Minh Uong / The New York Times

March 18, 2019

Public Forum: The Rising Costs of Improved Healthcare

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According to the Centers for Medicare & Medicaid Services, healthcare spending in the United States has increased by 3.9 percent in 2017 and composes 17.9 percent  of the nation’s gross domestic product. This marks a total increase of $3.5 trillion, or roughly $10,739 per person.

On Wednesday, March 13th, Cornell’s Debate in Science and Health organization held a public forum in Duffield Hall to discuss the impact of these rising costs on the American public. The forum addressed the possible causes behind rising healthcare costs in the United States, the necessary steps to reduce rising costs and how the US system compares to those in other countries.

Students and faculty also discussed whether healthcare should be seen as a privilege or a right, how medical businesses should function relative to the businesses of other industries and whether pharmaceutical companies prioritize making money over people’s health.

The first debate commenced with the question of why healthcare costs are rising in the first place.

“[Healthcare costs] are increasing because of the rise of pharmaceuticals,” said Rui Maki ’20. “We’re really embracing technology, especially in biomedical fields  — different drug inventions are an example of this — but to create a drug, it costs billions of dollars.”

David Zhang ’20 explained that pharmaceuticals have become very expensive because they are personalized to treat an individual patient’s illness. While personalized medicine is very beneficial for addressing the varying needs of each patient, it is quite costly.

“Healthcare spending in the US rose nearly a trillion dollars from 1996 to 2015,” Rishi Singhal ’21 stated. According to Singhal, increased healthcare costs have reached the point in which Americans often refuse to seek medical treatment due to expense.

“In a lot of these cases, the people who refuse treatment even have medical insurance, but they still have this issue,” Singhal said about Americans refusing medical treatment.

Although the medical industry is considered a business, a frequently debated question is whether healthcare should be treated the same as normal, corporate businesses.

“[Medical businesses] should be treated differently, because we’re talking about people’s lives here and people’s health,” said Lindsey Forg ’22.

According to Singhal, because the medical industry heavily operates as a business, drug companies recycle and repurpose drugs rather than inventing new ones. This also influences how doctors prescribe medicine to their patients.

“If doctors are prescribing medicine, even partially because they just want to make money, and not completely because the patient needs the medicine, then there’s a problem,” Forg said.

Some people believe that medicine is not designed to reach its full potential so that patients will continue to need more of it. This could explain the lack of effective treatments to many common diseases, such as cancer and type II diabetes.

“Medicine is [viewed as] this supply and demand product rather than something that treats people,” said Zhang.

According to Zhang, compared to academic institutions or other research companies, pharmaceutical businesses have a different goal to profit.

“There’s a whole dichotomy between research done at a pharmaceutical company and research done at an academic or research institution … people at pharmaceutical companies want to make money,” said Zhang.

A counter argument is that reducing costs of pharmaceuticals could disincentivize innovation. Making pharmaceuticals more universally accessible could result in deacreased efforts towards creativity and proactivity. Innovation is still important, as it could lead to finding disease cures.

However, lack of transparency is still a major problem, speakers said, as many procedures are still charging too much money when it’s not necessary.

“[Hospitals] have to do a lot of personal insurance … lawsuits in medicine are pretty common,” said Zhang.

According to Zhang, extremely high prices for medical procedures can be attributed to expensive equipment, protection against lawsuits, malpractice insurance and doctors operating by fee for service.

The Wall Street Journal said that there was one hospital that charged more than $50,000 for a knee replacement surgery that only really cost between $7,000 to $10,000,” Singhal said.

Although the future is still uncertain when it comes to rising healthcare costs, increasing awareness is a step in the right direction. It is important for Americans to be informed about the basics, which can lead to wiser decisions from the government and the medical industry.