Healthcare in the United States

Main article: United States

Ministry of Health

Main article: U.S. Department of Health and Human Services (HHS)

Medicare - Health Insurance Program

Main article: Medicare - U.S. health insurance program

Drug addiction

Main article: Drugs in the United States

US Pharmaceutical Market

Main Article: U.S. Pharmaceutical Market

Telemedicine in the United States

Main article: Article:Telemedicine in the United States

2024

The right to abortion has been abolished in the United States: now women choose sterilization

On April 9, 2024, the Arizona Supreme Court upheld an 1864 law to ban abortions at the request of the mother. Thus, Arizona becomes the 15th American state to completely ban abortion. Against this background, the popularity of sterilization procedures is growing among young people in the United States. Read more here.

One of the largest cancer centers in the United States was convicted of tampering with cancer treatment research

On January 22, 2024, it became known that the Dana-Farber Cancer Center in Boston (an affiliate of Harvard Medical School) was convicted of falsifying research related to the therapy of malignancies. The organization is recalling six scientific papers, and adjustments will be made to another 31 articles. Read more here.

2023

TB incidence is on the rise in the US

The incidence of tuberculosis has increased in the United States. This is stated in a report by the Centers for Disease Control and Prevention (CDC), published in March 2024. Read more here.

Child psychiatrist in the United States received 40 years in prison for creating pornographic deepfakes

On November 8, 2023, the US Department of Justice announced that Charlotte (North Carolina) child psychiatrist David Tatum was sentenced to 40 years in prison for the production, possession and transfer of materials related to child sexual abuse. The criminal, in particular, is charged with creating pornographic deepfakes - images generated using artificial intelligence. Read more here.

In American operating rooms began to put "black boxes" to control the work of surgeons

In early October 2023, it became known that "black boxes" designed to record data on ongoing surgical operations are gaining popularity in American medical institutions. It is claimed that such devices are designed to improve the safety and effectiveness of the procedures performed.

By analogy with flight recorders in airplanes, recorders in operating rooms conduct audio and video recording. In addition, such devices retain readings from medical devices and sensors monitoring the patient's condition. The accumulated data can help in the investigation of incidents and in assessing the actions of the surgical team in emergency situations. All records received by the system are impersonal and are used exclusively to improve the quality of personnel. After 30 days, the footage is removed to protect the privacy and privacy of patients and healthcare professionals.

As of early October 2023, "black boxes" are used by at least 24 medical institutions in the United States. For example, Stanford Hospital in Palo Alto (California) uses a registration system called OR Black Box: it is installed in four operating rooms.

Given the many advantages, it makes sense for hospitals to install such a system not only in operating rooms, but also in intensive care units, emergency departments and other high-risk areas, "said Mary Hawn, MD, a specialist at Stanford Hospital in Palo Alto.

"Black boxes" in medical institutions can help reduce the number of medical errors, increase efficiency and improve teamwork. The readings collected may be combined with electronic medical record data to form a comprehensive picture of the patient's condition and procedures performed.^[1]

The cat of the sysadmin disabled the largest medical IT system in the United States

In the United States, a cat jumped on the keyboard of a system administrator's computer and erased data from a Veterans Affairs center in Kansas. This became known in early October 2023. Read more here.

Rural hospitals in the US are closing en masse due to financial problems

It became known about the closure of 600 rural hospitals USA in due to financial difficulties faced by institutions. This is stated in the report of the Center for Quality health care and Payment Reform (CHQPR), which was published at the end of March 2023.

It is reported that more than 30% of the total number of American medical institutions in rural areas can stop serving patients. All states have rural hospitals facing closure, with the exception of five: Delaware, Maryland, New Jersey, Rhode Island and Utah. In more than half of all American states, a quarter or more rural medical institutions are at risk of curtailing activities. And in 16 states, 40% and more rural hospitals were at risk.

