ABSTRACT
This Viewpoint summarizes inefficiencies in the 340B program and provides suggestions for equitable reform that will potentially benefit patients.
Subject(s)
Drug Costs , Government Programs , Prescription Drugs , Drug Costs/legislation & jurisprudence , United States , Government Programs/economics , Government Programs/legislation & jurisprudence , Federal GovernmentABSTRACT
PURPOSE OF REVIEW: Cardiovascular medications improve health and prevent early death. However, high drug prices reduce the use of these medications and strain the health system. The Inflation Reduction Act (IRA) of 2022 allows Medicare to negotiate drug prices with manufacturers and reduces out-of-pocket drug costs for Medicare beneficiaries. This article explores the potential impact that the IRA will have on the treatment of cardiovascular disease. RECENT FINDINGS: Cardiovascular disease medications are likely to be selected for price negotiations under the IRA, leading to savings for patients and for Medicare. Recent work suggests that the IRA's reforms to the Medicare Part D drug benefit will meaningfully reduce out-of-pocket costs for important cardiovascular medications. The IRA is expected to impact cardiovascular disease treatments via price negotiations and through the broader access to medications afforded by improvements to Part D coverage design.
Subject(s)
Cardiovascular Diseases , Heart Diseases , Medicare Part D , Aged , Humans , United States , Negotiating , Drug CostsSubject(s)
Betacoronavirus , Community Health Centers/legislation & jurisprudence , Coronavirus Infections , Pandemics , Pneumonia, Viral , Universal Health Insurance/legislation & jurisprudence , Boston , COVID-19 , Community Health Centers/organization & administration , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Financing, Government/legislation & jurisprudence , Humans , Patient Protection and Affordable Care Act , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Racism , SARS-CoV-2 , United StatesABSTRACT
Medicare for All has emerged as a major topic in the national health reform debate. A clear understanding of the policy issues raised by Medicare for All would benefit both public discussion and policy design. In this article we identify key policy design issues for a Medicare for All system: comprehensiveness of coverage, the private sector's role, the payment approach, and financing. We analyze policy options within these domains and show that the Medicare for All bills under consideration in the 116th Congress propose a comprehensive benefit structure with a limited role for supplementary private insurance. We suggest that Medicare for All could adopt payment rates between existing Medicare rates and the average all-payer rate, or it could implement global payment starting at a level similar to current spending. We propose a financing framework that includes repurposing existing public funds, redirecting private health care spending to public spending, and implementing a mix of progressive taxes to replace the regressive financing of private insurance.
