Reforming the insurance system and achieving universal coverage are critical to maintaining and enhancing innovation in healthcare.
High out-of-pocket expenses often leave patients unable to afford necessary treatments. This leads to poorer health outcomes and higher long-term costs than would exist if health insurance functioned properly. The fragmented nature of the U.S. Healthcare system, with its misaligned incentives, further exacerbates these issues. Moreover, the U.S. Still lacks universal healthcare coverage, leaving about 10% of Americans uninsured and many more underinsured. Comprehensive coverage with minimal out-of-pocket costs is essential to ensure all patients can access the treatments they need without facing financial ruin.
While we are calling out where insurance fails society, it’s worth coming back to a key point we make at the outset of this chapter. Insurance is what makes costly innovations affordable. It incentivizes investors and innovators to strive for better treatments and cures. And insurance already works for many Americans who have access to the care they need at prices they can afford. We need to extend insurance’s true power to everyone, because when insurance fails some of us, we’re at risk of misdiagnosing the real problems with our healthcare system, which can result in policy that curtails or even halts important therapeutic innovations. We’ll talk more about this in the next chapter.
On our way there, let’s end on a hopeful note. When insurance covers treatments like Trikafta, it tells us that society values them. And that means more resources are marshaled toward even better options for patients. An even though Trikafta is a miracle drug for many people with CF, there is room for improvement. Take a moment to read this piece from RA Capital managing director Josh Resnick, an emergency room physician, who shares his thoughts on why “good enough isn’t good enough” in CF. And why we need to continue our quest for better treatments. And what ultimately makes those kinds of quests possible? Insurance!