid approximately 11%(almost $330 million) out-of-pocket for their healthcare expenses.3The rising cost of our healthcare system can be attributed to many things, including: 1) the expectation from patientsthat all diagnostic capabilities be exhausted, regardless of cost and whether or not that level of care is evidence-based; 2) that specialists should be used even for routine care; 3) improved technology and reduction in infectiousdiseases has increased our life-expectancy and the prevalence of (expensive) chronic diseases, and 4) extensivelife-saving measures for end-of-life care, which may (or may not) lengthen life, but often leave quality of life inquestion.Our current model of healthcare focuses on treating diseases. Investing in primary prevention of diseases and publichealth approaches to health promotion are much more cost-effective than trying to address concerns downstreamafter they become problems. Seeking healthcare from primary care providers first rather than specialists, reducingthe number of second and third opinions we demand, and allowing our healthcare providers to practice medicinewithout fear of malpractice lawsuits will save the system (and ourselves) money. Whether we support a regulatoryapproach to cost-containment or a competitive demand-supply approach, we should all continue to educateourselves on the ethics of the costs of our current healthcare system. There is no “simple solution” to thismultifaceted problem. Now is the perfect time to become involved in advocating for policies that will promote the besthealth for the most Americans, because we are called to promote shalom, while keeping our costs as low aspossible as stewards of our God-given resources.Footnotes1. Shu, L. & Singh, D.A. (2004). Delivering Health Care in America: A Systems Approach  (3rd ed.) Sudbury, MA:Jones and Bartlett Publishers. ↩2. Shu, L. & Singh, D.A. (2004). Delivering Health Care in America: A Systems Approach  (3rd ed.) Sudbury, MA:Jones and Bartlett Publishers. ↩3. Centers for Medicare and Medicaid Services. (2015). National Health Expenditures 2014 Highlights.Retrieved from: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/highlights.pdf. ↩

Healthcare Costs in the U.S.

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Healthcare Costs in the U.S.

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