Saum Sutaria, M.D.

In the drug, and I would add to that maybe drug and device category, I'm including the cost of pharmaceuticals that might be administered in a doctor's office or a hospital. So just think about it as a third, a third, a third.

In the drug, and I would add to that maybe drug and device category, I'm including the cost of pharmaceuticals that might be administered in a doctor's office or a hospital. So just think about it as a third, a third, a third.

And that's how people can think about when I go spend my money or I go into the healthcare system and I'm spending money, on average, a third, a third, a third is happening there. Obviously, some people never end up in the hospital. Small proportion of people end up costing us a lot in hospitals, for example. Some people are not on any drugs. Some people may be on five or six drugs.

And that's how people can think about when I go spend my money or I go into the healthcare system and I'm spending money, on average, a third, a third, a third is happening there. Obviously, some people never end up in the hospital. Small proportion of people end up costing us a lot in hospitals, for example. Some people are not on any drugs. Some people may be on five or six drugs.

The system has a variety of what I call cross subsidies in it.

The system has a variety of what I call cross subsidies in it.

The delivery industry is a pass-through to other things in some ways. And the 3-2-1 framework was probably an older framework. If you look at the rise of the total drug costs, which I'm sure we'll get into, the third of third of third is absolutely a more transparent and simplified way of looking at how we're spending our dollars.

The delivery industry is a pass-through to other things in some ways. And the 3-2-1 framework was probably an older framework. If you look at the rise of the total drug costs, which I'm sure we'll get into, the third of third of third is absolutely a more transparent and simplified way of looking at how we're spending our dollars.

The one piece of context I would add to that introduction is that at the same time, the U.S. economy has grown robustly since then. Proportionally, I think that's an important factor in affordability, which is had the U.S. economy stagnated and others grown, this affordability question would be a very different question than what we've seen happen, which is the U.S.

The one piece of context I would add to that introduction is that at the same time, the U.S. economy has grown robustly since then. Proportionally, I think that's an important factor in affordability, which is had the U.S. economy stagnated and others grown, this affordability question would be a very different question than what we've seen happen, which is the U.S.

economy has grown incredibly robustly. But if you go back to the 1950s, and by the way, this is a global phenomenon. In and around the late 40s and let's say into the late 1950s, in many places, significant investments in social welfare programs and healthcare were made. So we'll talk about the US, but just as context, the NHS in the UK was created in 1948, okay? Okay.

economy has grown incredibly robustly. But if you go back to the 1950s, and by the way, this is a global phenomenon. In and around the late 40s and let's say into the late 1950s, in many places, significant investments in social welfare programs and healthcare were made. So we'll talk about the US, but just as context, the NHS in the UK was created in 1948, okay? Okay.

So the systems that were designed to increase coverage originated in that timeframe, roughly. Now, for us, it was 1965 when Medicare and Medicaid came into being, but it was somewhere in that range. So you go back to the 1950s. I mean, first of all, we were spending less than 5% of GDP on healthcare, okay? Put that in context versus 17 and a half.

So the systems that were designed to increase coverage originated in that timeframe, roughly. Now, for us, it was 1965 when Medicare and Medicaid came into being, but it was somewhere in that range. So you go back to the 1950s. I mean, first of all, we were spending less than 5% of GDP on healthcare, okay? Put that in context versus 17 and a half.

Almost 20 from that perspective. More than half of those dollars were spent out of pocket, meaning you went to the doctor and you paid your bill. Which is today 25%. where some of the dollars that you're putting in are going to cover your insurance premium, it's really 15%. So your direct exposure, what you see and feel in terms of what you're spending on healthcare is down to 15%.

Almost 20 from that perspective. More than half of those dollars were spent out of pocket, meaning you went to the doctor and you paid your bill. Which is today 25%. where some of the dollars that you're putting in are going to cover your insurance premium, it's really 15%. So your direct exposure, what you see and feel in terms of what you're spending on healthcare is down to 15%.

That's important because the socialization of coverage of costs has made the American consumer less sensitive to the price points. that they're seeing for everything, for drugs, for doctor's offices, for hospitalizations, etc. The other thing that's interesting is today, that means 85% of healthcare expenditures are covered by a third party, whereas it used to be about 50%.

That's important because the socialization of coverage of costs has made the American consumer less sensitive to the price points. that they're seeing for everything, for drugs, for doctor's offices, for hospitalizations, etc. The other thing that's interesting is today, that means 85% of healthcare expenditures are covered by a third party, whereas it used to be about 50%.

So again, that sensitization phenomenon is real. The federal government contributed about, say, 12.5% to expenditures back then. Today, it's north of 35%. We've already been through that. When you add direct spend plus tax benefits and other things that lost taxes for the federal government, et cetera, when you look at that, you're about a third of the expenditure being the federal government.

So again, that sensitization phenomenon is real. The federal government contributed about, say, 12.5% to expenditures back then. Today, it's north of 35%. We've already been through that. When you add direct spend plus tax benefits and other things that lost taxes for the federal government, et cetera, when you look at that, you're about a third of the expenditure being the federal government.