KHN: Kaiser Health News

At a Capitol Hill hearing Tuesday, journalist Steven Brill, who examined the issue of the high cost of health care in a much quoted March 2013 Time magazine article, told Senate Finance Committee members that President Barack Obama’s health care law will do very little to lower prices for consumers.

Photo by Karl Eisenhower/KHN

Joined by a panel of health policy experts at the hearing to explore ways to make health pricing more transparent, Brill said that while he views efforts to disseminate prices for health services to consumers favorably, he believes that increasing transparency has its limits. “[Transparency] starts the conversation about prices that we didn’t have in the debate over Obamacare. It’s only a start,” Brill said. “Obamacare does nothing about these prices. Nothing to solve the problem – Zero.”

In his article, Brill looked at several patients with inadequate insurance and went through their medical bills line by line to explain why their care was so expensive. Among the many reasons he identified were massively inflated charges for common drugs and services and the hospital chargemasters that bore little resemblance to true costs.

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Federal health officials have proposed that all health plans selling insurance on the new online marketplaces must allow for easy payment options for households without bank accounts or credit cards.

The government’s decision to mandate a menu of payment options including cashier’s checks, money orders and re-loadable pre-paid debit cards comes amid increasing pressure from consumer advocates and business groups that are concerned low-income working families would be required to purchase health coverage under the Affordable Care Act but would have no way to pay their monthly bill.

“What we see here is a real commitment to do what is right,” said Brian Haile, Senior Vice President for Health Policy at Jackson Hewitt Tax Service. “[It’s] a decision that is data driven. It’s not partisan.”

One in five households in the United States, or about 51 million adults, have only a tenuous relationship with a traditional bank, relying instead on check-cashing stores and money lenders, according to the Federal Deposit Insurance Corporation. Kaiser Health News and NPR first reported the concerns over payment options in May. Soon after Jackson Hewitt released its own report that found that more than one in four Americans eligible for the new tax credits under the health law do not have a checking account, and the tax preparation company concluded those households could not enroll for coverage if insurance companies only accepted electronic funds transfers from checking accounts.

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Toni Lewis-Bennett remembers hesitating when she was asked to be an organ donor while applying for her driver’s license.

But years later, when a friend at work became sick, she got tested to see if she could donate her kidney to save his life. And with a green light from doctors, there was no question in her mind that she would go through with the transplant.

“I felt honored to be able to do it,” Lewis-Bennett said. “I don’t think many people in their lives get the opportunity to make a significant change in someone else’s.”

She said not enough people are part of the organ donor dialogue, which doesn’t always come up in normal conversation. But a social  media campaign might be changing that culture.

In May 2012, Facebook introduced an option that lets users add “Organ Donor” to their profiles, just as someone would add their favorite movies or marital status. It also provided users a quick link to sign up for the national registry of organ, eye and tissue donors through Donate Life. The Facebook project was a partnership with a team from the Johns Hopkins Medical Center, the Living Legacy Foundation of Baltimore and Donate Life America.

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A new study suggests that cash-strapped Medicare missed an opportunity to save more than $1 billion by not addressing the varying costs and use of prescription drugs.

Photo by Erin DeMay via Flickr

Comparing Medicare enrollees and those on the U.S. Department of Veterans Affairs (VA) health plan, researchers found that Medicare beneficiaries were up to three times more likely than VA patients to choose higher-cost brand name drugs over generic brands, according to the Annals of Internal Medicine report.

“The main issue, and the only way to fix this, is to change what physicians are doing,” said Dr. Walid Gellad, a lead author and internist with the VA Pittsburgh Healthcare System and the University of Pittsburgh.

Physicians in the VA system follow an approval process that requires them to try the generic drug before they prescribe a patient the brand-named version. The system also limits their providers’ interactions with pharmaceutical representatives, which Gellad said can alter the way a doctor chooses to prescribe certain drugs.

Researchers compared diabetic patients of similar ages – about 75 years old – and health outcomes. They calculated that if Medicare Part D followed the VA system, drug spending would have been $1.4 billion less in 2008. If the VA had adopted Medicare practices, on the other hand, its spending would increase by $108 million.

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