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 | U.S. PIRG | Health Care

Our Statement on House Passage of the American Health Care Act

Today’s House vote is a big step in the wrong direction for American consumers and the American health care system. It’s no secret that there are plenty of problems with health care in America, but the AHCA in its current form not only won’t address the real problems in our health care system—it is likely to make them worse.

> Keep Reading
News Release | OSPIRG | Health Care

Oregon takes important step toward addressing rising prescription drug prices

OSPIRG applauds the Oregon House Health Care Committee’s vote to advance House Bill 2387, an urgently needed comprehensive approach to addressing the rising cost of prescription drugs.

> Keep Reading
News Release | OSPIRG | Health Care

OSPIRG Applauds Oregon House Passage of HB 2339

OSPIRG applauds the Oregon House of Representatives vote to advance House Bill 2339, an urgently needed measure to protect Oregon consumers from large surprise medical bills.

> Keep Reading
Blog Post | Health Care

The American Health Care Act is a bad deal for Oregon | Jesse O'Brien

Congress may be about to make a historic mistake that could raise costs and degrade the quality of health care for countless Oregonians—all without seriously taking on any of the myriad problems in our health care system.

> Keep Reading
Blog Post | Health Care

Our Statement on the American Health Care Act

Instead of taking on the high cost of health care and other urgent problems for consumers, Congress may be on the verge of severely damaging the nation’s health insurance markets, raising costs and degrading care for millions of Americans.

> Keep Reading

Pages

News Release | OSPIRG Foundation | Health Care

Regence Rate Hike To Reach 16.4% for Some Customers

More than 52,000 Oregonians with individual health insurance plans will see rate hikes of 9.6% on average, and as high as 16.4%, if the premium rate hike posted today by Regence BlueCross BlueShield goes forward. At the same time, customers in lower-deductible plans will face out-of-pocket costs starting at $2,500 before coverage kicks in, and consumers in the Portland metro area may need to change providers.

> Keep Reading
Media Hit | Health Care

Portland-area Regence BlueCross BlueShield individual members could see rate hikes as high as 15.3 percent

Individual members of Regence BlueCross BlueShield could see an average 9.6-percent rate increase statewide, requested by the insurer months after announcing network changes to cut costs.

> Keep Reading
News Release | OSPIRG | Health Care

Supreme Court Upholds Affordable Care Act

Today’s decision is good news for consumers in Oregon. Now it’s time for Oregon leaders to move forward on the next steps, and make sure health reform delivers lower costs and better quality coverage.

> Keep Reading
News Release | OSPIRG Foundation | Health Care

Health Net Rate Hike Not Justified

If approved, the rate increase would impact 38,492 Oregonians with coverage through a small business employer. Of those enrollees, 14,298 would see rates rise between 11% and 30%.

 

> Keep Reading
News Release | OSPIRG Foundation | Health Care

Health Insurance Rates to Rise 8-14% for Many Oregon Small Businesses

If approved, the insurer will raise rates 5.56% on average beginning in July, affecting 35,224 Oregonians enrolled in coverage through a small business employer.

> Keep Reading

Pages

Blog Post | Consumer Protection, Health Care

Latest Regence Health Insurance Rate Hike

Regence BlueCross BlueShield of Oregon is proposing to raise rates an average of 22% on 60,000 Oregonians. This is the fifth straight year of double-digit rate hikes. But this year, something interesting is happening.

> Keep Reading
Blog Post | Consumer Protection, Health Care

The Oregonian and health care costs | David Rosenfeld

If you haven't seen the Oregonian's editorial on the Senate's health insurance exchange bill, it's worth a read. Unfortunately, the Oregon Senate decided to prohibit the exchange from negotiating with insurance companies to get consumers a better deal (which I'm sure insurers are happy about.)

> Keep Reading
Blog Post | Consumer Protection, Health Care

Holding health insurers accountable for costs | David Rosenfeld

What if health insurance companies had to stand before the public and clearly justify their rate hikes?

> Keep Reading
Blog Post | Consumer Protection, Health Care

For Health Net Customers | David Rosenfeld

If you are a Health Net customer, you may have received a notice in the mail this week. If you did, we urge you to open it.

> Keep Reading

Pages

Health Care

Victory: Medical debt to be scrubbed from consumers' credit reports

One in 5 American households report having medical debt. Now, new credit industry policies will help keep that debt from hurting their credit.

 

Health Care

OSPIRG-backed bill to lower health care costs now heads to governor's desk

Oregonians at risk of losing their health insurance once the federal public health emergency concludes may soon be able to breathe a sigh of relief thanks to an OSPIRG-backed bill.

 

Health Care

OSPIRG analysis: How to make Oregon's new public option as successful as possible

With Oregon on the verge of implementing a statewide public health insurance option, OSPIRG is analyzing the best paths forward for the policy and sharing our findings with key state lawmakers. We're also helping Oregonians share their health care stories and show support for a strong public option.

 

Health Care

OSPIRG applauds legislative progress on health care, recycling; urges further action

Oregon has passed legislation that requires a plan for the implementation of a public option for health care, and requires proof of reduction of consumer costs before medical consolidations. OSPIRG applauds this and other progress state lawmakers have made for the public interest.

 
View AllRSS Feed

Support Us

Your donation supports OSPIRG’s work to stand up for consumers on the issues that matter, especially when powerful interests are blocking progress.

Consumer Alerts

Join our network and stay up to date on our campaigns, get important consumer updates, and take action on critical issues.
Optional Member Code



OSPIRG is part of The Public Interest Network, which operates and supports organizations committed to a shared vision of a better world and a strategic approach to social change.