Our Healthcare System Needs a Prescription of Competition and Accountability

In this July 11, 2014 photo, patient Amanda Thornton, left, of Aloha, Ore., speaks with primary care doctor John Guerreiro at a clinic run by the Virginia Garcia Memorial Health Center in Beaverton, Ore. The center comprised of nine clinics in northwestern Oregon, serving 36,000 patients in Washington and Yamhill has been overwhelmed under the Affordable Health Care Act’s Medicaid expansion. It has closed to new enrollees and is working through a backlog to assign thousands of patients to a doctor. (AP Photo/Gosia Wozniacka)


It has never been more clear that our healthcare system is broken, as rising costs and shrinking choices are pushing more Americans out of the health insurance market.

Nowhere is this truer than for our nation’s bloated entitlement programs, such as Medicare and Medicaid. These programs cost American taxpayers hundreds of billions of dollars, eating up funds that individuals could otherwise spend on their own care when and as they need it.

In fact, the Medicare trustees report in June found that the Medicare Trust Fund, a key funding source for the program, will run out of money by 2026, threatening the solvency of the program and promising to further eat up tax dollars to cover the shortfall. And an aging population means that Medicare will be further strained.

Bloomberg recently published an important look at how the first generation of Americans with HIV will soon age into Medicare. It’s beyond dispute that this is Medicare’s purpose: to cover our most vulnerable and our seniors who have worked hard for decades.

But the current system is unsustainable. As Bloomberg reports:

The biggest concern for older people living with HIV is their prescription drug costs. This population is “used to being in an employer-based plan or other plan where the costs were covered,” and they’re having to figure out how to pay for them now, Scott Schoettes, counsel and HIV project director at Lambda Legal, told Bloomberg Law.

As I’ve written about before, there are actionable steps that our elected officials in Washington can take to bring market forces into our healthcare system to increase competition and transparency to bring down prices.

Specifically, CMS should evaluate the Part D model that uses private negotiation to inject competition into the system. This is why Medicare Part D SAVED Medicare approximately $106.3 BILLION from 2006 to 2014. It’s also why it’s a hugely popular program among seniors of all political stripes.

The Trump Administration has already taken huge strides to increase approvals of generic drugs, expand choice for consumers and examine the role that middlemen play in driving up the cost of care. Now Congress can take immediate action to address this mounting Medicare problem.

They can start by fixing the alterations that they made to Part D as a part of the Bipartisan Budget Act in February. Congress should go further by finally repealing the Affordable Care Act, which is still driving up costs for American families across the entire country.

We need action to increase competition and accountability across our healthcare system. The time is still right for our leaders in Washington to do something.