Make Health Care Work Better For America

IMPROVING QUALITY WHILE CONTAINING COSTS—Health care costs too much in this country, and doesn't deliver enough based on what we pay for it. Fortunately, many of the best ways to improve the quality of our health care would also help contain costs. 

U.S. PIRG is calling on policymakers to go back to the drawing board and start working on solutions that will fix the fundamental problems in the American health care system. 

The bitter and contentious partisan debate in Washington is focused almost entirely on how to contain or assign the extraordinary cost of health insurance. And the specific bills being debated would likely make things worse for millions of Americans by degrading the quality of care, weakening protections for people with pre-existing conditions, and forcing many Americans to give up the coverage they currently have. 

But the biggest failure with these proposals is that they fail to address the underlying problem with the American health care system: We are spending far too much, and getting far too little in return, for our health care dollar. Despite a health care system world-renowned for developing advanced treatments, and an army of skilled and well-meaning doctors, nurses, researchers, hospital and pharmacy staff, our crazy-quilt health care system still fails to deliver an acceptable value proposition for consumers.

Health care is too expensive

Health care costs too much in this country, not because too many people have access to it, but because the system is simply too expensive. From $1,000 toothbrushes to giant price hikes for decades-old medicines like insulin, unjustifiably high costs are everywhere in the U.S. health care system.

And these excessive costs can largely be attributed to widespread waste that doesn’t actually improve quality of care — waste that is estimated to represent a third or more of every dollar we spend on health care. Fortunately, many of the best ways to improve the quality of our health care would also help contain costs.

How we can make health care work better

  • Holding the health care industry to a higher standard. America’s health care system is world-renowned for developing advanced treatments. But we often fail to get the basics right, frequently failing to provide effective, low-cost treatments that work, triggering unnecessary treatments and higher costs down the line. By expanding research into evidence-based medicine and holding providers accountable to higher standards of care, we know we can make progress.
  • Investing in prevention. Our current system rewards hospitals and doctors for performing as many procedures and prescribing as many drugs as possible, with little consideration given toward whether they actually keep us healthy and out of the hospital. We need to change those incentives, and provide easier access to preventative services. Despite some promising small-scale efforts, there’s still far too little being done to change this.
  • Holding health insurers accountable. There is often too little oversight to ensure insurance companies are delivering on their commitments to their members. In many states, insurers are not held to meaningful standards to ensure adequate access to needed services. Health insurance rate hikes receive little scrutiny even though states that review rates have cut a great deal of waste from premiums—for example, in Oregon, where OSPIRG’s advocacy for consumers has helped cut over $179 million from premiums since 2011. By focusing on insurers’ payment strategies and quantitative goals and results, closer scrutiny of health insurers can complement other efforts to drive systemic reforms to improve safety, increase care coordination, boost prevention, and bring down costs for consumers and small businesses.
  • Comprehensive prescription drug reform. America’s prescription drug development and patent system is failing consumers, too often leading to egregious price hikes or the development and marketing of the next “blockbuster” drug that may be of marginal health benefit, rather than research into needed breakthrough therapies for life-threatening conditions. The savings from overhauling the patent system—which gives pharmaceutical corporations immense pricing power—can be reinvested in research into high-priority therapies. Other commonsense reforms could also make a huge difference, like allowing Medicare to negotiate drug prices, requiring drug manufacturers to explain the basis for their prices, and stopping anti-competitive practices by big pharmaceutical corporations.
  • Price transparency for health care services. The very least we can do about rising health care costs is make sure consumers can get prices for services or treatment up front, to allow for more informed decisions about value, encourage price competition that could help keep costs in check, and create accountability for unreasonably high-cost providers.
  • Preserving competition. With countless mergers in recent years between hospital systems, health insurers, pharmaceutical corporations and others, health care has become increasingly consolidated. Unfortunately, bigger is not always better for consumers; studies show consolidation often leads to higher prices and worse service. More scrutiny of health care mergers and tougher anti-trust enforcement against companies that seek to avoid competition could make a big difference.
  • A public option health plan—e.g., providing Americans under 65 with the option of buying into Medicare or Medicaid—could provide consumers with a cheaper alternative to commercial health insurance, ensure that there are coverage options for consumers who lose their employer-based coverage or those in parts of the country where health insurers are dropping coverage, and put pressure on health insurers to provide a better deal or lose our business. 

We need your help

Powerful health care industry lobbyists will fight these changes and work to preserve the status quo, and the politics of health care has never been more divisive. But now is the time—in fact, long past the time—for our leaders to work together to advance the public interest, and address the fundamental problems of cost and quality in our health care system.

Please join us in calling on Congress to take concrete action to make health care work better for American consumers by enacting these commonsense reforms.

Photo credits, clockwise from top: Ilmicrofono Oggiono via Flickr CC by 2.0, Images Money via Flickr CC by 2.0, skeeze via Pixabay CC0 Public Domain.

