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US health care needs fixing Posted 01/06/2018

US President Donald Trump has noted with some exasperation that the nation’s health laws are unbelievably complex and ‘nobody knew health care could be so complicated’.

The president has vowed to reform the laws as part of his bid to replace Obamacare, which he argues is too costly and complicated. However, despite having said some time ago that ‘a replacement plan would be unveiled soon’, the president has still not come up with a new plan acceptable to the US Government. This lack of progress is frustrating many and, according to some it is time we started looking elsewhere – in states and municipalities – for solutions.

One example of efforts being taken at the state level is a group of governors – John Hickenlooper, Tom Wolf, Brian Sandoval, John Kasich and Bill Walker; two Democrats, two Republicans and an independent – who recently released a strategy, called ‘A Bipartisan Blueprint to Improve Our Nation’s Health Care System’.  Among their health insurance-related recommendations, the governors urge immediate action to stabilize the individual market and note the need to ‘ensure that all Americans have access to appropriate, affordable, high quality coverage independent of their health, age, gender, employment status, or financial situation’. Another similar example is that of Maryland, where Governor Larry Hogan and the state’s Democratic legislature worked together to stabilize the health insurance market for individual purchasers.

Maryland also passed a law targeting generics drug ‘price gouging’ in April 2017, making it the first state to pass a law to combat excessive price increases. Nevada and California have also advanced measures requiring manufacturers to disclose operating costs and give early notification of any planned price increases [1]. Then Oregan also introduced a new law that requires drugmakers to provide data justifying price hikes [2].

But not everything can be managed at the state level. At the national level, the Patient Protection and Affordable Care Act of 2010 (ACA), also known as Obamacare, introduced reform of the healthcare system in order to finally provide universal health care to most of the US population. It also allowed for a pathway for marketing approval of biosimilars and introduced discounts of 50% on generics for the elderly (in the Medicare system) [3]. The ACA, however, also allowed unrestrained healthcare cost increases. The intentions were good, but the law has been accused of being complicated and polarizing.

The conclusion is that politics should be left out of this issue and that long-term bipartisan solutions should be found.

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References
1.  GaBI Online - Generics and Biosimilars Initiative. US states progress drug-pricing legislation [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2018 Jun 1]. Available from: www.gabionline.net/Policies-Legislation/US-states-progress-drug-pricing-legislation
2.  GaBI Online - Generics and Biosimilars Initiative. Oregon introduces pricing transparency bill [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2018 Jun 1]. Available from: www.gabionline.net/Policies-Legislation/Oregon-introduces-pricing-transparency-bill
3.  GaBI Online - Generics and Biosimilars Initiative. US healthcare reform [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2018 Jun 1]. Available from: www.gabionline.net/Policies-Legislation/US-healthcare-reform

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Source: Baltimore Sun, Health Affairs

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