Over the last century, America evolved a patchwork health care system characterized by coverage gaps, high costs and uneven quality. In a new century, our challenge is to create a high-quality, low-cost health system for all. Innovation is the key. It’s time to retire an obsolete fee-for-service payment system that rewards more, not better, medical services, and replace it with strong incentives for preventive care and healthier lifestyles. We need to lower bureaucratic obstacles and encourage development of breakthrough cures, treatments and devices. Crucially, we need to equip all Americans with new, high-tech tools that enable them to monitor their own health and enhance the productivity of health-care workers.
But instead of focusing on modernizing our health care system, Washington policymakers are mired in yesterday’s ideological battles and the American people are seeing costs rise in a complex system that doesn’t always help them get the care they need. PPI’s Health Innovation Project highlights new ideas for creating a distinctively American approach to universal coverage and high-quality health care – one that is decentralized, powered by the ingenuity of our inventors, entrepreneurs and workers, and disciplined by both market competition and strong public oversight.
Carl Icahn, the billionaire businessman and investor, recently advised shareholders to reject Cigna’s proposed $67 billion acquisition of the pharmacy benefit manager (PBM) Express Scripts. He says that a reckoning is coming for PBMs and that the price grossly exaggerated their value as “over-earning middle men.” In 2016, PBMs made $23 billion in gross profits […]
Americans who buy health insurance on the exchanges set up by the Affordable Care Act (ACA) are having sticker shock as preliminary rates are filed for the 2019 plan year. Healthcare analysts expect insurance premiums to skyrocket during the next open enrollment period, which inconveniently begins just before the 2018 midterm elections. These higher premiums […]
Federal policy should move beyond fee-for-service and prioritize prevention Nearly half a million Americans suffering from kidney failure depend for their survival on dialysis. For many of them, life is nasty, brutish, and short. One in four dialysis patients will die within the first year of treatment, and six in 10 will die within five years. Patients […]
Last week, the Centers for Medicare and Medicaid Services (CMS) announced that it had approved a reinsurance proposal in Wisconsin and Maine in an effort to keep health premiums down. Reinsurance is essentially insurance for insurers: The government helps pay for the cost of exceptionally high-cost claims. It’s no wonder states have been working on […]
President Trump’s nomination of Judge Brett Kavanaugh to fill the seat on the Supreme Court vacated by Justice Anthony Kennedy have left many to wonder: What will replacing an often swing vote with a more conservative one mean for health care? There are many pending cases in lower courts that, if they make it a […]
Two weeks ago, the U.S. Department of Justice (DOJ) filed a legal brief in support of a Texas lawsuit that would kill one of the most popular provisions of the Affordable Care Act (ACA): the one that ensures people with past medical problems can get affordable health insurance. It’s the latest twist in the Trump administration’s unrelenting […]
The drug industry, like any industry, has its share of bad actors. The loathsome Martin Shkreli is now serving time after his company, Turing Pharmaceuticals, jacked up the cost of a lifesaving AIDS drug by 5,000 percent. Mylan, a Dutch company, was caught overcharging the federal Medicaid program $1.27 billion for EpiPens, used to protect […]
President Trump promised Americans cheaper and better health care than what is provided under the Affordable Care Act (ACA). Yet his latest move, to expand access to short-term, limited-duration health plans, may make insurance cheaper but far from better. These short-term plans have existed under the ACA as a short-term stop-gap measure for people in […]
Several times in the past, I’ve examined the contribution of pharmaceuticals to rising health care costs (here, here, and here). It seems appropriate to do again, given President Trump’s latest tweets on drug prices, and Pfizer’s decision to roll back recent price hikes. I note first that an April 2018 report from the IQVIA Institute entitled Medicine […]