Tuesday, July 18, 2017

Health Care Reform #HCR, and "The Art of the Deal"

Real Health Care Reform #HCR and "The Art of the Deal".

Real health care reform will deal with costs not access. Donald Trump operating within his strengths as a dealmaker should be able to negotiate these cost reforms through "The Art of The Deal". Each of these reforms require negotiation. I believe the reforms of this BLOG post to be bipartisan, and they can be summarize as... pharmaceutical reciprocity, pharmacist empowerment, and required flexible savings accounts.

Senator Dick Durbin recently suggested that legislators must look at "Big Pharma" if they truly want to reform the cost of health care. The increasing percentage of pharmaceuticals is a key driver in health care costs. Pharmaceuticals were 9.3% of health care costs in 2013 and projected to be 10.4% in 2024. There needs for transparency between the cost of prescription medicines and their actual costs. Pharmaceutical companies are selling the same drugs to third world countries at significant discounts. Past presidents have accomplished greatness by reaching across the aisle to take on traditional opposing party positions. Theodore Roosevelt was willing to take on the monopolies of the industrial revolution by talking softly and carrying a big stick. Could Donald Trump as a republican take on the pharmaceutical companies to enforce transparency of profits and reciprocity of costs that other countries enjoy? Pharmaceutical drugs should be globally priced.

In my first visit to Egypt I ate some bad food on an overnight train from Cairo to Luxor. When I arrived in Luxor that morning, I went straight to the local drug store, and with their broken English they were able to prescribe an antibiotic to cure my intestinal pain within an hour.  In other countries you can get pharmaceutical drugs by going to the local pharmacy and having the local pharmacist prescribe the drug for you. This elimination of the gatekeeper, middle man is a large cost savings. I agree that we need to continue to guard some drugs like opiates, and blind spots with drug interactions, but most people are not asking for that type or quantity of medicine. The Food and Drug Administration in the name of safety is suffocating us with unnecessary costs. Pharmacist should be empowered to dispense most pharmaceutical drugs.

When I had my fifth child my health insurance deductible was $2500 in 1994. I decided to negotiate upfront the cost of the hospitalization. I went to my local hospital and explained my situation. They said they had a program for me and the cost would only be $1500. I realize that the real cost of my child's birth was more that $1500. I was the beneficiary of cost shifting from other people's insurance policies.  However, this does not make the negotiation of a fee for service a mute point. If more people would ask the cost of procedures instead of pulling out their insurance cards, then most doctors would agree that prices would come down. Flexible savings accounts should be required.

The debate about health care reform needs to focused on costs instead of access. Donald Trump has stated that there will be winners and losers in health care reform. While I agree with him, I disagree that the middle class should should shoulder the costs. Instead, they should be empowered to negotiate costs. Taking away people's access to health care cannot be the solution. We must look for win-win cost saving strategies. These strategies can systemically lower costs so that the affluent and the middle class will embrace these strategies.

What can you do? I found a website where you can vote on at least some of these reforms. Currently the con position is winning. Will you vote yes to these reform?