by Greg Tapley
As the vice president and Chief Financial Officer of a Middle Georgia ambulance service, I’ve seen firsthand how the exorbitant cost of healthcare is a heavy burden on Georgians from all walks of life. This isn’t just a problem for the sick or the elderly, it’s a shared struggle we must all confront together.
A recent study ranked Georgia as the worst state in the nation for healthcare, a stark reminder of the urgent need for change. The study cited high costs, the lack of doctors (particularly specialists), and unaffordable insurance as the prime reasons for this designation. Nearly fifteen percent of Georgians deferred seeing a doctor within the last twelve months due to concerns about costs, and almost one in seven residents lacked health insurance.
Regrettably, this comes as no surprise to me. Our company has direct contact with patients daily, and these types of stories are all too common among those we serve.
But it’s not just those in need of care who are suffering. The government is also making it extremely difficult for many small businesses like mine to provide affordable health insurance to our employees.
One key provision of our healthcare package is the use of Pharmacy Benefit Managers (PBMs), which help us keep the cost of prescription drugs low.
PBMs are companies we hire to manage our prescription drug benefits. They negotiate directly with pharmaceutical companies to achieve bulk pricing discounts, reducing the overall cost of prescription medication. PBMs also handle the complex paperwork and federal compliance regulations for us, allowing our team to focus on our clients instead of filling out an endless stack of forms. The savings we achieve by using PBMs enable us to increase employee benefits elsewhere, a win-win situation for all involved.
Of course, the savings that PBM clients enjoy aren’t free. This money comes directly from the bottom line of big pharmaceutical companies. Big Pharma isn’t happy with this, and they are pulling out all the stops and using all their influence – both in Atlanta and Washington, DC – to put PBMs out of business.
While the Georgia legislature enacted some regulatory structures on PBMs in the 2019 legislative session, their recent efforts have gone nowhere. In January, a legislative committee rejected a proposal to impose new mandates on their operations. In May, Governor Brian Kemp also vetoed legislation that would have added new regulations on PBMs.
Small business owners like me are grateful for Mr. Kemp’s willingness to use his veto pen to oppose Big Pharma’s lobbying and political pressure and applaud the sensible legislators who rejected a scheme to add more government control on these powerful healthcare allies of ours.
However, there is still plenty of room for concern.
Now that Atlanta has shown these pharma lobbyists the door, they have begun working to convince decisionmakers in Washington, D.C. to undercut our state politicians’ decisions with federal action. Recent actions by the Federal Trade Commission (FTC) and proposed legislation in Congress suggest plans to impose a burdensome regulatory structure on PBMs. This wouldn’t only undermine Georgia’s state rights, but it would also eliminate many instate businesses’ ability to deliver lower prescription drug prices for their employees.
Without PBMs, businesses and consumers alike would face even higher drug costs, and the anticipated savings of nearly $1 trillion over the next decade would be in jeopardy. This money will go directly onto the balance sheets of the big drug companies, further enabling them to exert influence over the political process.
Hopefully, Georgia’s leaders, such as Gov. Kemp, convince Washington, D.C. to respect our right to federalism and not pass new PBM mandates over our heads. It’s the honorable thing to do.
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Greg Tapley (pictured above) is Chairman of the Monroe County Board of Commissioners and the Vice President and Chief Financial Officer of MedPro EMS, a Middle Georgia ambulance service.
Photo “Greg Tapley” by Greg Tapley and “Pharmacy” is by Mike Mozart. CC BY 2.0.
