Health Insurance Success by Jeffrey R. Lewis (NAPSA)—America’s health system is due for a checkup—but it doesn’t have to be expensive. Encouraging transparency and cooperation between state govern- ments, unions and business provides instant results. Consider the cases of Ohio and Florida. Over 93,000 Ohioans have enrolled in Ohio’s Best Rx for total savings of almost $9 million. Meanwhile, almost 18,000 Floridians have taken advantage of a similar program, saving about $2.7 million. Thousands moreareeligible. William A. Burga, chairman of the Ohio AFL-CIO, helped form an unlikely coalition of statewide nonprofit organizations, including the pharmaceutical industry. No union leader had been so insightful. Burga’s effort created Ohio’s Best Rx, the first comprehensive prescription drug program to aid worthy yet uninsured Americans. The union had partners: the Heinz Family Philanthropies, the Pharmaceutical Research and Manufacturers of America (PhRMA), the National Council of Churches, nonprofits and Envision, a pharmacy benefits manager (PBM). Their full transparency and full disclosure policies credit 100 percent of rebates, rebate administrative fees and pharmacydiscounts back to the payer when prescriptions are filled. Most other pharmacy benefits managers keep the rebates, fees and discounts, making pharmacy benefit management a billion-dollar industry. Envision’s approach guarantees two things: First, people get the best price, and second, the process is totally transparent. What’s more, Sometimesthere really is a difference between price and value. its accounting and record keeping are available for inspection byall. The result: a commitment to better and more cost-effective health care that achieves results. Perhaps better still, these programs happen at no cost to state or federal governments. “The Burga Revolution” proves that labor and management, Democrats and Republicans, drug companies and communities, can work together to lower health care costs without spending taxpayer dollars. If President Obama really wants to move a market, there should be a requirementfor all PBMs to provide full and complete transparency over the subsidies they currently receive. Today, the only two companies that follow this path are Envision and Maxor National Pharmacy. The Ohio Legislature set aside divisiveness and put uninsured Ohioans before politics. Similar things happened in Florida, may soon happen in Los Angeles and could happen across the U.S. America is closer to the day when uninsured individuals needing prescriptions aren’t forced to choose between buying food and medicine. America needs people like Mr. Burga, businesses such as Envision and Maxor, andlegislatorslike they have in Ohio more than ever during these tough economic times. Mr. Lewis is the president of the Heinz Family Philanthropies and helped bring together the coalition in Ohio. He can be reached at jlewis@heinzoffice.org.
