Dr. Coburn spent years as a physician and a patient. He twice survived stage 4 cancer, a feat to which he credits the U.S. healthcare system.
The senator retired from Congress in 2014, but he still has targeted ideas for his colleagues and policymakers to enhance the patient experience. In an op-ed column for The Hill, Dr. Coburn details two reforms he’d like to see.
1. Reform the utilization management practices health plans enforce with patients. Insurance company restrictions on patient care present major obstacles for the physician-patient relationship, and this is an issue Republicans and Democrats can agree on. “We must make returning the power of practicing medicine to those with medical degrees a top priority,” the former senator wrote. He points to states that have passed step-therapy reform legislation, which allows physicians to override insurers’ protocols for drugs that must be tried first and proven ineffective before patients can move on to the treatment their physician or care team originally prescribed. For example, New Mexico signed SB 11 into law in March, which provides exceptions to the step-drug practice and allows patients to access the appropriate drugs originally prescribed to treat their disease faster.
2. Ensure health coverage is keeping pace with medical innovation. New treatments and procedures are coming to the market to extend and better lives, but health coverage has not kept up due to misaligned incentives. As a result, patients are forced to pay more out of pocket for innovative therapies, such as oral versus traditional IV chemotherapy, even if the treatments have the same price to the insurer. Dr. Coburn writes that such “innovation is all for not if barriers prevent patients from accessing the critical cancer medicines they need.” He points to 43 states and Washington, D.C., as leaders on this issue, as they have passed oral parity legislation, which limits patient out-of-pocket costs for oral medications used to treat cancer.
Read Dr. Coburn’s column in full here.
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