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 | Health Care

Great News for Consumers: Anthem Drops Bid to Take Over Cigna

This morning, health insurance giant Anthem dropped its troubled bid to take over one of its top competitors, Cigna. A February district court decision to block the proposed merger on anti-trust grounds was recently upheld by the DC Circuit Court of Appeals, but with Anthem’s decision today, this anti-competitive takeover bid is finally laid to rest. This development comes after months of work by OSPIRG and a broad coalition of consumer and health care groups, urging close scrutiny of the merger from state and federal regulators and raising questions and concerns about the potential impact on consumers.

> Keep Reading
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

Pages

News Release | OSPIRG | Health Care

Vote on health care price transparency proposal blocked by health industry lobbying

Yesterday a scheduled vote on an OSPIRG-supported bill to require health care providers to give consumers up front prices was pulled from consideration, and the bill will not meet today’s deadline for all bills to clear their first committee vote.

> Keep Reading
News Release | OSPIRG | Health Care

Oregon lawmakers poised to debate two proposals to make health care prices more transparent

Today, an Oregon Senate Committee will hear public testimony for the first time on two pieces of legislation with very different approaches to making health care price information more widely available. To clarify what is at stake, OSPIRG has released a white paper (pdf) outlining the key differences between the two proposals.

> Keep Reading
News Release | OSPIRG | Health Care

Legislation introduced to make sure consumers get to see health care prices up front

Senate Bill 891, introduced today, would require Oregon health care facilities to post their prices and provide real-time price estimates for consumers on request.

> Keep Reading
News Release | OSPIRG Foundation | Health Care

Over $24 Million in Waste Cut from 2015 Health Insurance Premiums

Close scrutiny of proposed health insurance premiums for 2015 has cut over $24 million in waste and unjustified costs from premiums for Oregon consumers and small businesses, according to a new OSPIRG Foundation report released today. The cuts come after OSPIRG Foundation’s analysis questioned the justifications of four major rate proposals. Taken together with cuts made since new standards were implemented, state officials have required insurers to cut $179 million in waste since 2010.

> Keep Reading
News Release | OSPIRG Foundation | Health Care

Four proposed health insurance rate hikes lack adequate justification

New OSPIRG Foundation analysis of 2015 rates proposed by four Oregon insurers—Moda, PacificSource, United and Health Net—identifies problems and gaps in the insurers’ filings, and calls for increased scrutiny of insurers’ efforts to cut waste and improve quality of care.

> Keep Reading

Pages

Report | OSPIRG | Democracy, Health Care

2013 Legislative Vote Chart

Want to know how your Oregon state legislators voted on key bills related to democracy, health care and government transparency during the 2013 legislative session? Download OSPIRG's vote chart.

> Keep Reading
Report | OSPIRG | Health Care

Top 20 Pay-For-Delay Drugs

Too often, consumers are forced to shoulder a heavy financial burden, or even go without needed medicine, due to the high cost of brand-name drugs. Our research indicates that one significant cause is the practice called “pay for delay,” which inflates the drug prices paid by tens of millions of Americans.

> Keep Reading
Report | OSPIRG Foundation | Health Care

Comment on Providence Health Plan's Proposed Individual Health Insurance Rates

Providence Health Plan has proposed premium rates for its individual and family plans for 2014. The insurer initially filed for significantly higher rates than Oregon’s other top insurance companies,   but then proposed lowering the rates. Doing so would bring the rates in line with those of competing insurers. OSPIRG Foundation's analysis of Providence's initial filing and the supplemental information provided raises some concerns about the insurer's proposal and its justification.

> Keep Reading
Report | OSPIRG Foundation | Health Care

Comment on Kaiser Foundation Health Plan's Proposed Individual Health Insurance Rates

Kaiser Foundation Health Plan of the Northwest has proposed premium rates for its individual and family plans for 2014. Since its initial rate filing, the insurer has submitted a proposal to reduce those rates. OSPIRG Foundation's analysis of Kaiser’s initial filing and the supplemental information provided raises some concerns about the insurer's proposal and its justification.

> Keep Reading
Report | OSPIRG Foundation | Health Care

Comment on BridgeSpan Health Company's Proposed Individual Health Insurance Rates

BridgeSpan Health Company—a new health insurer affiliated with Regence BlueCross BlueShield of Oregon through a parent company, Cambia Health Solutions—has proposed premium rates for its individual and family plans for 2014. OSPIRG Foundation's analysis raises questions about the insurer's justification for the proposal, and about BridgeSpan's efforts to reduce costs by cutting waste and focusing on prevention.

> Keep Reading

Pages

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.

> Keep Reading
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.

> Keep Reading
Blog Post | Health Care

All you need to know about the 2014 health insurance rate decisions--in one chart! | Jesse Ellis O'Brien

Scrutiny of health insurance rates has cut over $69 million in waste and unjustified costs from 2014 premiums. This chart breaks it down for you.

> Keep Reading
Blog Post | Health Care

Few Oregonians will receive health insurance rebate checks this year—Here’s why that’s a good thing | Jesse Ellis O'Brien

This summer, consumers and businesses nationwide will receive $500 million in rebates from health insurance companies. Only 1 in every 200 Oregonians will see a dime as a result of this program, and that’s great news for our state. Here’s why.

> Keep Reading
Blog Post | Health Care

Competition and Transparency Bring Down Health Insurance Costs—Here’s the Proof | Jesse O'Brien

Something remarkable just happened to health insurance costs here in Oregon. Last week, after the state’s health insurers posted their proposed premium rates for next year, two insurers publicly reversed course and moved to cut their prices.

> Keep Reading

Pages

View AllRSS Feed

Defend the CFPB

Tell your senators to oppose the “Financial CHOICE Act,” which would gut Wall Street reforms and destroy the Consumer Financial Protection Bureau as we know it.

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