JEFFERSON CITY — Lawmakers are looking into what the state can do to address the high cost of health care as they prepare for the 2020 legislative session, including making the cost of care more transparent and examining drug prices.
House members held a hearing Wednesday to discuss ways to help Missourians get more information on what medical procedures will cost before choosing a provider. A major theme of the hearing of the House Healthcare Reform Committee was that people struggle to know the real costs of their health care until after their bills come in the mail.
“The cost is ultimately the problem in this debate,” Rep. Steve Helms, R-Springfield said. “Not all networks are driven around saving me money.”
It becomes even more confusing when trying to compare the costs between different hospitals and physicians. While one hospital could charge a certain amount for any given service, another hospital right down the street can charge twice as much.
“I think there are different levels of transparency,” Rep. Dale Wright, R-Farmington said. “The challenge of transparency is in a hospital setting.”
Opportunity Solutions Project lobbyist James Harris discussed “right to shop,” meaning the right to know the real prices while looking into the health care market. States such as Kentucky, New Hampshire, Florida, Maine, Nebraska, Tennessee and Virginia have already passed legislation concerning this.
“If you know the price of some of these procedures, you’re given the right to save,” Harris said.
But without that transparency, health care customers can often be left in the dark.
Harris recently had his own experience with this issue after he tore ligaments in his leg. While comparing prices for an MRI, he found a 45% difference between two nearby hospitals. But Harris said it was time-consuming and difficult to get those figures.
Show Me Institute representative Patrick Ishmael said people want some sort of explanation on differing health care costs.
“No one really knows why there are differences,” said Ishmael.
While being able to compare costs is important, Rep. Helms said, making sure that consumers understand the quality of that care is also crucial.
“I would like a 50-year hip, not a 30-year hip,” Helms said.
The newly formed Senate Prescription Drug Transparency Committee also met Wednesday. The committee, chaired by Sen. Jason Holsman, D-Kansas City, was created to tackle the high cost of pharmaceutical drugs.
“Our goal is to get our constituents to not have to choose between prescription drugs and any other necessities for life,” Holsman said.
The committee invited Sharon Brigner, the deputy vice president of PhRMA, an advocacy group that represents biopharmaceutical research companies, to discuss the issue. Brigner said that, in general, the cost of drugs like insulin — which was discussed at length during the hearing — are driven by the expensive process of research and bringing the drugs to the market. Brigner said it costs about “$2.6 million to bring a medication from the bench to the patient’s bedside.”
There was tension during the hearing between the pharmaceutical experts and the senators. Holsman and Sen. Bill White, R-Joplin, took issue with the lack of concrete data provided by Brigner and Scott Woods, the assistant vice president of state affairs for the Pharmaceutical Care Management Association, which is the national association representing pharmacy benefit managers (PBMs). The senators requested concrete numbers outlining the total profits that are made by pharmaceutical companies that create, market and sell prescription medication.
“I would like to see some real numbers,” White said.
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