Did you know that the healthcare sector is among the largest and most complex industries in the United States? The health and medical industry account for nearly one-fifth of the overall gross domestic product (GDP). Its consistent growth can be attributed to a wide range of factors, from robust medical research and development to the aging population.
But what exactly comprises the healthcare sector? These include for-profit and non-profit organizations that provide medical products and services, medical insurance, and medical equipment and facilitate the provision and distribution of healthcare-related services to professionals and patients. While doctors and nurses may be the face of the healthcare sector, more professionals are involved behind the scenes, including medical scientists, engineers, and administrators.
In economic terms, the healthcare sector has distinct characteristics that differentiate it from the rest of the industries. For one thing, there’s pervasive government intervention, including regulations on drugs, medical professionals, and healthcare administration. The demand for healthcare services is characterized by high price elasticity, which means their prices don’t significantly change despite supply and demand changes.
Suffice it to say, too, that the healthcare sector in the United States isn’t without its flaws, but it also has numerous things going for it! Thanks to the extensive network of hospitals, pharmacies, and nursing care facilities, patients quickly access healthcare products and services. Healthcare facilities and their professionals have a patient-centered philosophy, which translates to patient choice and empowerment and provides a comfortable environment.
The U.S. healthcare industry is also a notable leader in medical research and development, innovation, and entrepreneurship. Many of the world’s life-saving medications and procedures were developed by American companies – and who can forget that Pfizer made the COVID-19 vaccine currently being administered in the country and other parts of the world.
These establishments are the face of the healthcare industry because the general populace largely contacts them. The hospitals provide diagnostic, prevention, and treatment services to patients and many sub-sectors, such as general medical and surgical hospitals, psychiatric and substance abuse hospitals, and teaching hospitals. The medical practitioners and healthcare professionals are, hands down, among the most hardworking people we have ever known! Doctors, nurses, psychologists, social workers, nutritionists and dietitians, and physical therapists are just a few examples.
These establishments provide the healthcare industry’s tools and technologies to diagnose and treat injuries and illnesses. We can thank them for everything from needles to MRIs and C.T. scans, even robots.
These consist of health maintenance organizations (HMOs), Medicare, Medicaid, medical claims processing services, and medical case management services. Think of them as the behind-the-scenes players whose hard work makes healthcare facilities possible to care for their clients.
These are the players that deliver the drugs to the healthcare providers and patients and, thus, include pharmaceutical companies, drugstores, and pharmacies.
The healthcare and social assistance sector is the nation’s top employer, with 20 million employees and more than $1.0 trillion in annual payroll (2018).
The healthcare industry’s extensive nature encompasses about 890,000 single-location companies and branches of multi-location corporations across the U.S. These companies range from world-famous names like Pfizer, Kaiser Permanente, and Ascension to small-town mom-and-pop drugstores.
CVS Health Corporation is the top healthcare company based on 12-month training (TTM) revenue of $257.3 billion as of March 24, 2020. It owns CVS Pharmacy, among the largest pharmacy chains in the U.S., and MinuteClinic, the country’s largest medical walk-in clinic.
Both physicians and patients accept digital engagement, data sharing, and other digital technologies designed to increase patient care and decrease costs.
The Internet of things (IoT) will reduce operational and clinical inefficiencies by 25% or $100 billion every year in healthcare facilities. Current uses include insulin delivery, ingestible sensors, and coagulation testing.
While the most common uses of IoT are in smart home devices, it’s projected that 40% of IoT technology will be related to health – the most in any category.
IoT isn’t a novelty either! It’s predicted to revolutionize healthcare through training simulators, patient monitoring, and preventive care, as well as workflow optimization.
Cyrcadia Health released its pioneering Cyrcadia Breast Monitor, a smart insert consisting of two wearable breast patches that monitor circadian temperature changes in breast tissue. It’s useful in the early detection of breast cancer, and it actually works!
As of May 2019, healthcare practitioners, including physicians and surgeons, registered nurses, and dental hygienists, earn the highest annual median wage at $39,810.
