Dr. Robert Pearl: 5 biggest health stories of 2018

Robert Pearl, MD, the former CEO of Oakland, Calif.-based Permanente Medical Group, outlines five of the biggest healthcare issues of 2018 and explains why he believes 2019 "will be a year of ongoing inaction and erosion within the U.S. healthcare system."

In an op-ed for Forbes, Dr. Pearl outlined five of the biggest stories that dominated the healthcare industry in 2018:

1. The 2018 midterm elections. Healthcare was ranked the No. 1 priority among voters during the midterm elections in November. While the Republican party retained control of the Senate, Democrats achieved a majority in the U.S. House and vowed to protect healthcare coverage for those with pre-existing conditions. The "Medicare for All" movement also gained substantial notoriety, with more than 70 percent of Americans supporting a single-payer system, according to data analyzed by CNBC.

2. Kavanaugh's Supreme Court nomination and women's healthcare. Justice Brett Kavanaugh's appointment to the U.S. Supreme Court this fall ignited a slew of questions about how the court might rule on issues of women's rights and abortion now that the court maintains a conservative majority.

3. Presidential powers and the ACA. President Donald Trump has repeatedly called on Congress to create new healthcare legislation to replace the ACA and has eliminated some of the law's key provisions through presidential executive actions and orders. By shrinking the enrollment period and withdrawing funding for marketing and outreach programs, the Trump administration contributed to ACA enrollment declining in all 39 participating states, and total enrollment has reportedly declined for the second straight year, Dr. Pearl notes.

4. Drug prices continue to soar. Skyrocketing drug prices continue to be an issue for consumers. One such case in 2018 involved the CEO of Nostrum Laboratories, who raised the price of an antibiotic by more than 400 percent and argued that it's a "moral requirement to make money when you can" by charging the highest price for a product.

5. Amazon, Apple and others disrupting the industry. In June, the joint healthcare venture created by Amazon, Berkshire Hathaway and JPMorgan Chase appointed Atul Gawande, MD, to serve as the health venture's chief executive. Dr. Pearl claims each business giant also aims to disrupt certain aspects of the industry on their own: Amazon's foray into the pharmacy space, Berkshire's moves into the insurance industry, and JPMorgan's steps into IT, privacy and security.

Dr. Pearl states that while the healthcare industry saw several stories with significant news value, the industry as a whole failed to make any real progress.

"Looking back on 2018, so much positive progress could have been made," Dr. Pearl writes. "We could have reined in drug prices. We could have begun a five-year financial reform plan to move healthcare from fee-for-service to comprehensive pay-for-value. We could have required electronic health record companies to open their Application Processing Interfaces (APIs), making it easier for doctors to share data and improve clinical quality. But we didn't."

"Next year won't be much different," he adds. "I predict that a decade from now we will look back on 2018 and 2019 as missed opportunities, moments in history when our nation recognized the problem, but did little to prevent the inevitable and painful healthcare crisis that will come. I'm hoping my predictions are wrong."

To access the full report, click here.

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