US needs to move toward universal coverage: Oscar CEO

Anjalee Khemlani
·Senior Reporter
·3-min read

The U.S. healthcare system has established a reputation of being one of the most complex and expensive in the world. On one hand, its drug development sector is the envy of the world, with capital from markets pouring in at record levels. On the other hand, gaps in access to care and inequities within the industry, are now in the spotlight amid the coronavirus pandemic.

It’s one reason why the idea of universal coverage gained so much traction in the past election cycle, with at least some form of such care expected to be discussed by an incoming Biden administration.

At the virtual Web Summit 2020 Wednesday, Mario Schlosser, CEO of insurance startup Oscar, said that the U.S. needs to move towards universal coverage.

“Clearly, there’s a tremendous amount of waste in the system ... driving up the cost for everyone,” Schlosser said at Web Summit.

“Incentives are just wrongly aligned” and there is “no correlation between cost and quality,” he added.

It’s why, he says, the industry has been moving toward what is known as value-based care —the idea that better outcomes can be reached if health providers are paid for taking care of an individual, rather than simply getting paid for services rendered for a single symptom or visit, has been around for some time but has been slow to pick up.

Oscar
Oscar

Schlosser wants to move one step further, creating “a subscription package for your health.”

That, he said, will enable better health care management further down the line in a patient’s life.

The company is already trying to curb costs for patients with a list of drugs capped at $3, including insulin, and new plan designs focusing on free virtual care, including for additional services such as lab tests or scans, Schlosser said.

This can help address health needs more equitably by removing the cost pressures for chronic or low-income patients, he said.

Schlosser said the U.S. health care system is “screwed up” because market forces in a “supposedly free market system” don’t have true market competition as it should.

“You just don’t have that transparency of information flowing through the system; you don’t have that level of choice in the system,” he said.

President Donald Trump’s administration brought more prominence to the conversation, pushing the needle on transparency of prices in drug and hospital services. Schlosser believes transparency is a key.

“I find it very interesting that both the hospital systems and the insurance companies are fighting back against this,” he said. “And that’s always a sign that, in a system that’s way too expensive, you’re on the right track at least.”

‘Unmasked issues’

Dr. Leana Wen, a visiting professor of health policy at George Washington University and a former Baltimore health commissioner, also attended the virtual summit. She said the pandemic has “unmasked issues” in health care that the incoming administration has the opportunity to address.

President-elect Joe Biden will have several topics to address, including drug pricing, improving the Affordable Care Act — a signature policy of the Obama administration — and improving health disparities.

“I would imagine their short term priority is going to be on stopping the surge. We are in this third surge in the U.S. that is the deadliest yet. We know that the worst is yet to come, we are shattering our own records every day,” Wen said.

Wen noted that the Biden administration has an opportunity, especially during the global health crisis, to address health care issues that are now front and center.

“I hope we will not let, so to speak, this crisis go to waste,” she said.

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