BY JACCQUELINE
LEMP AND JUDY LUCAS September 11, 2019
JEFFERSON
CITY — Lawmakers are looking into what the state can do to address the high
cost of health care as they prepare for the 2020 legislative session, including
making the cost of care more transparent and examining drug prices.
House
members held a hearing Wednesday to discuss ways to help Missourians get more
information on what medical procedures will cost before choosing a provider. A
major theme of the hearing of the House Healthcare Reform Committee was that
people struggle to know the real costs of their health care until after their
bills come in the mail.
“The
cost is ultimately the problem in this debate,” Rep. Steve Helms, R-Springfield
said. “Not all networks are driven around saving me money.”
It
becomes even more confusing when trying to compare the costs between different
hospitals and physicians. While one hospital could charge a certain amount for
any given service, another hospital right down the street can charge twice as
much.
“I
think there are different levels of transparency,” Rep. Dale Wright,
R-Farmington said. “The challenge of transparency is in a hospital setting.”
Opportunity
Solutions Project lobbyist James Harris discussed “right to shop,” meaning the
right to know the real prices while looking into the health care market. States
such as Kentucky, New Hampshire, Florida, Maine, Nebraska, Tennessee and
Virginia have already passed legislation concerning this.
“If you
know the price of some of these procedures, you’re given the right to save,”
Harris said.
But
without that transparency, health care customers can often be left in the dark.
Harris
recently had his own experience with this issue after he tore ligaments in his
leg. While comparing prices for an MRI, he found a 45% difference between two
nearby hospitals. But Harris said it was time-consuming and difficult to get
those figures.
Show Me
Institute representative Patrick Ishmael said people want some sort of
explanation on differing health care costs.
“No one
really knows why there are differences,” said Ishmael.
While
being able to compare costs is important, Rep. Helms said, making sure that
consumers understand the quality of that care is also crucial.
“I
would like a 50-year hip, not a 30-year hip,” Helms said.
Drug costs
The
newly formed Senate Prescription Drug Transparency Committee also met
Wednesday. The committee, chaired by Sen. Jason Holsman, D-Kansas City, was
created to tackle the high cost of pharmaceutical drugs.
“Our
goal is to get our constituents to not have to choose between prescription
drugs and any other necessities for life,” Holsman said.
The
committee invited Sharon Brigner, the deputy vice president of PhRMA, an
advocacy group that represents biopharmaceutical research companies, to discuss
the issue. Brigner said that, in general, the cost of drugs like insulin —
which was discussed at length during the hearing — are driven by the expensive
process of research and bringing the drugs to the market. Brigner said it costs
about “$2.6 million to bring a medication from the bench to the patient’s
bedside.”
There
was tension during the hearing between the pharmaceutical experts and the
senators. Holsman and Sen. Bill White, R-Joplin, took issue with the lack of
concrete data provided by Brigner and Scott Woods, the assistant vice president
of state affairs for the Pharmaceutical Care Management Association, which is
the national association representing pharmacy benefit managers (PBMs). The
senators requested concrete numbers outlining the total profits that are made
by pharmaceutical companies that create, market and sell prescription
medication.
“I
would like to see some real numbers,” White said.
Supervising editor is
Mark Horvit.
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