A public health emergency

The Veterans Administration has proved to be too large to be run effectively.

So Congress turned to competition in recent years, providing options for veterans to use vouchers in the private health care market.

In 2014, Congress created the VA Choice Program, which has allowed more than 1.7 million veterans to seek health services in the private sector.

In 2015, the VA began planning for competition with private-sector providers.

In a paper in The New England Journal of Medicine, David Shulkin — the former head of the VA — and physician Kyle Sheetz outline ways to advance quality.

First, there must be reliable data.

Second, community-based providers must be present as options for veterans.

Third, the VA must deal swiftly and efficiently with hospitals that are performing poorly.

Constantly comparing the VA to the private sector will allow veterans to have real choices — and it will keep VA officials accountable.

Repealing Obamacare

The headline in The Wall Street Journal announced, “Conservatives make new push to repeal Affordable Care Act.”

There was no mention of replacing Obamacare with something else; instead the act is being dismantled piece by piece.

This is a disservice to Americans who need affordable, quality health care — a need more pressing than ever in an era when part-time jobs and contractual services are growing.

There have been a variety of bipartisan plans offered in Congress to provide near-universal health care, but none have gone anywhere.

One conservative proposal would use federal block grants to the states to help consumers buy coverage; in addition, health savings accounts would be expanded.

Medicaid would be repealed and vouchers would be used to help people buy coverage.

The fact is Medicaid has such low reimbursement rates in some cases that it has been difficult to find providers.

Republicans like vouchers and health savings accounts, but the problem always comes with funding them at realistic and adequate levels.

End the drug gag order

How rigged has the game become when it comes to high prescription drug prices?

It has become so rigged that some pharmacists are banned from telling Medicare consumers they can save money by paying cash rather than using insurance.

Yes, if a consumer asks, the pharmacist is allowed to answer. But how is an uninformed consumer supposed to know they can ask in the first place?

According to Kaiser Health News, out of 9.5 million Medicare Part D prescriptions, the cash price was lower than the co-payment in 1 of 4 cases.

And patients have overpaid by more than 33 percent when purchasing 12 of the most commonly prescribed drugs.

The gag order goes against everything that makes America great, and it should be eliminated.

End roadblocks for generics

Another example of the rigged game of drug prices: generic drugmakers have been blocked from producing cheaper drugs because brand name companies stall in providing samples for testing.

The federal government logically requires generic drugmakers to prove that their products are functionally equivalent to the brand names.

But the Food and Drug Administration has listed 50 drugs whose brand manufacturers withheld or refused to provide samples.

This leads to two logical questions:

• Where’s the enforcement to make sure manufacturers provide samples?

• Why not start fining manufacturers for failing to meet reasonable deadlines?

Fighting opioid deaths

Deaths due to opioid overdoses could be dramatically reduced if antidotes were readily available.

One solution involves reducing the price of naloxone; the federal government has the authority to use a patented invention without permission of its patent holder so long as the government pays reasonable compensation.

This means the government could purchase generic versions of naloxone and distribute them to government agencies as a public health matter.

Based on the shocking surge of overdose deaths, this is a public health emergency that warrants federal action.

An editorial from the Jacksonville Florida Times-Union.