It is not a party issue—both sides have tried and failed to lower health care costs.
Everyone knows the problem needs fixing. One in three Americans have not filled a prescription they need because of cost, and medical bills remain the leading cause of bankruptcy in the U.S. I fully support any idea that will improve this situation. But when new laws and regulations are introduced, there are typically missteps along the way that end up driving prices higher.
There are many examples, but the Affordable Care Act is the biggest recent health care policy that hasn’t worked as intended. The ACA has brought health care coverage to 20 million previously uninsured Americans. It has not, however, made health care more affordable.
While some Americans pay lower premiums under the ACA, a similar portion saw their premiums increase. Meanwhile, the actual cost of care, particularly prescription drugs, has skyrocketed since 2010. For the most part, employer groups absorb this burden, which increases every year.
Health care policy proposals tend to address the problem in one of two ways. The first is sweeping reform. Despite its 906 pages of legalese, the ACA couldn’t anticipate every loophole and trick.
The system is too big, too complex, and too broken for sweeping legislation to avoid unintended consequences that provide an opportunity for someone in the supply chain to profit.
The second approach is a simple and narrow initiative to fix a particular problem. This is the only approach that can work. The trouble is that policymakers don’t understand how interconnected our health care system is. They can’t help but create new problems every time they fix an old one.
For example, the Hospital Price Transparency Rule that went into effect Jan. 1 is a good idea in theory—it requires hospitals to disclose their markups so that patients can shop around. But hospitals can pick which services to disclose and the rule lacks an effective enforcement mechanism. Plus, there’s no realistic system in place for consumers to process the pricing data and make comparisons.
Greater collaboration with private-sector experts might have led to a rule that would be more effective, though it’s hard for policymakers to know who really has the public’s best interest at heart. In any case, the rule has shown no signs of driving costs down. It only adds administrative burden, which ultimately causes prices to rise further.
The only people who have a clear understanding of the U.S. health care system are those who have worked in the industry for many years. Often, these professionals can see how their corner of the industry could be improved to lower costs, but they have either no incentive or no resources in their current roles to bring about these changes.
Our private health care system is unique in the world in its capacity to drive clinical innovation. It’s time we apply that mechanism to reshape the industry itself. Through entrepreneurship and creativity, we can bring transparency and competition into the marketplace to drive costs down.
So many industries have changed dramatically in recent decades—retail, communications, entertainment, automotive, energy, hospitality—and fortunes were made along the way. There is a tremendous opportunity for companies that can lower cost and increase access to health care.
The existing players will never change unless they have to in order to survive in the marketplace. The health care industry is full of professionals who can already visualize how to make one key aspect of the system more transparent or fair. They have a responsibility to do all they can to make that vision a reality. For those who succeed, the rewards will be enormous. Just ask Netflix, Spotify or Tesla.