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

Media Hit | Health Care

Oregon Adopts New Rules To Slow Rise Of Health Care Costs

New Oregon Health Policy Board rules require that insurance companies better justify increases in their premiums.

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News Release | OSPIRG | Health Care

Kitzhaber Administration takes action on health care costs

At the direction of Gov. Kitzhaber, the Oregon Health Policy Board has adopted an OSPIRG-backed proposal to take steps toward cutting the waste out of our health care system, estimated to make up as much as 1/3 of every dollar we spend on care.

> Keep Reading
Result | Health Care

Kitzhaber Administration takes action on health care costs

At the direction of Gov. Kitzhaber, the Oregon Health Policy Board has adopted an OSPIRG-backed proposal to take steps toward cutting the waste out of our health care system, estimated to make up as much as 1/3 of every dollar we spend on care.

> Keep Reading
Blog Post | Consumer Protection, Health Care

Thousand Dollar Ointment (No, it’s not from Sephora) | David Rosenfeld

Lately, it has seemed like everyone I know has a story about an irrational hospital bill. Here’s one from my friend, Dave.

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Blog Post | Health Care

A New Health Care Marketplace is Coming: Get Informed and Protect Yourself from Fraud | Jesse Ellis O'Brien

In just a few weeks, Oregon’s new health insurance marketplace, Cover Oregon, will be open for business. Any new program can be confusing for people at first, and scam artists and unscrupulous business ventures may try to take advantage of that confusion to rip off consumers. To make sure this doesn’t happen to you, be sure to check out these top tips for protecting yourself from fraud.

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Pages

Media Hit | Health Care

Oregon pushes back on insurance rate increases

Oregonians with spendy individual and small-business health insurance plans are again facing double-digit increases.

It could be worse.

> Keep Reading
News Release | OSPIRG | Health Care

15,000 Young Oregonians Can Now Keep Coverage

An estimated 15,000 young adults and their families in Oregon could benefit from a new provision of the federal health care law, effective today, that allows parents to keep their adult children on their family coverage plan until age 26.

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News Release | OSPIRG | Health Care

Plan to Cut Health Care Waste Moves Ahead

This week, state officials advanced a plan to cut needless administrative paperwork -- red tape that wastes doctors’ time and adds to already unaffordable health care costs.

> Keep Reading
News Release | OSPIRG Foundation | Health Care

Oregon the Focus for Next Stage of Health Reform

The new federal health care reform law puts state leaders in the driver’s seat, according to a new report by consumer advocacy group OSPIRG.

> Keep Reading
Media Hit | Health Care

Oregon approves Regence rate increase of 14.7%

Rates increases exceeded four times the rate of inflation last year for more than 400,000 Oregonians with individual, small group and portable insurance plans, according to a report released this week by the OSPIRG Foundation, an affiliate of the Oregon State Public Interest Research Group.

> Keep Reading

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News Release | OSPIRG

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.

News Release | OSPIRG Foundation

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.

Report | OSPIRG Foundation

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.

Blog Post

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.

Blog Post

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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