Transcripts For ALJAZ Counting The Cost 2019 Ep 44 20240713

Hello im Adrian Finnegan this is counting the cost analysis serial weekly look at the world of business and economics this week the way we pay for health care millions of people in the us go without medical insurance many file for bankruptcy because they cant afford to pay their medical bills. Or the chances of rolling out universal health care in an Unequal World will take a look at Zimbabwes Health care system which is on the brink of collapse. Plus the Tech Companies have a solution to the way that everyone accesses health care well talk to an investor and c. E. O. Of a diagnostic camp. Now just because you are the richest nation in the world and spend more than any other nation on health care doesnt mean the outcomes are better or that more people will Access Health services more than half a 1000000 people turn to bankruptcy in the us because they cant pay their medical bills and more than 27000000 people are without medical insurance in the poorest nations the weakest dont have access to even rudimentary treatments yet its a goal of the United Nations to achieve universal Health Coverage for all by 2030 how well take a look at this the World Health Organization estimates that it would cost around 58. 00 per person per year to achieve universal health care in all low and middle Income Countries that comes to about 371000000000. 00 per year by 2030 where does that money come from well the World Health Organization believes some 85 percent of the total cost can be met by domestic resources in the 32. 00 poorest nations a funding gap of around 54000000000. 00 would need to be filled through International Aid and what will that mean in terms of outcome well some 97000000 premature deaths would be a versus it would also avert 20000000 deaths from noncommunicable diseases like Heart Disease diabetes. And cancer Life Expectancy would jump anywhere between 3 point one and 8. 4 years well as the world inches towards spending 10 trillion dollars a year on health care by 2022 we have 2 reports for you in a moment from zimbabwe how takes a look at a Public Health care service thats on the brink of collapse but 1st from the United States al jazeera. Reports on how the Health Insurance industry is failing patients when virgil clark was diagnosed with cancer she felt confident her Health Insurance would cover her medical expenses how many years there had been paying in the to their insurance peramivir oh my god every flight. And he is i guess maybe she wasnt fully covered by Health Insurance paid for most of her treatments but there remained a few 1000. 00 that she was expected to cover and that she just didnt have the hospital withheld her counsel treatment of the hippocratic oath 1st do no harm. But i dont think that applied. And then she wound up detained at a courthouse of the hospital sued and walking up the only seconds in handcuffs i didnt bring in my Pain Medicine because i didnt think i would be there all day this sort of trauma for medical bills isnt common experience for americans in fact 2 thirds of bankruptcies a jew to medical issues in the us to find out why we travel to philadelphia to speak to Wendell Potter he was once an executive at the Health Insurance Company Cigna most people in the us pay monthly premiums to Health Insurance Companies Like cigna as a safety net in case they need medical treatment of some kind just look at these companies then determine whether they will receive and can afford that treatment in 2009 blew the whistle on the Health Insurance industry to the u. S. Congress my name is one of puttering for 20 years i worked as a Senior Executive health and Health Insurance companies and i saw how they confuse their customers and dump the sick so all the so also they can satisfy their wall Street Investors that if the Affordable Health care act obamacare was passed it did wipe and coverage and close loopholes Insurance Companies were using to refuse that plans health care. Yes. Im 20000000 more americans were able to get Health Insurance as a result theres still some 28000000 americans would remain uninsured here but Health Insurance is still a for profit enterprise yes you can now get insured but if you actually need treatment it will cost you just as bad if not worse is the rising number of people who are under insured these are people who are paying good money every month for their Health Insurance premiums the finding that they now have very high deductibles for their words they have to pay a lot of money out of their own pockets before their coverage kicks in for part of the fundamental principles that guide Insurance Companies havent changed to make as much money as they can to bring as much revenue and but to pay out as little as possible in claims because when that happens theyve got more money to reward shareholders and to enrich their executives i know that because i was one of them that made quite a lot of money this is just in dispute the u. S. Has the most expensive Health Care System in the world however when Health System performance is compared such as quality efficiency access to care equity and the ability to lead a long life the u. S. Is launched against other developed countries the u. S. Does rank top for one indicator that the amount it spends on administrative costs per capita and part of that money is dedicated to Insurance Companies hiring doctors and nurses as what are called medical directives but they dont treat patients they try to find ways to treat patients everyone is employed by the Insurance Company knows that they have their part to play and they can sure that that Company Meets wall streets financial expectations so it doesnt have to be direct. That you will deny x. Number of things or treatments but you know that if youre going to keep your job and hopefully get a raise in a bonus youve got it. Do what the Company Expects you to do Health Insurance is expected to be a major