“What we hear from patients is cost, cost, cost”: Experts discuss real-world affordability solutions at LOWN26
The recording below is from a panel at LOWN26: Confronting Healthcare Affordability. All panel recordings are available on Youtube.
In Washington, across the states, and in boardrooms, everyone’s got ideas for addressing the healthcare affordability crisis. At LOWN26, a group of experienced practitioners discussed what happens when theory meets reality. What’s politically viable, operationally feasible, and capable of actually making a difference?
Panelists:
- Lily Cervantes, MD, Director of Immigrant Health and Professor of Medicine, University of Colorado Anschutz Medical Campus; 2024 BLASR winner (Moderator)
- Fred Cerise, MD, President and Chief Executive Officer, Parkland Health
- Jeanne Lambrew, PhD, Director of Health Care Reform and Senior Fellow, The Century Foundation; Former Commissioner of the Maine Department of Health and Human Services
- Noam Levey, Senior Correspondent, KFF Health News
Cost versus choice
To kick off the panel, KFF Health senior correspondent Noam Levey discussed findings from public opinion polls and interviews. While reducing the overall cost of healthcare for society is important, Levey emphasized the need for policies that have a tangible impact on patients’ out-of-pocket costs.
“We asked people, if they could make one change to their health insurance, what would it be?” said Levey. “And forty to forty-five percent said, lower my out-of-pocket costs.”
Levey suggested that policymakers look to “connect policies to the outcome.” For example, in Germany there is a $10 maximum cost to fill a prescription and a $10 per hospital day out-of-pocket cost. This standard cost and structure makes the system more predictable.
“Bending the cost curve is meaningless for people if they still owe $8,000 in medical debt.”
Noam Levey
In response to the previous panel’s discussion on patient choice, Parkland Health CEO Fred Cerise noted the downsides of giving patients more skin in the game. “The ability to choose involves making people price-sensitive, which has a negative impact on access,” said Cerise. “We see people all the time with late-stage cancer or diabetes requiring amputation who haven’t had care in 10 years because of the cost.”
“We put too much stress on worrying about the 5% of patients trying to game the system rather than making it easier for everyone else to get care.”
Fred Cerise
The high cost of care also negatively impacts physician mental health. Doctors just want to see their patients, but they constantly get frustrated by red tape around coverage, said Cerise.
Cooperation and common ground
When it comes to policy solutions, Americans agree on more than we may think, noted Noam Levey. Public opinion polls shows that most people support policies to protect people from medical debt such as capping hospital prices as a percent of Medicare and limiting collection actions.
Hospitals are also working on simplifying their financial assistance programs and automating eligibility, to ensure that patients don’t fall through the cracks, said Cerise.
From a state policy perspective, The Century Foundation’s Director of Healthcare Reform Jeanne Lambrew emphasized cooperation over competition. As former health secretary of Maine during COVID-19, she saw how this public health emergency allowed for innovative policies that expanded access. They made COVID care free using emergency rules, expanded telehealth, and paid providers per patient per month payments to allow them to keep caring for their patients, said Lambrew.
“We should all try to figure out how to capture the common sense of caring and decency.”
Jeanne Lambrew
Although the spirit of cooperation during COVID-19 diminished, we can still look to maintain a common sense of caring and decency, said Lambrew. “People said we care. We care about our neighbors. We care about our friends, our families, our school kids, our elderly people. And that overrode some of the political differences,” she said.