How the 2024 U.S. election could reshape the global healthcare landscape

The most important western election: A defining moment for U.S. healthcare and global M&A trends

At Heligan, we see things differently. This November, all eyes will turn to the U.S. in a pivotal election that could reshape the global healthcare landscape for years to come. The election’s outcome will significantly impact cross-border M&A activity and the trajectory of the U.S. healthcare system, as each party brings a distinct approach to managing the high cost of care. Both parties, however, are united in pushing for greater price transparency.

The stakes: blue vs. red

Regardless of a Democrat or Republican victory, the U.S. healthcare landscape will change. A comparative look at the U.K. offers insights into the potential direction for American healthcare.

A) Healthcare showdown: UK vs. USA and broader global comparisons

Comparing U.S. healthcare outcomes with those of other countries illustrates the challenges facing the U.S.’s healthcare system. According to Statista’s 2024 global healthcare rankings shows the U.S. trailing behind several European countries:

Denmark (Ranked 8th)
France (Ranked 10th)
Spain (Ranked 12th)
U.K. (Ranked 13th)
U.S. (Ranked 36th)

This disparity reveals that high U.S. healthcare spending does not necessarily translate to better outcomes, as fragmentation and inefficiency persist.

U.S. vs. U.K. - Key Health Indicators

1. Life expectancy

U.K. - 81 years
U.S. - 77 years
Conclusion - The U.K.’s better health outcomes indicate the strength of its public health policies

2. Healthcare system rankings

U.K. - Higher ranked, reflecting equitable access and efficiency
U.S. - Continues to lag, with significant room for improvement
Conclusion - The U.K.’s universal healthcare model offers advantages over the fragmented U.S.’s system. However, we do recognise the U.S. is made up of 50 different states with their own respective systems, as a republic.

3. Infant mortality rate

U.K. - 3.6 deaths per 1,000 live births
U.S. - 5.7 deaths, higher than in other high-income nations
Conclusion - Strong public health systems support better infant health outcomes in the U.K.

4. Access and equity

U.K. - Universal coverage through the National Health Service (NHS)
U.S. - Many remain uninsured or underinsured within a primarily private system
Conclusion - The U.K.’s publicly funded model promotes more equitable access

5. Cost of healthcare

U.K. - About 10% of GDP
U.S. - 17% of GDP—the highest globally without corresponding health outcomes
Conclusion - Higher spending does not correlate with better health outcomes

6. Preventable diseases

U.K. - Strong public health initiatives control preventable diseases effectively
U.S. - Higher obesity (42% vs. 28% in U.K.), diabetes (11.3% vs. 6.7%), and heart disease (6.7% vs. 3%)
Conclusion - Preventive care in the U.K. results in healthier population

B) Democratic agenda: expanding access and pharmaceutical focus

If the Democrats win, expect ongoing expansion in healthcare access with a strong pharmaceutical focus:

Strengthening the Affordable Care Act (ACA): Efforts may include expanding Medicaid and introducing a public option
Prescription drugs: Initiatives to increased access and control out-of-pocket expenses
Vaccination: Continued support for vaccinations and public health efforts
Mental health and addiction treatment: Expanding access and pharmaceutical support for mental health
Drug innovation investment: Balancing pharmaceutical industry support with price regulation
Preventive care: Funding for public health and prevention initiatives

C) The republican perspective: MAHA and healthcare transparency

If the Republicans win, under the “Make America Healthy Again” (MAHA) movement, they will emphasise personal autonomy and reduced regulation, challenging the “pill-popping” culture, promoting preventative care based on lifestyle, wellbeing and outcomes-based plans. Key initiatives which could include:

Vaccine policies: Possible shifts towards vaccine choice and safety
Personal autonomy: Less government intervention, emphasising individual responsibility
Environmental health: Addressing pollution and dietary impacts
Alternative medicine: A focus on therapies like vitamins, medicinal cannabis, and lifestyle adjustments
FDA reform: RFK Jr. has promised a radical restructuring of the FDA, targeting practices he says restrict public health advancements. He criticised FDA suppression of options like psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, vitamins, and nutraceuticals, that cannot be patented, vowing to change this if the Republicans take office. (source RFK Jr 25/10/2024, on X)

D) Investment areas with notable 2024 M&A deals

As healthcare priorities shift, investments in digital health, AI diagnostics, wearable tech, and preventive care have surged. A look at notable M&A deals underscores the trend toward transformative healthcare models focused on prevention and wellness:

1. Digital health and telemedicine

eConsult acquired by Huma (U.K., October 2024): Strengthens Huma’s leadership in AI and digital solutions for primary and emergency care, particularly in digital-first triage and automated consultation platforms.
Cloudbreak acquired by GTCR (U.S., March 2024, £144m): A provider of language access and telehealth services
DOCSUN BioMed Ltd acquired by BioRegenx (U.S., January 2024, £11.5m): It designs and develops non-contact, non-invasive, and non-intrusive vital signs software as a medical device. It offers video-based, vital signs monitoring, telehealth portal, gym and sports fitness tracker, and home personal health.
Oak Street Health acquired by CVS Health’s (U.S., Feb 2023, £8.5 billion): Emphasises CVS’s commitment on preventive care, population health, and value-based models, especially for chronic disease management

2. AI-Powered diagnostics and predictive analytics

Ferrum Health (U.S., Sep 2024): Raised £12m, a secure AI platform without compromising data privacy or innovation
Select assets of PathAI Diagnostics acquired by Quest Diagnostics Inc (U.S., May 2024, £80m): PathAI Diagnostics state-of-the-art digitised laboratory in Memphis has been rebranded as AmeriPath and will act as the national AI and digital R&D and solutions centre, supporting Quest's specialty pathology businesses.
Announced: Amedisys to be acquired by UnitedHealth/Optum’s (U.S., Aug 2024, £2.6 billion EV, approx. 15.2x EBITDA): Amedisys brings predictive analytics capabilities in patient home care, subject to regulators approving the deal.

3. Medicinal cannabis

Northern Green Canada Inc acquired by Curaleaf, a U.S.-based cannabis leader, (Canada, May 2024, £15.4m): A Canadian licensed cannabis producer focused on expanding the international market through its EU-GMP certificate.
Panaxia Labs Israel Ltd acquired by Barak Investment House Ltd, (Israel, April 2024): in a reverse merger transaction, Panaxia Labs Israel Ltd offers pharma-grade smokeless cannabis products
Terra Health Group acquired by Aurora Cannabis’s (Canada, May 2022, £39m EV): This acquisition supports Aurora’s medicinal cannabis offerings and expands its market reach in North America and internationally, meeting demand for alternative therapies.

4. Nutraceuticals and vitamins, supplements and minerals

MEG-3 fish oil business of DSM-Firmenich AG acquired by KD Pharma Group SA acquired (Switzerland, October 2024): DSM-firmenich will obtain a minority stake of 29% in KD Pharma's parent company O³ Holding GmbH
Emulsifiers business of Corbion NV acquired by Kingswood Capital Management acquired (U.S., April 2024, £285m): Provides lactic acid, emulsifiers, functional enzyme blends, minerals, vitamins, and algae ingredients
DSM-Firmenich’s acquisition of Adare Biome (Switzerland, July 2023, £237m EV, EBITDA 18x): Tackles gut health with postbiotics

5. Wearable health tech and remote patient monitoring (RPM)

Convexity Scientific Inc. acquired Spire, Inc (U.S., September 2024): Health-tracking device and remote patient monitoring solutions for chronic respiratory disease management
Fitbit and Quest Diagnostic collaboration (U.S., January 2024): Enhance metabolic health tracking through wearable devices
GrAI Matter Labs SAS acquired by Snap Inc (France, October 2023): Expands wearable AI for health monitoring
Current Health acquired by Best Buy Health (US, November 2021): Supports RPM solutions and Best Buy’s focus on home health care and integrating RPM services with wearable devices, aligning with broader industry goals to support aging populations at home

E) Path forward: beyond a “Pill-Popping” model

With U.S. medicine spending between $685–715 billion, accounting for 45% of global pharmaceutical sales (source: IQVIA, Biospace.com), both parties see the need to move beyond this costly model. Republicans, under MAHA, advocate for preventive and holistic solutions, promoting lifestyle changes, dietary supplements, and nutraceuticals. Democrats focus on broader access and transparency.

F) Conclusion

The 2024 election could mark a turning point for U.S. healthcare. While Democrats advocate for broader access with pharmaceutical focus and Republicans emphasise transparency and holistic care, U.S. firms are already capitalising on these shifts by investing in European digital health, nutraceuticals, and alternative therapies. As the M&A landscape evolves, investor and corporate strategies will need to adapt to the direction set by the election's outcome, whether Democratic or Republican.

I’m not a betting man, but if Republicans win, expect a radical shake-up. Hold on to your MAHA hat—it could be a wild M&A ride over the coming months!