Saturday, March 6, 2010

Lower Health Care Costs???

Lower Health Care Costs?

The campaign for health care reform has two distinct goals. On the one hand, the reformers want to reduce the number of persons not covered by health insurance. On the other hand, they want to reduce the cost of health care.

The bill passed by the House of Representatives originally included a so-called “public option,”-- an attempt by the government to offer our health insurance more cheaply than many private plans. The hope was that in attempting to compete with government insurance plans, private insurers will be compelled to lower their prices. But that option is now off the table. I am sure that insurance company lobbyists had something to do with that. One opportunity for lowering health care costs has disappeared.

But of course, insurance is only one of costs of health care. Another significant source of soaring health care cost are the medicines produced by US and European drug companies. The New England Journal of Medicine notes that 13 European nations successfully regulate the price of drugs, reducing the average cost of name-brand prescription medicines by 35% to 55%. The US Veterans Administration is able to push down the price it pays for patent medicine by 40% through its bargaining power because it buys such large quantities of medicines. George Bush stopped Medicare from bargaining for similar discounts, an insane ban that Obama, during his campaign for the presidency, promised to overturn. But that seems to have disappeared from the scene.

As a consequence drug prices will be at least 40% higher than they need be under any health care reform bill this Congress may pass..
Another source of waste of medical dollars is the use of ineffective drugs or use of drugs in situations where they make no difference. The Boston Globe cites the case of a kidney drug in use for 20 years or more, which has recently been shown to be quite ineffective for most of the patients using it. Doctors did not know, for a long time, that the drug was useless. If some of the money saved by bargaining with the drug companies would be used for effectiveness studies, the use of many drugs could be severely limited or stopped altogether with an enormous further savings for the American health care industry. But at present government supervision is hampered by lack of money. The FDA relies too heavily on the drug companies' testing. The firms producing drugs conceal negative test results; they may know that the drug has negative side effects or complications, or is plain ineffective. But neither the government nor the physicians ever hear about that.

The pharmaceutical industry, flush with excess profits, clearly has the upper hand over Congress and the President. They are too powerful to try to limit their obscene profits. As long as no one dares to limit their price gouging, there will be no lowering health care costs.

Once again ordinary Americans suffer for the sake of increased profits for the very large international corporations. Our politicians are on their side, not on our's. Before we can reform health care, we need to fix our political system to once again represent all Americans and not just the very large businesses and global corporations.

1 comment:

  1. I agree. And let us keep our eye on the ball, or the three balls:

    We need to:
    1. Cover everyone. We all have to be in it together.
    2. Control costs. Do our best to have consistent use of treatments across regions (not necessarily the lowest or cheapest, but the best balance), not have any for-profit insurance companies.
    3. Increase health, of which little is health care but much is poverty, ignorance, and stress. Our society should be designed to encourage health (good jobs, exercise, healthful foods, stress reduction) not reduce it.

    We are being distracted by small pieces of the puzzle.

    ReplyDelete