Issue updates

News Release | US PIRG Education Fund | Consumer Tips, Health Care

Report: Nursing homes endure massive PPE shortages

Seven months into this pandemic, PPE shortages have become much worse, according to “Nursing home safety during COVID: PPE shortages,” a report by the U.S. PIRG Education Fund and Frontier Group.

> Keep Reading
News Release | U.S. PIRG | Health Care

Humira manufacturer’s efforts to block generic options challenged in court

The maker of Humira, the world’s best-selling drug, faces a new legal challenge over alleged anticompetitive tactics. Monday, U.S. PIRG filed an amicus brief in the 7th Circuit Court of Appeals arguing that AbbVie’s strategies of reverse payment settlements and creating “patent thickets” have delayed the entry of biologically similar generic drugs (biosimilars) onto the market, costing Americans billions of dollars. 

> Keep Reading
Blog Post | Health Care

Chase away loneliness - visit your loved one in the nursing home | Patricia Kelmar

New federal policy gives greenlight to nursing homes to allow safe outdoor visits

> Keep Reading
Blog Post | Health Care

Is it safe to return to the dentist? | Patricia Kelmar

It’s probably been over six months since your last dental appointment. Should you return for your check up?

> Keep Reading
News Release | U.S. PIRG Education Fund | Health Care

Weds. panel discussion: Two major reasons consumers don’t get a fair price or effective prescription drugs

U.S. PIRG Education Fund is co-sponsoring a free Zoom panel in which panelists will discuss two ways consumers and patients are harmed by drug industry price manipulation and lack of competitive restraints: step therapy and rebate walls.

> Keep Reading

Pages

News Release | US PIRG Education Fund | Consumer Tips, Health Care

Report: Nursing homes endure massive PPE shortages

Seven months into this pandemic, PPE shortages have become much worse, according to “Nursing home safety during COVID: PPE shortages,” a report by the U.S. PIRG Education Fund and Frontier Group.

> Keep Reading
News Release | U.S. PIRG | Health Care

Humira manufacturer’s efforts to block generic options challenged in court

The maker of Humira, the world’s best-selling drug, faces a new legal challenge over alleged anticompetitive tactics. Monday, U.S. PIRG filed an amicus brief in the 7th Circuit Court of Appeals arguing that AbbVie’s strategies of reverse payment settlements and creating “patent thickets” have delayed the entry of biologically similar generic drugs (biosimilars) onto the market, costing Americans billions of dollars. 

> Keep Reading
News Release | U.S. PIRG Education Fund | Health Care

Weds. panel discussion: Two major reasons consumers don’t get a fair price or effective prescription drugs

U.S. PIRG Education Fund is co-sponsoring a free Zoom panel in which panelists will discuss two ways consumers and patients are harmed by drug industry price manipulation and lack of competitive restraints: step therapy and rebate walls.

> Keep Reading
News Release | U.S.PIRG | Health Care

Approved CVS-Aetna merger leaves Americans facing even higher prescription drug costs

Judge Richard J. Leon of the United States District Court for the District of Columbia today approved a massive merger of CVS, the country’s largest retail pharmacy chain, and Aetna, the third-largest health insurer in the United States, despite significant opposition from consumer advocates and health care organizations. Consumer Watchdog Adam Garber put out a statement in response.

> Keep Reading
News Release | U.S. PIRG | Health Care

Medicare X Act would provide better-value health care options for Americans

The Medicare X Choice Act, newly introduced by Sen. Michael Bennet of Colorado and Sen. Tim Kaine of Virginia, is poised to transform the discussion about how to fix America’s broken health care system.

> Keep Reading

Pages

Result | Health Care

KEEPING HEALTH CARE AFFORDABLE

Across the country, U.S. PIRG has stood up against unjustified rate hikes and won victories in Oregon and California so far. Thanks in part to our advocacy, California now requires insurers to justify rate hikes to the public, and Oregon state regulators recently cut a proposed 22% rate hike almost in half, saving $12.5 million for some ratepayers.  

> Keep Reading
Result | Health Care

Young People Now Covered

This year, the federal health care reforms that U.S. PIRG worked to win have started to pay off for young people. In the past, teens saw their premiums soar or were denied coverage when they turned 19, even if they’d been insured their whole lives. Now, they can remain on their parents’ plans until age 26. 

> Keep Reading
Report | U.S. PIRG Education Fund | Health Care

The Real Price of Medications

People living in the United States have access to some of the best medical care in the world, from life-saving drugs to cutting-edge surgical techniques. But our system is deeply flawed, with spiraling costs forcing many Americans to spend more on care and often receiving poor quality care for all the extra money spent.

> Keep Reading
Report | U.S. PIRG Education Fund | Health Care

Should I Stay or Should I Go?

Tips for consumers deciding whether to keep their individual health insurance plan or switch to a new plan.