In contrast, healthcare support occupations have the lowest median annual wage for all occupations at $28,470 as of May 2019. The good news is that this industry has plenty of career advancement options.
As the nation’s largest industry, healthcare employs one in every eight citizens—the largest source of work.
The U.S. spent nearly 17% of its GDP on healthcare services in 2018, the highest of all OECD member countries. Switzerland, France, and Germany spent less on healthcare.
In a 2020 IPSOS survey, 71% of Americans surveyed rated healthcare quality as good or very good. This was an eight-percentage point increase from 2018.
With a $156 billion market share in 2017, the U.S. is still the world’s largest market for medical devices, machines, and equipment. By 2023, the industry is expected to increase its market share to $208 billion.
In 1975, there were 7,156 hospitals in the U.S., but their number has decreased to 6,146 in 2020, according to the American Hospital Association. Many of these were due to industry consolidation and competition.
Likewise, the number of beds has also declined from 1.5 million in 1975 to 924,000 in 2018. However, it’s worth noting that patients are more likely to use outpatient services than inpatient services.
Elizabeth Blackwell (February 3, 1821 – May 31, 1910) is acknowledged as the first woman doctor in the U.S., but she wasn’t American by birth. She was born in England but received her degree from the Geneva Medical College.
In August 2020, 54 students of the Oklahoma State University College of Osteopathic Medicine participated in a historic white coat ceremony. Based at the Cherokee Nation in Tahlequah, Oklahoma, the college is the first Native American tribally-affiliated medical school.
Between 2000 and 2017, the average length of hospital admission for acute care increased from 6.1 days to 6.8 days. But there are differences between types of medicine – it’s 14 days for rehabilitation medicine, eight days for internal medicine, and ten days for neuropsychiatry.
In 2018, Wyoming residents stayed the longest in community hospitals. On average, they stayed for nine days. In contrast, Utah residents stayed for an average of 4.4 days.
In 2000, the occupancy rate in U.S. hospitals was 63.9%, and it slightly increased to 64% in 2017. High occupancy rates can signal the risk of bed shortages but its positive connotations, such as efficient care and high productivity.
In 2016, hospitals contributed $2.97 trillion to the country’s economy, with more than $1 trillion on wages and salaries. Indeed, these are an economic mainstay, a force that provides stability and growth even during the recession. Hospitals are also the largest segment in the healthcare industry.
The NYC Health + Hospitals/Bellevue Hospital Center in New York City, New York was established in 1736, and, thus, it’s the oldest hospital in continuous operation in the U.S. But it would take 188 years before the first POTUS born in a hospital came along – President Jimmy Carter, born October 1, 1924.
Kaiser Foundation Hospitals ($20.81 billion in gross assets); Howard Hughes Medical Institute ($18.12 billion); Partners Healthcare ($12.6 billion); Cleveland Clinic Foundation ($10.22 billion); Mayo Clinic ($8.53 billion); and Memorial Sloan Kettering Cancer Center ($8.48 billion). These are the organizations with the largest endowments and foundations in the U.S. as of 2015 though we suspect it still holds in 2020.
As of 2020, the U.S. has an estimated 25.8 intensive care beds per 100,000 inhabitants. This was third after Germany (33.9) and Austria (28.9), and after France (16.3), Canada (12.9), and England (10.5).
As of May 31, 2020, about 72% of survey respondents stated that they are satisfied/very satisfied with the pandemic response among hospitals in the country.
And that’s by choice, too! This is because nurses can work 12-hour shifts for three days so they can enjoy four days off. This is possible because of the 24/7 nature of the healthcare industry, particularly hospitals and nursing facilities.
Many hospitals and long-term healthcare facilities now allow employees to adopt self-scheduling, a more flexible work arrangement. Nurses report being in better control of their time and being able to provide better patient care.
In a survey of nearly 400 healthcare professionals, they predicted telemedicine will still be used in almost 20% of patient appointments after the coronavirus pandemic. Before the pandemic, only 2% were telemedicine appointments.
