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Our Broken Medical System

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Hepatitis liver. Symptoms of hepatitis C in the form of color icons with corresponding marks. Vector illustration in flat style isolated on white background.

The United States: Where People Die for Corporate Profits

It was only two years later, in October 2014, that medical science provided a cure for hepatitis C infection. Based on groundbreaking research that later was recognized by a Nobel Prize, the treatment is simple — one pill a day for eight to 12 weeks, with essentially no side effects, and a 95 percent cure rate.

When the cure became available, I was serving as director of the National Institutes of Health. I was overjoyed that a cure had been approved, but the news was bittersweet. What gave me hope was thinking of the many other individuals and their families who would be spared from the misery that Rick and our family experienced. And to a significant extent, that hope was justified: These medications have cured about a million people in the United States.

But nearly a decade later, at least 2.4 million Americans remain infected with hepatitis C. About two in five people with hepatitis C don’t even know that they have the virus. Of those who do, many do not have access to the cure. Congress has an opportunity to turn this ongoing human tragedy into a public health advancement, by providing support for a five-year project to eliminate hepatitis C in the United States. But the time available for approval is growing short.

Hepatitis C progresses slowly. Over years, the virus causes fibrosis of the liver that can result in cirrhosis, esophageal bleeding and liver failure requiring transplantation. Hepatitis C is also the leading cause of liver cancer, responsible for half of the 40,000 annual liver cancer cases in the United States. Each year, about 15,000 Americans die from hepatitis C, many in their 40s and 50s. Given the safe and effective cure available for the last nine years, the correct number of deaths in 2023 should be zero.

Put simply, we are squandering one of the most important medical advances of the 21st century. It’s time to eliminate this threat to the health of Americans.

It’s no secret what has gone wrong. The cost of curative medications remains stubbornly high, so many insurance companies and Medicaid programs have erected barriers to coverage, requiring, for instance, abstinence from drugs and alcohol before people can receive treatment, referral to a specialist, or that the patient already shows liver scarring. Relatively few doctors offer treatment, and many sites where people at risk come for care do not even offer testing, let alone the cure. The result is that fewer than one in three people diagnosed with active infection get timely treatment.

Between protecting corporate profits and engaging in moralistic attacks on behavior, well, actually what could be more America than people dying for these two things?

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