The report notes that the dire financial situation of hospitals in rural areas is due to two main reasons. The first problem is that health insurance rates do not properly cover the costs of such facilities. Providing health care in rural areas is often more expensive than urban clinics due to fewer patients and higher costs of recruiting staff.

The second reason is that rural hospitals have few financial reserves. According to the report, such facilities do not have enough net assets (other than buildings and equipment minus debt) to offset losses from patient care for more than six or seven years.

Existing problems can be solved by increasing payments from insurance companies. Raising funding to the level that ensures the operation of endangered hospitals will cost about $4 billion a year - this is only 0.1% of the total US national spending on health care.^[2]

US health market leaders buy up home health care firms and spend billions on it

health care USA dollars On July 11, 2023, the American Hospital Association reported that market leaders were spending billions to buy home health care companies.

It says corporations such as CVS Health and Optum are showing interest in home-based health care firms. This market is actively developing, and therefore health leaders are striving to strengthen their positions in it. This trend is also growing amid analysts' claims that some services under the $265 billion Medicare Advantage health insurance will be provided at home by 2025.

In June 2023, Optum offered to buy Amedisys with its more than 465 thousand patients for $3.3 billion. Meanwhile, CVS acquired Signify Health in March 2023 for $8 billion, and Walgreens said in October 2022 that it would buy a stake in CareCentrix for $392 million.

The market USA is likely to become increasingly competitive in terms of transforming patient care services - whether traditional providers or large corporations that have insurance assets, ample opportunities and services focused directly on the elderly population, the American Hospital Association said.

While CMS has proposed a 2.2% reduction in reimbursement to home health care agencies, "the opportunities for winners in this market will be significant." In 2022, McKinsey & Co. estimated that $265 billion would be transferred from traditional medical facilities to home, a quarter of Medicare Advantage insurance costs.

It is also noted that Amazon, CVS, Optum, Walgreens and Walmart are seeking to change primary health care in the United States by expanding accessibility, virtual care and introducing new services.^[3]

In the United States, hospitals were allowed to create their own police units

In mid-May 2023, it became known that the Governor of Georgia Brian Kemp (Brian Kemp) signed a law toughening the criminal punishment for attacks on employees of medical institutions. In addition, state hospitals can form their own police units to maintain order and counter violators.

Health care workers in the United States are five times more likely to experience violence than employees of other organizations, according to statistics. Nearly 40 states have laws that define or toughen penalties for attacks on health care workers, according to the American Nurses Association. And in 29 states, norms have already been approved or are being worked out that allow medical institutions to create their own police units. It is noted that employees of such units can carry firearms and make arrests. In addition, they have higher training requirements than regular guards.

The appearance of police detachments in hospitals, according to the authors of the initiative, will help increase the safety of medical workers. However, critics argue that this will lead to an escalation of violence in health care institutions. So, according to a study by Johns Hopkins University, in 23% of shootings in emergency rooms recorded from 2000 to 2011, criminals took weapons from security personnel. The formation of police detachments in hospitals can only worsen these statistics.

It is also said that measures aimed at strengthening the presence of law enforcement officials in places where people receive medical care can provoke excessive tension. Racial minorities and undocumented patients may be at risk.^[4]

Highly drug-resistant gonorrhea strain first found in US

A USA gonorrhoeas highly drug-resistant strain was first found in, raising public officials health care "concerns about a shortage of treatments and the future when gonorrhea could become untreatable.

Gonorrhea is the second most common bacterial sexually transmitted infection in the U.S. after chlamydia, and its incidence has skyrocketed in recent years, the Center for Disease Control and Prevention reported in January 2023. Read more here.

In the US, many nurses live in vans in clinic parking lots

In early January 2023, it became known that health care systems in the United States are stepping up the construction of their own residential complexes. Such projects help employees overcome the problem of high housing prices, and medical institutions - to retain staff and attract new workers.

