Posted At The Oakland Press

BY : Sven Gustafason

Two Republican state lawmakers are touting legislation they say would help lower the costs of health care for individuals and businesses.

While the two packages, introduced in recent weeks, are unrelated, they could come as welcome relief to a state staggering under the economic burden of spiraling health care costs.

The most recent announcement came last week from Saginaw Township Republican Rep. Roger Kahn, a cardiologist.

He announced a three-bill package designed to lower the cost of prescription drugs by requiring pharmaceutical companies to disclose their physician-directed marketing practices, requiring pharmacies to publicly post drug prices according to class or the most frequently prescribed, and holding pharmacy benefit managers accountable for passing on savings they work for to consumers.

Kahn said the bills are about helping to lower the price of prescription drugs but added, "There's also the notion of restoring confidence on the part of purchasers, whether that is a company that purchases drugs or patients who are prescribed drugs. ... These bills are largely about sunshine and confidence."

Kahn said most of the marketing of products by drug companies is "above board," but that he once declined an offer of a two-week, allexpenses-paid trip to Switzerland to see a plant where pacemakers were produced.

He said forcing pharmaceutical companies to reveal marketing techniques and costs would ensure that doctors prescribe medicines for the right reasons. He said that would also help lower the amount of money companies spend on advertising by requiring those companies to divulge how much they spend on marketing.

"That information ought to be available," he said.

Another bill to post drug prices at pharmacies would allow consumers to shop for the best prices on prescription drugs, he said, adding, "This is not something that there's much of in medicine."

It would complement another bill authored by Kahn that would create a Web site through the state Attorney General's office listing prices of prescription drugs throughout the state. That bill has already passed the House and is pending in a Senate committee.

Recent polling data from Lansing-based EPIC/MRA showed that 89 percent of respondents believe making prescription drugs more affordable should be either a top or important priority. The poll, which sampled 600 and had a margin of error of plus or minus 4 percentage points, also showed wide support for the concepts of Kahn's bills.

The Michigan branch of AARP has signed on to support the bills as part of the organization's national effort to reduce prescription drug prices, said Bill Knox, a spokesman for the state group.

"It throws the light of day on transactions and prescription drug manufacturers and salespeople," he said.

In the state Senate, meanwhile, Sen. Tom George, a Kalamazoo County Republican and licensed anesthesiologist, has come up with a plan that would require health insurers, HMOs and nonprofit health care corporations to offer wellness coverage and provide rebates in premiums for participation. Health insurance providers, unlike life, home and auto insurance companies, cannot offer incentives for behaviors that reflect low risk.

"There's a lot of companies that are doing this, that are innovative," George said. "A lot of them are in Michigan, but if you look at it, a lot of them are big companies that self-insure."

George said those selfinsuring companies, which hire health insurance providers to administer and pay claims but buy insurance on their own, can realize benefi ts if their employees remain healthy.

"Here's the problem: If you're a small company and you only have 12 employees, you're too small to self-insure. So they're buying insurance" from providers, which rate premiums by pooling employees based upon factors such as age and area of the state. "If you're healthy, you're basically going to be subsidizing everybody else.

"My bills change that. They allow carriers that sell to small employers in small group markets, they require them to design a rebate for healthy behavior."

George said examples of healthy behavior would be exercise, refraining from smoking and maintaining a proper diet.

According to a 2004 report by Ann Arbor-based Altarum, which compared Michigan with 17 benchmark states, Michigan ranked No. 1 among the states for coronary heart disease-related deaths and No. 2 for rates of obesity and diabetes. The report said overweight and obese residents incur up to $1,500 more in annual premiums for health insurance.

"Per capita expenditures on drugs and other medical nondurables is almost 14 percent higher in Michigan than the benchmark states, and the number of retail prescriptions per capita in Michigan is 19 percent above the benchmark states," the report said. The report went on to recommend that Michigan expand its promotion of following healthful lifestyles and preventing diseases.

George said estimates show that unhealthful behaviors account for 25 percent to 30 percent of health care costs nationwide.

"We're not looking at the underlying causes," he said. "And this gives someone a pocketbook incentive" to change behaviors.