The new GOP health care bill does almost nothing to address some of the biggest health care issues troubling Americans, many experts agree.
With so much focus on health care by Congress, the White House and news media, Americans might be forgiven for thinking the health care system is about to be transformed. Every year a new report shows the U.S. health care system is a mess, with Americans spending far more for medical care than people in any other comparable country, and getting less to show for it.
Republicans who support the new bill, which passed the House of Representatives on May 4, say it will cut costs and help get government spending on health care under control. But neither the 2010 Affordable Care Act not the proposed partial replacement bill, the American Health Care Act, digs deeply into some of the biggest flaws in the U.S. medical system.
Here’s a look at five issues the bill does not address:
Lower drug prices
Americans are angry about high drug prices and there’s no question that Americans are charged far more for prescription drugs than people in other countries are. President Donald Trump has said he wants to do something to lower drug costs and Congress has held a series of hearings in which they’ve scolded drug company executives.
Drug costs now account for about 17 percent of total U.S. healthcare spending.
But there’s nothing in either the ACA or the new bill about drug costs.
Quality of care
Americans routinely get tests, drugs, and surgery they don’t need. Recent reports have shown people get unneeded knee pain, back pain and end-of-life treatments. Medical care is mostly regulated by states, and licensed doctors are free to prescribe any approved drug or treatment. But quack clinics still proliferate and even legitimate hospitals and clinics offer unproven, unneeded or out-of-date treatments.
The new bill may make this worse, doctors argue, because it allows states to decide whether insurers have to follow the Affordable Care Act’s prescription to cover a list of tried-and-true services, from vaccination to cancer screening.
“We are overusing approaches that aren’t helpful,” Dr. Nicholas Bedard of the University of Iowa Hospitals and Clinic said in March, when he published a study showing patients and health insurance companies are wasting money on unnecessary knee treatments.
At the same time, a report from the Commonwealth Fund last November found that Americans skip doctor visits because of costs, and end up sicker as a result.
Surprise medical bills
Americans are almost never told up front what medical procedures will cost them. There’s no price list at most doctors’ offices, and many studies have shown a surprising and inexplicable variation in what people get charged for the same treatments.
For example, a knee replacement costs $29,000 in Kansas but $40,000 in Colorado, the Health Care Cost Institute found. Cataract removal costs $8,000 in Alaska but just $2,300 in Florida. Patients often get bills long after they’ve left the hospitals because one of the doctors who treated them was out of network, or because the insurance company didn’t pay the full price charged for a procedure.
A study last November found that 22 percent of emergency room patients got hit with out-of-network bills later. The new bill doesn’t mention this problem.
Help prevent mistakes
A recent, controversial report suggested that medical errors are the third leading cause of death in the U.S., behind heart disease and cancer. It’s true that tens of thousands of people die each year from medical errors, including hospital infections.
Legislation enacted as part of the 2010 Affordable Care Act seeks to address these errors using Medicare reimbursement as a stick. The new bill doesn’t address this issue.
Provide care to more Americans
The GOP supporters of the American Health Care Act say it will help get more Americans covered by lowering premiums. And experts said it might encourage younger, healthier people to buy health insurance by allowing companies to offer cheaper insurance plans that offer fewer services.
But medical and advocacy groups say it will result in fewer people getting coverage — especially the people who need it the most.
“As introduced, the bill would profoundly reduce coverage for millions of Americans — including many low-income and disabled individuals who rely on Medicaid — and increase out-of-pocket costs for the sickest and oldest among us,” a coalition of 10 groups representing patients and medical professionals, including the American Diabetes Association, the American Cancer Society Cancer Action Network, the March of Dimes and the American Heart Association, said in a statement.
The nonpartisan Congressional Budget Office said the last version of the AHCA would result in 24 million fewer Americans having health care. It promises to report on the latest version by May 22.