In March 2022, the American Hospital Association called the staffing issues facing clinics a national emergency. Paramedics leave hospitals for a variety of reasons. Some quit due to emotional exhaustion, while others move to work as medical staff for travel agencies or other organizations with relatively little workload.

According to Becker's Hospital Review resource, the high cost of housing does not allow many potential employees to get a job in the healthcare sector. For example, Erin Pfaeffle, director of health at St. Luke Wood River Medical Center in Ketchum, Idaho, said that nurses are forced to live in vans in hospital parking lots because they cannot find affordable housing. People refuse to get a job in medical institutions, because if they move from another region, they simply have nowhere to live.

In order to solve the problem, several medical centers at once announced projects for the construction of their own residential complexes. So, Moab Reginal Hospital (Utah) is in the process of buying land to create a residential building for staff. The University of Vermont Medical Center has invested $6 million in a complex of 120 apartments for doctors and employees. St. John's Health, located in Jackson, Wyoming, is building a three-story apartment complex for employees. Similar initiatives are being implemented by Northern Arizona Healthcare and the Heart of the Rockies Regional Medical Center (Colorado).^[5]

2022

Record number of recalls of medical equipment with the most critical marriage committed in the United States

In the United States, in 2022, a record number of recalls of medical equipment with the most critical marriage were made. In the terminology of the Food and Drug Administration (FDA), we are talking about first-class (Class I) recalls. This became known in early March 2023. Read more here.

One in five U.S. hospitals refuse to provide care to debtor patients

On December 21, 2022, Kaiser Health News (KHN) published the results of a study indicating that one in five medical institutions in the United States refuses to provide non-emergency care to patients with outstanding debts.

The conclusions of the authors of the report are disappointing. The practice of "debt knocking out" is common for all types of hospitals in all regions of the country, including public university systems, leading academic institutions, small community clinics and for-profit networks. The results are based on work data from approximately 530 of 5,100 health facilities in the United States. To collect information, journalists made requests by phone and e-mail, as well as studied official websites and other documents of clinics.

It found that more than two-thirds of hospitals are suing debtor patients or taking other legal actions against them, such as seizing property. Approximately the same number of medical institutions report clients with unpaid accounts to credit rating agencies. A quarter of clinics sell patient debts to collectors, and one in five refuse to serve people with outstanding debts.

At the same time, such actions can be a complete surprise for patients. The fact is that almost 40% of all hospitals studied do not post information about collection activities on their websites. At the same time, the practice of "knocking out debts" can cause irreparable damage to people. Clinics, as the study showed, actually force more than half of American adults with health-related debts to make heavy sacrifices, including taking on additional work, changing housing conditions or postponing education. At the same time, many hospital officials say they have a duty to collect debts from patients and that charitable care is provided in most clinics in the country.^[6]

In the US, hospitals began to charge for doctors' responses to patient emails

As of November 17, 2022, the Cleveland Clinic, part of the Cleveland Clinic Foundation, which operates several hospitals and medical centers in the United States, began charging fees for some of the emails its doctors send to patients. It is noted that this is a precedent for American health care. Read more here.

In the US, a federal network of clinics performed tens of thousands of dollars worth of unnecessary surgery on patients using Boston Scientific equipment

On September 19, 2022, a case was unsealed from which it became known that Boston Scientific ignored complaints from its employees about the federal medical network Modern Vascular conducting unnecessary operations using its devices. Read more here.

In the US, waiting times for a doctor's appointment since 2004 have increased by a quarter - to 26 days

The to data time it takes to make an appointment with a new patient in the 15 largest CIF cities has increased by 8% since 2017 and by 24% since 2004, according to a study released Sept. 12, 2022, by AMN Healthcare and its specialist hiring arm, Merritt Hawkins.

The study includes data from 1,034 medical offices located in 15 large cities, including,,,, Atlas Boston Dallas Denver Detroit,,,, Minnesota,, Houston Angeles Miami New York Philadelphia,,, and. Portland San Diego Seattle Washington

The study results show that in 2022, the waiting time for a doctor to see a patient in these cities averages 26 days, an increase from 24.1 days in 2017 when the last study was conducted and an increase from 21 days in 2004 when the study was conducted for the first time.

