Feature Title/What Is the Meaning of These Data-Driven Facts

What Is the Meaning of These Data-Driven Facts?

Growth in the medical products and food industries has resulted in the U.S. Food and Drug Administration (FDA) regulating more than one-fourth of the U.S. economy. This means about $1.5 trillion is regulated by this one agency annually.
The FDA regulates almost everything Americans put into their bodies.
At $698 billion, the budget of the U.S. Department of Health and Human Services is greater than the combined budgets of all other federal agencies.

See Chapter 2: Introduction to Health Law.

It is prohibitively expensive and literally impossible to comply with all health care laws and regulations all of the time.

See Chapter 3: Health Care Compliance Programs.

American antitrust laws, designed to encourage and protect fair competition, often actually impede competition because they do not make good business sense.

See Chapter 4: Antitrust and Regulation of Health Care Providers.

About one-seventh of the American population has no health insurance, and most of the uninsured are earning middle-class incomes.
Only 54 percent of the American population is able to obtain insurance coverage through employers.
Health insurance now costs 17 percent of family income, up from about 7 percent in the early 1990s.
Lack of health insurance causes over 18,000 deaths per year in the United States (two people every hour).

See Chapter 5: Access to and Reimbursement for Medically Necessary Health Care.

Medicaid supplies public health insurance coverage for over sixty million Americans and cost the federal government over $400 billion in 2008.

See Chapter 6: Medicaid and Equal Access to Medically Necessary Health Care.

Medicare is the nation’s second largest social insurance plan, behind only Social Security, and currently costs $477 billion per year to provide coverage for just over one-seventh of U.S. residents.
Soon, approximately one-third of U.S. residents will be eligible for Medicare coverage.

See Chapter 7: Medicare Reforms.

Uninsured and underinsured patients are often charged four to five times more for the exact same treatment as insured patients are charged.
Because the relevant federal regulations are broad and vague, the tax-exempt hospitals, which combined receive over $12.6 billion in tax exemptions each year, are not necessarily required to offer free or reduced-cost care to the uninsured or underinsured in return for their tax exemption.

See Chapter 8: Mutually Affordable Health Care.

It is extremely difficult for patients who have been harmed as a result of a health care coverage decision to successfully sue and recover damages against their health insurer.

It is impossible to cut health care costs without rationing care, and it is impossible to ration care in a manner acceptable to all parties involved.

See Chapter 9: Patient Rights and Responsibilities.

In reality, medical malpractice costs account for less than 2 percent of health care spending; a reduction in such costs would have little effect on premiums.
The greatest improvements in patient safety come from greater attention to risk management, since most medical errors are due to system failures rather than individual errors.

See Chapter 10: Tort Reform and Reducing the Risk of Malpractice.

Top executives at the nation’s health care systems are compensated with multimillion-dollar salaries and lavish benefits, seemingly without regard to performance, while top-performing lower wage employees are often not paid living wages.

See Chapter 11: Human Resources Departments.

Health care costs for smokers are estimated to be as much as 40 percent higher per capita than those for nonsmokers.
From the estimated $1.9 trillion employers spend on health care costs each year, over 60 percent of the costs go toward treating tobacco-related illnesses, while smokers cost the U.S. economy $98 billion a year in lost productivity.
Obesity and weight-related conditions are significant contributors to health care costs, contributing as much as $93 billion to the nation’s yearly medical bill.

See Chapter 12: Employers’ Health Care Costs.

In the U.S., 20,000 deaths could be prevented annually with adequate nurse-to-patient ratios.

See Chapter 13: Labor and Management Relations.

More than half of the insured population in the U.S. is taking prescription drugs, often more than one prescription per person, and more than 20 percent of the time the use is off-label.

See Chapter 14: Managed Care and Other Strategic Health Care Restructurings.

Very few hospitals are consistently profitable, have excellent credit ratings, and claim a substantial share of their market.
Hospital bankruptcies are increasingly on the rise because, although health care is viewed slightly differently than other service industries, it is subject to the same financial constraints as are all service industries in a tumultuous economy.

See Chapter 15: Integration Deals in the Health Care Sector.

It is estimated that at least one-third of U.S. health care costs are a result of overhead and management expenses, and nonstrategic services that could be outsourced.
Outsourcing various functions of the health care industry has the potential to save about 80 percent in direct wages alone.

