Lowering prescription drug prices was a rallying cry for politicians in last year’s midterm election, and people came out in droves to support candidates who promised action on this front.
Drug pricing, as well as the broader issue of crippling health care costs, cuts across lines that divide liberals and conservatives, millennials and baby boomers. Drug pricing is also particularly important to racial/ethnic and sexual minority communities. While we spend more money on more expensive medicines -- especially considering the disproportionate rates and severity of diseases that we suffer -- our access to them is less guaranteed when compared to our white counterparts.
We all suffer more when health care is too expensive and out of reach.
According to the National Institutes of Health (NIH), lesbian, gay, bisexual, transgender, queer and same gender loving (LGBTQ/SGL) people are more susceptible to addiction, obesity, and mental health struggles due to discrimination and trauma. Diabetes is 60 percent more common among African Americans compared to white Americans. Being either black or identifying as LGBTQ/SGL is quite literally bad for your health. Being both black and queer is even worse.
At the same time, there’s also a significant coverage gap between black and white Americans, despite significant strides made under the Affordable Care Act. LGBTQ/SGL adults are twice as likely to be without health insurance. And even for minority patients who do have insurance, out-of-pocket costs can price working people out of the medications and treatments they need to live and to thrive.
Average out-of-pocket costs for deductibles and co-pays for inpatient treatments were more than $4,600 in 2018 — up significantly from the year before. Patients are being slammed with “surprise bills” more and more. Even if you go to a hospital that’s in-network for your insurance company, the doctor who actually treats you can be an out-of-network provider. This morally repugnant practice is crippling families who get stuck with the bill.
Finally, our elected officials in Washington, D.C. are starting to wake up.
The Lower Health Care Costs Act of 2019, being considered by the Senate right now, contains a provision that would set a benchmark rate for in-network providers. It would also cap out-of-pocket costs for seniors whose pills are covered under Medicare Part D. Both actions would go a long way towards helping vulnerable patients avoid being forced to choose between getting the care they need, self-rationing medications, or skipping payments on other bills.
Unfortunately, the same bill also contains section 207, which would repeal the current system of public standards for biologic drugs, which ensures the medications we take are safe and effective. Repealing this requirement is a terrible idea, and it wouldn’t do anything to make prescription drugs cheaper.
Instead, it would remove transparency requirements, while expanding the role of pharmaceutical companies in self-policing their own products. For the most vulnerable patients among us, this presents challenges – black patients have been subjected to abuses like the Tuskegee Syphilis Study, without their knowledge or consent. We cannot further erode this trust.
We’ve got enough problems. Discrimination of racial/ethnic and sexual minority patients is well documented, and it keeps too many members of our communities from seeking preventative care, which can make chronic conditions worse and lead to death. There’s also the stigma of anti-gay HIV/AIDS prejudices that still keeps us from getting the care we need and deserve. Finally, there simply aren’t enough culturally competent doctors and nurses to provide care for the most marginalized among us.
Heading into 2020, Congress should focus on solving the health care policy problems that are harming the health of our communities and our economic stability, not making new problems for at-risk patients. The Senate should push forward pro-patient policies, like capping Medicare Part D costs and stopping surprise billing to ensure affordable drug prices.
David J. Johns is the Executive Director of the National Black Justice Coalition, which works to end racism and homophobia so that all Black people can get free. He is an educator, researcher, federal policy expert, and advocate.