The study statistically evaluated the average waiting time for a physician in five areas: obstetrics/gynecology, cardiology, orthopedic surgery, dermatology, and family medicine.

The average waiting time for an obstetrician-gynecologist visit in cities covered by the study was 31.4 days, up 19% from 26.4 days in 2017. The longest waiting time for an obstetrician-gynecologist in Philadelphia is 56 days, and the shortest in New York is 19 days, according to the study.

The average waiting time for a cardiologist visit was 26.6 days, up from 21.1 days in 2017, a 26% increase. The longest waiting time for a cardiologist in Portland is 49 days, and the shortest in Dallas is 13 days. The average waiting time for an orthopedist visit was 16.9 days, an increase from 11.4 days in 2017, a 48% increase. The longest waiting time for orthopedic procedures in San Diego is 55 days, and the shortest in Washington, D.C., is five days. The average waiting time for a dermatologist visit was 34.5 days, up from 32.3 days in 2017, a 7% increase. The longest waiting time for a dermatologist in Portland is 84 days, and the shortest in Philadelphia is nine days.

Family medicine is the only area where the average waiting time for a doctor's appointment has decreased compared to 2017, the study notes. The average wait time to see a family medicine doctor was 20.6 days, a 30% decrease from 29.3 days in 2017. The longest waiting time for a family doctor in Portland is 44 days, and the shortest in Washington is eight days.^[7]

US Department of Health equates audio consultations of doctors to full-fledged telemedicine

On June 13, 2022, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights issued guidance on the provision of audio-telemedicine services under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). In accordance with the rules, audio consultations of doctors are equated with full-fledged telemedicine. Read more here.

The US spends $200 billion a year on cancer treatment, but deaths there are more than in countries with lower costs

At the end of May 2022, it became known that the United States spends more than $200 billion a year on cancer treatment, which is approximately $600 per person, while the average for other high-income countries is $300. However, high costs have little or no effect on neoplasm mortality rates. Read more here.

Americans owe $195 billion for medical services

On April 4, 2022, a study was published by the Peterson Center for Health Care and the Kaiser Family Foundation (KFF), according to which medical debt in the United States "remains a constant problem": almost 23 million Americans owe approximately $195 billion for medical care. Nearly one in 10 adults have at least $250 in medical debt.

More than 90% of the U.S. population has some form of health insurance. However, health insurance debts occur in different demographics, with people with disabilities, people with impaired health, people with low incomes, black Americans and people living in the south of the country or in states not covered by Medicaid at greater risk.

Medical debt remains an ongoing problem even among people with insurance coverage, according to a report by researchers Matthew Ray, Gary Claxton, Krutika Amin, Emma Wager, Jared Ortaliza and Cynthia Cox.

Most Americans have private health insurance, which typically requires deductions, co-insurance and surcharges for services and medical prescriptions, according to the study.

Among the 23 million people in significant debt:

• Nearly half, 11 million people, owed more than $2,000.

• 3 million people, or 13%, owed between $5,001 and $10,000.

• 3 million people, or 13%, owed $10,000 or more.

At the beginning of the COVID-19 coronavirus pandemic, amid job losses and declining incomes, people began to experience difficulties paying for medical services. People also delayed medical care or did without it altogether, so fewer people were subjected to expensive treatment, the study said.

The researchers noted that the total amount of medical debt is difficult to estimate with any accuracy, and adults account for a small proportion of all debts.

The results of the study surpassed official data from the federal Bureau of Consumer Financial Protection, which estimated that American credit reports indicated medical debts worth $88 billion. That figure is likely understated, as not all medical debt is visible to reporting companies and not all people compile credit reports.^[8]

2021

Annual US government spending on cancer screening reaches $43.2 billion

The total costs of the system health care USA for primary screening examinations associated with malignant formations in 2021 amounted to $43.2 billion. Moreover, more than half of this amount fell on a screening colonoscopy - an effective way to prevent colorectal cancer. This is stated in a study by the US National Institute of Oncology, the results of which were published on August 5, 2024.