See Chapter 16: Business Process Outsourcing.

The average cost to discover and develop each successful new drug is between $800 million and $1 billion.
For every five to ten thousand compounds entering the drug discovery pipeline, one new drug receives FDA approval.

See Chapter 17: Pharmaceuticals.

The U.S.is the world’s biotechnology leader, with about 75 percent of the industry’s global revenues.
Through biotechnology, the science fiction possibility of living forever may become a reality.

See Chapter 18: Biotechnology and Biopharmaceuticals.

Reprocessed medical devices are a cause for concern, as FDA standards are not always strictly adhered to, patients are not necessarily informed they are receiving a reprocessed device, and such devices are often obtained from unregulated sources, such as the Internet.

See Chapter 19: Medical Devices.

There are no international laws or treaties regulating Internet drug sales from entities outside the U.S. to individuals within the U.S.
Whoever gathers an individual’s health information owns it, whether it is the individual or not; health records are the property of health care providers, not patients.
It is estimated that a nationwide integrated health care network would save the U.S. health care system $77.8 billion a year, but could cost over $400 billion to build.

See Chapter 20: Health Information Technology.

In theory, U.S. employers have the power to drive change because they provide health insurance coverage for over 160 million people at a cost of nearly $2 trillion. Indeed, employers spent an average of $12,680 for a family and $4,704 for single coverage health insurance premiums in 2008, above the employee’s contribution.
More employers are shifting the costs of their health insurance plans to employees, partly because costs have ballooned more than fifty percent during the past six years.

See Chapter 21: Disease Management.

Estimates indicate ninety million people in the U.S.live with a chronic disease, the ongoing care for which amounts to 75 percent of the annual $2.5 trillion health care budget.
Although evidence-based medicine can help pinpoint which treatments are best for which conditions, patients often still do not receive the best available treatment because health care professionals are not aware of the best treatment or have their own reasons for not using it.

Almost one-third of the surgeries performed on Medicare patients are unnecessary.
One-third of medical spending is devoted to services that do not improve health or the quality of care, and may make things worse.

See Chapter 22: Evidence-Based Medicine.

A study found that 44,000 to 98,000 people die in the United States each year because of medical errors; the estimated annual cost of medical errors, including the expense of additional care, lost income, and disability, was estimated to be between $17 and $29 billion.
One of the largest and most expensive components of U.S. health care is the intensive care units (ICU) in acute care hospitals, representing approximately 30 percent of the nation’s acute care costs; they cost over $180 billion annually, and serve more than five million patients each year; nearly every ICU patient suffers at least one potentially life-threatening adverse event.

See Chapter 23: Improving Patient Safety and Quality of Health Care.

There is a billion dollar body parts and products industry; some experts estimate the underground market is worth at least $150 million.

Recently, several scandals have come to light involving harvesting body parts from the dead without consent from either the deceased’s last will and testament or from the surviving family members, and then selling the parts for profit; all of the pieces of a corpse combined can generate up to $200,000.

See Chapter 24: Human Body Parts Industry.

Approximately 100,000 people are awaiting organ donations in the United States and will die while waiting an average of five years or more.
Despite the fact that most Americans approve of organ donation, only about 25 percent expressly declare themselves donors.

See Chapter 25: Organ and Tissue Procurement and Transplantation.

Almost half of all new adult HIV infections in the United States occur among young people fifteen to twenty-four years of age.

See Chapter 26: HIV/AIDS Pandemic.

Forty-four million people suffer from mental illness in the U.S., making it the leading disease burden on health care; yet, mental illness receives very little public attention.
About 6 percent of Americans suffer from severe mental illness, meaning the sufferers risk harming themselves or others.

See Chapter 27: Mental Health.

The increase in Americans’ life expectancies now means chronic disease is a common form of death.
Palliative sedation is endorsed by the U.S. Supreme Court, which has repeatedly leaned toward protecting personal dignity, bodily integrity, and autonomy in the right-to-die debate,

See Chapter 28: Hospice Care.

