Make Health Care Work Better For America

IMPROVING QUALITY WHILE CONTAINING COSTS—Health care costs too much in this country, and doesn't deliver enough based on what we pay for it. Fortunately, many of the best ways to improve the quality of our health care would also help contain costs. 

OSPIRG is calling on policymakers to go back to the drawing board and start working on solutions that will fix the fundamental problems in the American health care system. 

The bitter and contentious partisan debate in Washington is focused almost entirely on how to contain or assign the extraordinary cost of health insurance. And the specific bills being debated would likely make things worse for millions of Americans by degrading the quality of care, weakening protections for people with pre-existing conditions, and forcing many Americans to give up the coverage they currently have. 

But the biggest failure with these proposals is that they fail to address the underlying problem with the American health care system: We are spending far too much, and getting far too little in return, for our health care dollar. Despite a health care system world-renowned for developing advanced treatments, and an army of skilled and well-meaning doctors, nurses, researchers, hospital and pharmacy staff, our crazy-quilt health care system still fails to deliver an acceptable value proposition for consumers.

Health care is too expensive

Health care costs too much in this country, not because too many people have access to it, but because the system is simply too expensive. From $1,000 toothbrushes to giant price hikes for decades-old medicines like insulin, unjustifiably high costs are everywhere in the U.S. health care system.

And these excessive costs can largely be attributed to widespread waste that doesn’t actually improve quality of care — waste that is estimated to represent a third or more of every dollar we spend on health care. Fortunately, many of the best ways to improve the quality of our health care would also help contain costs.

How we can make health care work better

  • Holding the health care industry to a higher standard. America’s health care system is world-renowned for developing advanced treatments. But we often fail to get the basics right, frequently failing to provide effective, low-cost treatments that work, triggering unnecessary treatments and higher costs down the line. By expanding research into evidence-based medicine and holding providers accountable to higher standards of care, we know we can make progress.
  • Investing in prevention. Our current system rewards hospitals and doctors for performing as many procedures and prescribing as many drugs as possible, with little consideration given toward whether they actually keep us healthy and out of the hospital. We need to change those incentives, and provide easier access to preventative services. Despite some promising small-scale efforts, there’s still far too little being done to change this.
  • Holding health insurers accountable. There is often too little oversight to ensure insurance companies are delivering on their commitments to their members. In many states, insurers are not held to meaningful standards to ensure adequate access to needed services. Health insurance rate hikes receive little scrutiny even though states that review rates have cut a great deal of waste from premiums—for example, in Oregon, where OSPIRG’s advocacy for consumers has helped cut over $179 million from premiums since 2011. By focusing on insurers’ payment strategies and quantitative goals and results, closer scrutiny of health insurers can complement other efforts to drive systemic reforms to improve safety, increase care coordination, boost prevention, and bring down costs for consumers and small businesses.
  • Comprehensive prescription drug reform. America’s prescription drug development and patent system is failing consumers, too often leading to egregious price hikes or the development and marketing of the next “blockbuster” drug that may be of marginal health benefit, rather than research into needed breakthrough therapies for life-threatening conditions. The savings from overhauling the patent system—which gives pharmaceutical corporations immense pricing power—can be reinvested in research into high-priority therapies. Other commonsense reforms could also make a huge difference, like allowing Medicare to negotiate drug prices, requiring drug manufacturers to explain the basis for their prices, and stopping anti-competitive practices by big pharmaceutical corporations.
  • Price transparency for health care services. The very least we can do about rising health care costs is make sure consumers can get prices for services or treatment up front, to allow for more informed decisions about value, encourage price competition that could help keep costs in check, and create accountability for unreasonably high-cost providers.
  • Preserving competition. With countless mergers in recent years between hospital systems, health insurers, pharmaceutical corporations and others, health care has become increasingly consolidated. Unfortunately, bigger is not always better for consumers; studies show consolidation often leads to higher prices and worse service. More scrutiny of health care mergers and tougher anti-trust enforcement against companies that seek to avoid competition could make a big difference.
  • A public option health plan—e.g., providing Americans under 65 with the option of buying into Medicare or Medicaid—could provide consumers with a cheaper alternative to commercial health insurance, ensure that there are coverage options for consumers who lose their employer-based coverage or those in parts of the country where health insurers are dropping coverage, and put pressure on health insurers to provide a better deal or lose our business. 

