State of the Union from the healthcare purchaser lens
Last night’s State of the Union address was light on healthcare, but here are a few key takeaways:
The Administration’s Drug Blueprint is still alive - After last week’s announcement proposing to eliminate drug rebates, the President refocused on the lack of pricing equity for drugs between the United States and other countries. This is a critical issue (see our key Rx Purchaser Policy Issues) but focus should not be limited to Medicare as US employers cannot afford to be the last ones standing to pick up the brunt of the costs associated with pharmaceuticals. Other areas not addressed included policies and practices that support a more competitive drug marketplace and the need for a focus on drug value based on comparative effectiveness in the real world.
Conflating the opioid crisis with immigration reform - Dealing with the opioid crisis is not the same as immigration reform. Policies are needed ranging from prevention to treatment to recovery and not limited to illegal drugs. In much of the country, it is the number one health issue impacting employers and there has been bi-partisan support to take action. There is an emerging consensus that the opioid crisis needs comprehensive policy reform and the recognition and treatment of substance use disorder needs to be a priority of all of the stakeholders.
to end HIV a good first step to journey - The progress we have made on HIV is important and committing to end HIV is a valuable moonshot for the country. But the health issues in our population are greater than HIV. The obesity crisis rages on leading to unprecedented growth in chronic disease. As concerning is a suicide rate which is increasing across the country and a mental health system that is not accountable or accessible for the vast majority of Americans. Our ability to treat cancer has never been greater but our ability to afford that treatment has never been worse. These are big issues that need leadership, policy and stakeholder collaboration.
Health reform policy continues to center on the edges of ACA - The campaign to end the ACA appears to be over but the efforts to tinker with its provisions continue. Some of that tinkering is essential and some of that tinkering can be harmful to its sustainability. What’s missing is a more fundamental discussion on how to finally tackle the most expensive healthcare system in the world which is producing inferior outcomes to that of other countries. This is a challenge that will require unprecedented collaboration and alignment (e.g., delivery and payment reform) between the public and private sectors that will influence stakeholders across chain. This is the leadership that seems to be missing on both sides of the aisle.
Michael Thompson
President & CEO
National Alliance of Healthcare Purchaser Coalitions
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