issue in the 2020 election proposer recognizes the framing of the debate as one he and other executives would shape in the boardroom before funneling money to politicians the terms that are being used today are the same terms that i used to use and in fact in some cases helped create it is to get people to be afraid of change is a term thats an acronym thats used for this kind of Propaganda Campaign its fun and its fear uncertainty and doubt and these campaigns are designed to get people to fear change to make them feel uncertain about whats being proposed and that they would benefit from it and to doubt those who are advocating it i store v. A. But they have someone there because i know theres someone out there who have been through the sinking of even worse than i have and so that it was like my story may make a difference for someone or it may embolden someone with a makes me get but for now its unsettling how familiar of a story is in the u. S. Armed how powerful the forces are that want to keep it sir. Marketa lana worries finding drugs for chronic illnesses is going to get a lot harder for poor and struggling zimbabweans some Public Health centers have no drugs for hiv patients the cost of one months supply at a private pharmacy is roughly 60 u. S. Dollars a Civil Servant and about 70. 00 a month if youre into these. Places because you live. For you to maintain your life but if you baby here it is that means im going to look after the children of. All the people that. Those who can afford it go abroad for the treatment others use the well starts expensive private facilities a luxury millions of others dont have is the way has more than 20 registered Health Insurance and we have about 800000 members the government has its own Health Insurance for Civil Servants which caters roughly to 340000 workers that means most people here dont have medical coverage while children under the age of 5 we see basic features meant a Public Hospitals everyone else without Health Insurance pays cash for such Pain Management the patient must have free killer i mean true up to access to medication. The medication is becoming extremely expensive. Traditionally and historically medication has been funded largely by donors but were finding that donors themselves not through lack of will but because of pressures on their mostly local donors they are unable to support that doctors have been striking for nearly 2 months of a poor pay and work conditions its another sign the Public Health sector is in trouble after numerous negotiations broke down the government issued this ultimatum. Coming to work will be disciplined. So the 1st thing were both most coming to work there will not be paid and some here blame the collapse of the public Health Care System on corruption and the states failure to prioritize government officials they wish to impose sanctions are the reason for the crisis not them but its patients who end up suffering and as a bubble economy worsens there is no sign that issue ation will improve soon how tasa had forgotten the cost joining us now from oxford is andrew follow hes a Senior Research fellow at Oxford Martin School Andrew good to have you with us on cutting the costs as we were hearing there there are many many issues with the us Health Industry pharmaceuticals for profit hospitals insurance vast Administration Insurance not even covering the cost is this a free market failure or a failure of capitalism well im not sure how did morning it and im not sure it goes far as that but the u. S. Does. Rate in sums of its performance on hospital performance and help performance and that spending on how much lower would be justified by the magic up suspends all out spends about 70 percent of its g. D. P. On out just about one in 6. 00 to get it racks up in 42nd among 224. 00 nations if you look at the most developed industrialised countries the top 35. 00 its 22. 00 in the table which tells you something about the way in which that system works and its a its a very high cost system but its also a system that misses a lot of you probably know well about the when risk Insurance Industry works in a way in which you know 20 or 30000000 people quite rightly are not troubled by that system and thats the big source of its actual relative failure minutes in other countries and then when the expenditure takes place when hospitalization if it is quite bureaucratic in spite of the pain. And there are things in the system that dont necessarily push the direction of efficiency is there anything. To recommend about the us system of healthcare is the hit anything that anyone else should be looking to replicate thats a really interesting point i mean at that very start where the best in the u. S. Its actually the best of the us the globe if you need the top quality treatment of some sort or other you know it can often be found in the u. S. But you can know one of the things to take out of his story is actually but for our relatively lower levels of money you can actually a cheap pretty high success so one of the projects sort of highlighting the huge amount of expenditure in the u. S. Is it coming out and send the signal that you need to spent lots and lots and as you know theres a big push is to create universal how to cut rich basic package and actually you can achieve a lot with a lot less money in the u. S. The World Health Organization says that 371000000000. 00 or 58. 00 a person per year is all or all it will cost to get health care to lower a middle Income Countries what kind of care does that provide and is is that if feasible is anyone willing to pay to pick up the cost. Well theres 2 things the 1st thing is to get this whole thing in perspective you quoted. Well were in a Global Economy of 80 plus trillion dollars so when we talk of 3 or 400000000000. 