We need your help

Powerful health care industry lobbyists will fight these changes and work to preserve the status quo, and the politics of health care has never been more divisive. But now is the time—in fact, long past the time—for our leaders to work together to advance the public interest, and address the fundamental problems of cost and quality in our health care system.

Please join us in calling on Congress to take concrete action to make health care work better for American consumers by enacting these commonsense reforms.

Photo credits, clockwise from top: Ilmicrofono Oggiono via Flickr CC by 2.0, Images Money via Flickr CC by 2.0, skeeze via Pixabay CC0 Public Domain.

Issue updates

News Release | OSPIRG | Health Care

OR Legislature Advances Bill Targeting RX Price Hikes

Oregon's Senate voted unanimously to advance HB 2658 to the Governor's desk, 25-0.  This bill requires pharmaceutical manufactuers to provide 60-days advance notice before implementing substantial price hikes on prescription drugs.  Advance notice gives patients and health benefit companies time to plan around price hikes instead of being blindsided.  A similar policy in California has bee associated with rollbacks of several planned price increases over the summer of 2018.

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News Release | OSPIRG Foundation | Health Care

Oregon’s Insurance Market Faces Rising Premiums, but the State has Options to Stabilize the Marketplace

Oregon consumers face rising health insurance premiums on the individual market, due to rising health care costs and recent changes to federal policy.  A new report from OSPIRG Foundaiton and Frontier Group explores the drivers of market instability and policy options for the state to stabilize the marketplace and expand consumer choice.

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Report | OSPIRG Foundation | Health Care

A Better Health Insurance Market For Oregon

New report from OSPIRG Foundation and Frontier Group details rising health care costs and federal disruptions to the individual insurance market; explores policy options to stabilize prices and expand consumer choice.

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Blog Post | Health Care

Consumers Can Now Report Drug Price Increases to the State of Oregon | Numi Lee Griffith

This March, the State of Oregon launched a system that allows consumers to report price increases on their prescription drugs.   OSPIRG encourages consumers to report price increases on their prescriptions to the state whenever possible.

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Blog Post | Health Care

New Survey Finds Massive Variations in Prescription Drug Prices | Numi Lee Griffith

Oregon's legislature is considering several bills that could bring down the high cost of prescription drugs.  OSPIRG Foundation's recent report, the "Real Price of Medications" exposed vast and illogical price variations between different pharmacies.  Lawmakers should take concrete actions to address this problem, but there are steps consumers can take right now to save money on prescription drugs.

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News Release | U.S. PIRG | Public Health, Consumer Protection, Health Care

Second recall of King Bio’s homeopathic drugs in the past month

King Bio Inc. issued the second significant voluntary recall since late July of their homeopathic drugs on Wednesday. Safety concerns over homeopathic drugs extend beyond King Bio as over the past several years, the FDA has issued recalls to several companies for a variety of health products from zinc-containing intranasal medicine to asthma drugs with toxic ingredients. 

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News Release | OSPIRG Foundation | Health Care

Providence’s proposed double-digit rate hike merits close scrutiny, may overcharge consumers

Providence Health Plan has proposed a rate hike of 13.6% on average—as high as 24.1% for some—on over 90,000 Oregonians. According to a new OSPIRG Foundation analysis released today, this rate hike proposal may overstate costs and overcharge consumers for health coverage.

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News Release | OSPIRG Foundation | Health Care

Oregonians Need Better Information on Health Care Costs

Oregon consumers are paying more and have less ability to make informed decisions about their health care due to opaque prices for health care services, according to a report released today by OSPIRG Foundation and Frontier Group. The report provides an in-depth analysis of the power of price transparency to contain costs and improve the experience of care for patients and health care providers, and identifies evidence-based policies and strategies for Oregon to advance health care price transparency. 

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News Release | OSPIRG | Health Care

Statement on passage of HB 4005

In an overwhelming bipartisan vote in both chambers, Oregon lawmakers stood up to the powerful pharmaceutical corporations and did the right thing.

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News Release | OSPIRG | Health Care

CONSUMER ALERT: Surprise Medical Bills Ban Begins Today

As of today, Oregon consumers can breathe a little easier when they visit the hospital or emergency room.

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Plan to cut health care waste moves ahead in Oregon

Members of the Oregon Health Policy Board approved a plan to cut health care administrative waste and save Oregonians $100 million per year in the process.

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Victory! Oregon Legislature Passes Landmark Health Reform

The bills expand access, tackle soaring costs, and set a path for possible public plan option. Passage of HB 2009 bodes especially well for national reform efforts to tame health care costs, which include many of the same strategies as the Oregon bill.

