Last month, the 12th anniversary of the Affordable Care Act was celebrated at a White House ceremony. With former President Barack Obama in attendance, Joe Biden, who currently holds that office, signed a proposed rule designed to fix the so-called family glitch, a provision that prevents several million people from obtaining health care subsidies under the ACA.
After a dozen years of experience, it’s clear that the landmark legislation has, to a considerable degree, succeeded in one of its two primary objectives — expanding access to health care — but fallen well short in the other — controlling costs. Fueled in large part by the fight against COVID, the nation’s health care expenditures totaled $4.1 trillion, or 19.7% of gross domestic product, in 2020. While the response to the pandemic exacerbated America’s health care spending crisis, it didn’t create the problem, and bringing COVID under control won’t solve it.
For many decades, the U.S. has devoted far more money to health care than other developed nations. A new study from Bridge Patient Portal shows that this country now spends $10,921 per person, 11.5% more than Switzerland, which has the second-highest per capita expenditure, and 50% ahead of No. 10 Australia. Much work has to be done if the U.S. hopes to bring health care costs more in line with its peers.
Among the many measures that will be required to limit health care spending, ensuring that quality care is delivered as efficiently and economically as possible should be a top priority. The desirability of keeping patients who don’t need to be there out of the emergency room has garnered a lot of attention, but that isn’t the only practice setting where resources are not always used as productively as they could be.
Retail pharmacies and the primary care facilities that are increasingly on offer there are well equipped to make a decisive contribution. With a store located within five miles of more than 90% of the population, pharmacy operators provide unmatched access to health care professionals. Convenience, together with the high level of trust that pharmacists enjoy, encourage people to seek care, and receive it with no diminution in quality relative to other settings.
To cite just one example, immunizations used to be the domain of physicians’ offices and clinics; now millions of vaccines for COVID, flu and many other conditions are routinely administered at the pharmacy. The result of the shift is an easier, more agreeable experience for patients and lower cost for payers. The health care system will be better off if that example can be emulated, wherever appropriate, across the spectrum of care.