From Kansas City Medicine, Third Quarter 2020
Read PDF of full Kansas City Medicine candidate Q&A
(Steve Hohe did not respond to our candidate questionnaire.)
What lessons have we learned from COVID-19, and how can we be better prepared for future pandemics?
Adkins: The coronavirus pandemic has taught us the American people don’t want politics; they want leadership and clear direction. Congress lacks enough leaders with business and health care experience. As a leader in health care for more than a decade, my mission is to make the system better. In the midst of the crisis, I shared a coronavirus response plan focused on: 1) Disease detection; 2) Risk mitigation; and 3) Supply chain management. Providers in KS-03 have done a solid job of detection and managing risk, but the federal government has more work to do on supply chain management.
Davids: The coronavirus pandemic revealed that our economy and health care system need to change. I’m committed to making sure those changes benefit hard-working Kansans, not just the well-connected. That’s why I’m fighting to lower prescription drug costs and to expand Medicaid in Kansas so that more people have access to affordable health care that will cover medical emergencies like COVID-19. I also wrote legislation to help small businesses manufacture medical equipment that is made in America, so doctors and nurses have the supplies they need to keep themselves and their patients safe as they work to save lives.
The benchmark median rate and arbitration are two approaches that have been presented in Congress to end the practice of surprise medical billing. Which of these approaches do you support for handling out-of-network charges?
Adkins: I am committed to making health care smarter, more transparent and affordable. Benchmark median rates are an ok, but not ideal solution as rates are often varied and high. I do not support arbitration as I believe it contributes to higher insurance premiums without adding value to the consumer. The best answer aligns consumers and providers. We need transparency on total cost of care and local decision-making on how money is spent. Decisions must center on the individual and the family, not be dictated by the government. These decisions should assume that health care dollars are directly managed by the individual, based on their health care risks and needs. I support incentivizing improved quality at a market- driven price.
Davids: The last thing that Kansans need after receiving medical care is a bill they never saw coming. The reality is there is merit to both approaches, but at the end of the day, what is most important is that consumers are not responsible for these frequently absurd bills. I’m willing to work with both parties and take the approach most likely to become law. I’ve even introduced my own legislation to help combat surprise medical billing by requiring insurance companies to keep up-to-date provider directories, so patients don’t unintentionally receive out-of-network care.
What actions would you take to control the rise in drug prices and end shortages of needed drugs? Do you support removing the “safe harbor” provision of the 1987 Medicare Act that exempts hospital group purchasing organizations (GPOs) and pharmacy benefit managers (PBMs) from anti-kickback provisions?
Adkins: I am concerned by both shortage of needed drugs and overall transparency on price. The “safe harbor” provision in this case has led to monopoly and added unnecessary expense. The federal government needs to take more aggressive steps in oversight, planning and security of the U.S. medical supply chain—particularly as it pertains to programs paid for by the federal government. U.S. health care providers—our communities’ first line of defense—should not have to depend on limited suppliers in any given region and/ or a national medical supply chain that is coming from a single country, often China where many medical and drug products are manufactured. I strongly support international business, but the role of the federal government is first and foremost the safety and security of our citizens.
Davids: PBMs have become an important part of the story when it comes to higher drug prices for the government and consumers. Their special role must be examined, and any exemptions that are causing higher prices should be removed. I have also been excited by those seeking to work around PBMs in this space.