If Congress wants to do something about health care costs, it needs to do something about drug costs. To try to make sense of the pricing of prescription drugs is to enter a topsy-turvy universe where patients may be forced to spend more money than they should have to, and for reasons unrelated to their health.
Consider the plight of Nathan Taylor, a Houston-area resident featured in a New York Times story published in The Buffalo News. Following standard cost-cutting advice, Taylor has sought to use generic versions of drugs when possible. But with his monthly prescription for Adderall XR, used to treat his attention-deficit disorder, that doesn’t work.
That’s because his insurance company, Humana, won’t cover the generic version of the drug. So Taylor has to spend more. He said he never got a clear answer to why Humana imposes that policy and the Times said the insurer didn’t respond to repeated requests for comment.
This is the kind of problem that Congress should be looking into, assuming it is serious about improving and reshaping health care in this country, and not simply looking to blow up the Affordable Care Act. There has been no suggestion that Humana, or any other insurer with similar policies, has done anything legally wrong, but when companies adopt policies that drive up the nation’s already high costs of health care, then Congress should demand answers.
The ACA, despite its weaknesses, has slowed the growth of those costs, but more needs to be done. The country cannot continue paying the highest health care costs of any developed nation while achieving results that are generally no better than average. Conservatives and liberals both have cause to be alarmed by that fractured equation.
The work of bringing down the costs of prescriptions won’t be easy. Government typically can’t control the prices levied by private companies, but there are options. One is to ensure that prices and policies are driven internally, not in collusion with competitors or manufacturers.
In addition, Washington can – and should – get over its reluctance to use its vast buying power to secure bulk discounts for expensive drugs. That’s an easy and legitimate way to help bring down costs, at least for some patients.
As much as anything, though, this is another wake-up call. When insurers refuse to cover generic drugs, it’s a flashing sign of malfunction. Health care is an issue the country is legitimately concerned about. Instead of flailing about in an effort to kill the Affordable Care Act, Congress and the president should be working to ensure that Americans aren’t being forced to spend more than they should have to on the prescriptions they require. That’s a great place for Democrats and Republicans to work together.