A New Year and Seniors Remain Concerned
I first want to wish everyone a happy new year! I remember thinking about 2025 60 years ago, wondering if I would even be alive and wondering what life would be like. I had read an article in Popular Mechanics, one of my favorite magazines of my youth, about the possibility of flying cars early in this century, they missed a little on that one. I don’t remember reading anything about what healthcare might be like in 2026 but I’m pretty sure no one could have predicted the scientific breakthroughs and new medicines that would be discovered. I don’t think as a 16-year-old I even understood or cared, for that matter, how healthcare was administered or worried that in 2026 we would find ourselves concerned about how our healthcare is rapidly changing and wondering its future. Well, here we are, at the start of a new year, and it’s a good time to look back at what our concerns were in 2025 and see where we stand as we look forward to 2026.
Last year brought an unprecedented number of changes to Medicare and especially Medicare Part D, the prescription drug program. Historically changes to Medicare have been the result of legislation like the Inflation Reduction Act (IRA), which gave the government the ability to fix the prices of specific drugs. However, 2025 saw the swift changes brought about by Presidential executive orders and the threat of tariffs, especially the executive order used for the Most Favored Nation (MFN) approach to influence drug pricing. This action sought to use the prices for selected drugs in specific foreign countries to establish a baseline for negotiating a price with the manufacturers here in the US. This approach not only imports the foreign government’s price setting methodology but also threatens to saddle us with increasing barriers to life-changing drugs.
In our annual survey back in September, we asked seniors how they felt about Medicare and Part D and about the MFN approach. We got responses from more than 1,000 seniors and they were adamant on both subjects. While an overwhelmingly 93% of seniors were satisfied with their Part D prescription plans, a large majority of respondents – 88 percent – fear such policies [the MFN approach] could devalue seniors’ access to care. 89 percent feel they will conflict with doctors’ and patients’ choice, and more than 80 percent believe it could cause Part D to collapse.
The President and CEO of the Healthcare Leadership Council and Chair of Medicare Today, Maria Ghazal, said it best when she said, “Seniors know when something works—and Medicare Part D works. It’s one of Medicare’s greatest success stories, delivering real value and peace of mind. But that success is now at risk. Seniors are deeply concerned about foreign price-setting schemes that could undermine the coverage they rely on. They’re urging lawmakers to protect this vital program.”
Older Americans understand that Americans are paying most of the cost of innovation for the world. Did you know that 9 out of 10 drugs that start through the discovery, testing and the clinical trials never make it to market. This is one of the reasons that the cost of a successful drug is more than one billion dollars with some estimates approaching two billion dollars. Foreign countries have not been paying their fair share but having the government insert themselves into the process and dictating drug prices is not the answer.
The President has used the threat of tariffs and individual deadline letters to force drug companies to agree to lower prices on selected drugs. Fourteen different drug manufacturers have agreed to some manner of lower prices, with three more unnamed companies rumored to have also come to an agreement. Some look at this development as success but I’m not sure it will really accomplish its goal, and I fear that there’s a price to pay. First, there is no clear path that indicates the lower prices will result in lower out-of-pocket savings for you and me . . . the patients. Lowering the list price has not shown in the past to have had a noticeable impact on what the patient pays. As I’ve said before, short term politically based solutions are NOT the way to truly serve older Americans. Second, government intervention has already threatened the innovation system that has made our country the focal point for new drug discovery. Other countries, like China and France, are now offering key positions to scientists and the promise of funding to support the discovery of new life altering and lifesaving medicines. This shift will threaten our early access to new medicines to say nothing of the economic impact of losing our leadership in this area. The government’s decision to reduce the funding and the workforce at federal agencies has further hampered our country’s ability to discover new cures.
While the MFN scheme has been talked about for 7 or 8 years it only now has come into play. It is just one of many approaches that seek to increase our government’s involvement in our lives. It’s this continued march toward getting between our doctors and ourselves that concerns me. I would not be surprised if we begin to hear a renewed cry for a single payer, government run healthcare system. We need to tell our lawmakers to pay attention to what seniors truly want. It’s evident in our recent survey. They don’t want more government involvement in our healthcare.
Best, Thair