Dr. Denise Faustman believes type 1 diabetes might could be cured using a tuberculosis vaccine already sold as a generic. Unfortunately, she’s had trouble obtaining funding for research. Too many people have a financial incentive to keep the status quo.
Faustman, a Harvard Medical School researcher, found that the vaccine, long sold on the market, showed promise when tested on mice.
That would be big news, especially for the 1.25 million Americans living with type 1 diabetes. And it did cause a stir when she published the initial results – in 2001.
However, the pharmaceutical industry wasn’t interested in funding further research because it didn’t see a pathway to profits using a drug that’s already on the generic market. The big medical foundations haven’t wanted to fund her research because they’re allied with the pharmaceutical industry – in fact, often financially invested in its products. Despite the roadblocks, Faustman managed to find enough funding to publish further research in 2012. Now she’s raising money through her website, www.faustmanlab.org.
Faustman’s story is one anecdote in “An American Sickness,” a book by Elisabeth Rosenthal, a medical doctor who became a New York Times reporter and is now editor in chief of Kaiser Health News. If you want to better understand why the American health care system is failing, read this 330-page book.
Rosenthal says medical providers get paid to treat us, not heal us. The entire system is oriented toward expensive long-term interventions like insulin pumps versus cures and prevention. It increasingly sees Americans as consumers, not patients, and like any market sector it seeks to maximize profits. However, unlike other sectors, the system is completely stacked against the consumer. We don’t know how much services cost. We often don’t know what’s being added to our bills. And we’re not in a position to say no because we’re sick and vulnerable or just don’t know how.
No one else does health care like the United States. Because of the system’s perverse incentives, costs keep rising to the point that health care now consumes one-sixth of the nation’s economy. That’s far more than the rest of the developed world, while producing no better results.
Unfortunately, the political system hasn’t been able to offer a cure and often doesn’t even correctly diagnose the disease. The Affordable Care Act, otherwise known as Obamacare, did increase the number of insured Americans, but it did not control costs. This past year, the focus in Washington has been on repealing and replacing that law. But even if that effort had succeeded, it wouldn’t have solved the system’s root problems.
Rosenthal offers a range of solutions. Fee schedules could be mandated so there’s some consistency in pricing, as in Germany and Japan. Or the government could pay for most health care costs, as in the single-payer systems of Canada and Australia. Or the United States could strengthen its free market approach by making prices more transparent, as they are in Singapore.
These are all big fixes that will take years to implement, and they’ll be opposed by people making a lot of money off the current system. In the meantime, Americans now are selecting their insurance policies for 2018. In Arkansas, prices are rising significantly for some people who buy their insurance on their own – by an average of 14.2 percent for Blue Cross customers, and by more for those covered by other carriers. Those amounts, already set to rise, spiked after President Trump ordered an end to federal cost-sharing reduction payments that had subsidized the cost of insurance.
Rosenthal does offer steps for average Americans to take. Be less quick to access the system. Be more assertive and questioning. That nice specialist you’ve never met who stops by your hospital bed and asks how you’re feeling? He can bill you for that. Research medical providers long before you’re sick. Negotiate outrageous medical bills. Make sure you understand the network covered by your insurance policy.
These are, at best, limited interventions. You and I can’t do anything about the system. By understanding it better, we can enjoy its benefits while lessening how its ills affect us personally. But we’re still going to pay through the nose for insurance and care.
In other words, we’ll have to settle for treating symptoms, not finding a cure – sort of like the system often does.
Steve Brawner is an independent journalist in Arkansas. Email him at firstname.lastname@example.org. Follow him on Twitter at @stevebrawner.