Alright, the Senate Republicans say that they have “new” ideas on fixing healthcare, it’s called “Patients First” (notice the Trump word play with America First – so you already know it will be kind of dumb); but since they think this is an actual proposal, let’s talk about it….here we go:
#1 Direct Primary Care: A flexible new way for doctors and patients to work together without the insurance middleman. Direct Primary Care often includes unlimited office visits, faster scheduling, more time spent with your doctor, and low, flat rates.
So, are you talking about payment without insurance? Currently doctors sign contracts with carriers and agree to abide by the negotiated rates. If there is no negotiation, how will those costs be limited? A single patient has no leverage.
#2 ‘Right to Shop’: Gives patients the right to shop around for the best value for their health care dollar, even if the doctor or clinic is out of network.
Again, do you really think that one person can negotiate “better value” to a particular doctor? And if there is no actual contract, what obligation does that doctor have to take on one particular patient? This “shopping” idea depends on health care being like any other commodity – and it definitely is not.
#3 Pre-existing conditions coverage: Eliminates any doubt that Minnesotans with pre-existing conditions are protected.
Well, there would not be “any doubt” if Republicans would stop tampering with the existing ACA. Remember, it was Republicans who filed the lawsuit that objected to the mandates that protected pre-existing patients. This continued hypocrisy regarding a very important personal protection is disturbing.
#4 Pharmacy Benefits Manager (PBM) reform: Provides transparency and accountability for PBMs, which are middlemen many consumers don’t even realize exist between them, their doctor, and their pharmacy. Reforms include: Licensure of PBMs, disclosure of conflicts of interest, and a requirement to expand pharmacy networks so patients have access to local pharmacies no matter where they live in the state.
Once again, Republicans focus on the wrong problem. The high cost of drugs occurs at the Pharmaceutical Manufacturers level… a business subset that Republicans have been protecting for years. If they had to negotiate pricing with Medicaid and Medicare, the problem would almost go away. PBM’s were formed to try and put together a larger group for negotiating purposes. But like everything else, it got out of hand and became part of the problem.
Minnesota Republican continue to band-aid (forgive the health care pun) health care for Minnesotans. If you are serious about reducing costs, then do these simple things:
- Maintain the provider tax AS IT IS NOW and allow an option for a Minnesota Care buy-in as Gov. Walz is proposing. This will create a situation for the insurance carriers to either compete on price or allow special health care options that can attract the consumer. The provider tax extension is critical to keep MNCare solvent. And it is NOT even raising NEW revenue. Let’s make that clear for our tax doublespeak Republican obfuscating friends.
- Find a state method to allow competition on drug pricing. Whether it is via Canadian imports or a special state purchasing method that gets around the Federal restrictions – I don’t care. The pharmaceutical companies have a government mandated monopoly on drug prices. Fix it.
- Create a state health care ombudsman office that can handle appeals by consumers to insurance companies with knowledgeable people to help navigate the insurance double talk that forces payment for services that are actually covered if investigated properly.
- If we have to subsidize some of the individual insurance plans to keep them affordable then we must work that into a broader plan.
I am tired of this crazy assumption that health care can be part of a commodity competition plan to fit into a capitalist society which only thrives on making you need something you don’t. Health care is too essential to each and every citizen of the country and it is time to end this winner and loser narrative. Everyone needs and deserves health care and all of self created confusion by people who put profits over people has to end. Then we can join the rest of democratic societies that take care of their people.