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5 Takeaways From AHIP's Health Insurance Exchanges Forum and National Health Policy Conference

Laura Joszt
The Affordable Care Act and rising healthcare spending were the main topics of conversation at America’s Health Insurance Plans Health Insurance Exchanges Forum and National Health Policy Conference, which were held March 8-10 in Washington, DC.
The Affordable Care Act (ACA) and rising healthcare spending were the main topics of conversation at America’s Health Insurance Plans Health Insurance Exchanges Forum and National Health Policy Conference, which were held March 8-10 in Washington, DC.
 
The pharmaceutical industry was a favorite punching bag as speakers lamented the high cost of medicines and discussed potential policy actions to make care more affordable for consumers.
 
Here are 5 key takeaways from the 2 meetings.
 
1. Pharma is the problem
Multiple speakers are laid the blame on the pharmaceutical industry for rising prices and the burden on consumers. There was even an entire panel devoted to shifting the prescription drug cost paradigm—and the panelists were angry about increasing drug prices.
 
“I’m not sure there has been any other issue that has or should grab our attention as much as prescription drug costs,” said Brad Wilson, president and CEO of Blue Cross and Blue Shield of North Carolina.
 
He added that for his company, pharmacy costs increased more than inpatient hospital stays, outpatient care, or physician office visits combined.
 
Diane P. Holder, executive vice president of UPMC, president of UPMC Insurance Services Division, and president and CEO of UPMC Health Plan, wondered if it wouldn’t take a miracle to make a difference in the pharmaceutical industry.
 
John Bennett, MD, FACC, FACP, president and CEO of the Capital District Physicians’ Health Plan, didn’t hold back, calling it “unethical, immoral, and unconscionable” that drug companies are taking “every penny of the future value” of curative drugs and using it to price the treatments.
 
“We’re seeing a huge moral dilemma today in how we price these drugs, but we have to face up to the fact that we simply cannot afford it.”
 
2. Consolidation is a huge challenge
Martin Gaynor, E.J. Barone Professor of Economics and Health Policy at Carnegie Mellon University, discussed challenges in US healthcare spending and placed a spotlight on consolidation. He pointed out that consolidation is not easily reversed, so if a merger occurs and competition is harmed or eliminated, it will be difficult to go back.
 
He added that he worries about leaving consolidation unchecked and realizing one day that all the various sectors in healthcare are highly consolidated by a small number of players, which will hinder any attempt to make progress.
 
“My fear is that we’ll have an even more expensive and less responsive healthcare system,” Gaynor said.
 


 
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