While leaders in Washington appear unable or unwilling to act conscientiously on health care reform, private sector providers are forced to muddle through another year of adjusting business models to adapt to a fractured system. In some cases, as exemplified by the work of Utah’s largest health care provider, the situation is forcing companies to think more about efficiency and innovation.
Still, market-driven reform can only go so far, and it remains an exercise in frustration and uncertainty for companies like Intermountain Healthcare, whose chief executive recently lamented the “craziness” in the arena of pharmaceutical pricing. President and CEO Marc Harrison said among his company’s prime objectives is to “combat the perversions we have seen” in the pharmaceutical industry.
The issue of prescription drug costs has again risen to prominence in advance of the midterm elections with the Trump administration’s promise to address pricing discrepancies between foreign and domestic markets for the same drugs. The gaps in those costs are large enough to encourage one insurance provider in Utah to pay for its customers to travel to Mexico to pick up their prescriptions at prices that are low enough to justify the cost of travel.
IHC, to its credit, is seeking to help create an alternative drug-pricing model by forming a coalition of hospitals and other entities in building a nonprofit generic drug company, still in the planning stages. The coalition will seek to make available a number of generic drugs to patients at price levels much lower than those inflated by what IHC and its cohorts call “unethical” practices by some drug companies. Those practices have resulted in unnecessary shortages of certain prescription drugs as well as “crazy, arbitrary drug price increases,” according to the IHC president.
Rising drug costs are but one part of the larger issue of where efforts to revise or replace the Affordable Care Act now stand. Polling by the Pew Research Center shows health care is top of mind for voters as they head to midterm balloting, yet there is no energy in Congress to tackle the issue, and the gridlock is likely to worsen should Democrats gain control of the House of Representatives. And when it comes to the question of regulating drug pricing, the enormous lobbying and campaign-funding clout of the pharmaceutical industry has historically been able to subdue efforts by either party.35 comments on this story
In the current policy morass, a number of “workaround” systems have been created by private health care insurers and providers, with mixed results. The availability and affordability of quality care remains a chief concern of Americans, regardless of their political allegiances. What IHC and its partners are doing reflect commitment to the welfare of patients as well as an entrepreneurial disposition to create new models of health care delivery, which is commendable.
What is lamentable is what isn't happening: Federal policy should encourage companies to innovate and find more efficient ways of doing business. Instead, companies are seeking innovation in the manner of desperation, fumbling through the darkness of a void of policy in Washington, which sadly seems likely to persist.