As of November 13, 2020, the FDA has granted a total of 180 emergency use authorizations (EUAs) for COVID-19 viral RNA tests, while 57 EUAs were for antibody tests and 17 for other tests.
In 2018, the pharmaceutical industry in the U.S. spent around $62 billion on research and development within the country and another $17 billion abroad. R&D is the root from which all healthcare drugs and devices in the market come from.
More than 982 drugs and vaccines against COVID-19 are in development as of December 14, 2020. Sorrento Therapeutics led the pack with 12, followed by ImmunoPrecise Antibodies with nine and Roche with eight. AstraZeneca, GlaxoSmithKline, and Novartis are also in the running.
About 44% of survey respondents stated they had used health apps, according to a Statista Global Consumer Survey in 2020. Leading health apps today include MyFitnessPal, Headspace, and FitPlan, although the sector also experiences fast obsolescence.
A silver lining to this coronavirus pandemic is that nearly 60% of adult users increased their dietary supplement intake. About 65% of adult Americans take nutritional supplements, too.
Health Share of Oregon was the foremost victim of a cybersecurity breach in 2020! More than 654,000 patients were notified of the security breach since their personal information, including contact details, Medicaid ID numbers, and date of birth, were likely compromised.
From 2017 to 2019, the rate of electronic prescriptions increased from 66% to 80%. This means that in 2019, 80% of all prescriptions were issued electronically. But e-prescriptions for controlled substances like opioids were significantly lower at 38%.
In 2011, there were 253,700 work-related illnesses and injuries in U.S. hospitals, or the equivalent of 6.8 incidents for every 100 full-time employees. Fortunately, many hospitals are adopting safety measures to decrease these work-related incidents.
With over 94,000 registered nurses, 38,000 active physicians worldwide and 185 hospitals, HCA Healthcare is the largest hospital and healthcare system in the U.S. Ascension Health (151 hospitals), CommonSpirit Health (142 hospitals), Community Health Systems (105 hospitals) and Trinity Health (92 hospitals) round out the top five.
With 1,705 beds, AdventHealth Orlando in Florida is the country’s largest hospital. But it’s just one of 26 hospitals in the AdventHealth system, and it’s known worldwide for its cutting-edge treatments and topnotch research for advanced patient care. The Methodist Hospital (San Antonio, Texas; 1,550 beds) and Jackson Memorial Hospital (Miami, Florida; 1,550 beds) come close.
According to AHA, non-profit hospitals with tax-exempt status contributed about $95 billion in community health services rendered in 2016. These services include community health clinics, financial assistance for low-income patients, and disaster relief. Their importance in underserved areas cannot be overemphasized.
Medical records, information technology, and finance are just a few examples of healthcare jobs that don’t require a strong stomach for blood, poo and pee, and other gory stuff.
While the subject of hospital food quality is subjective, many hospitals are making an effort to offer better and healthier food selections. There are also cafes and coffee shops aside from the usual cafeteria.
In a U.S. News article, Hawaii was ranked as the best state for healthcare! It was best in terms of quality of care, access to care, and overall health of the population, among other performance measures. Plus, it has a great environment and friendly people.
While medical school can be expensive, many doctors graduate debt-free! This is made possible through attendance in federally-funded medical schools where students become commissioned officers and earn an annual salary. Other ways include free tuition in public schools and scholarships, both merit- and need-based.
The U.S. spent $11,200 per person in healthcare in 2018, a significant increase from the 1980 level of $2,900 per person. This represents a 290% increase or a 3.6% annualized growth in real per capita spending.
Vicodin (hydrocodone/acetaminophen) is used to treat acute and chronic moderate to moderately severe pain, and it’s the most prescribed drug in the U.S. Simvastatin, lisinopril, levothyroxine, and azithromycin are among the top five prescribed on the list.
