Senator Marshall: Making America Healthy Again Starts with Cost Transparency
Senator Marshall Questions Healthcare Experts on Solutions to Rising Healthcare Costs
Washington – On Thursday,U.S. Senator Roger Marshall, M.D. (R-Kansas), questioned healthcare experts, Ms. Chris Deacon, Principal and Founder at VerSan Consulting, Dr. Benedic Ippolito, Senior Fellow at the American Enterprise Institute, and Mr. Wendell Potter, President of the Center for Health and Democracy, during the Senate Health, Education, Labor, and Pensions Committee hearing focused on making American health care more affordable.
Click HERE or on the image above to watch Senator Marshall’s full exchange.
Highlights from the hearing include:
On Healthcare costs transparency:
Senator Marshall: “I think that we have today before us a 90 to 10 issue. Maybe it’s 95 to 5. Americans are concerned about the cost of health care. Since I got here four years ago, eight years ago, four years ago in the Senate, I’ve talked about the pillar of transparency, more innovation and consumerism, letting patients be consumers again. So, it’s wonderful that we get an opportunity to address solutions. We’ve all described the product and the problem. Now let’s talk about solutions. I’m very proud of one of our signature legislation we’ve been working on for eight years, the Patients Deserve Price Tags Act. I appreciate Senator Hickenlooper’s support, Senator Hassan, Senator Grassley, she he and Ernst their support as well. Could you imagine walking into a grocery store, going to the meat department, and not seeing the prices on the different meats? Could you imagine going to a clothing store and not knowing what the prices are on the suits? Most of us walk up there, and we look at a suit, what’s the first thing I do? I look at the price of it. But in health care, they buried the prices. So, what our legislation attempts to do is to get price tags on health care. What a novel thought, and a couple of thoughts on what our bill does, and get your reaction. Ms. Deacon, I’ll start with you as a consumer. You have a choice of getting your hip replaced at one facility for $10,000, another one is $50,000, and that’s not unreasonable numbers to compare a hip replacement 10 versus 50. How would you, as a consumer, how would that impact the eventual cost of healthcare? If you’re in a self-insured plan and you’re running that plan, how would it impact your decisions to drive down the cost of healthcare?”
Ms. Chris Deacon: “I mean, as a consumer, absolutely, if I had out of pocket, I would both evaluate for quality and cost to determine value, and I would likely find myself at the $10,000 clinic, but as an employer sponsor, if all of my members were to have such information, it would dramatically lower the cost of premiums every year, especially for our self-insured employers, because more consumers would be able to evaluate such terms.”
On driving down the costs of health insurance:
Senator Marshall: “And this is a wild guess, could it drive down the cost of health insurance for an employed, self-employed fund, 10, 20, 30, 40% perhaps. I mean, it’s a big number.”
Ms. Chris Deacon: “Yes, we’ve absolutely seen employers that are able to do that, save 30 to 40% on premiums.”
On group health care plans access to their own data:
Senator Marshall: “Dr. Ippolito, another component of our bill ensures that group health care plans have access to their own claim data. Can you believe it? I have a self-insured plan, and I can’t look at my own claim data? Would that be helpful to us, specifically a self-insured plan?”
Dr. Benedic Ippolito: “Well, sure. I mean, at a minimum, if you’re sitting there trying to think about what services are we going to use next year, what kind of plan looks good for us? If you don’t know what services you use, you can’t do that. And so, in terms of those basic tasks that your employer, who’s your agent in this world, for many of us, is tasked with providing, they need that information. So yeah, it seems like a baseline, a prerequisite.”
Senator Marshall: “So is there anyone in this panel that disagrees that price tags could not be helpful in driving down the cost of healthcare? Does anyone want to counter that argument? Okay, good. I want to turn to delinking just for a second. Of course, talking about pharmaceutical benefits. PBMs, right? Very horizontally, vertically integrated, four companies, three companies controlling 85% of the of the industry. And many of you talked about the oligo monopolies that they’re forming here, specifically Senator Kaine and I have a bill called delinking, and it delinks the money the pharmacy benefit managers make from the cost of the of the drug. So PBMs create formularies that really prevent you from using the generic drugs at less cost, they push you to the more expensive ones. So, I’ll start with Mr. Potter. Would reform such as delinking PBM compensation from the list price of medicines benefit patients in meaningful ways and drive down the cost of drugs?”
Mr. Wendell Potter: “I absolutely agree. I think it’s very important legislation. I think there should be delinking. That game, I think, incentivizes drug companies to have a higher list price, and then the middleman that you’re showing, that they’re on that board, are sucking so much money from the pharmacy supply chain. When I was at Cigna, Cigna didn’t own a very big PBM. It bought Express grips recently, a few years ago, and now it is largely a PBM that also has insurance plans.”
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Contact: Payton Fuller
