Back Button
Menu Button

Presidential Candidates: Take the Pledge to Serve ‘We the People’

This Op-Ed was published by the Des Moines Register on August 21.

I write this not as a Republican, nor as a Democrat – I’m politically agnostic. When it comes to addressing healthcare, a critical election issue, Iowa voters have the first crack at drilling down and asking presidential candidates for details on how costs will be meaningfully lowered, who will be covered, what will be covered, how it will be paid, and how higher-quality care will be delivered consistently to all populations.

The candidates we eventually elect must thoroughly analyze the details of their plans, including the possibility of unintended consequences that will invariably result. Acknowledging the pros and cons of the plan they support is both honest and crucial.

For presidential candidates to successfully make it out of Iowa and live to compete in future primaries and caucuses, Iowans must require each to articulate the specifics of their plan. Generic responses of supporting “Medicare for All” or “Single-Payer” does little to inform voters, other than allow candidates to merely checkoff one of many issues they support. In healthcare, the devil is definitely in the details.

During the Democratic debates this summer, many candidates singled out insurance and pharmaceutical companies as being responsible for the cost predicament we have across the nation. In fact, Sen. Bernie Sanders, (I-Vt), pledged to reject any donations over $200 from political action committees, lobbyists and executives of insurance and drug companies. Sen. Sanders called on other Democratic candidates to do the same.

Per Sanders’ pledge, “Candidates who are not willing to take that pledge should explain to the American people why those corporate interests and their donations are a good investment for the healthcare industry.”

This pledge, although well-intentioned, does not go far enough. The narrative that insurance companies and pharmaceutical manufacturers are the lone villains is grossly naïve because it excludes other major contributors to the cost problem – hospitals and physicians.

Healthcare prices in the U.S. are considerably higher when compared to other industrialized countries, and a large part of this comes from those providing this care. In fact, providers do not want their negotiated fees with private payers to be transparent, largely under the guise that once prices are publicly known, costs would go even higher because lower-paid providers may want better deals through higher prices. This is merely a convenient approach to keep prices opaque and largely unknown. This status quo only benefits the intended stakeholders, not most Americans.

According to MapLight, a nonpartisan research organization, the American Medical Association and the American Hospital Association are the fifth and sixth largest lobbying spenders over the past decade. In the first half of 2019, the AMA has spent $11.5 million on lobbying while the AHA has spent $10.2 million. The AHA amount is equal to the combined lobbying contributions of three large insurance organizations: America’s Health Insurance Plans, Blue Cross and Blue Shield Association and UnitedHealth Group. Since 2008, the AMA has spent almost $228 million in lobbying, while the AHA spent over $205 million.

Sen. Sanders and all candidates (congressional included) should pledge to avoid donations and other influential contributions from all key healthcare stakeholders, including the AMA and AHA. Candidates must distance themselves from external influences that undermine a system that needs to be designed for the people, not by special interests.

These three foundational healthcare cornerstones – cost, coverage and quality – are the overriding factors that should determine whether our reformed healthcare system is run solely by the government, as some “Medicare for All” proposals tout, or through public-private reforms that improve or replace the existing Affordable Care Act (ACA).

Candidates of all parties – do the right thing – rid yourselves of conflicts of interest and represent all Iowans and Americans.

To stay abreast of employee benefits, we invite you to subscribe to our blog.

How Do You Spell ‘Healthcare’?

I really should not be so absorbed about the spelling of one particular word – but I am. Especially when that word is ‘healthcare.’ You see, I have ALWAYS combined ‘health’ and ‘care’ together, making it a one-word noun, rather than spelling it as ‘health care,’ a two-word noun or adjective.

But apparently my preference is just that, a personal preference. This spelling debate is being waged by healthcare (notice my spelling?) professionals from all walks of life – physicians, media, academia, and self-described ‘Heinz 57’ people who don’t fit nicely into any of these professional buckets (such as this author!).

Because my work includes blogs, white papers and research studies that pertain to the medical field, I have paid special attention to how certain writers spell ‘healthcare’ – e.g. do they spell it as one word or two words? Sometimes, it may even have a hyphen added between both words – “health-care.” So, which is the correct way to spell this most-often-used word?

To be honest, I’m not entirely sure. It appears that it boils down to preference…and perhaps which part of the world you reside. According to the Grammarist:

Healthcare is on its way to becoming a one-word noun throughout the English-speaking world. The change is well underway in British publications, where healthcare already appears about three times as often as health care and is used as both a noun and an adjective. Many American and Canadian publications resist the change, meanwhile, and health care remains the more common form in North American newswriting, as well as in government and scholarly texts. In many cases—such as on health-related U.S. government websites—health care is the noun (e.g., “your health care is important”) and healthcare is the adjective (e.g., “find a healthcare professional”), but this is not consistently borne out, and both forms are widely used both ways. Many publications and websites seem to have no policy on this at all.

Bottom line:

If your preference is to include a space or hyphen between ‘health’ and ‘care,’ you are to be forgiven! With this in mind, however, I hope that you will please forgive my proclivity to spell this common phrase as ‘healthcare’!

To learn more, we invite you to subscribe to our blog.

CVS and Aetna – A New (and Improved) Healthcare Giant?

Just announced this past Sunday, pharmacy chain giant CVS Health agreed to purchase Aetna, a large, national health insurance company, for about 70 percent of Jeff Bezos (Amazon) net worth – or $69 billion.

CVS is one of the largest providers of pharmacy services in the country, with almost 10,000 retail pharmacy locations and about 1,100 MinuteClinic walk-in clinics, while Aetna is the third-largest U.S. health insurer. By combining, their total annual revenue would be $240 billion. In a joint statement, CVS and Aetna claim this deal will “redefine access to high-quality care in lower cost, local settings – whether in the community, at home, or through digital tools.” Further, according to the CVS Health President and CEO, Larry Merlo, “…With the analytics of Aetna and CVS Health’s human touch, we will create a healthcare platform around individuals.”

Both organizations jointly claim the combined company will “dramatically further empower consumers,” and “better understand our members’ health goals, guide them through the healthcare system and help them achieve their best health.” By having a broader use of data and analytics, the new organization hopes to benefit the entire healthcare system and be able to address the cost of treating patients with chronic diseases. The combined synergy of both organizations lay out a vision to reshape healthcare into a new approach.

This large ‘deal’ has the makings of being a great thing – for both organizations (CVS and Aetna), their shareholders and those covered through their products.

But will it?

Quite often, the American culture is fixated on the belief that “bigger is better,” or that “new and improved” will always serve us best. Perhaps it will. But as I mentioned in my blog, “The Illusion of Getting ‘Bigger‘” – when Aetna was attempting to purchase Humana (a deal that was subsequently blocked by a judge in early 2017 for antitrust purposes) – such deals are not a slam-dunk to fix an ailing and complex $3+ trillion healthcare system. In fact, in some cases, larger integrated delivery networks may make the coordination efforts to serve patients more cumbersome and inefficient.

The twists and turns of organizations finding new approaches and seizing opportunities to make healthcare more affordable, safer and much more efficient is clearly a laudable goal. But, to be so, the patient must always be at the center of these initiatives. The profit and incentive motives are important, but getting it right for the patient should be the primary driver of any meaningful change.

Let’s hope the hype is matched by results.

To learn more, we invite you to subscribe to our blog.