The review looks at breast and cervical cancer screening, colorectal cancer and lung neoplasms, and prostate cancer screening. It is noted that colorectal cancer is one of the most common types of malignant neoplasms. Various methods are used to screen it, including colonoscopy, rectoromanoscopy, CT colonography, fecal immunochemical testing, and the Cologne test (designed to screen adults 45 years of age and older).

US annual costs for cancer screening amounted to $43.2 billion

According to the results of the study, in 2021, out of a total amount of $43.2 billion, screening colonoscopy accounted for $23.7 billion, or about 55% of costs. The contribution of all other screening tests for colorectal cancer is estimated at an additional $3.8 billion.

Breast cancer screening costs are estimated at $8.8 billion, which corresponds to 20.4% of the total. Then there is cervical cancer screening with 12.8% ($5.5 billion). Approximately 1.5% of expenses ($656 million) fell on lung cancer screening, about 1.6% ($702 million) - on prostate cancer screening.

The authors of the study emphasize that the estimates given only relate to the number and cost of health care in primary screening tests and do not include the costs of subsequent procedures in the event of abnormal results from the initial examination, although this is an important element of the screening process.^[9]

Annual health spending reaches 17.8% of GDP

In early February 2023, it became known that the United States has the worst health indicators of all high-income countries. At the same time, the country spends more funds on this area and does not have a system of universal health insurance, according to a published study by the Commonwealth Fund.

In 2021, the United States spent 17.8% of its GDP on health care, which is almost twice as much as in comparable countries. Health spending per person was almost twice as high as in Germany and four times as high as in South Korea. Those costs include Medicaid, Medicare and private insurance. In 2021, 8.6% of the U.S. population was uninsured, and it is the only high-income country where a significant portion of the population has no form of health insurance, the report said.

Despite the highest costs, the results in the United States are worse than in similar countries. Life expectancy in the United States in 2020 will be 77 years, which is three years lower than in any other similar country. Life expectancy is expected to decline even more, judging by the first data of 2023. In addition, the number of avoidable deaths has risen since 2015, and in 2020 in the United States, this figure was the highest among all the countries studied.

In 2020, according to the study, the infant mortality rate in the United States will be 5.4 cases per 1,000 live births, which is the highest among all the countries studied and much worse than in Norway, where 1.6 deaths occur per 1,000 live births. The maternal mortality rate is more than three times higher than in other high-income countries.

Deaths from physical violence, including gun violence, are 7.4 per 100,000 people, far above the average of 2.7 and at least seven times higher than in all other high-income countries, with the exception of New Zealand.

Obesity and chronic diseases affect the US population. The country has the highest obesity rate of any country studied, and the rate is almost twice as high as other countries. In 2020, 30% of adult residents of the country said that at some point in their lives they were diagnosed with two or more chronic diseases. No more than a quarter of residents in other countries reported the same. With four visits per person per year, Americans are less likely to see a doctor than residents of similar countries, according to the report, which may be because the average number of medical practitioners in the U.S. is less than in other countries.

In the United States, on average, the length of hospital stay is shorter than 4.8 days, which is much lower than the average, but there are 2.8 hospital beds per 1,000 inhabitants, which is lower than the average of 4.3.^[10]

Drone drug delivery network launched across US

In early August 2021, the German manufacturer drones Wingcopter entered into a strategic partnership with the company Air Methods to create a drug delivery network throughout the territory. USA More. here

U.S. health care system ranked worst among rich nations

In early August 2021, the United States has the worst health care system among 11 high-income countries despite spending the highest share of its gross domestic product on health care, according to a Commonwealth Fund study.

