- 1895: Lower Healthcare Costs Act
On 19th June 2019, Senator Lamar Alexander, Joni Ernst, and Patty Murray introduced the bill, lower healthcare costs act. The introduction of the bill aimed to protect patients from surprising medical bills, expand transparency in healthcare costs, reduce the cost of prescription medicine, and improve investment in public health (Gaffney & McCormick, 2017). According to the bill, patients will be protected from surprising medical costs through the use of benchmark rates, which resolve payment disputes between insurance plans and out-of-network providers.
Background for the problem
America spends most of its expenditure on healthcare compared to other countries globally, and most of the healthcare cost is incurred by the federal government (RR). In 2017, the U.S. spent approximately 3.5 trillion dollars in healthcare, translating to 18% of its GDP. Out of the $3.5 trillion, the federal government dedicated $1.5 trillion, which means the federal government spends almost 8% of its expenditure on health. According to (RR), it is projected that by 2028, the costs of healthcare will escalate to $2.9 trillion, which precisely means 9.7% of the economy will cater to healthcare.
Evidence to support the proposed policy
Surprising medical bills refer to charges incurred by an insured individual when they receive care from out-of-network providers. Often, it includes emergencies, women in labour, and requirements of specialized care, which the physician or facility considered in-network cannot provide. According to Luna et al. (2020), 66% of Americans are worried of their ability to afford unexpected medical bills; while a more significant proportion of this population cites that they are concerned about other types of healthcare costs and household expenses. Besides, about 50% of insured Americans are worried about their ability to afford health insurance deductible, and 40% are concerned about their ability to afford premiums. More than 40% of insured Americans are worried about affording prescription medications, while 42% are concerned about the cost of rent and mortgages (Luna et al. 2020). Also, 38% of Americans are worried about their capability to afford gasoline and other transportation expenses, with 34% being worried about affording food and utilities. From the statistics, healthcare should be made affordable. Before a patient is attended to by an out-of-network service provider, they should be made aware to avoid surprising medical expenses.
References
Gaffney, A., & McCormick, D. (2017). The Affordable Care Act: implications for healthcare equity. The Lancet, 389(10077), 1442-1452.
Luna, L., Audrey, K., Lizz, H. & Mollyann, B. (2020). Data Note: Public Worries About and Experience with Surprise Medical Bills.