BIO supports the following three principles, and believes that each is a vital step toward meaningful health care reform and providing a solution to the nation’s health care crisis. BIO believes that each principle is equally important, that they are inextricably intertwined, and that any meaningful health care reform proposal must address all three. Specifically, BIO believes:
BIO supports universal access to affordable, sustainable, high-quality health care for all. Achieving universal access requires universal responsibility on the part of all stakeholders: individuals, employers, physicians, manufacturers, insurers, hospitals, and society as a whole. BIO believes that market-based reforms provide the best opportunity to achieve the goal of universal access while providing high quality care and incentives for the discovery and development of innovative improvements throughout the health care delivery system.
Today, nearly 46 million people in the United States lack health care coverage. Whether due to barriers in the enrollment process, limited choices because of preexisting conditions or simply the inability to afford health insurance, many Americans do not have access to the life-saving medications and therapies they need.
BIO and its member companies are committed to expanding the boundaries of science by discovering, developing and delivering innovative and needed medications to patients. Our products not only enhance the quality of life, they often offer patients the best option for medical treatment. We believe that all patients who can benefit from our medications and therapies should have access to them, and we believe that physicians, not third parties, are best equipped to decide whether and which medications are most appropriate for patients. Our goal is to get the right medical product to the right patient at the right time. However, BIO and its member companies can only help achieve this goal if effective and sustainable solutions are provided to ensure more people secure health care coverage and gain access to the latest innovations in medical treatment while maintaining incentives for innovation to occur.
To that end, BIO has identified the following issues as critical for policymakers’ to address as they craft policies designed to improve access to health care services and coverage:
1. Ensure universal access to medically appropriate, innovative therapies and diagnostics.
Patients should have access to the most appropriate treatments regardless of cost. It is both the role of the patient and physician to choose the best treatment and use the benefits of innovation appropriately. BIO member companies are actively engaged in developing innovative pharmacogenomics, as well as personalized medical therapies and diagnostics to improve patient care.
Proposals that limit access to these medical technologies can lead to potential delays in obtaining care or sub-optimal care, resulting in higher health costs and poor health outcomes. Through such means as Patient Assistance Programs (PAPs), many of BIO’s members are meeting their responsibility to assist financially vulnerable patients in accessing needed therapies when cost is a barrier. Outreach efforts to educate patients, health care providers, and pharmacists about manufacturer-sponsored PAPs that provide life-saving therapies to vulnerable patients at no cost should continue as part of a comprehensive approach to improving access to health care services and coverage.
2. Implement market-based, consumer-oriented solutions to increase patient access to innovation.
BIO supports solutions that encourage and enable the private market to ensure that consumers and providers have a choice among affordable coverage options, while enhancing and continuing the discovery of new innovative therapies and their accessibility to those patients who need them the most. Fostering innovation is the best way to sustain the growth in value of the health care delivery system. Innovation, including new medical therapies, can help to ensure access to needed health care by reducing the burden of or even curing costly diseases, as well as keeping total societal costs down. Innovations in the way treatments are covered and paid for, such as diagnosis-based formulary design, can enhance access while reducing costs. These kinds of innovations can only occur within a market-based, consumer-oriented system. Incentives should be realigned, potentially through tax credits or vouchers, to ensure that individuals obtain insurance through their employer, existing public programs or individually. In addition, medical malpractice reform should be considered a critical element to enhancing the delivery of medicine.
3. Maximize participation in and support consumer-oriented reforms to existing public programs, especially Medicaid and SCHIP.
Providing education and information regarding the programs which many of the uninsured are currently eligible for, but are not enrolled in, is an essential step to ensure that existing solutions and programs are fully utilized by the most vulnerable individuals. Outreach and awareness programs should be enhanced to ensure that those who are eligible do not face complex obstacles in enrollment, such as language barriers, complicated application processes, or inconsistencies between Medicaid and SCHIP rules and regulations. In addition to increased education efforts, BIO supports continued reauthorization of SCHIP. To the extent that Medicaid and/or SCHIP are expanded, BIO believes that such expansions will be most efficient if they are done concurrently with consumer-oriented reforms.
4. Enhance individual and employer responsibility in accessing health care coverage.
BIO and its members believe that individuals must take greater responsibility for their own health and obtaining health coverage. It is critical that all individuals be insured for the benefit of the entire health care system and have access to critical life-saving preventive care measures, such as immunizations, early detection and screening. Incentives should be provided to ensure that all eligible individuals participate in health plans where offered, either by employers or through the individual market. At the same time, employers, particularly small businesses, should have incentives to make providing health care to employees both affordable and efficient. Caring for uninsured individuals places a heavy burden on the health care system, with federal and state governments, as well as providers assuming significant responsibility for the costs associated with uncompensated care. These costs are ultimately passed on to insured individuals in the form of higher premiums and to all taxpayers. BIO also believes that patients should have access to continuous health care coverage and supports policies that improve health insurance portability.
5. Strengthen our nation’s health through increased access to preventive health measures.
Improvements to our health system are needed to ensure that all individuals have better, timelier access to care and therapies. Preventive health measures, such as screenings and immunizations, should be viewed as potential life-saving tools that will improve a patient’s quality of life. Early detection is essential for the early intervention and successful treatment of disease, and all patients should have access to these services. Our public and private health system should be reformed to reflect the importance of preventative health and in doing so, ensure that more extensive preventive health services are made available.
6. Embrace new technologies such as information technology that can improve the quality and delivery of health care.
The widespread adoption of secure and interoperable health information technology (health IT) has the potential to improve the quality of care while curbing the costs of health care. BIO supports efforts to promote the adoption of health IT, aimed at improving the efficiency and effectiveness of America’s health care system. It is also essential to improve efforts to coordinate data on clinical outcomes, so that physicians have access to the right data to make informed decisions about best practices, and to ensure that patients have the best treatments.
7. Recognize that universal access is most likely to be achieved through the employment of a combination of many coordinated solutions.
In order to better understand the effectiveness and implications of different approaches, federal and state governments should examine and learn from state and private sector initiatives that have proposed or implemented universal health coverage reforms. These proposals aim to affordably expand and improve health coverage through a combination of solutions that may be applicable in other states or at the Federal level.
BIO’s members remain committed to advancing innovation and developing new therapies and diagnostics to improve patient health. BIO welcomes the opportunity to continue to work with policymakers and other stakeholders on ways to improve access to innovative medical therapies, and to ensure that the most appropriate care is delivered to each patient.