The researchers compared the health systems of 11 high-income countries:,,,,,,,,,, and Australia Canada France Germany Netherlands New Zealand. Norway Sweden Switzerland Great Britain USA

The study relied on 71 performance indicators based on surveys conducted in each country and administrative data from the Organization for Economic Co-operation and Development and the World Health Organization. The indicators analyzed are divided into five topics: access to medical care, the process of providing medical care, administrative efficiency, fairness and health care outcomes.

The United States took the last place in the overall ranking, as the researchers found, being much lower than the average of other countries as a whole, and when compared with the leaders Switzerland and Canada, the difference is simply huge.

However, on the care delivery process, which measures things like preventive care and patient engagement, the United States performed well in the latest version, finishing second to New Zealand. For example, the United States has high rates of mammography screening and influenza vaccination, and a larger percentage of adults discuss topics such as nutrition, smoking and alcohol abuse with their doctors.

The data were collected before the start of the COVID-19 pandemic or in the first months of its development, so they do not reflect how the coronavirus has affected health systems.

Health spending as a share of GDP grew in all countries surveyed by the Commonwealth Fund, even before the pandemic. But growth in the United States has vastly outstripped growth in other countries. In 2019, the United States spent 16.8% of its GDP on health care; the next country on the list was Switzerland - 11.3%. The lowest was New Zealand, which spent about 9% on health care in 2019. Meanwhile, health care in the United States is the least affordable.

Unlike other countries covered by the study, the U.S. does not have universal health coverage. American doctors are more likely than others to face difficulties obtaining drugs or treatment for patients due to restrictions on insurance coverage, the report said.

To study equity in health care, the study focused on differences in income levels. Australia, Germany and Switzerland have the fairest systems, the study said, while the United States consistently shows the largest differences between populations across all measures except those related to preventive services and health care safety.

Health care inequality fuels underlying conditions in populations with less access to care in the U.S., making these populations more vulnerable to the pandemic. Americans, on average, are more likely to get sick than populations in other high-income countries, according to the report.

The study's findings suggest the U.S. should invest more in primary care. The report also highlights the need to expand and strengthen insurance coverage, as well as the need to focus on spending more wisely.^[11]

31 million Americans do not have health insurance

The rise of investment in digital healthcare

Over the past decade, digital health funding in the United States has grown by more than 1,200%.

Investments in the United States in digital health companies continue to break records: in the first half of 2021, $14.7 billion was invested in the sector, which is already more than in the entire 2020.

The first two quarters of 2021 were the largest in U.S. history in terms of digital health funding, according to a Rock Health report. Most of the funds came from mega deals with amounts of $100 million or more.

2020

No guaranteed paid sick leave

In the United States, 67% of citizens would agree to vaccination against COVID-19

1.2 million people in the United States are infected with HIV

According to rough estimates for August 2020, 1.2 million people in the United States are infected with HIV.

US sorely lacks dialysis equipment

In April 2020, the United States began to lack dialysis equipment due to the COVID-19 pandemic. The sharply increased demand for dialysis equipment and supplies took doctors by surprise because they considered the virus a respiratory disease. However, some patients against the background of coronavirus infection develop not only damage to the respiratory system, but also renal failure, so they need round-the-clock dialysis.

As with ventilators, doctors have to decide which COVID-19 patients will benefit most from dialysis, or use dialysis machines for shorter time intervals to reach more patients.

In response, Fresenius and Baxter announced they would provide hospitals with additional dialysis equipment and supplies. Fresenius Medical Care promises to manufacture about 150 pieces of dialysis equipment ready for rapid deployment in hospitals, and will almost double the production of consumables.

