You Won’t Believe How Much Diabetes is Costing the U.S.
The budget-busting price of Sovaldi, a drug used to treat hepatitis C has generated wave after wave of media attention, but it’s far from the only drug creating cost problems for patients and insurers.
As Michelle Andrews of Kaiser Health News points out, diabetes affects 29 million Americans, or 10 times as many people as hepatitis C, and the costs of treating it have been rising quickly. And because it’s a chronic condition, people require lifetime care.
Related: Diabetes Detection Up in Pro-Obamacare States
In 2011, the average annual health spending for individuals with diabetes was $14,093. Two years later, it had risen to $14,999, according to the Healthcare Cost Institute. In contrast, a person without diabetes spent about $10,000 less in medical costs in 2013. Pharmacy provider Express Scripts said earlier this year that 2014 marked the fourth year in a row that medication used to treat diabetes were the most expensive of any traditional drug class.
In all, diabetes costs totaled an estimated $245 billion in 2012, including both direct medical expenses and indirect costs from disability and lost work productivity.
While some of the most popular diabetes drugs aren’t particularly expensive, the new brand-name drugs that are continually being introduced offer more effective treatment and fewer side effects — but also come with a higher price tag. Less than half of the diabetes prescription treatments filled in 2014 were generic.
Nearly a century after its discovery in 1921, insulin is still a common form of treatment for the millions of people with type 1 diabetes, yet there is still no generic form available. Patent protection has been extended in some cases due to improvements in existing formulations. Once those patents expire, Andrews notes, biologically similar drugs could replace them and reduce the price by up to 40 percent.
Related: This Disease Hikes Health Care Costs By More than $10,000 a Year
The financial ramifications of diabetes don’t just stem from the cost of drugs or medical treatment — it’s also been proven that people with diabetes have a high-school dropout rate that is six percentage points higher than those without the disease, according to a Health Affairs study. In addition, young adults with diabetes are four to six percentage points less likely to attend college than those without the disease.
Diabetes also contributes to lower employment and wages. On average, a person with diabetes earns $160,000 less over the course of their lives than people who don’t develop the disease. By age 30, a person with diabetes is 10 percent less likely to be employed.
So even if it’s not generating as many headlines as hepatitis C at any given point in time, the costs of diabetes can’t be ignored.
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Martin Feldstein Is Optimistic About Tax Cuts, and Long-Term Deficits
In a new piece published at Project Syndicate, the conservative economist, who led President Reagan’s Council of Economic Advisers from 1982 to 1984, writes that pro-growth tax individual and corporate reform will get done — and that any resulting spike in the budget deficit will be temporary:
“Although the net tax changes may widen the budget deficit in the short term, the incentive effects of lower tax rates and the increased accumulation of capital will mean faster economic growth and higher real incomes, both of which will cause rising taxable incomes and lower long-term deficits.”
Doing tax reform through reconciliation — allowing it to be passed by a simple majority in the Senate, as long as it doesn’t add to the deficit after 10 years — is another key. “By designing the tax and spending rules accordingly and phasing in future revenue increases, the Republicans can achieve the needed long-term surpluses,” Feldstein argues.
Of course, the big questions remain whether tax and spending changes are really designed as Feldstein describes — and whether “future revenue increases” ever come to fruition. Otherwise, those “long-term surpluses” Feldstein says we need won’t ever materialize.
JP Morgan: Don’t Expect Tax Reform This Year
Gary Cohn, President Trump’s top economic adviser, seems pretty confident that Congress can produce a tax bill in a hurry. He told the Financial Times (paywall) last week that the Ways and Means Committee should be write a bill “in the next three of four weeks.” But most experts doubt that such a complicated undertaking can be accomplished so quickly. In a note to clients this week, J.P. Morgan analysts said they don’t expect to see a tax bill passed until mid-2018, following months of political wrangling:
“There will likely be months of committee hearings, lobbying by affected groups, and behind-the-scenes horse trading before final tax legislation emerges. Our baseline forecast continues to pencil in a modest, temporary, deficit-financed tax cut to be passed in 2Q2018 through the reconciliation process, avoiding the need to attract 60 votes in the Senate.”
Trump Still Has No Tax Reform Plan to Pitch
Bloomberg’s Sahil Kapur writes that, even as President Trump prepares to push tax reform thus week, basic questions about the plan have no answers: “Will the changes be permanent or temporary? How will individual tax brackets be set? What rate will corporations and small businesses pay?”
“They’re nowhere. They’re just nowhere,” Henrietta Treyz, a tax analyst with Veda Partners and former Senate tax staffer, tells Kapur. “I see them putting these ideas out as though they’re making progress, but they are the same regurgitated ideas we’ve been talking about for 20 years that have never gotten past the white-paper stage.”
The Fiscal Times Newsletter - August 28, 2017
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