> Keep Reading
Report | U.S. PIRG | Health Care

Top Twenty Pay-For-Delay Drugs

Our research revealed 20 major drugs that were subject to an industry practice called “pay for delay,” in which brand name pharmaceutical companies pay off generic drug manufacturers to keep lower cost equivalents off the market, forcing consumers to pay higher brand-name drug prices.

> Keep Reading
Report | U.S. PIRG | Public Health, Health Care

Prescription for Danger

Compounding pharmacies are increasingly behaving like pharmaceutical companies by producing drugs in bulk, despite the fact that they are not inspected or regulated like the pharmaceutical industry. Due to this lack of oversight, many compounding pharmacies have not adhered to safe manufacturing practices, and shown little regard for consumer safety. According to an analysis of warning letters sent to other compounding pharmacies by the FDA from 2002 to 2012, there is a long history of violations that have in many cases led to unnecessary illness, injury, and even death.

> Keep Reading
Report | U.S. PIRG Education Fund | Health Care

Making the Grade

This report assesses the progress that the states have made, and for the states that have begun to set up their health care exchange, evaluates them on the myriad policies and criteria that will determine whether it is ultimately successful in improving health care for consumers.

> Keep Reading

Pages

Blog Post | Health Care

Chase away loneliness - visit your loved one in the nursing home | Patricia Kelmar

New federal policy gives greenlight to nursing homes to allow safe outdoor visits

> Keep Reading
Blog Post | Health Care

Is it safe to return to the dentist? | Patricia Kelmar

It’s probably been over six months since your last dental appointment. Should you return for your check up?

> Keep Reading
Blog Post | Health Care

Webinar Wednesday: Why consumers don't often get a fair price or effective prescription drug | Ed Mierzwinski

U.S. PIRG Education Fund is co-sponsoring a free zoom webinar Wednesday, June 24, at noon ET on two ways consumers and patients are harmed by drug industry price manipulation and lack of competitive restraints. Consumers often don't get a fair price and don't always get an effective drug. Read further to register for the free "Rebate Walls and Step Therapy" event featuring leading experts.

> Keep Reading
Blog Post | COVID-19, Health Care

What the coronavirus pandemic means for overall health care costs | Elizabeth Ridlington

Elizabeth Ridlington, Frontier Group Senior Policy Analyst explores some questions about how the coronavirus will affect health care spending overall and by governments, and the health care system itself.

> Keep Reading
Blog Post | COVID-19, Health Care

What the coronavirus pandemic means for health insurance | Elizabeth Ridlington

The coronavirus pandemic is reminding us, once again, of how expensive the nation’s health care system is. It’s the high cost of health care that makes health insurance so expensive for individual consumers, employers and the nation, and the cost and structure of insurance can have real consequences for health.

> Keep Reading

Pages

News Release | US PIRG Education Fund

Seven months into this pandemic, PPE shortages have become much worse, according to “Nursing home safety during COVID: PPE shortages,” a report by the U.S. PIRG Education Fund and Frontier Group.

News Release | U.S. PIRG

The maker of Humira, the world’s best-selling drug, faces a new legal challenge over alleged anticompetitive tactics. Monday, U.S. PIRG filed an amicus brief in the 7th Circuit Court of Appeals arguing that AbbVie’s strategies of reverse payment settlements and creating “patent thickets” have delayed the entry of biologically similar generic drugs (biosimilars) onto the market, costing Americans billions of dollars. 

Blog Post

New federal policy gives greenlight to nursing homes to allow safe outdoor visits

Blog Post

It’s probably been over six months since your last dental appointment. Should you return for your check up?

News Release | U.S. PIRG Education Fund

U.S. PIRG Education Fund is co-sponsoring a free Zoom panel in which panelists will discuss two ways consumers and patients are harmed by drug industry price manipulation and lack of competitive restraints: step therapy and rebate walls.

Health Care

U.S. PIRG files amicus brief in Humira court challenge

U.S. PIRG has filed an amicus brief in a legal challenge brought against pharmaceutical company AbbVie, maker of the world's best-selling drug, Humira, arguing that its use of pay-for-delay settlements and "patent thickets" constitute anticompetitive practices and have cost Americans billions.

 

Health Care | U.S. PIRG

Searching for common ground on caregiving

In our politically divided time, it's difficult to see where we can find common ground. But the need to value the work of caring for our loved ones is one such place. PIRG Senior Director of New Economy Campaigns Evan Preston explains in his blog, "Toward Consensus on Caregiving."

 
View AllRSS Feed

Support Us

Your donation supports U.S. PIRG’s work to stand up for consumers on the issues that matter, especially when powerful interests are blocking progress.

Consumer Alerts

Join our network and stay up to date on our campaigns, get important consumer updates and take action on critical issues.
Optional Member Code



U.S. PIRG is part of The Public Interest Network, which operates and supports organizations committed to a shared vision of a better world and a strategic approach to social change.