An exception to parents’ complete legal control of medical decision- making regarding their children is emerging for mature minors; the consensus is that mature minors should be able to consent to or decline life-sustaining medical treatment.
In some states, parents may be charged with neglect or even manslaughter if death results from the minor’s refusal of treatment, especially if the refusal was made for religious reasons and the treatment’s risks or side effects would have been negligible compared to the treatment’s benefit.

See Chapter 29: Mature Minor Rights to Refuse Life-Sustaining Medical Treatment.

The largest portion of hospital expenses is incurred in the last few weeks of life.
In the United States, life expectancy has increased by about three months every year since the mid-nineteenth century as a direct result of improved health care.

See Chapter 30: Care of the Critically Ill and Dying.

Stem cell research is the first major scientific endeavor the U.S. federal government attempted to strictly regulate during the Bush presidency.
Stem cells are cells that can develop into any of over two hundred kinds of specialized cells in the human body, and have the potential through research to result in organs engineered for transplantation and treatments for diseases such as cancer, diabetes, Alzheimer’s, and Parkinson’s.

See Chapter 31: Stem Cells and Regenerative Medicine.

Chimeras are organisms with cells from at least two genetically distinct organisms, whether from the same or different species; they can be animal-animal, human-human, or human-animal.
Because current federal regulations do not encompass chimera technology, chimeras are created with increasing quantities of human tissues and genetic materials without limitation.
Rapid advances in genetics, cloning, and embryology have already resulted in the blurring of species lines

See Chapter 32: Reprogenics and Assisted Reproductive Technology Experimentation.

We cannot predict how the United States might be able to handle a modern pandemic, as it has been over ninety years since the nationimplemented any quarantine or social distancing measures.
One potential problem for the United States to address in dealing with any national public health emergency is its health care supply chain; the nation has a limited ability to surge-produce medical products and does not have sufficient stockpiles.

See Chapter 33: Global Pandemics and Public Health Emergency Threats.

The U.S. infant mortality rate is high compared to other industrialized nations, perhaps because many babies are born prematurely without proper prenatal care.
Reproductive health care needs are not adequately met in the United States, as evidenced by the high rate of teen pregnancies, unintended pregnancies and abortions, and the lack of access to birth control.
As evidence of the gender discrimination women continue to face, the U.S. Supreme Court, the U.S. Circuit Courts of Appeal, and the state Supreme Courts have written more opinions addressing new legal theories affecting the health care of women than for any other patient group in the nation.

See Chapter 34: Health Care Issues for Women.

Clinical trial research may be conducted without first obtaining informed consent on people who are experiencing a life-threatening condition.
Over $88 billion was spent on researching and developing new drugs in the United States in 2007.

See Chapter 35: Clinical Trials.

The recent increase in weight-related chronic illnesses in the United States coincides with the change in American eating habits, with dietary intake consisting mostly of highly processed, prepackaged, and ready-made meals high in carbohydrates and sodium content.
Fully one-third of the daily calories Americans eat is eaten outside the home at fast-food and chain restaurants.
Almost three hundred million U.S. consumers have spent more than a decade consuming genetically modified foods without any known adverse effects.

See Chapter 36: Food Safety.

The biggest burdens to the U.S. health care system are depression and violence, followed by road traffic accidents, then birth asphyxia/birth trauma, and then HIV/AIDS.
The cost of gun violence in the United States is approximately $100 billion annually, equal to the cost of smoking, obesity, and other preventable behaviors and conditions.
Americans pay about $2 billion in additional costs for their health benefits as a result of the reduced life expectancy from gun violence.

See Chapter 37: Environmental Safety.

While exact numbers are unavailable, it is likely that over eleven million American children per year are victims of serious child abuse or neglect, and another three million are indirect victims of the abuse as witnesses.

See Chapter 38: Prevention of Child Abuse and Neglect.

Intrinsic in the transformation of health care is the transforming of the nation’s health care laws and regulations, which are complex, exceedingly nuanced, incomplete, and tend to encourage evasion and avoidance rather than compliance.
Although the United States spends more on health care than any other country in the world, Americans rank twenty-eighth in life expectancy at seventy-eight years.
Americans spend more on health care than any other developed nation, yet they are neither healthier nor more likely to live longer; further, the U.S. is the only industrialized nation that does not provide basic health care for all of its citizens, which is impeding its economic competitiveness.

See Chapter 39: Future Prospects: Health Care Management and the Law.