Health inequalities could cost the US healthcare system $1 trillion by 2040, new report says

Differences in disease rates and unequal access to quality health care among certain populations have increase attentionfrom White House to business world.

But health disparities are not just a matter of justice and equity. They are also expensive.

According to a report published this week by Deloitte, inequality is currently costing the US health care system an estimated $320 billion. Left unchecked, the cost of health disparities could reach $1 trillion or more by 2040.

“Health inequalities are not trending towards a crisis, we are in crisis mode now,” said Andy Davis, healthcare practice director at Deloitte Consulting LLP and one of the report’s authors. “By being able to quantify the impact that these inequalities [have] on the costs of health care, understanding the magnitude and the implications of these costs for all members of society, we can highlight how widespread this crisis is today and how important it is to solve it .

Deloitte’s analysis is based on quantifying unnecessary health spending that stems from structural inequalities and biases, specifically related to race, gender and socioeconomic status, factors that tend to be interconnected and well documented.

A body of evidence suggests that women and people of color face stigma that can lead to delayed care, missed diagnoses, medical errors and limited access to the best treatments. Repeat visits seeking a diagnosis, subsequent diagnoses when treatments can be more extensive, and lost productivity when people are sick and unable to work cost more. The resulting costs could be avoided by eliminating or reducing bias.

To quantify the avoidable costs resulting from inequalities, Deloitte first identified the overall health expenditures on several costly diseases, including breast cancer, diabetes, colorectal cancer, asthma and heart disease, then calculated the percentage of expenditure attributable to health inequalities.

The results show that documented disparities in diagnosis, treatment, and outcome come at a high price.

For example, according to US Department of Health and Human Services Office of Minority Health, Black adults are 60% more likely than white adults to be diagnosed with diabetes and two to three times more likely to have complications. The higher the disease burden and the worse the outcomes, the more expensive that disease will be overall.

Some of these additional costs are due to prejudices and inequalities. Deloitte estimates that this share represents 4.8% of annual US expenditure on diabetes, or nearly $16 billion per year.

On another dimension of inequality, people living below the federal poverty line are more than 50% more likely to have asthma than people earning higher incomes, according to Deloitte’s analysis. According to Deloitte, these disparity costs represent 4.3% of total asthma spending, or $2.4 billion annually.

“Understanding the causes and consequences of differences in health care utilization and health outcomes based on socioeconomic status, race and gender is important to ensure that with advances in technology of health and medical knowledge, no group is left behind,” said Anupam B. Jena, MD. , PhD, Ruth L. Newhouse Professor of Health Care Policy in the Department of Health Care Policy at Harvard Medical School and a contributor to the Deloitte effort.

Current health spending would increase at a compound annual growth rate of 5.3%, while spending due to health inequalities would increase by 6.2%.

Deloitte predicts that the impact of health inequalities will cost Americans at least $3,000 a year by 2040, three times the current level, whether they are directly affected by systemic inequalities or not.

“Not everyone is directly impacted by systemic inequities in the care they receive, but everyone is impacted financially…it makes it personal,” Davis said. “We know this is just the tip of the iceberg for the economic burden of those who are victims of inequity today. All of this stands in the way of a vision of the future where every person has the opportunity to thrive and be healthy.

Davis said the authors hope the report will spur health industry leaders to action, recognizing not only the moral imperative, but also the business case for reducing health inequities.

“We deeply believe that to play a meaningful role in serving patients today, taking action to eliminate health inequities is both the right thing and the most fiscally responsible thing to do,” he said. -he declares.

This analysis also highlights the need for collective action, because according to Davis, no single entity can do enough to improve equity.

“A lot of times we’ve seen actions that can only go as far as your organization can reach, but that impact is understated on a large scale,” Davis said. “Working together is the only way to solve this problem.”

The report urges healthcare organizations across all sectors to work to improve equity through intentional product and service design, cross-sector partnerships, and metrics to identify progress.

For Davis, this effort is personal.

“With two young girls, I feel a sense of urgency to bring organizations together to drive change and be intentional about the actions we take now,” he said. “It’s not anyone else’s problem to solve, but it’s ours, and none of us can ignore it.”

Leave a Comment