Healthcare Professionals Can Help Mitigate the Consequences of Government Price Controls

In August, the Centers for Medicare & Medicaid Services (CMS) released details around medicine that will be subject to the first round of government price controls—newfound authority originating from the 2022 Inflation Reduction Act. While the intent to lower costs for patients is commendable, the approach is fraught with flaws.

Notably, clinical healthcare professionals such as physicians and pharmacists are at best being kept an arm’s distance from the process. We are already seeing the results of the distance.

The new policy is flipping Medicare upside down for seniors and increasing out-of-pocket costs. Average Medicare Part D premiums are up more than 20 percent this year compared to 2023. And these downsides are only expected to spiral as the government price controls expand.

This was wholly predictable.

We only need to look back at our collective experience with the suffocating pandemic shutdowns, engineered by politicians and their appointees. Americans shouldered the brunt of the decisions; businesses closed permanently, people lost their jobs, the “free” money train led to the inflation we’ve seen the past two years, and school closures set the stage for extensive learning losses in our kids.

Nowhere were these shutdowns felt more than in healthcare.

Clinical healthcare professionals, the real heroes of the pandemic, delivered care in sometimes very risky circumstances, but we were left out of policy setting. That mistake has been criticized by many, most notably by the former head of National Institute of Health, Francis Collins.

My experience is instructional.

Dentists, along with ears, nose and throat specialists, were at the tip of the spear when it came to treating unmasked and potentially contagious patients, presumably raising our risk of contracting the coronavirus. Surprisingly to some, the worst part for us was not the risk of contracting the virus, but the ever-changing, conflicting, and costly regulatory “pandemic” prescribed by non-clinical government regulators.

The result was a glaring increase in the severity of dental disease, increased costs and an accelerated retirement rate for dentists and dental auxiliaries, resulting in less access. Do we want to follow the same path, jeopardizing choice and access, when it comes to medicine access through Medicare?

There is a lesson to be learned from clinicians such as myself by those who promote staying the course with this new CMS government price control plan: Stop trying to solve shortcomings within the less-than-ideal healthcare system by relying on those who do not actually provide the care.

CMS can reduce the negative repercussions of the present price control folly by giving clinician voices a bigger seat at the table when decisions are being made to mitigate fallout. Physicians and their healthcare colleagues possess a deep understanding of the nuances of healthcare—real-world experience that can help CMS sidestep the proverbial landmines that are avoidable.

It is wishful thinking to believe that government bureaucrats can successfully navigate this complex web of patient incentives, drug market dynamics, and most importantly personal patient care without leadership from clinical professionals. Common sense and the coronavirus shutdown experience should be proof enough.

The forced lowering of prices for selected drugs, as opposed to ensuring patients have access to the proper drugs, is wrongheaded and harmful. But if that is the primary goal of this or any future Administration, I’d prefer that clinical care professionals lead that process to help mitigate the damages that are sure to arise.