Politics has no place in healthcare. How the world turned.
Congress, when it formed Medicare inserted a message that Medicare could not practice medicine and would not interfere with professional judgment. That did not last very long. Soon new regulations imposed restrictions on treatments.
When Medicare in 1965 went into effect professional medical organizations warned that open and free access to medical care would bankrupt the country in short order.
It is a conundrum to deliver health care to all who need it since demand is infinite and supply is limited. Health care has its own algorithm outside of the free market enterprise.
As decades have passed the percentage of the GDP has risen to 18%, although at a slower rate due to balanced budget restrictions.
Historical NHE, 2021:
NHE grew 2.7% to $4.3 trillion in 2021, or $12,914 per person, and accounted for 18.3% of Gross Domestic Product (GDP).
Medicare spending grew 8.4% to $900.8 billion in 2021, or 21 percent of total NHE.
Medicaid spending grew 9.2% to $734.0 billion in 2021, or 17 percent of total NHE.
Private health insurance spending grew 5.8% to $1,211.4 billion in 2021, or 28 percent of total NHE.
Out-of-pocket spending grew 10.4% to $433.2 billion in 2021 or 10 percent of total NHE.
Other Third Party Payers and Programs and Public Health Activity spending declined 20.7% in 2021 to $596.6 billion, or 14 percent of total NHE.
Hospital expenditures grew 4.4% to $1,323.9 billion in 2021, slower than the 6.2% growth in 2020.
Physician and clinical services expenditures grew 5.6% to $864.6 billion in 2021, slower growth than the 6.6% in 2020.
Prescription drug spending increased 7.8% to $378.0 billion in 2021, faster than the 3.7% growth in 2020.
The largest shares of total health spending were sponsored by the federal government (34 percent) and the households (27 percent). The private business share of health spending accounted for 17 percent of total health care spending, state and local governments accounted for 15 percent, and other private revenues accounted for 7 percent.
Projected NHE, 2021-2030:
On average over 2021-30, National Health Expenditures (NHE) and Gross Domestic Product (GDP) are both projected to grow 5.1 percent per year; as a result, the projected NHE share of GDP in 2030 (19.6 percent) is similar to 2020 (19.7 percent).
Near-term NHE patterns are significantly influenced by the COVID-19 pandemic. NHE growth in 2021 is projected to have slowed to 4.2 percent (down from 9.7 percent growth in 2020) as federal COVID-19 supplemental funding declined substantially.
Following the declines observed in 2020, healthcare utilization is expected to rebound starting in 2021 and normalize through 2024. By 2024, the government's (federal and state & local) share of health spending is expected to fall to 46 percent as COVID-19 supplemental funding is expected to wane, down from an all-time high of 51 percent in 2020.
The percentage of the population with health insurance is expected to peak in 2022 at 91.1% (mainly due to Medicaid enrollment) before falling back towards pre-pandemic levels as the public health emergency is assumed to end. The 2030 rate is projected to be 90.5%.
For 2025-2030, factors that typically drive changes in health spending and enrollment, such as economic, demographic, and health-specific factors, are again expected to primarily influence trends in the health sector.
The Judicial Branch has now stepped in to overrule Congress and the Federal Drug Administration attempting to overrule scientific decisions. Not only that they are conflicting rulings between state jurisdictions. Legal maneuvering delays treatment plans.
Two federal courts —one in Washington and one in Texas—issued conflicting rulings on mifepristone, one of the two drugs used for medication abortions. Matthew Kacsmaryk, the Trump-appointed federal judge in Texas, ruled to invalidate the FDA approval of mifepristone (with a stay of 7 days)—a decision we anticipated after the hearing earlier this spring. But a Washington federal judge, who also has the power to bind the FDA, ruled that the FDA shouldn’t restrict mifepristone and that the role of an Article III judge is not to second guess the expertise of the FDA.
This is important: Both have equal bearing over abortion access going forward. And medically-safe sources of medication abortion pills, including mifepristone, are still available, despite the ruling out of Texas. Fear is just as strong of a tool in the anti-abortion movement as any legal ruling.
To get a clearer picture of what the two conflicting federal opinions mean and what the FDA and the Biden administration can do to protect mifepristone, Abortion, Every Day went to law professors Greer Donley and Rachel Rebouche—who have been leading the national conversation on abortion medication and the FDA approval process since Roe fell.
A Tale of Two Lawsuits - by Jessica Valenti
