Health affairs
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David Himmelstein and colleagues recently contended that medical problems contribute to 54.5 percent of personal bankruptcies and threaten the solvency of solidly middle-class Americans. They propose comprehensive national health insurance as a solution. A reexamination of their data suggests that medical bills are a contributing factor in just 17 percent of personal bankruptcies and that those affected tend to have incomes closer to poverty level than to middle class. Moreover, for national health insurance to have an impact, it would have to define "medical" expenses in a much broader way than is now typical of either private or government-funded plans.
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Growth in national health spending is projected to slow in 2005 to 7.4 percent, from a peak of 9.1 percent in 2002. Private health insurance premiums are projected to slow to 6.6 percent in 2005, with a rebound expected in 2007. The introduction of Medicare Part D drug coverage in 2006 produces a dramatic shift in spending across payers but has little net effect on aggregate spending growth. Health spending is expected to consistently outpace gross domestic product (GDP) over the coming decade, accounting for 20 percent of GDP by 2015.
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Congress adopted legislation in 1984 to encourage pharmaceutical companies to develop new drugs, while simultaneously allowing competitors to bring cheaper generic versions to market. More than twenty years later, Congress may be faced with a similar balancing act for biologics. ⋯ It should also evaluate the patent law, which is yielding increasingly narrow patents. If additional measures are not adopted in light of the intersection of these factors, then any legislation allowing for "follow-on" biologics could stifle development of new medicines from biotechnology.