This guest post is by Marc Hymovitz, Director of Government Relations and Advocacy for the American Cancer Society, New England Division. Marc has been a long-time leader in the ACT!! health reform coalition, and a strong advocate for comprehensive health care that meets the needs of patients with cancer.
As leaders in Massachusetts seek to address the unsustainable increases in health care costs, leaders must keep in mind the core goals of the Commonwealth’s landmark health care reform – to not just ensure access to health care for every resident but to guarantee that the care they receive access to is comprehensive and adequate.
Recent suggestions to remove prescription drug coverage from the basic level of services a plan must have to allow a consumer to meet Minimum Creditable Coverage (MCC) are short-sighted and will ultimately increase costs and reduce patient care.
Prescription drugs play a central role in health care today – equal to the role of doctor’s visits and hospital care. In most cases, drugs are the first line of defense in preventing and treating disease and illness. Those who suffer from chronic or acute disease rely on medications to control their illnesses and avoid costly hospitalizations. An avoided hospitalization saves far more than the cost of many courses of prescriptions.
The need for drug coverage is not isolated to those with chronic diseases, however. Drugs including allergy medicines and antibiotics are widely used to stay healthy. In fact, according to the CDC, nearly half of all Americans are using at least one prescription drug in any given month. This is compared to 7% who have a hospital stay in any given year. Additionally, 71% of doctor visits and 73% of hospital visits result in a prescription.
Additionally, ensuring everyone has prescription drug coverage included in their benefit package wisely spreads the costs across all those with insurance lowering the costs for everyone. This is the fundamental idea behind insurance. Without the MCC rules, patients who need prescriptions would face much higher expenses, and would be threatened with worse health outcomes.
We at the American Cancer Society are all too familiar with the need to bring health care costs under control. We hear often from cancer patients and their families who are unable to access or afford the care they need to fight their illness. Removing prescription drug coverage from MCC is counter to all of our shared goal of ensuring access to quality, affordable health care for every resident of the Commonwealth. Having an insurance card is meaningless if it does not provide you access to the care you need.