For those of you in the rest of the country, this all probably old hat.  But for us here in California, the circus finally came to town last week in the form of the presidential primaries.  By the time you read this, the voting results will be widely known.  But as I sit here on an unusually overcast weekend in Northern California, all we know is that the three remaining presidential candidates are here and they are pouring it on as strongly as possible.

Ahead of the hoopla, a good friend and Sacramento-insider forwarded me a full copy of the state-wide Field Poll released on May 25, 2016.  The pollsters identified the top 10 issues likely voters (all parties/affiliations) were considering when deciding on whom to support for president.  Healthcare ranked #3, after only jobs/economy and education. 


I think that #3 ranking is about right and I imagine that most Californians would roughly agree.  The pollsters didn’t press the details on many of these issues, especially about healthcare.  But I think most people’s concerns are access to quality care and the cost of that care.  In terms of access, we here in the northern reaches of the San Francisco Bay area are pretty fortunate.  We have a strong Kaiser network and a beautiful new Sutter hospital.  Within a couple of hours drive, we have access to world-class academic medical institutions like Stanford and UCSF.  That’s a lot better than some, but unfortunately we’re just as exposed to the risks on the rising cost of healthcare as everyone else.

So while the three remaining candidates have all held rallies and events within 100 miles of our Santa Rosa location this week, it has been really disappointing to hear precious little substance in any of their remarks about healthcare.

We heard a bit about Senator Sanders’ proposed single payer system, Secretary Clinton’s vision to expand and improve upon the Affordable Care Act, and Mr. Trump’s promise to, well, “end Obamacare and replace it with something terrific.”  It’s easy to take pot-shots at Mr. Trump’s lack of specificity but the reality is none of the candidates dug into the issues of healthcare costs and access over the past few days.

It’s really a sad state of affairs.  It wasn’t that long ago that it seemed we were going to get a substantive discussion about healthcare, and that drug pricing in particular was going to become a hot button campaign topic.  I’m not sure why drug pricing ceased to be an issue in this political season – but the problem sure isn’t going away. 

I guess in today’s 24-hour news cycle, everyone’s already forgotten about Martin Skreli’s shenanigans a few short months ago.  And the few groups – like ICER – who continue to beat the drum on correlating pricing to value are coming under increased attack by pharmaceutical companies

As the head of a small company, I see our annual health insurance costs going up by 20-30% per year.  We strive to provide a menu of quality options for our team and we’re fortunate that most of our group is younger and healthy (which keeps our costs relatively lower).  Still, health insurance premiums are by far our number one company expense after direct compensation.  Rent, travel, marketing, etc. don’t even come close.

I’m grateful to live in a country – and a state -  with access to world-class medical care.  But I worry about the long term viability of our current system.  Two months ago, my daughter broke her foot playing soccer.  Despite having the best possible insurance plan, I still got stuck with a nearly $2,000 bill.  That’s on top of the thousands of dollars Advera Health pays for premiums on my behalf every year (as it does for all participating team members).  I’m guessing that everyone reading this has had a similar - and likely much worse – experience in our current health care system.

If we can’t even stay on track to discuss the emerging problem of drug pricing, how are we ever going to tackle the bigger systemic issues?  It just seems ridiculous.  But not as ridiculous as the fact that we have a national campaign going on with no one talking about these issues in detail.

Hopefully the circus atmosphere will die down as we head into the national election, but I’m personally not hopeful.


If you’d like to learn more about what Advera Health is doing to better identify and mitigate systemic healthcare costs, please contact us.


 Brian M. Overstreet, President, Advera Health Analytics, Inc.



Brian Overstreet

Written by Brian Overstreet