Obamacare’s Big Fail

Consumers struggle under weight of rising health costs

by Ramin Oskoui, MD | Updated 07 Dec 2015 at 5:40 AM

It all sounded so promising, didn’t it? Obamacare would “finally reduce the costs of health care,” and “be the largest deficit reduction plan in over a decade.”

That was President Obama’s promise in 2009.

Sure. And lollipops would fall from the sky and chocolate bars would grow on bushes.

Ask any individual or small business owner what has happened to their health care costs since that promise was made. Prices have continued to rise substantially. In my own cardiology practice, the irony is that the rising cost of the drugs, treatments or insurance that should help my patients recover from illness or avoid cardiac issues in the first place are among the reasons they feel increasingly stressed, which puts them at risk for additional health-related events.

One patient said to me last week, “This new heart failure drug does make me feel better. But I can’t afford the extra $350 a month.”

It is one of several drugs he needs to live longer and stay out of the hospital.

It was always assumed that government intervention would decrease costs, or at least bend the cost curve from rising.

Yet when the next president takes office, the deficit will have doubled since that fateful promise of "the largest deficit reduction in over a decade" was made. In my opinion, higher prescription drug prices are a major reason both individual out-of-pocket costs are higher and government spending on health care continues to rise.

U.S. health care spending increased 5.3 percent following growth of 2.9 percent in 2013 to reach $3 trillion, or $9,523 per person. The faster growth experienced in 2014 was primarily due to the major coverage expansions under the Affordable Care Act, particularly for Medicaid and private health insurance.

Americans pay much higher prices for prescription drugs than citizens of other developed countries. Sometimes, as in the case of the hepatitis drug Sovaldi, Americans pay a hundred times more. Big Pharma continues to lobby for laws that not only handcuff Medicare from negotiating drug costs, but also continue to hold American consumers captive as prescription drug buyers, legally barring them from purchasing drugs from other countries.

Drugs are specifically exempted from the “first sale rule” for putative safety reasons. But do we really think that drugs purchased in retail pharmacies in Canada are any less safe as to justify a 300-percent markup across the border in the U.S.?

The only reason other countries can negotiate down the price is that we are left to play the sucker.

The Maine Pharmacy Act was enacted two years ago in response to this growing cost and had broad community and business support in that state. No matter. Judge Nancy Torresen decided that the first-in-the-nation law was pre-empted by federal law — a law that Big Pharma lobbyists got passed to ensure their profits.

A simple solution exists: “Most Favored Nation.” In international economic relations and international politics, "most favored nation" is a status or level of treatment accorded by one country to another in international trade. The term means that the country, which is the recipient of this treatment, must receive equal trade advantages as the "most favored nation" by the country granting such treatment such as costs or tariffs.

By applying this to drug costs, Americans could quickly be paying the least of any country. This would also lower costs across the board more quickly than any other interventions (including letting Medicare negotiate). It bypasses the negotiation process. It simply says: OK, other countries do the negotiating and we'll get the benefit.

It also reveals a fundamental economic truth that the only reason the other countries can negotiate down the price is that we are left to play the sucker.

The fact that none of the presidential candidates, including two retired doctors (Ben Carson and Rand Paul) offer any practical solutions frustrates both health professionals like myself and patients who increasingly don’t fill potentially life-saving prescriptions. It’s a real and daily struggle my patients have.

Dr. Ramin Oskoui, a cardiologist in the D.C. metropolitan area, is CEO of Foxhall Cardiology PC. 

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