JustCare

Tag: Poll

  • Without hospital price regulation, expect gouging

    Without hospital price regulation, expect gouging

    President Biden and Democrats in Congress, unlike Republicans, speak to the value of data and science. But, when it comes to hospital prices, too many of them disregard the data and allow the health care players in the market to engage in price gouging. David Lazarus reports for the LA Times on one typical hospital’s cost markups.

    Hundreds of thousands of Americans unnecessarily die or suffer serious health conditions every year because they cannot afford the health care they need. A new Gallup West Health poll finds that three in ten “chose to” skip or forgo necessary care in the last three months because of the cost. Regulating health care prices would easily cut prices in half.

    But, instead of reining in health care prices to a reasonable level, as every other developed nation does, our Congress looks the other way. Hospitals, in turn, often hike up prices for their services four, five and six times. Do they really need to or are their outrageous prices paying for a new marble wing and multi-million dollar CEO salaries?

    At Scripps Memorial Hospital, price hikes of 675 percent, nearly seven times actual cost, apparently are routine. For a simple suture that costs $19.39, the hospital charges $149.58. And, many hospitals use the same EPIC software Scripps uses to drive up prices.

    Hospitals lay blame for these markups with insurers. They say that they need to increase prices a lot or insurers won’t pay them a fair price for services. But, that’s Orwellian. The answer to insurer issues is not price gouging if you care one iota for ensuring patients can afford needed care; it’s advocating for a different payment system.

    Of course, hospitals can’t justify the price gouging, and they don’t have to. They simply are trying to make up for the fact that insurers deny coverage for a lot of the services they deliver, often 20 percent of them.  So, prices for services bear no relation to cost.

    Of course, there’s a simple solution. Regulated prices for all medical services and treatments. And, government-administered coverage, with the insurer middleman out of the mix or playing the role of claims administrator, not doctor and price-maker.

    If . . .

    • we stopped allowing corporate health insurers to come between doctors and patients,
    • insurers could not decide what care is medically necessary,
    • insurers could not profit from denying care,
    • government, not insurers, was responsible for setting the prices we pay for health care services and treatments,

    the science and data show costs would come way down and quality would improve.  Why are we gambling with people’s health when we know how to reduce the number of unnecessary premature deaths in the US considerably?

    Every other wealthy nation follows the science.  It’s not complicated. It’s time we joined with them.

    Here’s more from Just Care:

  • US is a goldmine for pharmaceutical companies

    US is a goldmine for pharmaceutical companies

    Public Citizen released a report illustrating how the US is a goldmine for pharmaceutical companies. Pharmaceutical companies earn more from Americans who buy 20 best-selling prescription drugs than they do from everyone else in the world combined. No wonder that a new Politico-Harvard poll shows that drug price negotiation is Americans’ top policy priority for Congress right now.

    Public Citizen analyzed the financial filings of the pharmaceutical companies manufacturing 20 blockbuster drugs to arrive at its findings. It made clear that higher revenues in the US has nothing to do with the number of prescription drugs we take because we don’t take more drugs than people in other countries. It’s all about drug prices in the US.

    Public Citizen’s findings speak volumes as to why Pharma is so opposed to Medicare drug price negotiation.  We’re talking $158 billion in total revenue for just 20 drugs, nearly two-thirds (64 percent) of which comes from Americans. To date, Congress has expressly forbidden Medicare from negotiating drug prices, driving up drug costs.

    Pharmaceutical company profits would fall tens of billions of dollars a year if Americans paid prices comparable to people in other wealthy countries. That’s looking less and less likely as the Democrats try to pass legislation around drug prices. Perhaps, members will agree to some Medicare drug price negotiation and drug price increases capped at inflation but that’s not at all a done deal.

    In the meantime, Americans are forced to pay too high prices for our drugs relative to people in every other country or go without them. Pharmaceutical companies profit handsomely from their monopoly pricing power for brand-name drugs. Insurers and pharmacy benefit managers also make a lot of money off of high drug prices, but pharmaceutical companies earn more.

