Four healthcare policies Congress can agree on

Health

Medical director of Doctor on Demand Dr. Vibin Roy speaks to a patient during an online primary care visit conducted from his home, April 23, 2021, in Keller, Texas. A new poll shows that many Americans don’t expect to rely on the digital services that became commonplace during the pandemic after COVID-19 subsides. (AP Photo/LM Otero, File)

(NewsNation) — From high prescription prices and increasing insurance premiums to a lack of mental health therapists and specialists, ask almost any American and they’ll say: Our health care system is broken.

Almost 90% of midterm voters across party lines said they consider reducing the cost of health care as one of the most important issues for lawmakers to solve.

And while abortion proved to be an inciting issue, there are many more — and less divisive — health care policies that have widespread support among lawmakers and the public. Experts say these laws are long overdue for reform and may now have the political will to get passed.

Fairer prescription prices

What they agree on: The winding story of what kind of medications you’re prescribed, where you get them and how much you pay leads to powerful, under-regulated “Pharmacy Benefit Managers.” Lawmakers say these groups have too much power to manipulate higher prices without demonstrating more benefits to patients — and the way to fix it is more oversight.

Meanwhile, another bill aims to prevent future drug shortages like we saw during the pandemic.

“Right now, 72% of our pharmaceuticals are imported, 13% from China, and of course they’re an economic rival of ours,” Rep. Darren Soto told NewsNation affiliate The Hill.

Why this matters: The average list price has increased by more than 30% since 2016, which has been linked to higher outpatient costs, less effective treatment and higher insurance premiums.

Evidence of success: When patients can afford their medications, they’re more likely to follow treatment plans. For example, a study of people with high blood pressure found affordability to be the major factor in whether they took medicine consistently. Access to preventative drugs, in particular, could have a profound impact on lowering the economic burden of chronic illness.

Limitations: Numerous laws have been proposed to lower drug prices, yet differences in financial and political approaches, plus an overweighed power of pharmaceutical lobbyists, mean comprehensive reform has yet to be agreed upon.

Making mental care accessible

What they agree on: A current bill lawmakers are considering addresses pressing needs facing America’s mental health by increasing suicide prevention efforts, better integration of primary and mental health care, providing bonuses for workers in underserved communities, and more access to treatment in schools including making mental health a mandatory part of health education.

Why this matters: An overwhelming 90% of Americans say there is a mental health crisis today, and among children, experts say it is so dire it’s a “national emergency.” 

Evidence of success: When mental health treatment is affordable and easy to access, adults and children alike see improved outcomes, studies show. For example, school-based mental health services can lead to earlier identification and treatment and reduced absenteeism.

Limitations: Worker shortages mean there are not enough specialists, therapists or social workers to go around — something that isn’t a quick fix. And rural patients face extra barriers.

“We have folks that do want to follow up, but … if they don’t have a phone or internet, they don’t have a car, you see where it’s very difficult to try to follow up with folks,” said Julia Hanneken, a mental health crisis worker in eastern Tennessee. 

At-home addiction treatment

What they agree on: “Members are definitely hearing from their constituents, and sometimes even their own families, about some of the struggles that we are experiencing,” said Oliver Kim, health policy director for the Bipartisan Policy Center.

Lawmakers may extend COVID expansions that allow patients to access methadone, the medication to treat opioid addiction, virtually. Other lawmakers want to spend money on public education against fentanyl, a deadlier synthetic opiate that has led to a spike in young deaths.

Why this matters: A $26 billion national settlement with four pharmaceutical companies will be doled out to dozens of states. Individual states also receive huge payouts for addiction recovery programs, and a federal bill could influence how that money is distributed and spent in local jurisdictions. 

Evidence of success: Particularly when it comes to methadone, multiple studies during the pandemic found the flexibility allowed more patients to finish treatment without a higher risk of overdose or misuse.

Limitations: Many providers say addiction treatment — especially group and private counseling — is more effective in-person.

Virtual health care is here to stay

What they agree on: A bill currently before lawmakers would extend temporary pandemic measures for Medicare patients to allow physicians to deliver telehealth across state lines and drop certain requirements to prescribe controlled substances, among other allowances.

Why this matters: Private insurance often follows Medicare’s lead when deciding what services to offer, Kim said, in part due to pressure from providers who expect to offer similar services to all their patients. 

Evidence of success: The number of telehealth visits increased tenfold in 2020 and has remained high since. Researchers found more people attended primary care visits and follow-up visits after surgery when given a virtual option, such as text messaging to remind patients to take their medicine.

Limitations: Despite its recognized potential, rural, poorer and minority patients consistently lack access to high-speed internet or smart technology. Skeptics of telehealth also point out that doctors may miss underlying or concurrent conditions without a physical exam. And the industry is still facing worker shortages, Kim said.

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