00 it sounds like a lot but its actually only a fraction of one of those 1000000000 or that one of those trillion numbers so its actually as a percent of the global g. D. P. Its a practitioner of the sat the 2nd thing is that the push to create universal Health Care Coverage and the numbers you talked about her capita thats for a very sort of basic package and one of the things that thats been going on the last 5 or 10 years is has been measures to try to actually make it that many cultures can afford that package one of the things that perhaps 10 years or so ago we realized that it was important to get right is that you know theres a lot of tax revenues out there theres a lot of Economic Activity going on thats thats thats not so its fair whack so one of the things that the w. H. O. And the world bank and others have been analyzing and trying to understand is is the source of its revenue we have actually trillions of dollars of resources that dont find its way into the mechanisms that actually that we know that in the very coarse countries of war there will need to be a time where rich countries cant do it and the numbers are they sound a lot but theyre quite small if you think of i started a process if you think of the money i just quoted relative to the cost of the afghan years ago its family trivial and the other thing about the numbers you just quoted is that terms of Health Impact on the poorest one of the the terrible things about it is its often the most vulnerable its the people cant get access to cash when they need it and one of those sort of cheers as it were is that when you need Health Expenditure when youre in a very poor. And somethings gone wrong in the family. Your counterpart for getting good how are treatment because you cannot quickly or retina get hold of the cash so a large chunk of the initiative to create these programs for universal hacker alcan coverage is to make it that people in the past it in many cases conjugate so there are schemes in which even very poor people put something every now today and that gives them some sort of automatic right to some sort of access so its not just rich people and money and its its richer countries and towards the very poorest for a period of time and its really good to talk to im counting the cost many thanks indeed for being with us thank you my pleasure and. With the trillions spent on health care it should come as no surprise that investors are trying to crack the industry with new tech related products the Global Digital Health Care Market is expected to hit 504000000000 dollars by 2025 according to Global Market insights and the health tech wearable market which includes your smart watch trackers could be worth 60000000000. 00 by 2023 Juniper Research estimates. All right so lets talk health check with george davis whos the director of hambro parks george good to have you with us on counting the cost why is the Health Care Industry the least receptive of industries to Technological Developments well i wouldnt say is the least receptive i just think that it does face some challenges Global Health care is a huge part of global g. D. P. But of course a great deal of it is provided by governments and legacy systems so change and innovation does take time that being said i think were seeing a huge proliferation of start up businesses and innovative Business Models in the space and i definitely think that over the long term well see absolute transformation particularly as you see Large Businesses like google and apple entering the space as well as new startups and more established players who are now spending more and more time thinking about changes to the system so id say over the long term were going to see dramatic shifts at this point perhaps healthcares lags somewhat but i dont think that will be the case over the long term ive used a Company Called thrive 2 for Blood Analysis its a i did i did the test at home sent it off fantastic google results but i suppose the biggest challenge for Companies Like them it is data how do you store it what do you do with it and the potential for misuse yeah im familiar with rover its a really interesting business a Great British innovative startup actually. Data storage is obviously one of the challenges that Health Tech Startups face because both because of regulator issues but also because of the expectations of consumers who are increasingly i think aware of the challenges around the data that they give away both consciously and unconsciously to to big businesses i do think this is a challenge for earlier stage Health Care Businesses because theres a lot of cost involved and theres a lot of trust involved in the in the minds of consumers i think that often comes from more established players from the role of government that being said i do think those. Challenges are definitely possible to overcome for startups as long as they obey the rules and use the services that are available to them i think they can absolutely resolve it and what i would say on the other side of the equation is that the power of big data in healthcare to really change the way we diagnose and treat illnesses and also long term conditions is one that a lot of businesses are definitely looking to harness thriver being a good example and so i think we need to be conscious as consumers that there is a trade off but we need providers of services to be very clear with us what theyre going to do with our data what data theyre storing and how and build that trust over time to catch that opportunity. One of your products is smart t. M. s a Mental Health treatment for depression helping patients with severe Mental Health in the says now that from medical point of view is is an area that requires a lot of skill in terms of managing patients out how does it work so trans smart to mess is a as a non invasive treatment for Mental Illnesses and challenges that people face and thats obviously a massively growing sector importantly it does not it is not a chemical solution to the challenges that people face so and we wouldnt say that there is as an investor we wouldnt say that there is one