As we ushered in 2025, I found myself recovering from a third eye surgery and lamenting that my deductibles reset at midnight. I’m sure I was one out of many patients in a similar financial situation, given the rising cost of health care in America.
According to a study in 2024 by the California Healthcare Foundation, more than one-third of Californians (38%) have medical debt and a shocking 52% of low-income patients. I am not alone in worrying about the cost of health care in California as I am joined by 80% of my fellow Californians.
Addressing financial impacts to patients is multifaceted but there is work being done to call out the bad actors. One such example is the bold move of the Federal Trade Commission’s interim report on Pharmacy Benefit Managers and their nefarious practices driving up prices and decreasing access to life-saving options.
Health care deserts in California are a growing concern with the shuttering of local pharmacies being driven out of business. A staggering one-third of local pharmacies are at risk of closing due to inadequate reimbursements from insurance companies and PBMs. This is unacceptable and must be urgently addressed. Even the New York Times has warned this problem is going to get worse unless policymakers step in.
Affordable access to medication is imperative to maintain the health of all Californians, but lower prices don’t mean anything if patients don’t have valuable and timely access. Putting price controls on the medications themselves has been demonstrated to stifle innovation and have detrimental long-term impacts on patients. A University of Chicago study from 2021 demonstrates that a previous price control bill would result in a 29 to 60% research and development production, leading to a shocking 167 to 342 fewer drug approvals over the next 15 years. The study puts in perspective that the loss of life from these price controls will be 20 times larger than the tragic loss of life from COVID-19. Revenue is essential for innovation to continue, and the ramifications of price controls will have a ripple effect throughout the industry for decades. The potential loss of life is too high a price for Californians to pay.
As we step into the new year with renewed hope, our health care system must also evolve to truly serve its patients – ensuring affordability, accessibility and innovation are not mutually exclusive but rather the pillars of a healthier future for all. A new year will inevitably bring a new administration, new regulators, state elected officials, and new ideas on health care policies. My deepest hope is that these new policies will prioritize making health care more accessible and affordable for every patient.
Julie Gill Shuffield is the executive director of a newly founded consumer and patient group, Patients Come First. She can be reached at [email protected].
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