While Washington debates whether the “rebate rule” proposed by the Trump administration would cause federal spending to rise, too many are forgetting the people it would help. The rebate rule would convert rebates on brand-name prescription drugs—paid by pharmaceutical companies to health insurance plans—into upfront discounts—shared directly with patients at the pharmacy. The rule affects seniors and low-income Americans in privately run Medicare and Medicaid plans, but the administration wants Congress to extend the same protection to all Americans with private insurance. This is the quickest way to lower consumers’ out-of-pocket costs for medicines—by billions each year. It’s also a once-in-a-generation opportunity to reset our system to work better, for all patients.
Put simply, there is nothing like Medicare for All anywhere in the industrialized world. Socialized medicine proposals, like the House version introduced last month by Rep. Pramila Jayapal, (D-WA), would offer everyone living in the United States comprehensive coverage with no deductibles and no copayments. Jayapal claims, “This is not a particularly ambitious plan, in the sense that so many others have done it.” But no industrialized nation has tried anything so sweeping. Not one provides soup-to-nuts government-paid insurance that covers everything without any cost-sharing from patients. None. Even so-called single-payer systems rely on some forms of private insurance.
Other reports show Democratic leaders are not as enthusiastic as Jayapal, et al. House Speaker Nancy Pelosi in an interview with Rolling Stone said moving to a single-payer system was the simplest way to bring about universal health care, but then noted an estimated $30 trillion cost. “That is, administratively, the simplest thing to do, but to convert to it? Thirty trillion dollars. Now, how do you pay for that?” Pelosi said.
Today, Type 1 diabetes patients pay twice as much for insulin as they did in 2012. This is outrageous — but drug companies aren’t to blame. The problem is a dysfunctional supply chain that benefits everyone except patients.
In today’s system, insurers hire third-party firms, known as pharmacy benefit managers, to manage drug plans. These PBMs negotiate with drugmakers and have the power to decide which drugs are covered by each plan. Each year, manufacturers dole out $150 billion in rebates and discounts as a result of these negotiations. But patients rarely see these savings at the pharmacy counter.
In practice, the Democratic Party’s so-called Medicare for All would really be Medicare for None. Under the Democrats’ plan, today’s Medicare would be forced to die. The Democrats’ plan also would mean the end of choice for seniors over their own health care decisions. Instead, Democrats would give total power and control over seniors’ health care decisions to the bureaucrats in Washington, D.C.
Each life saved from addiction is an important victory. And while the epidemic still rages, we are now seeing signs of national progress.
Last week, the Department of Health and Human Services (HHS) released its annual survey of Americans’ drug use and mental health. For the second year in a row, the number of Americans misusing legal or illegal opioids dropped. Even more encouraging, the number of Americans initiating heroin use dropped by around half from 2016 to 2017.