No Need to Wait Until 2020 for Useful Health Reform

(Bloomberg Opinion) -- In the midst of an escalating trade war and calls to impeach the President, health policy can fall by the wayside. But a modest bipartisan miracle shouldn’t be ignored. 

The health-care debate in the U.S. usually occurs along strict political battle lines. There are at least a few things, though, that both parties agree on. A new bipartisan draft bill released by the leaders of the Senate health committee Thursday afternoon would crack down on surprise bills, abusive hospital contracts, and certain drug costs.

The legislation from Tennessee Republican Lamar Alexander and Washington Democrat Patty Murray wouldn’t fundamentally alter the fragmented and messy U.S. health-care system. It does propose practical reforms that could make it easier and potentially less costly for Americans to get drugs and treatment, and targets a variety of public-health issues. That’s an achievement in the rancorous current  environment and in general; lawmakers haven’t passed a major health cost law in years. This bill targets relatively low-hanging  fruit, and should break that streak. 

No one’s happy when Americans get massive emergency-room bills after being unwittingly treated by an out-of-network physician; this legislation offers multiple paths toward resolving such disputes. On top of consumer-focused reforms that would improve cost transparency, the proposal prohibits some of the more unpleasant contracting behaviors hospitals and insurers use to keep prices high. Hospitals, for example, would no longer be able to tell insurers they can’t access any of their facilities if they won’t contract with all of them. You’re unlikely to find anyone who’s not a lobbyist that opposes that reform. 

Any change that helps health plans negotiate more effectively is a positive. A recent Rand Corp. study found that employer-based plans face hospital prices that are more than twice as high as what Medicare pays. A set of Trump Administration transparency rules that are reportedly due next week could bring even more price data into the open.

By avoiding ideological landmines like the expansion of government coverage and the direct negotiation of drug prices by Medicare, the Senate arrived at a bill that probably won’t have a huge overnight impact on systemic cost, inequality, or coverage. But they did get something that has a hope of passing.

This proposal isn’t guaranteed to become law in its current form. The Senate still has to fold in ideas from other committees, overcome industry objections and decide its exact approach on surprise bills. It may have a harder time in the Democrat-controlled House, which isn’t inclined to hand President Donald Trump something that could be perceived as a legislative win. It recently packaged its own set of drug-price reforms with proposals to bolster the Affordable Care Act, scoring political points but also ensuring that they won’t become law soon. 

We’re years and a set of specific electoral outcomes from a government that could pass even tweaks to the ACA, let alone something like “Medicare for All.” This is a clear case where perfect shouldn’t get in the way of good, and scorekeeping shouldn’t get in the way of positive changes. 

To contact the editor responsible for this story: Beth Williams at bewilliams@bloomberg.net

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

Max Nisen is a Bloomberg Opinion columnist covering biotech, pharma and health care. He previously wrote about management and corporate strategy for Quartz and Business Insider.

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