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Healthier People Through Healthier Markets

Solutions to Improve Health Care Affordability and Access for Every American

Introduction

Every American deserves access to affordable, comprehensive, high-quality coverage and care. But health care prices continue to escalate year after year, making coverage and care less accessible for everyone. This challenge can be tied directly to less competitive health care markets, and it calls for a comprehensive effort to spur the robust competition that is essential to providing Americans with more choices, better quality, and lower costs.

The American health care system has been tested in extraordinary ways in recent years. As we seek to move past the COVID-19 pandemic, now is the time to take action.

Insights

Solutions

By improving competition in a few key areas of our health care system we can improve affordability and access for everyone. Health insurance providers are committed to working with federal and state officials and other health care leaders to take decisive action, and to advocate for the laws, regulations, and needed enforcement. Consumers deserve no less.

Improving patient choice

By expanding access to telehealth, home-based care, and biosimilar drugs – among others – we can give patients and consumers more control to get the care and prescription drugs they need, when they need it at a price they can afford.

Improving transparency

Private equity entities have vastly different business models than other health care organizations. We need more transparency into how private equity control has impacted quality and value for patients, consumers, and businesses.

Protecting patients, consumers, and businesses from overpaying for care

That means stopping anticompetitive behavior by health systems who use monopoly power to impose unreasonable contract terms that raise costs for everyone. It means defending consumers against having to pay more for the same service depending on the site of care. And it means taking real action to curb the effects of the dialysis duopoly that undermines affordability for kidney care patients.

Stop the drug pricing games

For too long, Big Pharma has gamed our health care system – and consumers pay the price. We must stop patent schemes that distort the marketplace to maintain monopoly profits, crack down on provider-acquired drugs to stop the rapidly escalating markups, and address the ways in which drug companies abuse charitable structures to protect monopolies rather than help patients.

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    ICER's Steve Pearson talked with AHIP about the lack of healthy competition in health care, which leads to dysfunctional markets that harm patients.