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Report | OSPIRG Foundation | Health Care

Comments on Providence Health Plan's proposal to raise individual health insurance rates

Providence Health Plan’s 105,406 members with individual health insurance plans will see rate hikes of 29.6% on average, and as high as 72.3%, if the premium rate hike proposed by Providence goes forward. At the same time, the insurer is planning to scale back its service area drastically and no longer offer its plans in many regions of Oregon.

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Report | OSPIRG Foundation | Health Care

Comments on Kaiser Foundation Health Plan of the Northwest's proposal to raise individual health insurance rates

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Report | OSPIRG Foundation | Health Care

Comments on Regence BlueCross BlueShield's proposal to raise individual health insurance rates

Regence BlueCross BlueShield’s 14,811 members with individual health insurance plans will see rate hikes of 17.9% on average, and as high as 36.1%, if the premium rate hike proposed by Regence goes forward.

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Report | OSPIRG Foundation | Health Care

Comments on Moda Health Plan's proposal to raise individual health insurance rates

Moda Health Plan’s 58,280 members with individual health insurance plans will see rate hikes of 32.3% on average, and as high as 84.2%,if the premium rate hike proposed by Moda goes forward.

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Report | OSPIRG Foundation | Health Care

Comments on PacificSource Health Plans' proposal to raise individual health insurance rates

PacificSource Health Plans’ members with individual health insurance plans will see rate hikes of 15.2% on average, and as high as 25%, if the premium rate hike proposed by PacificSource goes forward. At the same time, the insurer is planning to scale back its service area drastically and no longer offer its plans in many regions of Oregon.

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Blog Post | Health Care

Oregon healthcare is now more widely accessible

Medical debt is the number one cause of bankruptcy in America. Oregon is working to help people avoid that fate.

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Blog Post | Health Care

Open Enrollment for 2019: What You Need to Know | Numi Lee Griffith

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Blog Post | Health Care

OSPIRG Seeks Consumer Stories about Health Care in Oregon | Charlie Fisher

OSPIRG Foundation is conducting a statewide survey of consumers about experiences and challenges with the health care system in Oregon.

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Blog Post | Health Care, Solid Waste

Right to Repair is a simple way to cut health care costs | Nathan Proctor

Cost containment is is a critical first step in addressing the deep faults in our health care system - it's hard to image fixing problems of access if we continue to be charged $15 for a Tylenol pill or $1,000 for a toothbrush. It turns out that overpriced equipment repair helps add to those inflated costs.

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Blog Post | Democracy, Health Care, Tax

2018 Legislative Session Recap | Charlie Fisher

On March 3rd, the state legislature adjourned a four-week “short session.” See how our main priorities fared in the legislature.

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Report | OSPIRG Foundation

People living in the United States have access to some of the best medical care in the world, from life-saving drugs to cutting-edge surgical techniques. But our system is deeply flawed, with spiraling costs forcing many Americans to spend more on care and often receiving poor quality care for all the extra money spent.

News Release | OSPIRG

Oregon's Drug Price Transparency Program has released its first annual report.  The progam found that Oregonians, on average, pay five times the highest international price for prescriptions.  

Blog Post

OSPIRG Health Care Advocate Numi Griffith breaks down how health insurance reduced her medical bills by over $16,000 after a climbing accident.

Blog Post

It's open enrollment season for health insurance in Oregon's individual market, from November 1 until December 15th.  What's new in the marketplace, and what do you need to know in order to gt covered?

Blog Post

The Fifth Circuit head oral arguments in the Texas v. Azar Lawsuit on July 9, 2019.  Oregon has a lot at stake if the Affordable Care Act is overturned - hundreds of thousands of consumers will face higher premiums or lose insurance outright, and dozens of important cosumer protections could be rolled back.

Health Care

Oregon drug prices five times higher than in other countries, report finds

A prescription medication in Oregon, on average, costs five times as much as the most expensive international price. OSPIRG is calling on the Department of Consumer and Business Services  to improve transparency by compelling drug manufacturers to publish their profits, among other information.

 

Health Care | U.S. PIRG

Searching for common ground on caregiving

In our politically divided time, it's difficult to see where we can find common ground. But the need to value the work of caring for our loved ones is one such place. PIRG Senior Director of New Economy Campaigns Evan Preston explains in his blog, "Toward Consensus on Caregiving."

 
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