Hip replacements are usually made with metal-on-metal sockets. But carbon fiber-reinforced polyetheretherketone (PEEK) plastic will likely replace these metal parts, thanks to their superior strength, parts compatibility, and wear resistance.
Look around any healthcare facility, and you will see blue wrap as a protective layer. This is because the polypropylene-based material resists liquid and fights microbial contamination, making it easy to clean and sanitize equipment.
Plastics with antimicrobial additives are used for numerous hospital supplies and devices, from doorknobs to catheters, because these can kill bacteria by up to 99.99%. About 5% to 10% of hospitalized patients get hospital-related infections.
With 85% of hospital waste being non-infectious, most of these can and should be recycled instead of being burned or disposed of into landfills. Cleveland Clinics is among the healthcare facilities that recycle their waste – up to 33% or 194 tons of plastic in 2017.
According to a LinkedIn study, three of the top 10 occupations with the highest average cash bonuses were in the healthcare industry. The average bonus was $5,500 per year, #7 for the highest average bonuses. (The energy and mining sector was #1 at $10,000 per year on average)
Between 2015 and 2014, the salaries for registered nurses decreased by about $2,000 on average. But it must also be emphasized that the actual salary will depend on employment status (part-time or full-time), education, and geographical location. Advanced practice registered nurses earn the highest salaries.
The healthcare industry’s unemployment rate is relatively low, even when the national unemployment rate is high. But the COVID-19 pandemic may be an exception to the rule, with 1.4 million jobs lost in April 2020.
In a CNN Money article ranking the top 100 jobs in the U.S., three healthcare jobs were in the top 10 while a total of 15 jobs were in the top 100. These jobs included Q.A. coordinators, clinical apps specialists, and hospital administrators.
While there are over 900 insurance companies that offer healthcare coverage, the industry is dominated by five companies with more than 38% of the market covered. These are Anthem, UnitedHealthcare, Humana, Health Care Service Corporation (HCSC), and CVS Health.
The U.S. has a nurse density of 11.7 nurses for every 1,000 inhabitants, which places it behind Norway, Switzerland, Iceland, Finland, Germany, and Ireland.
Medishare is a system where Christian community members share each other’s eligible medical costs and enable everyone in the community to lead healthier lives. It’s an alternative to health insurance, but it isn’t one – it’s a voluntary fund sharing system administered by the non-profit Christian Care Ministry, Inc.
A.I. applications can result in improvements in access, quality, and cost of healthcare services, which explains its growing popularity in the healthcare sector. These are predicted to create $150 billion in annual savings by 2026.
While we view A.I. as futuristic, it has numerous applications in the healthcare industry now! These include virtual assistants for people with Alzheimer’s disease, early identification of pigmented lesions, robotic-assisted therapy for stroke victims, and caption guidance for echocardiographic images.
Robots are used for numerous healthcare applications, although their use in surgery isn’t widespread yet due to safety concerns. But robots are used for contactless disinfection and as general assistant techs.
We often think that strange medical devices are only in the past, but many are still used today. These include Endobeads and Wormbots, but don’t dismiss them as novelties for, indeed, what’s science fiction today can be science fact tomorrow!
America has seven of the ten leading medical device companies globally, a testament to its leadership in the global healthcare industry. These are Medtronic, Johnson & Johnson, GE Healthcare, Abbott Laboratories, Becton Dickinson, Cardinal Health, and Stryker.
Pfizer’s COVID-19 vaccine took less than a year to develop, but it’s a rarity in the healthcare industry. It takes up to 15 years to develop a drug or a vaccine, and in some cases, it can take nearly twice the time. The vaccines for the human papillomavirus and rotavirus each took 15 years to develop, while FluMist and the chickenpox vaccine took 28 years.
The Ebola vaccine, known as VSV-EBOV or rVSV-ZEBOV (Ervebo), was the fastest vaccine to be developed – just five years from October 2014 when tested in multiple trials in U.S., Europe, Kenya, and Gabon to its approval for medical use in November 2019.
Many of the world’s largest pharmaceutical companies are based in the U.S. Thus, American consumers benefit from easy access to the advanced pharmaceutical industry. In 2019, its market accounted for 48% of the world’s total market.
On the global stage, the U.S. pharmaceutical industry also leads the charge in the newest compounds and drugs created from 2014 to 2018. These include Alnylam Pharmaceuticals’ Onpattro, Loxo Oncology, Bayer’s Vitrakvi, and the first marijuana-extracted drug to manage a rare form of epilepsy.
Humira, a drug used in managing autoimmune diseases in adults and injected under the skin, sells for $4,480 for two kits on average (2017). In 2018, it generated sales revenue for its manufacturer, AbbVie, of around $21 billion, the highest of any drug in the U.S.
In 2019, revenues generated from the sale of antidiabetic drugs were about $67 billion, second only to anti-cancer drugs. But the number of related prescriptions dispensed remained almost the same for the 2018-2019 period.
The U.S. is home to three of the world’s five largest pharmaceutical companies by revenue. Topping the list are Johnson & Johnson, Pfizer, and Merck & Co, with Roche and Novartis following closely.
For therapeutic areas with five or more drugs available, the median estimates for their R&D costs range between $765.9 million for drugs targeting the nervous system to $2.7 billion for cancer and immunomodulating drugs.
The productivity of the U.S. pharmaceutical industry significantly fluctuates every year. In 2016, over 20 new drugs were introduced. In 2018, the number increased to 60, while nearly 50 were approved in 2019.
An experimental drug can take an average of 12 years from R&D in the laboratory to mass distribution – if it makes it that far, of course. This is because only 5 in 5,000 drugs – or 0.1% only – in preclinical testing are converted to human testing, and only one of these five drugs are usually approved. So, the odds for approval are 1 in 5,000.
The Orphan Drug Act of 1983 incentivizes orphan drugs in the U.S. Orphan drugs are used to manage rare diseases, defined as disorders with less than 200,000 patients.
If the federal prohibition on cannabis, or marijuana, ends in 2020, experts estimate that the value of cannabinoid-based drugs in the consumer market will grow to $25 billion in 2025 and then $50 billion in 2029. The State of California was the first to allow medical marijuana use, while Oklahoma currently has its fastest-growing market.
While it seems counterintuitive, some hospitals provide beer for alcoholics who go through withdrawal, a possibly fatal condition. But under the Willis-Campbell Act, it’s illegal for doctors to prescribe beer and other alcoholic beverages.
This is because teaching hospitals are updated on the latest research and where medical students are eager to provide better patient care under licensed physicians’ supervision. These healthcare facilities have also been found to provide better care for patients with serious injuries and minorities than general hospitals and report lower mortality rates.
When a natural or human-made disaster strikes, hospitals are among the most vulnerable structures, particularly with many ill and injured patients inside. Even a power outage can spell disaster and death. Hospitals are then turning to resilient architectural designs to ensure continuous operations.
Take, for example, the Nationwide Children’s Hospital in Ohio, where nearly everything is designed to cater to its main clientele – children, of course. Many of the facilities are kid-sized, such as the child-friendly potties, the toy wagons used as patient transport, and the so-called magic forest with low tables and chairs.
This is possible through the split flow design, where a team of doctors diagnoses the patient as soon as he/she arrives at the emergency room. Then, the team decides where to put him/her in one of two tracks. The Long Island Jewish Medical Center experienced moderate success with it.
Many hospitals strive to deliver hotel-like experiences to their patients. The Hackensack Medical University Center, for example, private rooms with ensuite bathrooms, room service with a selection of 26 entrées, and grooming services.
Copper has been found to possess a high antimicrobial property and, thus, its inclusion in patient gowns and bed linens, as well as bedrails, bedside tables, and hospital beds, make sense. Copper oxide is infused in these things as a way to reduce hospital-related infections.
Hospital medicine physicians, also known as hospitalists, are celebrated during the National Hospitalist Day every first Thursday in March. It was first celebrated in 2019.
