How Rother and CAP Remind Us That Obamacare’s Cozy Relationships Won’t Fix Our Health Care Woes

David Williams
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Posted: Apr 22, 2016 9:56 AM
How Rother and CAP Remind Us That Obamacare’s Cozy Relationships Won’t Fix Our Health Care Woes

Many can agree that for the past several years, the health care landscape has been rocky terrain. With ever-present challenges from the Affordable Care Act (ACA), bad actors like former Turing Pharmaceuticals CEO Martin Shkreli meddling with the cost of medicines, and a tumultuous presidential election cycle, it’s only fitting that consumers want to hear a plan to get the nation’s health care system back on track. However, the solution won’t be found by focusing on one aspect of the industry without looking at the bigger picture of health care costs as a whole.

On Monday (April 25), John Rother, former AARP executive, and the group he currently leads, the Campaign for Sustainable Rx Pricing (CSRxP), will hold a press conference discussing a set of recommendations to address the cost of medicines. On Tuesday (April 26), The Center for American Progress Action Fund (CAP) will host a discussion on policy options to lower costs for consumers and improve transparency in the pharmaceutical industry.

Transparency is essential to all levels of government. The problem with CSRxP’s transparency is that they aren’t looking for government transparency. They want to snoop into the business practice of drug makers by requiring them to disclose proprietary information regarding the maximum unit price for their products. They also want disclosure of the cost of treatment, the label being discussed with the Food and Drug Administration that indicates the target population along with other sensitive and important clinical details. This is well beyond the scope of what government should be mandating.

While both groups present themselves as organizations focused on broader health care issues, it’s clear they are being driven by their alliance with the insurance industry, which has inarguably benefited since the implementation of Obamacare. As a result, CSRxP (which receives a large amount of funding from America's Health Insurance Plans and has ties to AARP) and CAP have a history of focusing their events on praising the insurance industry’s priorities and demonizing drug makers. Both groups have strong ties to the Obama administration, with Rother lobbying for the implementation of the ACA before it was enacted. Yet, supporters of both groups are quick to ignore other cost accelerators, including hospitals, insurers and pharmacy benefit managers. Both of these one-sided events demonstrate the too cozy relationship between the Obama administration and insurers, who are using the ACA to make billions at the expense of taxpayers and patients.

As a result, the policies that will surely be proposed, coupled with misguided blame, could have disastrous effects on the health care industry as a whole. If anything, these events and their “convenient” timing, serve as tactics to shift the real issues facing the health care industry onto the companies and organizations that actually help Americans and spearhead the growth of American innovation and a competitive marketplace.

Americans need the quality, life-saving medicines the biopharmaceutical industry is responsible for producing. CSRxP and CAP’s narrow focus on one sector of a much broader industry is unwarranted, and their misguided proposals diminish the important progress researchers are making to develop treatments and cures. The week’s events are simply more proof of health insurers and the administration working hand in hand, a relationship that shields the real drivers of healthcare costs: the ACA and insurers.

If there’s one key takeaway from the current health care conversation, it’s that it is nearly impossible to address health care spending if we are only focusing on a few elements and not holding other cost drivers accountable. For instance, health insurance companies are negatively impacting consumers by raising premiums, increasing co-pays and narrowing networks. Recently, the Kaiser Family Foundation released a study that showed on employer offered health plans, insurers were raising premiums at a higher rate than their own costs.

Additionally, the failure of ACA co-ops have left too many people uninsured and too many taxpayers on the hook for wasted funding.

CSRxP and CAP believe government intervention and other “transparency” solutions aimed at giving the government more control over private business decisions will solve the nation’s health care burdens. But in reality, they would decrease vital marketplace competitiveness and jobs, putting our country at a great disadvantage. We need a shift in mindsets so that all sides of the industry can focus on positioning America as the leader in medical innovation, protect taxpayers and the economy, save jobs and businesses, and most importantly, keep Americans healthy.

As the 2016 election candidates hone in on different proposals to make health care more accessible and affordable, it is important to recognize that CSRxP and CAP’s desired proposals are flawed. To implement price controls and unnecessary transparency measures would mean imposing more barriers and restrictions for patients and consumers. It is time to stop scapegoating the biopharmaceutical industry for drug costs and start finding a tangible solution that will make health care accessible and sustainable in the long run without sacrificing innovation or the well-being of the country.