    Here’s more from Just Care:

  • Congressional candidates beware: Oppose lowering drug prices at your peril

    Congressional candidates beware: Oppose lowering drug prices at your peril

    The Alliance for Retired Americans (“ARA”) just released a poll showing that older adults so want affordable prescription drugs that they say they would switch political parties to support a candidate who favors Medicare drug price negotiation. Congressional candidates should beware!

    The ARA found that more than seven in ten voters over 65 say they would be more inclined to support candidates, regardless of their political party affiliation, who want to bring down drug prices for people with Medicare. Indeed, lower prescription drug prices is a policy issue that motivates people less likely to vote to go out and vote.

    Older adults like Medicare a lot, with 86 percent, overall, having “a favorable impression.” (91 percent of Dems and 85 percent of Reps.) But, they are unhappy with the amount they need to pay for their prescriptions. The Medicare Part D benefit has high out-of-pocket costs for anyone taking costly medicines, and it has no out-of-pocket cap.

    Prescription drugs are increasingly unaffordable for older adults. Yet, they often need these drugs to stay alive. An NBER study earlier this year found that a $10.40 increase in copays for Part D drugs led 20 percent of people to stop taking all their medicines. It further found that thousands of people die each year of stroke or heart attack because they stop taking their prescriptions.

    Nearly nine in ten people with Medicare support Medicare drug price negotiation. Democrats and Republicans are strongly aligned on this issue, with 89 percent of Democrats supporting it and 87 percent of Republicans. About half of voters strongly support this policy.

    Politicians should take heed. Older adults vote. In fact, three out of four older adults voted in the 2020 election, proportionally more than any other age cohort. They represent more than 25 percent of all votes cast.

    In addition, most older voters want Congress to take the Medicare dollars saved from drug price negotiation and put them towards additional Medicare benefits.

    Here’s more from Just Care:

  • Voters support improving and expanding Medicare

    Voters support improving and expanding Medicare

    There’s a huge gap between people who can access healthcare and people who cannot, be they uninsured or insured, though functionally uninsured, because of exorbitant out-of-pocket costs. People with Medicare are no exception; Congress needs to improve and expand Medicare.

    Improving and expanding Medicare is both “popular and right,” explain Congresswoman Pramila Jayapal and Senator Bernie Sanders in a Data for Progress op-ed. Congress should put a cap on out-of-pocket costs for everyone with Medicare. Only then will they have a meaningful choice between traditional Medicare and Medicare Advantage, which already has an out-of-pocket cap.

    Congress also needs to lower the price of prescription drugs and add vision, hearing and dental benefits to Medicare. The public strongly supports these improvements to Medicare. And, support runs across party lines. More than three in four Republicans (76 percent) support adding vision, hearing and dental benefits, according to a new Data for Progress poll.

    The data show that adding these Medicare benefits will improve health outcomes. Lack of dental coverage promotes an array of chronic conditions. Lack of hearing and vision benefits also jeopardizes people’s health.

    The novel coronavirus pandemic underscores the need for lowering the age of Medicare eligibility to 60. Again, across party limes, a majority of the public favors lowering the age of Medicare eligibility to 60.

    These improvements to Medicare are easily affordable.  The simplest way to pay for them is by lowering prescription drug costs, which continue to skyrocket. If we benchmark drug prices in the US to prices in other wealthy countries, they will come down significantly and save hundreds of billions a year.

    Here’s more from Just Care:

  • Public supports benchmarking US drug prices to prices in other countries

    Public supports benchmarking US drug prices to prices in other countries

    It’s still not clear whether President Joe Biden is going to push for prescription drug price negotiation in the American Families Plan, but public opinion strongly suggests he should. A recent Data for Progress poll shows that while the public believes that the pharmaceutical companies did a good job coming up with a COVID-19 vaccine, Americans still want Congress to regulate prescription drug prices. A substantial majority of people want to ensure that everyone in the US can get the life-saving medicines they need; they want some balance between drug prices in the US and other wealthy countries.

    Data for Progress found that 77 percent of the public supports drug price negotiation at the same time that they are pleased with the job that pharmaceutical companies have done developing COVID-19 vaccines. Just 17 percent of people oppose drug price negotiation. Of that 17 percent, eight percent strongly oppose drug price negotiation. Interestingly, 76 percent support matching drug prices in the US to prices in other wealthy countries–as does the drug price negotiation bill that passed in the House in 2019, H.R.3–with only 13 percent opposing this.

