In my many years as lawmaker, rarely have I seen an issue as complex and contentious as the debate around health care in this country. Yet, common ground did and still does exist. Policymakers today are advancing bipartisan policies that break down barriers and reverse a number of misaligned incentives that can jeopardize the doctor-patient relationship.
With experience as both physician and a patient, I’ve long fought for a comprehensive overhaul of our health-care system that would inject market-based forces, increase transparency and promote choice for patients, with the ultimate goal of placing health-care decisions back in the hands of doctors and patients. While much bigger market-based reforms are needed to meet these objectives and reduce the overall cost of healthcare, there are a number of targeted ways policymakers today can enhance the patient experience.
One way to do this is by reforming and improving utilization management practices health plans place on patients. As a doctor, I’ve seen firsthand how the role of the health-care provider has been marginalized with more and more restrictions like these that put up roadblocks for patient care. We must make returning the power of practicing medicine to those with medical degrees a top priority.
Fortunately, a number of states have done just that by passing step therapy reform legislation that allow doctors to override step therapy protocols if a patient meets a set of strict criteria. These responsible policies are a win for patients, doctors and the overall health-care system. Perhaps that’s why Republicans and Democrats alike have come together to pass these bills.
At the national level, it’s equally as critical policymakers and regulators value the doctor-patient relationship. A recent proposal to allow for Medicare Advantage plans to increase the use of step therapy needs more scrutiny to ensure the doctor-patient relationship is upheld so patients can access the critical medicines they need. Ensuring patients can get the right medicine at the right time is instrumental in containing long-term healthcare costs and policies such as step therapy reform are constructive and commonsense ways to accomplish those two important goals.
Since my time in Congress, medical innovation has flourished for the benefit of patients. New treatments and procedures are coming to market that extend and better lives. In the cancer space — one I know well — more medicines are becoming available in oral form. These products can be safer than traditional IV chemotherapy and allow patients to fight their disease while continuing to live their lives.
Yet, because of the many misaligned incentives in our current healthcare system, health coverage has not kept pace with medical innovation, and some patients are forced to pay much more out of pocket for innovative therapies like these than they would traditional IV therapies — even if the therapies have the same price to the insurer. These cost-sharing barriers on patients ultimately interfere with a doctor and patient’s decision to decide the best course of treatment.
I know the emotional and financial toll that disease puts on a person, and I feel fortunate that I’ve survived multiple bouts with cancer. I’ve been lucky to have the opportunity to work with my doctors to find a personalized approach and to benefit from innovative treatments. But that innovation is all for not if barriers prevent patients from accessing the critical cancer medicines they need.
By lessening the burdens of care and bringing parity to the way plans cover these new innovative oral treatments and traditional IV treatments, we can improve outcomes and adherence for patients. Forty-three states and D.C. have bipartisan legislation on the books that does just that, and cancer patients are benefiting from these efforts.
It’s too much for the average American patient to have to deal barriers like these while also dealing with an illness. It’s immoral for physicians to spend more time on the phone with the insurance company than in the examination room with a patient. As policymakers wrangle with bigger questions around how to better America’s health-care system, they should consider these two-targeted bipartisan concepts
Dr. Tom CoburnThomas (Tom) Allen CoburnBiden and AOC's reckless spending plans are a threat to the planet NSF funding choice: Move forward or fall behind DHS establishes domestic terror unit within its intelligence office MORE served in the United States Senate from 2005-2015 and in the United States House of Representatives from 1995-2001. Coburn is a cancer survivor and was a family physician for three decades in Muskogee, Okla.