Baxter increased production of PrisMax and Prismaflex dialysis systems along with supplies, Mini-Bag Plus drug delivery system, Spectrum IQ infusion system, and concomitant IV kits. All Baxter plants engaged in the production of these products increase production capacity to the maximum and are looking for ways to further increase the volume of supplies. Baxter intends to ship its products to hospitals most in need, which will be selected based on health system reports. Although the company's customers will still be able to place orders, Baxter plans to allocate a special share of products for hospitals with coronavirus patients.^[12]

2019

The incidence of early cancer has increased in the United States

The incidence of cancer among people under 50 in the United States increased from 2010 to 2019, with the largest increase among people aged 30 to 39 years. This is stated in the study, the results of which were published on August 16, 2023 in the journal JAMA Network Open.

The researchers analyzed data from more than 560 thousand patients in the United States who were diagnosed with malignant lesions. It is estimated that overall during 2010-2019, the number of cases of cancer with development at a relatively early age increased by an average of 0.28% per year. The negative trend, according to experts, is associated primarily with an increase in the incidence rate in young women - the annual increase averaged 0.67%. At the same time, the rates in men during the period under review decreased by an average of 0.37% per year.

Experts found that in 2010, 34,233 cases of malignant lesions were registered in women under the age of 50. In 2019, this figure was 35,721. Thus, an increase of 4.35% was recorded. Among men, the incidence, on the contrary, decreased by 4.91% - from 21,818 cases in 2010 to 20,747 diagnoses in 2019.

In 2019, breast tumors took the first place in the number of newly diagnosed cases of early cancer - 12.6 thousand diagnoses. Thyroid cancer was in second place (5869 cases), colorectal cancer was in third place (4097 cases). The highest growth rates during 2010-2019. showed malignant lesions of the gastrointestinal tract among people under the age of 50 - by almost 15%.

The largest increase in cancer rates among young adults was seen in Asian-Pacific Islanders (32%) and Hispanics (28%). Overall, patients under 50 years of age diagnosed with cancer still account for a relatively small fraction of the total number of malignancies.^[13]

Pharmaceutical companies for 5 years paid American rheumatologists $220 million for the promotion of products

On May 27, 2022, a study was published, according to which pharmaceutical companies for 5 years officially paid American rheumatologists $220 million for the promotion of products. Moreover, most of the payments were concentrated among several specialists.

The study, published by Michael Putman, MD, MSci, a rheumatologist-researcher at the Medical College of Wisconsin, tracked 1,610,668 pharmaceutical industry payments totaling $ 221 254 966 made from 2014 to 2019. These payments were received by 5,723 rheumatologists; the median total amount received by individual rheumatologists was $2,818 (IQR $464-11,560).

Although most rheumatologists (60%), according to the study, received less than $5,000, 368 out of 5,723 (6%) received more than $100,000 each, which is 78% of the total. These doctors received payment for speeches, consultations, business trips and private services more often than doctors of medicine earning less than $100 thousand. Annual cost of payments increased by $3,703,264 during the study period (P<0.001).

In addition, the average amount of payments to male rheumatologists was significantly higher than the average amount of payments to female rheumatologists ($3,723 [IQR $542 - $15,841] versus $2,084 [IQR $394 - $8,186]; P<0,001).

Bristol Myers Squibb (20%), AbbVie (17%) and Pfizer (12%) accounted for 49% of all funding.

The top ten drugs account for 51% of all purchases between 2014 and 2019. These include apremilast (Otezla; $20,724,517), adalimumab (Humira; $17,581,683) and tofacitinib (Xeljanz; $13,700,701).

Putman noted that the cooperation of rheumatologists with the pharmaceutical industry has benefited patients. At the same time, he expressed fears that some doctors were engaged in the promotion of drugs.^[14]

The rise in the number of measles cases

2018

Cardiovascular disease is the cause of the highest number of deaths

Number of intensive care beds by state. Card

2017

US leader in deaths after hospital admission due to heart attack

According to the International Collaboration for the Study of Health Systems, which uses participant data to compare care processes, revealed that the United States is the leader in mortality after hospitalization due to a heart attack. The study was prepared based on results and performance indicators in countries with highly developed health systems but different methods of organizing and funding them. Read more here.

Medical spending growth faster than GDP

In February 2017, Centers for Medicare and Medicaid Services (CMS; the body responsible for the implementation of state programs for the elderly and poor Medicare and Medicaid) made a forecast according to which health care spending in the United States will grow faster than the national gross domestic product (GDP) and will reach one fifth of its size.

CMS expects Americans' medical costs to increase by an average of 5.6% per year between 2016 and 2025. At the same time, the average annual GDP growth rate will be about 4.4%. In 2015, spending on medicine was measured at 17.8% of GDP, and by 2025 the figure would increase to almost 20%.

According to the researchers, the dynamics of growth in medical costs in the United States will decrease after the peak of 2014-2015, when people were actively insured under the provisions of the Affordable Care Act, and there was a widespread adoption of Medicare and Medicaid programs. In 2016, the growth rate of medical spending of the population is expected at the level of 4.8%.

After the slowdown in healthcare spending in 2016, we expect a gradual increase in dynamics due to the accelerated rise in prices, which will only be partially offset by the falling speed and depth of use of medical products and services, says CMS lead author Sean Keehan.

According to CMS estimates, healthcare spending from the US budget in 2016 amounted to $3.2 trillion, and in 2025 they will reach $5.6 trillion. In the same period, the cost of inpatient treatment, according to forecasts, will increase by 80%, to $1.8 trillion, and spending on prescription drugs - by 91% and will amount to $615 billion.

The authors of the study also note that in 2025 only 8% of uninsured people will remain in America, while in 2014 this figure was 11%.^[15]

2016: 4.3% increase in medical spending to $3.3 trillion

In December 2017, it became known that in 2016, healthcare spending in the United States increased by 4.3% and reached $3.3 trillion or $10,348 per person. At the same time, from the report of the Centers for Medicare and Medicaid Services (CMS) agency, which oversees state health programs, it turned out that compared to 2015, when an increase of 5.8% was registered, the growth rate slowed down.

The trend is associated with a decrease in the growth rate of the number of participants in health insurance programs, which in turn led to a decrease in the use of medical services, explained in the report, excerpts from which are published by Reuters.^[16]

The rate of growth in costs and the number of people covered by individual health insurance has decreased both under the federal Medicare senior care program and in the Medicaid poor health care system.

If in 2015 the costs of Medicare and Medicaid increased by 4.8% and 9.5%, then in 2016 the increase was 3.6% and 3.9%, to $672.1 billion and $565.5 billion, respectively. The organization explained that in 2015 and 2014, the Affordable medical Care Act (ACA) contributed to more pronounced progress.

In addition, it is noted that in 2016, the cost of medical care beyond insurance increased by 3.9%, while a year earlier, in 2015, the growth was within 2.8%.

Spending on prescription drugs in 2016 increased by 1.3% to $328.6 billion. For comparison, in 2014 and 2015 there was a rise of 2.4% and 8.9%. The slowdown is explained by the fact that in 2016 the number of new registered drugs decreased and the costs of expensive treatment of hepatitis C decreased.

It also turned out from the report that the cost of private health insurance in 2016 reached $1.1 trillion, an increase of 5.1%, after an increase of 6.9% in 2015, reports AuntMinnie.com.^[17]

2014: Rapid rise in autism among children

1967

1950s: Selling cigarettes in hospitals

1948: US scientists deliberately infect Guatemalan citizens with syphilis and gonorrhea

In 2010, the president USA Barack Obama deeply apologized over the phone Guatemala syphilis gonorrhea to the president for the fact that in the 1940s, American scientists deliberately infected Guatemalan prisoners, mentally ill and military personnel - in order to study ways to treat sexually transmitted diseases with penicillin. As a result, about one and a half thousand people were injured - including prostitutes used in the experiment (and not knowing about it).

1922: Spanish flu epidemic

Maternity leave

in

See also

• Healthcare in Russia
• Health care in Spain

Notes