    And, while the public supports using prescription drug savings to pay for President Joe Biden’s infrastructure plan, 5o percent more Americans strongly favor paying for the infrastructure plan through increased taxes on the wealthy and corporations. Almost one in four (24%) Americans favor using drug savings towards infrastructure building; nearly four in ten (38%) Americans favor paying for infrastructure through increased taxes on the wealthy and corporations. Of note, only six percent (6%) of Americans believe that the government should not be investing in infrastructure.

    The public also supports increasing government investment for research on affordable prescription drugs. Nearly seven in ten (68%) Americans support this initiative. Just 19 percent oppose it, and of that 19 percent, eight percent strongly oppose it.

    Eight in ten Americans support allowing multiple companies produce the same medicines in order to bring down their cost. Only 12 percent oppose this proposal.

    Here’s more from Just Care:

  • Insurers use prior authorization to keep people from getting care

    Insurers use prior authorization to keep people from getting care

    Private insurers are increasingly using prior authorization as a tool to keep people from getting needed care. Allison Bell reports for Think Advisor on what physicians are saying about the hoops they must jump through to ensure their patients’ care is covered. If you are enrolled in traditional Medicare, you do not have to worry about prior authorization rules; you and your physicians do not have to seek approval for care in advance of treatment. If you are enrolled in a Medicare Advantage plan, you might find that prior authorization rules make it harder for you to get needed care.

    In a survey for the American Medical Association, one in three physicians do not believe that there is clinical validity to insurers’ prior authorization programs. The rules are virtually never or never based on medical society guidelines. One in 11 physicians say that these programs hurt patients. Nearly one in four physicians say patients often do not comply with medical guidance because of prior authorization rules.

    Prior authorization rules are burdensome and time-consuming for physicians. They say that they typically have 40 procedures for which they need to secure prior authorization each week.

    One big issue is that the insurers do not disclose the terms of their prior authorization programs. Because they are not open to public scrutiny, they can impose them without having to justify them. Moreover, they can impose them with little worry of a big expose on their lack of validity.

    For sure, prior authorization requirements lower health care spending; they keep people from getting care. But, there is no comprehensive reliable evidence insurers can point to that shows that these requirements improve quality. Indeed, if you believe the physicians, they lower quality, delay care and force physicians to spend more time on paperwork that they could be spending with their patients.

    Recently, CMS removed barriers to prior authorization in most federal programs, but not Medicare Advantage. It’s time to go the next step. Congress should either prohibit their use or require full disclosure and justification for each rule insurers use.

    Here’s more from Just Care:

  • Fox News: 72% voters want “government-run healthcare”

    Fox News: 72% voters want “government-run healthcare”

    Vice-President Biden’s victory in the presidential election is cause for huge relief and celebration, though the number of people who voted for Trump should give us pause. What it means and how best to move our nation forward will be a subject of research and conversation for some time. What’s no surprise is that many people who voted for Trump support government-run health care, just as they overwhelmingly support Medicare and Social Security.

    A new Fox News poll finds that 72 percent of voters favor “changing to a government-run health care plan.” Of course, they do. They need health care, and they increasingly cannot afford it, even with private insurance.

    Unfortunately, many Democrats in Congress who ran for the first time for Senate and House seats, refused to take a bold stand on health care affordability, let alone Medicare for all. They lost. What’s noteworthy is that Democratic candidates in swing states who supported Medicare for all won. And, all 109 Democratic House candidates who co-sponsored Medicare for all were elected or re-elected.

    Even still, centrist Democrats refuse to admit that their failure to support Medicare for All is what cost them seats in the House and Senate. Majority Whip James Clyburn wrongly conflated Medicare for all–private health care paid for directly through the government–with socialized medicine–public health care provided by the government. And, he advised candidates to stay away from supporting Medicare for all.

    Clyburn receives a lot of support from the health care industry. Like his fellow Democrats in Congress who depend on the health care industry for support, he won’t concede that the cost of care with private health insurance is forcing tens of millions of Americans to forego needed care.

    Centrist Democrats appear to believe that the Affordable Care Act is a solution to the crisis in our health care system. But, only 20 million Americans benefit from coverage through state health care exchanges. And, though they get coverage, the deductibles and copays too often force them to go without care.

