Late last year, President Donald Trump published an op-ed criticizing Democratic proposals to replace private health insurance with a “Medicare for all” system.
His move came as progressive forces, led by Bernie Sanders and now declared presidential candidate Elizabeth Warren, continued to reorient Democratic Party ideology toward more socialized government control over health care markets.
One of the major sticking points of Trump’s op-ed was the detrimental effects government-run health care would have on American seniors. “The Democrats’ plan also would mean the end of choice for seniors over their own health care decisions. Instead, Democrats would give total power and control over seniors’ health care decisions to the bureaucrats in Washington, D.C.,” he wrote.
Drug Prices Set By Government
Many of the president’s criticisms were valid, insofar as he correctly pointed out the potentially devastating impacts of putting a bureaucratically burdensome straight jacket over America’s health care system.
So it’s ironic that just two weeks later, the Trump administration publicly announced a proposal to create an “international pricing index” (IPI) model as a way to cut drug prices. The plan would peg how much Medicare pays for certain drugs to the average price for those drugs charged in 16 other countries, where government price controls keep them artificially low. But this plan would fundamentally disrupt patient access to life saving treatments and add unprecedented layers of bureaucracy between patients and their doctors.
Despite the administration’s earlier assertion that state regulated health care markets would harm seniors’ decision-making ability and access to preferred treatment options, the proposed IPI model will do just those things. By making participation in the IPI model mandatory, it will coerce Medicare Part B beneficiaries to unwillingly take part in an unsubstantiated experiment that could limit their access to certain health care providers and preferred treatment regimens.
Mandatory Scheme On Drug Prices
What’s more, the compulsory nature of the IPI model would disrupt treatment by inserting a third party vendor between doctor and patient. Most therapies — particularly those used to treat cancer — often use highly specialized and case-specific drug regimens which require constant adjustment by highly-trained physicians.
Under our current system, these physicians are able to make meticulous adjustments based on a patient’s drug sensitivity or weight variation. This not only ensures patients have timely access to personalized (or tailored) treatment regimens, but it also gives doctors the ability to modify a patient’s drug dose or make substitutions.
By giving third party vendors control over the acquisition and circulation of Medicare Part B drugs, the IPI model throws a bureaucratic wrench into patient-centered care.
The introduction of these outside vendors will not only delay access to timely treatment, but also introduce unprecedented and unnecessary levels of bureaucratic complexities that will increase administrative burden over all aspects of care. Providers participating in the IPI model could be forced to navigate separate supply channels and maintain duplicative inventory management systems for drugs, something that would add substantial overhead costs and operational complexities into the system.
Flaws In The Drug Prices Plan
Many of the nation’s leading physician and patient groups have already drawn attention to these flaws. In a series of letters written to the Centers for Medicare & Medicaid Services, patient and provider groups rightfully argued the IPI model will outsource treatment decisions to vendors with no clinical or medical expertise, thus increasing the probability of treatment delays and restrictions. These criticisms only added to the growing chorus of health care providers, patient advocates, and even lawmakers on Capitol Hill who have come out against the administration’s proposal.
Given all the unpredictable and potentially devastating consequences of the mandatory IPI model, it’s clear the administration’s previous critiques against a “Medicare for all” type system can be used to describe its own proposal.
In what can only be described as a paradox, the IPI model embodies many of the “anti-senior, anti-choice and anti-consumer” critiques the president leveled against the socialized health care systems of other countries only weeks before.
- Topping is a lawyer in the Washington, D.C., office of Mintz, where he represents health care and insurance clients. He has held CEO roles with a health technology company focused on data and privacy and a specialty health insurer. He served as a DOJ lawyer during the Bush Administration, representing the Secretary of HHS in matters involving pharmaceuticals and vaccines.
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Author: JOHN MERLINE