Hold insurance companies accountable for high healthcare costs

By Sue Christenson of Portland, Oregon. I am a political activist for social justice and equality. I want the best for everyone in all aspects of life and liberty.

For those of us who view health care as a right, not a privilege, it is great to see that leaders in the Oregon Legislature have a convened a work group to look at the high cost of drugs.

While the ranks of the insured have grown, millions of American remains under insured and people are skipping the care they need due to the cost. This a systematic issue that requires a systematic response. However, in this recent Bloomberg article, it seems as though the work group may be in danger of zeroing in on one party as they look for solutions as opposed to reaching for a more global approach that would create a more lasting solution. While drug makers are an easy target all the collective players must own their part in creating and fixing this problem. Insurance companies specifically, seem to be doing their best to pass the buck and shift the blame.

Peter Pitts, former deputy commissioner at the FDA, noted: “The price of any given drug is the result of a lengthy process of meetings and negotiations between manufacturers and payers over a long period of time — often years before the FDA approves a product. So when insurance companies demonize the pharmaceutical industry for high drug prices, they’re being more than a little disingenuous. Insurers and pharmacy benefit managers — not drug companies — are the ones who determine what patients pay for medications.”

Consumers already pay higher out-of-pocket expenses for prescription drugs than other services, including hospital care and physician visits. Since the Affordable Care Act was signed into law in 2010, many insurance companies have found ways to hide their profits in order to justify significant consumer premium and cost-sharing increases. These strategies include moving funds to financial reserves – funds set aside to cover both anticipated and unanticipated health care costs – and providing executives with outrageous compensation packages, among other strategies.

Some insurance plans have singled out medicines for specific chronic conditions by delaying access or making claims difficult. This discriminates against the patients who often need insurance coverage the most, and often increases long-term costs for both patients and the healthcare industry.

Change is needed and I am glad that our leaders at the State level are looking to protect consumers and ensure affordable access to healthcare and necessary medical treatments. However, if the workgroup is to achieve a “dramatic solution” that makes the real changes that will benefit Oregonians and lead to lower prices, they must look at the complete game board and all the players on it. All parties have played a role in creating the current state of affairs and we need to ensure that all parties are involved in fixing it.

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