I don't think the spending story alone is helpful because it doesn't acknowledge where there's room for actual improvement. Of the $1.5T spent on "Hospital Care", if almost all of it went to medical staff, facilities, equipment etc, and if good data suggested that people aren't in hospital unnecessarily, maybe that number isn't a problem. But if private hospitals have very fat margins, and some significant share of patients could be served just as well through less expensive clinical services, maybe that's too much.
In the context of the cost of medication, the $449B on "prescription drugs" doesn't break out what goes to drug makers vs PBMs or anyone else. We can easily imagine a world without PBMs that still delivers drugs to patients, but someone has to actually make the drugs. We can also ask, are people on medications they don't actually need? Are we sometimes _causing_ later health issues when medicating (e.g. fueling a giant opioid crisis)? None of this is apparent in the top-line spending figures.
In the context of the cost of medication, the $449B on "prescription drugs" doesn't break out what goes to drug makers vs PBMs or anyone else. We can easily imagine a world without PBMs that still delivers drugs to patients, but someone has to actually make the drugs. We can also ask, are people on medications they don't actually need? Are we sometimes _causing_ later health issues when medicating (e.g. fueling a giant opioid crisis)? None of this is apparent in the top-line spending figures.