Lawmakers in Olympia have introduced a host of measures to address one of the biggest issues facing Washingtonians: rising health care costs.
A survey from November found more than four of five people in the state worry about being able to afford health care in the future.
Jim Freeburg, executive director of the Patient Coalition of Washington, said increasing costs affect the health decisions people make.
“It’s people that can’t afford their medications and so, they skip doses, or they delay care, just because they’re so scared about getting the bill,” Freeburg observed. “We just see instances like this all the time.”
Measures introduced this session would tackle costs on a number of fronts. They include bills to combat the increasing number of health system mergers, examine prescription drug prices and strengthen the authority of the Health Care Cost Transparency Board, which was created in 2020.
Bill Kramer, executive director of health care policy for the Purchaser Business Group on Health, said increased costs hurt businesses, too. He noted employers provide coverage to more than half of Americans and explained providing coverage is valuable to employees, but is becoming less sustainable.
“High health care costs are crowding out jobs, wages and business investment, and are a real drag on the economy,” Kramer pointed out.
One measure in Olympia would reduce the power large health care systems have when negotiating with insurance companies on prices.
Sen. June Robinson, D-Everett, a sponsor of the bill, said the health care systems sometimes take an “all or nothing” approach where they say they will only contract with a particular facility if providers contract with all the facilities in a state or region .
“In some places, that might not be the best or lowest-cost option available,” Robinson noted. “So, they’re basically using their market share to drive up the cost of health care.”
Robinson added the Senate bill would restrict uncompetitive practices when negotiating prices. It has a public hearing in Olympia on Friday.
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The North Carolina Institute of Medicine is making new recommendations to improve health care in the state.
The suggestions focus on expanding health care capacity, fostering healthy communities, and increasing local collaboration. A task force investigated the health care system’s strengths and challenges, and has developed a vision for the future of health care in the state.
One challenge is North Carolina’s per capita funding for public health has decreased by 30% in the past decade.
Brieanne Lyda-McDonald, project director for the North Carolina Institute of Medicine, said making the recommendations a reality will come down to dollars and cents.
“We are actually fairly low in the per capita funding for local public health, when we look at the rest of the country,” Lyda-McDonald pointed out. “Right now, we’re at $76 per capita in North Carolina.”
She compared it to the national average of $116. The group also urged finding ways to make funding sustainable and flexible, depending on the needs of each community. The recommendations also focused on building a stronger network of health care providers who can share data on the people most in need.
Beyond funding, the group recommended more collaboration among health care providers, to make better use of public health data and build community partnerships. Lyda-McDonald said the most important factor in these partnerships is including members who trust each other.
“Making sure that public health is representing and serving all the needs of community members, regardless of race and ethnicity, income and geographic location,” Lyda-McDonald stressed.
The report also suggested doing more to recruit and retain a strong public health workforce. The task force is sharing its findings with lawmakers and state public health policy experts.
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About 45% of Black Americans have hypertension, also known as high blood pressure, compared to 31% of white Americans. Now, a new program in Southern California is working to lower the numbers.
The American Heart Association is teaming up with the health care company Providence on a three-year program to narrow the disparities affecting Black and Latino Californians in the Los Angeles area.
Dr. David Pryor, regional vice president and medical director at Anthem California and co-chair of the American Heart Association Los Angeles Hypertension Task Force, called hypertension a “silent killer.”
“A person may have high blood pressure and they don’t even know it,” Pryor explained. “They actually could be feeling quite normal. It really is only when the blood pressure gets more severely elevated that a person might start noticing some symptoms like headaches, chest pains or shortness of breath.”
The program is placing blood pressure kiosks in the community, providing health resources to barbershops and salons, and training community health workers. The Heart Association also offers a lecture series for primary care providers on treating hypertension in the Black and Latino communities.
Dr. Daniel Lewis, regional medical director for Facey Medical Group in Tarzana and leader of the group’s Black Physicians Council, said it’s very important to “know your numbers.”
“The way people die, most of all, is heart attack,” Lewis pointed out. “And hypertension is one of the main associating factors. Unfortunately, hypertension runs highest in the Black community, and with that comes heart attack, stroke, kidney problems.”
The Centers for Disease Control and Prevention reported heart attacks are the country’s number one killer, taking almost 700,000 lives in 2020. In the same year, more than 160,000 people had fatal strokes.
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Big changes are underway for Medicare participants, after historic legislation put them in motion this month.
More than 1.8 million Georgians who are Medicare enrollees will see lower-cost premiums and deductibles, and can save money on some prescription drugs.
Leigh Purvis, senior director of health care costs and access at the AARP Public Policy Institute, described a few of the changes.
“The first is that recommended vaccines will now be free for Medicare beneficiaries,” Purvis pointed out. “The second is that insulin costs will now be limited to $35 per month for people who are in Medicare prescription drug plans. And the third is that drug companies are now going to be penalized for increasing their prices faster than the rate of inflation.”
She explained Medicare “Part B” premiums are deducted from people’s monthly Social Security payments. Since this year’s Social Security’s cost-of-living adjustment increased benefits by 8.7%, she noted people who are already enrolled in both programs will see more money in their pockets each month.
Purvis added more than 100,000 people in Georgia use insulin to manage their diabetes, and lowering the cost will help those who have struggled to afford insulin.
“As long as that insulin is covered by their prescription drug plan,” Purvis explained. “That’s really important because we know that previously, some people were facing, on average, monthly costs of around $50. And some people were paying more than $100.”
Purvis added this year, Medicare will start phasing in annual limits on how much people have to spend out of pocket on their prescriptions. As of 2025, the new limit will be $2,000 a year.
“And that is real savings, because we know that there are people out there who have been spending upwards of $10,000 per year on their prescription drugs,” Purvis observed. “Now, people in Medicare prescription drug plans will have a relatively low and meaningful out-of-pocket limit on their prescription drug costs every year.”
Medicare price negotiations will start with 10 drugs. People will learn what they are by this fall, and the negotiated prices will take effect in 2026. Medicare will add more drugs every year, and patients could see as many as 60 prescription drugs with negotiated prices by 2030.
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