    Fox News reports that nearly two in three voters in Georgia want the choice of public health insurance. Both Raphael Warnock and Jon Ossoff, two Democratic Senate candidates who face runoff elections in Georgia in January, support the public health insurance option for anyone who wants it. And, that’s what Americans support.

    But, if the centrist Democrats have their way, they will try to limit access to the public option to people with low-incomes only. That might please their corporate backers from the health care industry, but it would not address the need to decouple health care from employment and give every American access to public health insurance.

    Almost every working American risks losing a job and, with it, health insurance. Every working American deserves the protection of reliable government-administered public health insurance if they want it. If modeled on traditional Medicare, as the Biden-Sanders Unity Task Force proposes, with an out-of-pocket cap, the public option would ensure people have good health insurance. If public health insurance covered care from virtually every doctor and hospital in the country, as traditional Medicare does, and benefited from Medicare’s negotiated provider rates, Americans would have access to lower-cost health insurance and health care from the doctors and hospitals they want to use.

    Democrats in Congress should recognize that progressive activists organized voters in key communities and helped Biden win the presidential election. And, no one should disregard the fact that House candidates who backed Medicare for all, won reelection, even in swing states.

    Here’s more from Just Care:

  • Majority of Americans support a public health insurance option

    Majority of Americans support a public health insurance option

    Vice-President Biden is proposing that the government offer people a public health insurance option, if he is elected President. A new Data for Progress poll finds that a large majority of voters support the government offering a public health insurance option. That said, there’s not yet a clear definition of how a public option would work.

    The concept of a public option was first raised in the last wave of health reform. It was based on the notion that private health insurers were not meeting people’s needs, either in terms of access to care or affordability; they offered restricted provider networks and charged high premiums and out-of-pocket costs. What’s worse, many seem to indiscriminately deny care because they profit when they deny care. But, no one knows when they enroll in a plan, the extent to which that health plan inappropriately denies people care.

    Congress ultimately enacted the Affordable Care Act, which offers government-administered private health insurance. It opted not to offer people the choice of public health insurance, provided directly through the government, like traditional Medicare.

    Unlike private health insurance, which generally is accountable to shareholders, public health insurance, like traditional Medicare, is accountable to the public. It relies on the government’s leverage to control costs and to ensure people access to providers across the nation. It does not profit from denying care, and is designed to “spread risk,” so that people with costly conditions are not burdened with high health care costs.

    As the Biden-Sanders Unity Task Force spells out. Americans who opted for public health insurance would pay the government for their coverage. And, the Data for Progress poll indicates Americans are fine with that. Nearly half of voters, a plurality, say they would be willing to pay the government directly for public health insurance (49 percent).

    Members of Congress are still considering how to design a public option and whether it should be available to everyone. Americans want public health insurance to be available as a choice to everyone (45 percent). It should be. Private insurers, no matter how many there are in a given market, do not engage in meaningful competition–competition that drives value by lowering health care costs and improving quality.

    Americans also support automatic enrollment in public health insurance for people who do not have other coverage. The novel coronavirus pandemic has revealed the fragility of our employer-based health care system. You lose your job and, often, your health insurance as well. People who leave their jobs continue to need protection from health care costs and do not want to worry about having health care coverage.

    What’s most interesting is that two-thirds of Americans say they would get their health insurance through a government-run plan. Fewer than one in five voters say they would not get insurance through the government. Americans increasingly realize that they need an alternative to private health insurance, which is often unreliable and unaffordable.

    Lest there remain any confusion about the definition of a public option–the choice of public health insurance–it is not the same as the choice of private health insurance through the government. Americans already have government-administered private health plan options in the state health exchanges. These health plans do not have the power to rein in costs; they do not offer a broad provider network; and, they answer to their shareholders first and foremost.

    The question becomes whether Democrats in Congress, much less Republicans, are prepared to acknowledge that if they enact a public option it should piggyback off of traditional Medicare with an out-of-pocket cap and prescription drug coverage woven into the benefit. That would put it on a level playing field with private health plans. Only this improved traditional Medicare offers people the guarantees of easy access to care from the doctors they want to see at a price they can afford.

