Public Health

Europe’s new Pharmaceutical Strategy needs adjustments

The existing IP framework of the EU has allowed us to get a vaccine before Christmas.

The rapid development of several highly effective vaccines against COVID19 is a great success for humanity. The United Kingdom was the world’s first country to approve a COVID vaccine, and hopefully soon, the European and US drug agencies will follow the UK’s lead.

Thanks to the very robust intellectual property (IP) framework the EU has, we were able to have the first effective COVID vaccine being developed in the EU (Germany) by a European company backed by European venture capitalists. The response of many innovative pharmaceutical and biotech companies has shown how important they are for humanity to respond to new threats such as COVID swiftly. Companies such as BioNTech, Moderna, and AstraZeneca have quickly responded early on by developing new and ground-breaking vaccines that will make 2021 most likely more enjoyable than this current year. The next pandemic might just be around the corner. Given how many humans have suffered and even lost their lives from COVID and the immense economic toll on Europeans, we need to do everything we can to foster and not stifle innovation in Europe.

Our resilience can only be increased by embracing innovation (the permission to use gene editing for covid vaccines is a good example) and allow risk-seeking investors such as venture capitalists and companies to benefit from their investments. Intellectual property rights are an essential factor. While the Commission’s new pharmaceutical strategy acknowledges IP rights as a safeguard for innovation, it also aggressively talks about centralizing pricing and reimbursement decisions away from member states and towards a unified European approach. This could be horrible news for our resilience when facing future public health crises. 

The COVID pandemic has worsened public and personal finances and hence reduces patients’ accessibility to medicines. If we want to increase access to drugs in all parts of Europe and, at the same time, maintain our high innovation incentives, we need to focus on creating more prosperity. Ultimately economic growth is the critical driver for allowing more patients to access the drugs they need. Loud rhetoric aimed at eroding patent rights is dangerous saber-rattling that might reduce our ability to innovate in the future and find cures for that 95% of known diseases we can’t cure yet.

We need to acknowledge that there are wealth disparities among EU member states, and we can’t have a one size fits all approach when it comes to access to medicines. EU-wide pricing decisions might delay introducing new medicines across the entire block and hence would be a raise to the bottom in terms of access to lifesaving drugs. We might risk getting innovative drugs at the time of their approval elsewhere in the world. Instead of loud and bold statements to negotiate drug prices down, the Commission should embrace innovation and also work on OECD-wide reciprocity of drug approvals. Why should EU citizens have to wait for the EMA to approve vaccines when they have already proved safe and available to UK residents? 

The EU Commission should maintain our excellent intellectual property standards and not intervene in the national rules for pricing and reimbursement decisions. Furthermore, it is paramount that governments refrain from picking winners in the race for new treatments and vaccines and therefore maintain technology neutrality. The German government, for instance, was quick to invest in one vaccine manufacturer early on. Still, despite a massive injection of taxpayer money, another German company won the race to be the first one with an effective vaccine. Europe is home to half of the world’s top 10 pharmaceutical companies. We should not jeopardize this position but aim for more and not less innovation in the European Union.

Originally published here.

To beat cancer in Europe, let’s give vaping a chance

The European Union’s Beating Cancer plan is our once-in-a-generation opportunity to tackle cancer by embracing innovation and consumer choice.

By following the footsteps of the UK, France, Australia, and New Zealand, we can further achieve our goals by endorsing vaping as a harm reduction tool with incredible potential to help reduce health-associated risks. By doing so, the EU could ensure a better future for smokers.

It has been stressed many times that vaping has been proven to be 95% less harmful than smoking. And yet, despite the sound evidence at hand, anti-vaping rhetoric persists and continues to win the hearts and minds of European policymakers. However, in order to develop the most efficient and effective policies to tackle cancer, it is crucial to stay open-minded, and we should always be led by science over ideology.

Smoking-induced cancer takes nearly 700,000 lives every year in the EU, and various marketing schemes and branding restrictions haven’t succeeded in reducing these numbers. When conventional methods don’t work, innovation in the form of vaping must be embraced.

Unlike traditional cigarettes that create more than 7,000 chemicals when burned, 69 of which have been identified as potential carcinogens, vape liquids’ compounds are common food ingredients deemed safe and not harmful by regulatory bodies including the European Food Safety Authority (EFSA). Moreover, when compared to other alternatives in getting people to quit, including Nicotine Replace Therapy (NRT) patches and drugs, vaping has been found to be twice as effective.  

Vaping has the potential to drive down smoking-induced cancer rates significantly. The cancer risk of vaping relative to smoking is 0.4% according to a study conducted by the University of St. Andrews. The additional lifetime cancer risk for an e-cigarette user is 0,0095% compared to 2,4% of a smoker found by the same study. At present,t the European Union has 140 million smokers and many of them struggle to quit. Therefore, we need every possible method available to them to make quitting easier. We must expand their choices.

Consumer choice is more than an empty economic term: it is an essential part of our individual pursuit of what we perceive to be best for us, and the ability to do so voluntarily. The Europe Beating Cancer plan is a chance for Europe to inform smokers about vaping and how it can assist them in their efforts to quit. Another important part of the plan should be to actively encourage smokers to switch to vaping and guarantee access to vaping products for adults. 

Since it is impossible to change consumers’ smoking behaviour with a stick – not least because it is inhumane to disregard our freedom to choose – we need to go with encouragement and correct information as our main strategy. 

Creating and sustaining conditions under which adult smokers are able to switch to healthier options such as e-cigarettes is not only a forward-looking solution but also the one that would demonstrate the European Commission’s commitment to tackling cancer without undermining consumer choice. Europe’s Beating Cancer plan should become not just a policy roadmap, but also manifest Europe’s openness to innovation and recognition of freedom as the highest value. Smokers and future generations would be eternally grateful.

Originally published here.

The EU ‘should consistently charge no VAT on medicine’

In a recent move, the European Commission has suggested to EU member states to exempt Covid-19 diagnostic medical devices, as well as a potential vaccine, from value-added tax. The Consumer Choice Centre (CCC) has welcomed this move, since it incentivises a move to alleviate some of the burdens on patients and consumers as they deal with the pandemic. The CCC’s Managing Director and Health Economist Mr Fred Roeder said the EU should be more ambitious with regard to medicines.

“Member states would be right to implement VAT exemptions on medicines, not just in times of a crisis,” he commented.

“Too many patients in Europe pay too much for needed medicines because the government is taking too big of a cut. Some member states charge as much as 25 per cent for both over-the-counter (OTC) medicines, as well as prescription drugs. This burdens health insurance providers and patients alike”, said Mr Roeder.

“We should take the positive example of Malta, which is the only member state that charges no VAT for either OTC or prescription medicine, yet still manages to provide basic services to citizens. If we want to fund government services, we shouldn’t do it on the backs of patients who need medicine.

“We experience this great double standard in Europe: Politicians of major parties complain about the price of drugs on the continent, yet simultaneously charge large chunks of tax on the same drugs. It is time we end this inconsistency”, he concluded.

Originally published here.

Tarif PPN untuk Obat-Obatan di Eropa Diusulkan Maksimal 5%

Tarif PPN untuk Obat-Obatan di Eropa Diusulkan Maksimal 5%

Insentif pajak untuk barang-barang farmasi dinilai masih dibutuhkan mengingat kebutuhan masyarakat Eropa untuk produk kesehatan terus meningkat di tengah pandemi virus Corona atau Covid-19.

Analis Kebijakan dari The Consumer Choice Center Bill Wirtz mengatakan pembuat kebijakan di Eropa perlu merumuskan ulang kebijakan fiskal untuk produk farmasi pada masa pandemi Covid-19, terutama mengenai tarif PPN.Baca Juga: RS Ummi Bersiap Kena Sanksi Satgas Covid-19 Gegara Tak Lapor Hasil Swab Test Habib Rizieq

“Dalam komponen harga obat pendorong utama yang membuat harga menjadi lebih tinggi karena adanya pajak penjualan obat,” katanya dikutip Rabu (4/11).

Saat ini, lanjut Wirtz, sebagian besar negara Eropa masih memungut PPN untuk resep atau obat yang dijual secara bebas. Pungutan paling tinggi diterapkan Denmark dengan tarif PPN 25%. Lalu, Jerman mengenakan PPN 19% untuk resep obat dan produk obat yang dijual secara bebas.

Sementara itu, satu-satunya negara yang tidak memungut PPN atas resep obat atau obat yang dijual bebas adalah Malta. Kemudian negara seperti Luksemburg menerapkan tarif PPN rendah sebesar 3% untuk obat-obatan dan Spanyol dengan tarif PPN 4%.

Swedia dan Inggris menerapkan PPN 0% untuk resep obat yang dikeluarkan dokter. Namun, tetap memungut PPN 25% di Swedia dan PPN 20% di Inggris untuk obat yang dijual secara umum tanpa harus menyertakan resep obat dari dokter.

“Negara anggota Uni Eropa harus mencontoh Malta yang menurunkan tarif PPN sampai 0% untuk semua obat untuk mengurangi aktivitas komersial dan memastikan harga dijual dengan wajar,” ujar Wirtz.Baca Juga: Jika Vaksinasi Berjalan, Bisa Hentikan Penularan, Pulihkan Kesehatan, dan Bangkitkan Ekonomi

Wirtz berharap terdapat kesepakatan di antara negara anggota Uni Eropa untuk memastikan obat-obatan yang saat ini sangat vital dapat diakses oleh seluruh masyarakat dengan harga terjangkau. Misal, dengan mematok tarif PPN untuk obat-obatan maksimal 5%.

“Perlu adanya perjanjian mengikat untuk kebijakan tarif PPN dengan batas maksimal tarif 5% untuk menurunkan harga obat, meningkatkan aksesibilitas dan menciptakan Eropa yang lebih adil,” tutur Wirtz seperti dilansir eureporter.co

Originally published here.

Piano Ue contro il cancro, il Parlamento dà spazio alla sigaretta elettronica

Pietro Fiocchi (FdI), membro della Commissione parlamentare che sta stilando un rapporto per il piano, assicura che vi sarà un paragrafo sul vaping.

Il rapporto che lo Special Committee on cancer del Parlamento europeo consegnerà alla Commissione come contributo per il Piano contro il cancro includerà un paragrafo sulla sigaretta elettronica. A rivelarlo è stato l’europarlamentare italiano Pietro Fiocchi (Fratelli d’Italia), durante un incontro organizzato questa mattina dalla sede a Bruxelles della Camera di commercio britannica, incentrato proprio sul Beating Cancer Plan dell’Unione europea. Sottotitolo dell’evento, prevenire è meglio che curare e proprio sugli strumenti e le best practice in materia di prevenzione verteva l’intervento di Fiocchi. Il parlamentare italiano, che è relatore ombra della Commissione speciale sul cancro dell’Europarlamento ha aggiunto che “è importante che il paragrafo sul vaping contenga le cose giuste”, cioè presumibilmente che tratti la sigaretta elettronica come strumento di riduzione del danno da fumo.

Lo scorso ottobre, Fiocchi aveva presentato una interrogazione alla Commissione europea, chiedendo se nel piano europeo di lotta contro il cancro si stesse prendendo in considerazione la riduzione del danno provocato dal tabacco. “Può la Commissione – si leggeva nel testo della interrogazione – riferire se sta valutando la possibilità di promuovere l’adozione di misure preventive, come ad esempio strategie di riduzione dei danni? Come intende affrontare l’importanza della riduzione dei danni nel piano di lotta contro il cancro, ad esempio raccomandando politiche che incoraggino l’uso di prodotti a base di nicotina a rischio ridotto o campagne di sensibilizzazione per un consumo responsabile di alcol? Durante il processo di consultazione pubblica, la Commissione si è rivolta a gruppi di riflessione in rappresentanza dei consumatori che hanno beneficiato di metodi di riduzione del danno, come l’uso della sigaretta elettronica?”.

Ora lo stesso europarlamentare riferisce che, almeno per quanto riguarda il contributo del Parlamento, la riduzione del danno in generale e la sigaretta elettronica in particolare avranno uno spazio. Le parole di Fiocchi hanno raccolto il plauso dell’associazione World Vapers’Alliance, che da mesi conduce a Bruxelles una battaglia su questo tema. “Ci sentiamo estremamente incoraggiati dall’impegno dell’onorevole Fiocchi – ha dichiarato il direttore Michael Landl – per includere la sigaretta elettronica nel rapporto del Parlamento sul cancro. I parlamentari europei hanno la possibilità di prevenire migliaia di casi di cancro in tutta l’Unione europea, aiutando i fumatori a passare alla sigaretta elettronica”. “Ora è fondamentale – auspica Landl – che i colleghi di Fiocchi seguano il suo esempio e sostengano il vaping”.

Originally published here.

POUR PLUS D’ACCÈS AUX SOINS, RÉDUISONS LA TVA À ZÉRO SUR LES MÉDICAMENTS !

Alors que les Européens sont confrontés à une crise de santé publique, il serait nécessaire d’accroître l’accessibilité des médicaments en supprimant la TVA sur les biens les plus essentiels.

La pandémie de Covid-19 a remis à l’ordre du jour la politique de santé des décideurs européens. Avant l’épidémie, l’Europe était engagée dans un débat sur le prix des médicaments, mais cela n’intéressait que les échelons supérieurs des institutions politiques.

Les entreprises pharmaceutiques sont souvent blâmées, de même que le manque de transparence des prix. Un examen plus approfondi des coûts des médicaments montre cependant que l’une des principales causes de ces coûts élevés est la taxe sur les ventes de médicaments.

Les patients informés savent que tous les pays européens, sauf un, appliquent la TVA sur les médicaments en vente libre et les médicaments délivrés sur ordonnance. L’Allemagne impose jusqu’à 19% de TVA sur les médicaments, tandis que le Danemark se classe en tête, avec des taux de 25%, soit un cinquième du prix total d’un médicament !

La France applique un taux relativement faible de 2,1% de TVA sur les médicaments remboursables et 10% sur ceux qui ne sont pas remboursables.

Et chez les autres ?

Il n’y a qu’un seul pays qui ne perçoit pas de TVA sur les médicaments délivrés sur ordonnance ou en vente libre : il s’agit de l’île de Malte. Le Luxembourg (3%) et l’Espagne (4%) montrent également que les taux modestes de TVA sur les médicaments ne sont pas une idée folle, mais quelque chose dont des millions d’Européens bénéficient déjà.

La Suède et le Royaume-Uni appliquent tous deux un taux de TVA de 0% sur les médicaments délivrés sur ordonnance, mais de 25% et 20% respectivement sur les médicaments en vente libre.

Il est évident que l’un des principaux obstacles à un meilleur accès aux médicaments est la politique fiscale inadéquate de certains Etats membres de l’Union européenne (UE).

La TVA à 0% partout ?

Lorsque les autorités discutent de l’accès aux soins, il serait intéressant qu’elles se penchent sur ce problème dont elles sont les seules responsables avant de parler de l’érosion des droits de propriété intellectuelle ou de l’influence des grandes sociétés pharmaceutiques sur la fixation des prix.

C’est particulièrement le cas des médicaments délivrés sur ordonnance ou les médicaments contre le cancer qui peuvent atteindre des niveaux de prix substantiels avec des taux de TVA allant jusqu’à 25%. De telles taxes pèsent lourdement sur les patients et leur assurance-maladie.

En ce qui concerne les médicaments délivrés sur ordonnance, il n’est guère judicieux de commencer par appliquer une taxe sur la valeur ajoutée, puis de laisser les compagnies d’assurance-maladie nationales payer la note.

Pour les médicaments en vente libre, les décideurs politiques sont aveuglés par l’idée que le simple fait qu’ils ne soient pas prescrits par les médecins en fait des biens secondaires et non-essentiels.

De nombreux médicaments en vente libre, qu’il s’agisse de médicaments contre les maux de tête, les brûlures d’estomac, les remèdes respiratoires ou les crèmes dermatologiques, ne sont pas seulement des médicaments indispensables pour des millions d’Européens ; ils font souvent office de soins préventifs. Plus nous taxons ces produits, plus nous accablons les médecins de visites non essentielles.

A l’instar de Malte, les pays européens devraient abaisser leur taux de TVA à 0% sur tous les médicaments. Le but de la TVA est de réduire l’activité commerciale, en s’assurant que toutes les transactions commerciales paient ce qui est considéré comme leur juste part. Cela permet de toucher également les entreprises qui ne paient traditionnellement pas d’impôts sur les sociétés.

Cependant, considérer la vente de médicaments comme une transaction purement commerciale, du point de vue des patients, est une erreur. Des millions de citoyens ont besoin chaque jour de médicaments spécifiques délivrés sur ordonnance, et d’autres comptent sur l’aide de médicaments en vente libre pour soulager la douleur ou traiter des problèmes qui ne nécessitent pas de soins médicaux professionnels.

Il est temps que les nations européennes se mettent d’accord sur un accord contraignant de TVA zéro sur les médicaments ou au moins sur un plafond de 5%, ce qui permettrait de réduire drastiquement les prix des médicaments, d’accroître l’accessibilité aux soins et de créer une Europe plus juste.

Originally published here.

WHO Reverses Course, Now Advises Against Use of ‘Punishing’ Lockdowns

Even as the WHO calls on nations to refrain from imposing lockdowns, many governments continue to use this strategy.

For months, an overwhelming majority of the planet’s population has been subject to cruel and unnerving lockdowns: businesses closed, travel restricted, and social gatherings kept to a minimum.

The effects of the COVID-19 pandemic have sunk our economies, kept loved ones apart, derailed funerals, and made personal and economic liberty a casualty as much as our health. One report states it could cost us $82 trillion globally over the next five years – roughly the same as our yearly global GDP.

Many of these initial lockdowns were justified by policy recommendations by the World Health Organization.

The WHO’s director-general Dr. Tedros Adhanom Ghebreyesus, writing in a strategy update in April, called on nations to continue lockdowns until the disease was under control.

But now, more than six months since lockdowns became a favored political tool of global governments, the WHO is calling for their swift end.

Dr. David Nabarro, the WHO’s Special Envoy on COVID-19, told Spectator UK’s Andrew Neil last week that politicians have been wrong in using lockdowns as the “primary control method” to combat COVID-19.

“Lockdowns just have one consequence that you must never ever belittle, and that is making poor people an awful lot poorer,” said Nabarro.

Dr. Michael Ryan, Director of the WHO’s Health Emergencies Programme, offered a similar sentiment.

“What we want to try to avoid – and sometimes it’s unavoidable and we accept that – but what we want to try and avoid is these massive lockdowns that are so punishing to communities, to society and to everything else,” said Dr. Ryan, speaking at a briefing in Geneva. 

These are stunning statements from an organization that has been a key authority and moral voice responsible for handling the global response to the pandemic.

Cues from the WHO have underpinned each and every national and local lockdown, threatening to push 150 million people into poverty by the end of the year.

As Nabarro stated, the vast majority of the people harmed by these lockdowns have been the worse off.

We all know people who have lost their businesses, lost work, and seen their life savings go up in smoke. That’s especially true for those who work in the service and hospitality industries, which have been decimated by lockdown policies.

And even as the WHO calls on nations to refrain from imposing lockdowns, many governments continue to use this strategy. Schools in many US states remain closed, bars and restaurants are off-limits, and large gatherings–apart from social justice protests–are condemned and shut down by force.

The effects of the prolonged lockdowns on young people are now becoming more clear. A recent study from Edinburgh University says keeping schools shut down will increase the number of deaths due to COVID-19. Added to that, the study says lockdowns “prolong the epidemic, in some cases resulting in more deaths long-term.”

If we want to avoid any more harm, we should immediately end these disastrous policies. Any fresh calls to impose lockdowns should now be viewed with the utmost skepticism.

It’s time for the madness to end. Not only because the World Health Organization says so, but because our very lives depend on it.

As the doctors and scientists stated in the Grand Barrington Declaration signed this month in Massachusetts, the “physical and mental health impacts of the prevailing COVID-19 policies” have themselves caused devastating effects on both short and long-term health.

We cannot continue to risk our health and well-being in the long-term by shutting in our economies and our people in the short-term. That’s the only way forward if we seek to recover from the ruinous effects of government policy surrounding COVID-19.

Originally published here.

Americans Need to Divorce Health Insurance From Our Jobs

In between the jabs during the first presidential debate, both President Donald Trump and former Vice President Joe Biden stumbled through their visions for healthcare reform.

While Biden wants to expand a “public option,” a kind of Obamacare plus, Trump focused on his executive orders mandating cheaper drug prices and the congressional repeal of the Obamacare individual mandate.

Neither leaves voters feeling heard.

That there was no substantive health debate is a shame, considering health insurance costs and coverage personally affect every American. Who doesn’t have their own health insurance horror story?

If we want to radically improve insurance and healthcare in our country to ensure that every American receives the care they need, we have to be bold. And that begins with divorcing insurance from where we work.

Not only would that improve the choices of consumers, but it would also help lower costs and provide more options for people who aren’t covered in the current system. That would empower individuals to choose their health plans according to their needs.

As of March 2019, the U.S. Census estimates that 91 percent of the population had health insurance. Nearly one third receive coverage from government health insurance, whether Medicare, Medicaid or state employees. Left out are approximately 29.9 million Americans without health insurance — public, private or otherwise.

The number of uninsured is an important metric because it is the target group for most substantial health insurance reforms of the past decade, including Obamacare at the federal level and the expansion of Medicaid eligibility at the state level, both problematic in their own right.

According to a Kaiser Family Foundation survey, 45 percent of the uninsured say the cost is too high, while 31 percent of the uninsured lost their coverage because they made too much money for Medicaid or they changed employers.

The single largest category of the insured in our country is those who receive insurance through their jobs, approximately 54 percent. Why is that?

Since 1973, the federal government provided incentives to employers who set up Health Maintenance Organizations (HMOs) for their employees. Since then, our health insurance market has pivoted to match having a job with health insurance.

Incentives to employers to cover healthcare for their employees is good policy on its face, but it has led to unforeseen economic consequences.

Employee health plans, managed by state-based health insurers (another worthy reform to consider), often become a headache for workers and firms alike.

These plans aim to define benefits and coverage according to a firm’s needs and often have to hire several people to oversee them. Then, bureaucracy balloons, administrative costs creep up, and whatever advantage these plans initially offered is now buried in red tape.

Added to that, if you leave your job for another one or find yourself unemployed, you are now one of the 9 percent without health insurance, which puts you at risk.

There has to be a better way.

The alternative to this system would be a free and open marketplace in which individuals would be empowered to choose their healthcare insurance plan according to their needs, just like car insurance. Employers could offer cash subsidies in line with current federal incentives, but the choice of plan would remain that of the workers.

Such a plan would then empower people to try new innovative healthcare delivery models, such as direct primary care, concierge medicine, and medical startups.

As a relatively young and healthy person, for example, I opt for high deductible emergency insurance that is there when I need it. Smaller health expenses are paid in cash or with a health savings account that offers tax benefits. If I have a more serious injury or illness, my insurance covers the costs.

For me, and likely for millions of other individuals, this arrangement works. It is how insurance is supposed to work. We take out insurance to cover the costs and the risks we don’t foresee, not to cover each routine transaction we make with a provider. It’s the same reason we don’t insure windshield wipers or tires on our cars.

If someone wants more comprehensive insurance, they should be free to take it. And the costs should be reflective of that option.

If employees could be encouraged to build their plans, that would remove administrative and bureaucratic hurdles from existing insurance arrangements or mandates. It would also encourage more competition and lower prices from health insurers, helping bring down costs for employers and employees alike.

But doing so will require a huge shift in the way we think as Americans. We can no longer marry our health insurance to our jobs.

Separation of job and insurance should be a mantra as much as separation of church and state. And federal policy should encourage Americans who take control of their own private health insurance plan.

Originally published here.

Americans need to separate health insurance from our jobs

If we want to radically improve insurance and health care in our country to ensure that every American receives the care they need, we have to be bold. And that begins with divorcing insurance from where we work.

Not only would that improve the choices of consumers, but it would also help lower costs and provide more options for people who aren’t covered in the current system. That would empower individuals to choose their health plans according to their needs.

As of March 2019, the U.S. Census estimates that 91% of the population had health insurance. Nearly one third receive coverage from government health insurance, whether Medicare, Medicaid or state employees. Left out are approximately 29.9 million Americans without health insurance — public, private or otherwise.

The number of uninsured is an important metric because it is the target group for most substantial health insurance reforms of the past decade, including Obamacare at the federal level and the expansion of Medicaid eligibility at the state level, both problematic in their own right.

According to a Kaiser Family Foundation survey, 45% of the uninsured say the cost is too high, while 31% of the uninsured lost their coverage because they made too much money for Medicaid or they changed employers.

The single largest category of the insured in our country is those who receive insurance through their jobs, approximately 54%. Why is that?

Since 1973, the federal government provided incentives to employers who set up Health Maintenance Organizations for their employees. Since then, our health insurance market has pivoted to match having a job with health insurance. Incentives to employers to cover health care for their employees is good policy on its face, but it has led to unforeseen economic consequences.

Employee health plans, managed by state-based health insurers (another worthy reform to consider), often become a headache for workers and firms alike.

These plans aim to define benefits and coverage according to a firm’s needs and often have to hire several people to oversee them. Then, bureaucracy balloons, administrative costs creep up, and whatever advantage these plans initially offered is now buried in red tape.

Added to that, if you leave your job for another one or find yourself unemployed, you are now one of the 9% without health insurance, which puts you at risk.

There has to be a better way.

The alternative to this system would be a free and open marketplace in which individuals would be empowered to choose their health care insurance plan according to their needs, just like car insurance. Employers could offer cash subsidies in line with current federal incentives, but the choice of plan would remain that of the workers.

Such a plan would then empower people to try new innovative health care delivery models, such as direct primary care, concierge medicine and medical startups.

We take out insurance to cover the costs and the risks we don’t foresee, not to cover each routine transaction we make with a provider. It’s the same reason we don’t insure windshield wipers or tires on our cars.

If someone wants more comprehensive insurance, they should be free to take it. And the costs should be reflective of that option.

If employees could be encouraged to build their plans, that would remove administrative and bureaucratic hurdles from existing insurance arrangements or mandates. It would also encourage more competition and lower prices from health insurers, helping bring down costs for employers and employees alike.

But doing so will require a huge shift in the way we think as Americans. We can no longer marry our health insurance to our jobs.

Separation of job and insurance should be a mantra as much as separation of church and state. And federal policy should encourage Americans who take control of their own private health insurance plan.


Yaël Ossowski is a writer and deputy director at the Consumer Choice Center, a consumer advocacy group based in Washington, D.C.

Originally published here.

Scrapping Public Health England should only be the beginning

Scrapping Public Health England, a body with the ambition of nannying every Brit, is a significant step towards enhancing personal responsibility and allowing greater freedom. But there’s much further to go.

The UK government should drastically change its approach to healthcare and lifestyle regulations to create an enduring change. With 320,000 confirmed cases of Covid-19 across the country and close to 41,000 dead, there is an urgent need to find a scapegoat. PHE is problematic for many reasons, but it is hardly the root of the UK’s failed Covid response. Enormous centralisation and bureaucracy, on the other hand, are what the UK government needs to do away with. The response to the pandemic gives us clear examples.

It took the UK over six weeks to catch up with other developed countries’ testing capabilities. Germany’s decentralised and private laboratory network had already tested over two per cent of its population while the UK had tested a meagre 0.7 per cent. Britain’s centralised testing system, and its failure to scale up Covid-19 tests, might help explain part of the mortality gap between the two countries.

Testing, as we have learned, should be decentralised, which makes it more easily accessible to all groups of the population. The US government failed to stop the pandemic early on for a similar reason. The Food and Drug Administration (FDA)’s initial regulations prevented state and private labs from developing their own coronavirus diagnostic tests.

During the crucial weeks of February and March, it was only possible to get tested for Covid-19 in the US at the Centre for Disease and Control (CDC). The consequences were devastating. As a result of a massive shortage of tests, many undetected cases speeded up the spread of Covid. On 29 February, the US government allowed private labs to begin developing their own tests.

On 16 March, the procedure was decentralised further, making it possible for commercial manufacturers to distribute and labs to use new commercially developed before obtaining an FDA’s Emergency Use Authorisation (EUA). Not long after the red tape had been cut, private labs went on developing tests that were notably more effective, allowing many more people to get tested.

The centralisation at the NHS has also contributed to its vulnerability towards external shocks such as Covid-19. Decentralised hospital systems that promote private competition and patient choice have proven to be much more resilient, as Germany’s system demonstrates.

With that in mind, introducing more market mechanisms in the NHS would not mean that patients would be denied care – you can have universal healthcare in a social insurance model too. Having more private hospitals does not necessarily lead to fewer hospital beds, but a better allocation of skills and resources. Indeed, it allowed Germany to scale up its ICU capacity, as well as keeping services such as cancer treatments and screenings open in different locations.

Another reason not to get overjoyed about the season finale of the Public Health England’s reign is that it would continue to deal with the agency’s other non-Covid public health work, such as obesity policy, until the spring. Boris has set out to introduce radical anti-obesity measures, and there is every reason to expect the PHE will contribute its most poisonous ideas to that debate. One last time.

While free-marketers like me have been cheering the fall of the PHE with sugary milkshakes and burgers, health secretary Matt Hancock announced that nannying will be “embedded right across government… and in the work of every single local authority. We will use this moment to consult widely on how we can embed health improvement more deeply across the board.”

Even without PHE, we need to look at health issues, such as obesity, through the prism of innovation, education and personal responsibility. PHE’s better health marketing campaign to promote a healthy lifestyle is just one part of Boris’ anti-obesity approach, which tells us that even without institutions such as PHE, nannying will likely continue to flourish. That’s where we need a fundamental mindset change, not just an institutional one.

Abolishing old agencies and setting up new ones often gives the impression that such actions will have a positive lasting impact on our lives. Unfortunately, that is not always the case. While it is tempting to think that merely putting an end to the PHE will help make the UK better prepared for health crises, it is naive, to say the least. Neither will it move the needle away from paternalism. But it’s a great start!

Originally published here.


The Consumer Choice Center is the consumer advocacy group supporting lifestyle freedom, innovation, privacy, science, and consumer choice. The main policy areas we focus on are digital, mobility, lifestyle & consumer goods, and health & science.

The CCC represents consumers in over 100 countries across the globe. We closely monitor regulatory trends in Ottawa, Washington, Brussels, Geneva and other hotspots of regulation and inform and activate consumers to fight for #ConsumerChoice. Learn more at consumerchoicecenter.org

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