ACA restricts patient access to low-cost care
BY DOUG BEALL, M.D.

The highest-profile problems with the Affordable Care Act are well documented. Deficit spending and ever-increasing insurance premiums are among them. However, Obamacare’s most damaging side effects lie beneath the sexier headlines. They wreak havoc on physicians’ ability to deliver care in the private practice setting and restrict the ability of our neediest patients to access that care in places most convenient to them and at the lowest cost possible.

One example is the little-known 340B prescription drug program. When created by Congress in 1992, 340B intended to give vulnerable and uninsured patients affordable medicine by requiring drug companies to sell prescriptions to hospitals and other providers at deep discounts — often discounted 20 to 50 percent. However, what was originally designed as a program for hospitals serving a limited population has recently expanded into a money-making scheme that is shifting costs to private insurance buyers and incentivizing hospitals to buy out private medical practices.

340B was vastly expanded under Obamacare. According to the Health Resources and Services Administration (HRSA), which adminsters the 340B program, more than 11,000 entities participate in 340B, growing 30 percent since 2008. This trend is more dramatic in Oklahoma. The HRSA’s 340B online database shows that of the 277 Oklahoma hospitals and clinics currently participating in the program, an astonishing 83 percent joined the program since Obamacare’s passage.

These numbers suggest 340B has created a cash cow for the corporate hospitals in our state. Worse, Oklahomans have noticed private medical practices, maybe even their family doctor, being bought by big hospitals recently. It makes good business sense for an Oklahoma City hospital system to buy out private medical practices in surrounding areas to create revenue streams, particularly when those hospitals are getting drugs at 50 percent discounts and reselling them at astounding profit margins. This situation is comparatively worse for Oklahoma patients given that Texas and Colorado statutes prohibit the employment of physicians by hospital corporations.

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