And it’s, in fact, the fastest-growing medical specialty today, too! More than 600,000 practitioner physicians in 2020, a huge increase of just a few hundred more than 20 years ago. About three in four hospitals employ hospitalists.
While hospitalists have mixed demographics – 37% are Asians, 36% Caucasians, 8% Hispanics, 5% blacks, and 4% mixed race – most of them (55%) are in the 35-49 age bracket while 22% are in the 35 and below the bracket. Only 3% are 65 years or older.
First done on a human in 2001, telesurgery involves using computers, cameras, and robotic technologies in performing long-distance operations. The surgeon and patient aren’t in the same room or country, and it has been done for hysterectomies, heart surgery, and neurosurgery.
Women are outpacing men in medical school in terms of enrollment – about 50.5% in 2019. They also made up 47.9% of medical school graduates for the 2018-2019 academic year.
In 2013, there were over 6,000 urgent care centers in the U.S. By 2019, the number exploded to 9,600+ and counting. Urgent care centers are, indeed, becoming an essential unit of the healthcare industry.
During their early years, urgent care centers were mostly owned and operated by medical groups, doctor practices, and physicians. Nowadays, 39% are owned by corporations like UnitedHealth Group’s Optum, Dignity Health, and Carolinas Healthcare. Hospital-doctor partnerships own about 16%, while investors and doctors own others.
Digital humans are A.I. technology but with a difference – these look, act, and interact like real humans. But unlike humans, these are available 24/7 and can be programmed to speak in more than 40 languages. Patients seem to interact better with digital humans, or hyper-realistic digital avatars, because of empathy.
Zolgensma, a gene therapy used in treating spinal muscular atrophy in babies, is currently the most expensive drug. Its cost – a staggering $2.125 million per patient.
These are steam sterilization and incineration, and medical waste typically falls in one of these two categories but not in both. Sterilization is the more common method, with many sterilized medical waste being recycled, such as plastics and metal. Incineration is the legally approved method for trace chemotherapy, pathology waste, and drugs.
In November 2020, 22% of hospitals across the U.S. experienced staffing shortages, and the ongoing pandemic is making matters worse. Fortunately, thirty states address the issue by easing licensing requirements, particularly by allowing doctors and nurses who hold licenses in other states to work in their home states.
Surprisingly, appendectomies are a common occurrence in U.S. hospitals, with 250,000 cases reported annually. This translates to 1 million patient-days of admission.
In a study where physicians named select hospitals the best place for adult psychiatry, Johns Hopkins Hospital emerged as the best, followed by McLean Hospital. Both are in the State of Massachusetts.
Sadly, the U.S. only has nine psychiatrists for every 100,00 people, a number that falls short of the ideal 15-to-100,000 ratio. The good news: Medical schools like the University of Nebraska Medical Center (UNMC) have been successful in recruiting more aspiring psychiatrists.
Innovation drives the U.S. healthcare industry and fuels its leadership status worldwide. In the 21st century, these innovations include drone-delivered medical supplies, a stem cell cure for diabetes, a pocket ultrasound, A.I. with cancer diagnosis capacity, 3D digital hearts, and virtual reality rehabilitation.
The Patient Protection and Affordable Care Act or PPACA may seem like a new approach to universal healthcare, but the idea isn’t new. In 1945, President Harry Truman also proposed a so-called universal health insurance program, but it was only in 1965 when President Lyndon B. Johnson signed Medicare and Medicaid into law.
The dynamic healthcare industry thrives on innovation and competition, and startups deliver on both aspects. Many of these rising stars are based in the U.S., such as Verge Genomics, Embleema, Alector, K Health, Prognos, and Tempus.
Doctors, medical scientists, and other healthcare professionals will perform self-experimentation to test their theories or treatments. Examples include Barry J. Marshall, who proved that H. pylori could cause ulcers and won a Nobel Prize for it; Jonas Salk for his polio vaccine; and Kevin Warwick for Project Cyborg.