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.
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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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Fitch Sends a Warning on US Credit Rating
One of the three major credit ratings agencies warned Wednesday that a failure to raise the debt ceiling could result in a lower credit rating for the U.S.
Fitch Ratings currently assigns a AAA rating to U.S. debt, the highest level possible. However, a failure to raise the debt ceiling "may not be compatible with 'AAA' status," according to the agency.
If the U.S. cannot sell more debt after bumping up against the debt ceiling, it may not be able to make all of its interest payments on time and in full. The federal government could begin running out of cash as soon as October.
The debt ceiling is currently $19.9 trillion, and Treasury Secretary Steven Mnuchin has repeatedly urged Congress to raise the debt ceiling by September 29. A failure to do so could roil financial markets around the world, and ultimately increase the cost of servicing U.S. debt.
This is not the first time Congress has faced this problem. During an earlier debt ceiling showdown in 2011, Standard & Poor's reduced its rating on U.S. debt from its highest level to AA+. However, Fitch and Moody’s stuck with their top ratings.
Senators to Hold Hearings on a Bipartisan Fix for Health Care
Mark your calendars: Senate health committee Chairman Lamar Alexander (R-Tenn.) and Ranking Member Patty Murray (D-Wash.) announced today that they will hold bipartisan hearings on Sept. 6 and 7 focused on stabilizing premiums in the individual insurance market. The first hearing will be with state insurance commissioners; the second will be with governors.
In a statement, Alexander noted that 18 million Americans buy insurance on the individual market.
“My goal by the end of September is to give them peace of mind that they will be able to buy insurance at a reasonable price for the year 2018,” he said. “Unless Congress acts by September 27—when insurance companies must sign contracts with the federal government to sell insurance on the federal exchange in 2018— 9 million Americans in the individual market who receive no government help purchasing health insurance and whose premiums have already skyrocketed may see their premiums go up even more. Even those with subsidies in up to half our states may find themselves with zero options for buying health insurance on the Obamacare exchanges in 2018.”
McConnell: ‘Zero Chance’ the Debt Ceiling Will Be Breached
At an event in Kentucky to discuss tax reform, Senate Majority Leader Mitch McConnell and Treasury Secretary Steven Mnuchin insisted Monday that Congress will raise the debt ceiling by late next month, in time for the U.S. to avoid a default that could roil the global economy and markets.
Related: The Debt Ceiling — What It Is and Why We Should Care
The key quotes, per Roll Call:
McConnell: "There is zero chance — no chance — we won't raise the debt ceiling. No chance. America's not going to default. And we'll get the job done in conjunction with the secretary of the Treasury."
Mnuchin: “We’re going to get the debt ceiling passed. I think that everybody understands this is not a Republican issue, this is not a Democrat issue. We need to be able to pay our debts. This is about having a clean debt ceiling so that we can maintain the best credit, the reserve currency, and be focused on what we should be focusing on — so many other really important issues for the economy.”
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Mnuchin reiterated his “strong preference” for a “clean” increase to the debt limit — one without other policy proposals or spending cuts attached to it — but some House conservatives continue to press for such cuts.
Bonus McConnell quote on what tax breaks might be eliminated in tax reform: “I think there are only two things that the American people think are actually in the Constitution: The charitable deduction and the home mortgage interest deduction. So, if you’re worried about those two, you can breathe easy. For all the rest of you, there’s no point in doing tax reform unless we look at all of these preferences, and carried interest would be among them.”
Trump’s Travel and Family Size Squeeze Secret Service Budget
In an interview with USA Today, Secret Service Director Randolph "Tex" Alles said the agency is bumping up against federally mandated salary and overtime caps in executing its mission to protect the president and his family.
USA Today’s Kevin Johnson notes that 42 people in the Trump administration have Secret Service protection, including 18 of the president’s family members. Under President Obama, 31 people had such protection.
“The compensation crunch is so serious that the director has begun discussions with key lawmakers to raise the combined salary and overtime cap for agents, from $160,000 per year to $187,000 for at least the duration of Trump's first term,” Johnson reported.
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In a statement, Alles said the agency has the funding it needs for the rest of the fiscal year, which runs through Sept. 30, but estimated that 1,100 employees run into statutory pay caps as a result of overtime work during this calendar year.
“This issue is not one that can be attributed to the current Administration’s protection requirements alone, but rather has been an ongoing issue for nearly a decade due to an overall increase in operational tempo," Alles said in the statement.
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