Editorial: Two smart ways to improve Obamacare
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Instead of compulsively voting over and over again to repeal the Affordable Care Act, which ain’t gonna happen as long as Barack Obama is president, could Congress actually do something to improve the quality of health care in the United States?
Yes, it could, and we wish it would. Nobody on the left or right would argue that health care in America could not be less expensive or more effective.
Obamacare is working. Since Obama signed the ACA into law in 2010, 20 million people have gained health insurance. And the human story behind that statistic was illustrated in Milwaukee last week when Brent Brown, a lifelong Republican who has an autoimmune disease, gratefully credited Obamacare with saving him from an early death. Until the ACA came along, he said in a letter to the president and then a speech, insurance companies denied him coverage because his illness was preexisting and hospitals would not provide him with the best care possible.
“I would not be alive without access to care I received due to your law,” Brown wrote to Obama. “Thank you for serving me even when I didn’t vote for you.”
But so much more could be done, without doing violence to anybody’s political ideology, to make health care work better in America. Here are two excellent examples:
First, Congress should require drug companies to package expensive medicine in more cost-effective ways. This might not sound like much, but researchers have found that nearly $3 billion worth of expensive cancer medicines are thrown away each year simply because of inefficient packaging. And that’s just for cancer medication. You can bet the total cost for all medications is far higher.
The New York Times reported last week that many drugmakers distribute their products, especially to hospitals, only in large vials that contain enough medication for the largest patients. For most people, that’s too much. In those cases, nurses extract just the amount needed and, for safety’s sake, toss out the excess.
In Europe, where the government does a better job of looking over drugmakers’ shoulders, some of the same medicines are shipped in vials of different sizes, cutting down on waste and saving money. How hard is that? Congress could see to it that the same is done in the United States.
Second, Congress should put a law on the books that requires better training for medical professionals as to what they can or cannot discuss with the families of mentally ill patients.
A report on Sunday by USA Today, carried in the Chicago Sun-Times, spells out the challenges family members face if an adult-age relative is struggling with mental health issues.
A 10-year-old law called the Health Insurance Portability and Accountability Act protects patients’ privacy by limiting what information medical professionals may disclose to third parties. That’s a barrier for families trying to help uncooperative adult relatives who need assistance with their mental illnesses but haven’t authorized doctors to talk.
One lawmaker, U.S. Rep Tim Murphy, R-Pa., wants to create an exception to HIPAA’s privacy protections for mentally ill people, but we believe that would go too far. As the American Civil Liberties Union and the NAACP have pointed out, that sets a risky precedent, opening the door for chipping away at other privacy protections.
A better law, introduced by Murphy along with Rep. Doris Matsui, D-Calif. and Sen. Chris Murphy, D-Conn., would make sure health care providers are better educated about what HIPAA does or does not require.
As things stand now, medical professionals unsure of the legal line often play it safe by refusing to discuss medical information with family members even when they legally free to do so.
As USA Today reports, a study published last year in The Journal of Nervous and Mental Disease found that deaths from suicide, drug abuse, injuries and other non-natural causes declined 90 percent for people with schizophrenia if their families were closely involved in their care. Without compromising a patient’s right to privacy, Congress could make it more likely — simply by promoting physician education in this area — that families are more involved.
When Obamacare officially turns six years old in two weeks, the law’s knee-jerk critics will no doubt engage in the usual mud-throwing. A more thoughtful way to mark Obamacare’s birthday would be to take sensible bipartisan steps to improve the law and to, more generally, improve the delivery of health care in America.
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