    Here’s more from Just Care:

  • Coronavirus: Most Americans believe government should regulate drug prices for COVID care

    Coronavirus: Most Americans believe government should regulate drug prices for COVID care

    With the coronavirus pandemic, the dangers of rationing care based on ability to pay are all too clear. Financial barriers that deter people from getting COVID-19 care not only endanger their health, but they expose everyone else to heightened risk. A large majority of Americans want Congress to step in and regulate prescription drug prices for COVID-19 care.

    A new West Health Gallup poll suggests that Americans have little faith that the pandemic will lead Congress to address high health care costs. It finds that almost ninety percent of Americans are either somewhat or very concerned that drugmakers will use the pandemic to justify drug price hikes.

    Democrats are more concerned than Republicans that pharmaceutical companies will raise prices. Half of Republicans are very concerned, while two in three Democrats are very concerned. Most people do not believe that President Trump has done anything to address skyrocketing drug prices.

    Most noteworthy, nearly nine in ten Americans want the federal government to regulate drug prices for COVID-19 care. And, Republicans, virtually as much as Democrats, (89 percent v. 91 percent), support government price negotiation of COVID drug treatments. Americans across the political spectrum are justifiably worried about access to affordable care.

    Nearly half of Americans recognize that the government’s response to the pandemic was either fair or poor. The Trump administration still could step in and assure treatments are affordable to all Americans. But, there is no evidence that it will.

    Some states are stepping in to try to control drug prices because Congress has not acted. But, their reforms are limited and they likely will not apply to COVID-19 treatments. For example, some allow their residents to import drugs from Canada. Others are limiting people’s insulin costs. Still others are demanding that pharmaceutical companies justify price increases.

    More generally, the poll found that nearly eight in ten Americans are concerned about ever-rising health insurance premiums. And, more than eight in ten are concerned about higher health care prices, because of the pandemic. Medicare for All would address these concerns and more, but it is not likely to be enacted even if the Democrats win the Senate and Biden is elected President this Fall. As of now, it is not even likely that Congress will pass legislation that will regulate hospital or prescription drug prices.

    Here’s more from Just Care:

  • Coronavirus: Labs can charge what they please for COVID-19 tests

    Coronavirus: Labs can charge what they please for COVID-19 tests

    Sarah Kliff reports for the New York Times that labs around the country are charging wildly varying prices for COVID-19 tests. Why not? They can legally charge whatever they please, and Congress has required health insurers to pay. How is this not the definition of an insane health care pricing system?

    Unlike in any other wealthy country, the US health care system is designed to let health care providers charge corporate health insurers and the uninsured pretty much what they will. And, because corporate health insurers can profit more from high prices, they are not advocating for government price regulation. So, it’s not surprising–though it is shocking–that Gibson Diagnostic Labs in Irving, Texas is charging a bloody fortune for its COVID-19 tests, which are no different from tests that cost $100.

    Because Congress does not regulate health care prices, Gibson Diagnostic Labs can legally charge health insurers $2,315 for individual coronavirus tests, even though its cash price for the test is $150. And, likely its cost for the test is far less than $150.

    Kliff says that the laboratory is taking advantage of a federal law that requires insurers to pay the full cost of all COVID-19-related testing. But, the truth is that insurers pay insanely high rates even when Congress does not require them to.

    Health care prices in the United States are easily twice as much as prices in other wealthy country. The average charge for an appendectomy here is $13,020. In England, it’s $3,050.  

    Health care prices also vary wildly in the US. Kliff points to one study showing that the cost for a simple appendectomy in California ranged from $182,955 to $1,529.

    Even if you have insurance, you should know that you are paying these insane prices in the form of high health insurance premiums and out-of-pocket costs. Insurers pass these costs along to their members. Most likely, 2021 health insurance premiums will reflect astronomical testing and treatment costs, though health care spending overall has dropped significantly because so few people have been getting elective services.

    And, because doctors tend to provide a sea of services on top of the primary service their patients receive, many people receiving free COVID-19 testing are getting high medical bills  for unexpected services. Understandably, a Kaiser Family Foundation poll shows that Americans tend to be worried about the affordability of COVID-19 care.

    Here’s more from Just Care: