Nearly two weeks into the government shutdown, health care has become a spotlight issue and key proving ground for public support. Democratic leaders are insisting upon the extension of Affordable Care Act (ACA) subsidies as a key condition to reopen the government. ACA subsidies are set to expire at year end, resulting in premium hikes and coverage losses. Of the 24 million Americans currently enrolled in a Marketplace plan, 92% currently benefit from these subsidies.
As high-stakes spending negotiations continue, Republicans are on the defensive. Writing in the Washington Examiner, Charles Sauer, President and Founder of the Market Institute, argues that Republicans need to “seize back the mantle of health care champions for the long term”. Sauer offers three strategies, emphasizing market-driven solutions, patient control, and quick wins in Alzheimer’s care, where there is major political opportunity.
“Standing at the intersection of pharmacies, insurance plans, drug makers and patients are Pharmacy Benefit Managers or PBMs. [...] Their lack of transparency and potential conflicts of interest (the top three PBMs are owned by insurance companies and control 80 percent of the drug claims) have contributed to 30% higher prices and limited availability for patients.
Sauer added that an emerging model call direct primary care could significantly reduce healthcare costs.
“DPC is a monthly subscription like Netflix or Apple Music. For a cost averaging between $50-$150 per month, patients bypass the health insurance system and visit participating doctors. The model increases access and quality, lowers costs and solidifies the relationship between doctors and patients…There are already nearly 3,000 DPCs across this country in all 50 states.”
Perhaps most striking is the opportunity in Alzheimer’s care. Sauer emphasizes the importance of keeping up with medical innovation, by expanding coverage to breakthrough Alzheimer’s diagnostics that can be administered with a simple drug test, which the Food and Drug Administration (FDA) approved earlier this year. Polling data shows that voters across the political spectrum want to see the government prioritizing Alzheimer’s, and 92% of voters support requiring Medicare to cover blood tests that can detect the disease early on. As many as 87% of voters across party lines would credit Trump with a “major achievement in the war on Alzheimer’s” if he ordered Medicare to expand coverage and streamline treatment access.
“With President Trump making changes at a pace like no president before him, giving patients access to treatments that have already been approved by the FDA should be a no brainer. Creating a win, win, win scenario where patients win with early detection, caregivers win with early detection, and Republicans win politically by addressing this important issue.”
Most Americans worry about health care costs, even with insurance. Any jump in health care costs between now and next year’s midterm elections will be closely scrutinized. For the White House to champion health care without expanding government programs or regulations, they will need to focus on concrete solutions that reduce costs and improve health care access for everyday Americans.
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