Op-ed: Achieving savings and safety for vulnerable patients

Jackie Boschok is the president of the Washington State Alliance for Retired Americans. Boschok wrote the following op-ed on access, cost, safety, and a provision of S. 1895 (the Lower Health Care Costs Act) which impacts the nongovernmental organization U.S. Pharmacopeia. 

This past spring, Washington passed a law to establish a public option for purchasing health insurance, declaring once again through actions, rather than just words, that our state believes in the critical need for universal health care coverage. This isn’t the first time we’ve led by example. Following the passage of the Affordable Care Act, Washington quickly established a health care exchange which was praised for keeping premium increases well below the national average and strongly engaging private insurers. Even before that, the sickest patients were covered by a state-administered high risk pool.

Still, coverage is only one part of the health care equation. Just because patients have insurance doesn’t guarantee that they can afford the treatment or prescriptions they need. Out of pocket costs for both medicines and procedures are rising rapidly; the average 65 year old couple can now expect to pay nearly $300,000 in out-of-pocket medical costs over the course of their retirement. Americans, especially older Americans or people with disabilities who live on fixed incomes, are being squeezed dry. We live in the wealthiest country in the world: there’s no reason that people should be driven into poverty when they get sick.


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Some progress is being made, at least in developing policies that would rein in this cost explosion. The drug pricing package currently being considered in the U.S. Senate would cap out-of-pocket costs for Medicare Part D beneficiaries and “keep the growth of prescription drugs in line with inflation” for drugs covered by federal health insurance programs, according to the Campaign for Sustainable Rx Pricing. It would save seniors nearly $30 billion in out-of-pocket costs alone. If Congress can’t pass bipartisan, common-sense legislation like this, the system is truly broken.

At the same time, affordability does not necessarily equal quality. Medical errors are the third leading cause of death in the United States, and lives are lost, unnecessarily, to surgical and other treatment mistakes too often. This is devastating to families, and no amount of compensation can make up for the loss of a loved one.

But harm can come from other treatments, including prescription medications, that we put into our bodies, and our laws should guarantee that a strong system of safety and quality is in place to ensure prescription drug safety in the U.S. Fortunately, such a system exists, and has worked for nearly 200 years. Unfortunately, the Senate is considering repealing that system, a move which could put patient safety in jeopardy.

Why do this? No one seems to have a good answer – labor unions, aging organizations, patient advocates, and pharmacists have all come out in opposition. As 28 aging and provider organizations and unions, including the Alliance for Retired Americans and Service Employees International Union (SEIU) recently wrote to Congress, “The existing public transparent standards are a compendium of drug information that is produced annually by the United States Pharmacopeia, an independent, not-for-profit and nongovernmental entity. … They reassure doctors, pharmacists and patients that medicines contain the ingredients promised on the label at the promised dosage and purity and serves as a set of standards internationally for more than 100 other nations. Law enforcement agencies also use these public standards to stop counterfeit or substandard drugs from entering our country and harming patients.”

The provision in question, Section 207 of S. 1895, which is expected to be a part of the drug pricing package considered by the whole Senate, is buried deep within an enormous bill. It’s best left out.

Senator Patty Murray, who sits on the Senate Health, Education, Labor and Pensions Committee, is in a powerful position to take action on this anti-patient language, and she has always been a champion for vulnerable patients, seniors and working families in Congress, advocating for expanded Medicare coverage of life saving medications and lower health care costs for working Americans and retirees. We ask that she take action here to take this language out of the bill, and instead remain focused on the immediate and dire crisis of health care affordability for Washingtonians. We truly believe that patients can have affordable and safe health care, in America, in 2019. We just need the right policies to make it happen.