solution to those challenges at all and its absolutely a challenge that at the consumer level people will have Different Things that work for them this this effectively uses magnetic stimulation to change patterns in in brain behavior and can address a number of challenges depression anxiety and erect sirrah whole bunch of issues that people face and i think as we move into a phase where people are more accepting and open about the Mental Health challenges that people face and that is absolutely a good thing i believe and something that will increase overall social well being in societies i think you need a suite of these opportunities this business that weve invested in is growing very rapidly in the u. K. And is a really powerful innovation but it wont be the only one and you need to take a case by case basis as to to what the right one for for specific uses is now with a shortage of 7000000 doctors worldwide ada health hopes that it can fill the gaps that would reach parts of the world where health care is something of a lottery right now headquartered in berlin its developing and trialing its app aljazeera is economics editor of it early spoke with ada c. Daniel nath rough and asked how ada was different to people googling their symptoms youre completely right 8 out of 10. People go themselves for an example in germany where im from the thing with google is its a great tool for generalized information search but the results are not personalized to the user and theyre not actionable because google doesnt know enough at that point in time about the user aid of works in contrast to that very much like a Whatsapp Chat with a trusted Family Doctor that you have access to 247 except that in this case the Family Doctor is not human but its an Artificial Intelligence that supports you in finding out whats wrong with you and what you should be doing next and what have you deployed to soften the soft when are you working with Health Professionals or services. So ada has been launched basically in all countries in the world where there is an app store or a Google Play Store which meets over 150 countries and it has become the number one ep in the medical category in the app store in 140 countries and we do have partners that we work with for instance with a large Health System in the u. S. Called Sutter Health in the way on the west coast we also work with some of the Largest Health insurer us in germany and there are medical professionals and some of the leading medical institutions in europe who are using our doctor facing software and what is the reaction of those Health Professionals actually the reaction of Health Professionals to ada is very positive. I was expecting at least some of them to be a little bit skeptical and i was wondering whether some of them would say you know is this kind of a threat to my job but thats not the case at all the real Health Professionals once they realize that ada is actually very accurate they really appreciate the support it gives them in getting to the right diagnosis foster whats the backbone of the technology i mean how do you get the ai to read through medical textbooks saw what d. D. Has been around since 2011 and the 1st 56 years we didnt even go to market we had a large team of 100 plus doctors and computer scientists working on building a very very extensive medical Knowledge Base and refining a reasoning engine behind it and then we only launched the app for patients about 2 and a half years ago and what were doing now is that were using certain Machine Learning techniques also to learn from all of the cases that come into the system were trying to create feedback loops to make the system better and better every day now we used talk about Silicon Valley trying to just disrupt to sit. Industries why has it taken such a long time to disrupt the Health Care Industry i think its understandable that in health care things take longer if you look at some ecommerce businesses lets take the food Delivery Business for instance there you can create a simple shop solution a minimum viable product as they say and then you know you start generating revenue you react to users and you iterate and if something goes wrong its actually not that big a deal for instance if you know you deliver the wrong pizza its annoying for the customer and that moment but its not life threatening in health care you have to be a lot more careful this is why there is medical device regulation with a Software Like ours we have extremely high standards in terms of accuracy Data Protection data privacy because you know this is some of the most Sensitive Data that exists and if you use a product like ours you will be glad when you know you have a heart attack and it doesnt give you the right information it does not tell you or you just have a shoulder sprain dont worry about it is is something that needs regular 3 approval yes so it is certified as a medical device and there are obviously different regulatory authorities and in the e. U. In the u. S. And asian and other countries and were working very closely with the authorities to make sure that we obtain all the right certifications in europe were classified as a medical device done you know through a thank you very much for its im really appreciates on today thank you thank you very much. Thats it for this week if youd like to comment on anything that youve seen you can tweet me im at a finnigan on twitter please use the hash tag j. C. T. See what you do or you can drop us a line to the cost of aljazeera dont that is our email address as always theres plenty more few online at aljazeera dot com slash c. T. C. That takes you straight to a page and there youll find individual reports links even entire episodes for you to catch up on but thats it for this edition of counting the cost im Adrian Finnegan from the whole team here in doha thanks for being with us the news on aljazeera is next. 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