The U.S. does not have a “free market” health care system. 90 percent of Americans have health insurance, nearly all of whom have their coverage heavily subsidized by the government. Part of the misconception stems from the fact that 159 million Americans receive health insurance through their employers. Private coverage is not the same thing as market-based coverage. Thanks to long-standing distortions in the tax code, few workers have the opportunity to choose their own coverage in a transparent market where prices and benefits are easy to understand. Ultimately, the most important way to make employer-sponsored coverage more affordable is to evolve away from the group model and toward a system of consumer-driven, individually purchased health insurance.
Emergency medical care is an exception to the general principle of market exchange, whereby services are voluntarily bought and sold, with sellers competing on price. Under federal law, hospitals are required to treat patients that arrive needing emergency medical treatment, regardless of their ability to pay—but allowed to subsequently charge whatever they wish. In recent years, medical providers have increasingly exploited this arrangement by threatening exorbitant charges for out-of-network emergency care in order to force insurers to agree to generous reimbursement terms across the board. Patients have frequently been caught in the crossfire and forced to pay large “surprise bills” for emergency care by hospitals or doctors who remain out of network.
The Trump administration announced that it has finalized a new rule requiring all drug companies to include the list prices of their drugs in direct-to-consumer advertisements. If sunlight is the best disinfectant, the White House hopes that more visibility about drug prices will hold drugmakers more accountable and reduce costs for patients at the pharmacy counter.
President Trump announced Thursday his administration is working with Congress on a comprehensive legislative package to outlaw crippling surprise medical bills. The administration says it is aiming to increase transparency in health services billing. The president said that patients must be told ahead of treatment if a specialist, such as an anesthesiologist or radiologist, is out of their network. Patients should only be billed for out-of-network care if they consent to receiving treatment. “These bills have ruined people’s lives,” Trump said at the White House.
| By all accounts, Robert Pear of the New York Times was one of the most relentlessly probing journalists on the health–care beat, enlightening readers and rankling partisans with the clarity of his reportage and his savantlike understanding of the federal government and its arcana. With a seemingly ever-present byline on Page One of the Times, Mr. Pear was a constant and authoritative presence in Washington for four decades. He died May 7 at 69 at a hospice center in Rockville, Md. The cause was complications from a severe stroke that he suffered April 29, said his brother, Doug Pear. [Robert was the quintessential journalist who was always fair and thorough. We will miss Robert’s kindness and his incredible devotion to informing the health reform debate. RIP.] |
The GOP must narrow the Democratic health-care advantage. Too many people are too ready to believe that whatever Democrats offer on that front is better for the country. The GOP’s message for 2020 should emphasize the party’s strengths: taxes, jobs, regulatory relief, defense, energy and judges. But winning will also require Republicans to improve on health care. Unless Republicans make their case confidently and forcefully, the health-care issue could cost them victory in 2020.
Colin Rogers, 55, suffered a basilar artery occlusion on April 14, which he could have survived if he had undergone surgery which removes a blood clot from the brain. The University Hospital of Wales in Cardiff could have performed the procedure, but enough specialists staff were reportedly not available. Rogers died on April 18. His son Callum, 26, stated, “Although we don’t know what the outcome would have been, this potentially could have saved his life. My dad was denied the chance of survival as Wales does not have access to this treatment and doesn’t have any units. We were also told [by a stroke consultant] that if he fell ill on a weekday they would have had a chance to transfer him to a specialist unit in England. Because this was a Sunday it was impossible. To find this out is just gut-wrenching.”
A mother in Nova Scotia living with cancer is challenging Premier Stephen McNeil to meet with her after a years-long battle with the province’s health caresystem. In an emotional video posted to her Facebook page this week, Inez Rudderham said her cancer went undiagnosed for two years because she couldn’t access a family doctor to get a referral to an oncologist. By the time she was diagnosed, her cancer had progressed to its third stage. “I dare you to take a meeting with me, and explain to me, and look into my eyes and tell me that there is no health care crisis in my province of Nova Scotia,” said Rudderham, 33. Rudderham said she was turned away from emergency departments three times before her concerns were taken seriously.
Americans pay a lot for pharmaceuticals, and politicians of all stripes are offering prescription drug price-relief proposals to force prices downward. Top-down approaches, though, carry a high chance of failure. The astronomical price incorporates the massive up-front costs of testing and gaining FDA approval. The often erratic and unpredictable process can take 15 years and $1.5 billion. Most prospective drugs never make it to market. That’s much of what you’re paying for. Second, despite popular perception, drug manufacturers are only middle-of-the-road among American industries in terms of profitability. Employ blunt price controls, and you’ll likely cut industry profitability, drive investors away, and discourage development of new drugs.
Pharmacists and some health experts are opposing a legislative proposal to permit the wholesale bulk importation of drugs from Canada to Maine, arguing that it could result in unsafe drugs coming in to Maine and drug shortages in Canada. Kenneth McCall, past president of the Maine Pharmacy Association, said that trying to import Canadian price controls is a flawed model that would lead to drugs of dubious quality coming fromoverseas countries and unscrupulous sellers.