Axios Vitals: America's avalanche of medical debt

Plus: Dems' two-step on Trump's rebate rule | Wednesday, July 21, 2021

Open in app View in browser   Presented By PhRMA   Axios Vitals By Tina Reed ·Jul 21, 2021 Good morning, Vitals readers. Today's newsletter is 491 words, or a 2-minute read. Situational awareness: In 2020, life expectancy at birth in the U.S. dropped a year and a half compared to the prior year, reflecting the stark impact COVID-19 had, on the nation according to data released this morning by the CDC.   The data also reflects the racial and ethnic disparities highlighted by the pandemic, with the life expectancy for Hispanics declining 3 years and for Black people dropped 2.9 years while the white life expectancy dropped by 1.2 years.     1 big thing: America's alarming medical debt Illustration: Annelise Capossela/Axios   Americans' medical debt added up to about $140 billion last year, according to new research published Tuesday in JAMA. Americans owe debt collectors more medical debt than any other source of debt. By the numbers: Looking at 10% of all credit reports from credit rating agency TransUnion, researchers said they found nearly one in five Americans had medical debt in collections in June 2020. The mean amount of debt was $429. The big picture: Beyond this staggering economic sum — which works out to about $60 billion more than previous estimates — the study found a wide-reaching human impact. As the New York Times pointed out, the problem was concentrated in states that have not expanded Medicaid under the Affordable Care Act. Go deeper: America's biggest hospitals vs. their patients     2. Rebate rule in Dems' crosshairs Illustration: Aïda Amer/Axios   Repealing former President Trump's change to drug rebates could go a long way in helping Democrats pay for two legislative priorities, Axios' Caitlin Owens writes. One industry source said Democrats could claim savings from delaying Trump's rebate regulations in a bipartisan infrastructure bill — then more savings from repealing it their a party-line reconciliation measure. The intrigue: The rule hasn't actually gone into effect. But because the Trump administration finalized it, its cost was folded into baseline spending projections, so Democrats can still claim savings on paper from repealing it. "It has become the most popular offset in both packages' debate," said one source familiar with the negotiations. What we're watching: Insurers and pharmacy benefit managers would be thrilled if the rule is repealed. Pharma wants to keep the rule in place.     3. Patients are back HCA's Medical Center of Trinity in Florida. Photo: Eve Edelheit/Bloomberg via Getty Images   If HCA Healthcare's second-quarter earnings are any kind of bellwether for hospital systems, then it's clear patients are back, Axios' Bob Herman writes. Driving the news: HCA reported patient volumes, suppressed last year by COVID, have seen a turnaround as they've returned for emergency care or elective care that had to be delayed because of the pandemic. "Our volume, as indicated in the second quarter, will return to 2019 levels and perhaps moderately above that," HCA's CFO Bill Rutherford told investors. HCA's net profit jumped 34% year-over-year, totaling $1.45 billion in the quarter, while revenue increased 30% to $14.4 billion.     A message from PhRMA People want choice and access to medicines in Medicare – not barriers     In Washington, what politicians say and what they mean can be very different. To save money, some politicians are willing to sacrifice access to medicines in Medicare. This could make it harder for seniors and those with a disability to get the medicines they need. There's a better way.     4. Tweet of the day Illustration: Annelise Capossela       5. Experts raise alarm over syringe safety Safe injection practices should not be compromised in the rush to vaccinate the world, a group of health care experts cautioned in a Washington Post op-ed this week. "Producing the 15 billion to 19 billion doses needed will be an empty victory if it triggers avoidable deaths from the unsafe injection practices," wrote the group, led by Margaret Chan, the former director-general of the World Health Organization. In some countries, patients will demand a vaccination, even if a clinic has run out of new syringes, then experts wrote. In other cases, patients have been told to bring their own syringes to the clinic. The bottom line: The world needs to ramp up emergency production of vaccine syringes and direct funds to the problem "as aggressively as vaccines," they wrote.     A message from PhRMA People want choice and access to medicines in Medicare – not barriers     In Washington, what politicians say and what they mean can be very different. To save money, some politicians are willing to sacrifice access to medicines in Medicare. This could make it harder for seniors and those with a disability to get the medicines they need. There's a better way.   Like this email style and format? Learn more about Axios HQ. It'll help you deliver employee communications more effectively.   Axios thanks our partners for supporting our newsletters. If you're interested in advertising, learn more here. Sponsorship has no influence on editorial content. Axios, 3100 Clarendon B‌lvd, Suite 1300, Arlington VA 22201   You received this email because you signed up for newsletters from Axios. Change your preferences or unsubscribe here.   Was this email forwarded to you? Sign up now to get Axios in your inbox.   Follow Axios on social media: