The difference between 2003 and today is probably the public's awareness of this issue and the realization that, despite these astronomical prices and the money invested, the results are poor in terms of public health. Every week, the media relay bills of several thousand dollars received by patients for benign care, often hospitalization costs combined with drug prescriptions. Nicely called "surprise bills", these expensive bills not covered by health insurance represent nearly 15% of emergency room visits and 10% of hospital stays. They are the symbol of a dysfunctional and totally opaque system for patients, as illustrated by the example of these two women working in the same place, with the same health coverage, giving birth in the same way in the same maternity ward and for whom one will pay 1.600 dollars while the other will pay nothing.
Lowering costs: drugs first
Among health expenditures, those related to drugs are undoubtedly the most visible. Between 2013 and 2015, net drug expenditures increased by almost 20%. Today, they represent nearly 17% of the total cost of health care. Prices in the United States for non-generic drugs are two to three times higher than prices in European countries. One of the main reasons for this difference is that, unlike most OECD countries, the United States does not have a centralized pricing system nor do they negotiate with pharmaceutical companies, which therefore set their sales prices directly.