Chapter 709 - 332: Flattery

"The United States’ commercial medical insurance system creates numerous obstacles in the drug supply chain. For example, there’s prior authorization. Before a doctor can prescribe certain expensive drugs, they must apply to the insurance company and only get reimbursed after approval."

"There’s also step therapy, which forces patients to first try cheaper generic drugs. Only after those prove ineffective can they upgrade to brand-name drugs. There are even strict quantity limits."

"These practices mean many patients with chronic illnesses can’t get their full monthly supply of necessary medication at the insured price."

"That’s why they choose to join the Mutual Aid Alliance. Our barrier to entry is low, and we bypass the cumbersome review process of pharmacy benefit managers. For them, this is an irresistible appeal when it comes to buying medicine."

Ethan paused for a moment. Seeing the look in Leo’s eyes, he continued, "The entire medical system in the United States is deeply intertwined with commercial health insurance, and it’s extremely complex."

"PPOs grant patients the most freedom of choice, but they’re also the most expensive. HMOs have low premiums but strict network restrictions and require referrals from a primary care physician. EPOs combine features of both. Then there are POS plans and HDHPs—high-deductible health plans—linked to health savings accounts."

"The type of insurance a patient has determines which hospital they can go to and which doctor they can see. This commercialized nature, designed to reach a wider population, offers a dazzling array of choices, making the cost for an ordinary person to understand and select a plan extremely high."

Leo looked at the data and nodded slightly.

He was not yet able to touch the deep waters of hospital and referral networks.

The current Mutual Aid Alliance was, in essence, a form of supplemental insurance.

To go after the hospital and doctor networks would be to declare all-out war on the entire healthcare system.

He had only touched one corner of the pharmaceutical supply chain, and it had already caused a huge uproar. The road ahead for comprehensive healthcare reform was destined to be long and arduous.

"Besides patients with chronic illnesses," Ethan said, turning a page, "another significant group of participants is the so-called ’squeezed middle.’"

"This group’s income is too high to qualify for free medical assistance, yet their employers don’t provide insurance. Since they aren’t wealthy, buying individual commercial insurance on the marketplace—which can cost hundreds or even thousands of US dollars per month—is an undeniably heavy burden."

"So these people are basically gambling that they won’t get seriously ill this year," Leo said.

"Correct."

Ethan nodded.

"This group, along with many young people and entrepreneurs who were previously going without health insurance, have now joined the Mutual Aid Alliance. At the very least, we have significantly lowered their living costs when it comes to routine medication."

"Take a family of three in the Brooklyn District, for example." Ethan pointed to a specific case study. "The father suffers from chronic asthma, and the mother needs to take long-term blood pressure medication. In the past, due to various restrictions from their insurance company, they had to spend a great deal of extra effort and shoulder high co-pays every month just to buy their medicine."

"Now, they’ve kept a basic major illness insurance plan to cover catastrophic risks while also joining the Mutual Aid Alliance. They only need to pay a monthly membership fee of one hundred US dollars, and their daily medication expenses are between seventy and eighty US dollars."

Leo looked at these concrete numbers.

The results of the reform were tangibly reflected in these bills.

Ordinary people no longer faced the desperate situation of bankruptcy due to illness.

They could go to the supermarket and buy high-quality beef and milk without worry, and they could enroll their children in after-school tutoring classes.

The lower-income families of this city had regained their purchasing power.

He finished reading the report and closed it.

"Very good," Leo said. "Continue to expand the catalog of directly procured drugs. Try to include more anti-cancer drugs and specialized medications for rare diseases in the next round of negotiations."

Ethan nodded, jotting down the order, but didn’t leave immediately.

He stood by the desk, his gaze flickering, still clutching a document he hadn’t yet presented.

Leo leaned back in his chair and looked at him.

"Something else?"

Ethan hesitated for a moment before finally placing the document on the desk.

"The Allegheny County Council has unanimously passed an ordinance," Ethan said, pointing at the document. "They’ve unilaterally changed the name of a city landmark."

"According to administrative procedure, a copy of the notice was sent to us. At the same time, they’ve already submitted an application for an administrative registration change to the Federal Aviation Administration."

Leo picked up the document.

The document detailed the budget approvals for modifying the traffic guidance system, updating city promotional brochures, and replacing road signs.

At the very heart of the document, a brand-new proper noun was printed in stark letters.

[Leo Wallace International Airport].

The Pittsburgh International Airport had been renamed.

Leo frowned.

"What are they trying to do?"

Leo tossed the document back onto the desk.

"They want to hold a renaming ceremony." Ethan looked at Leo. "County Executive Brandon Bowman gave a long speech to the council. He said it was the spontaneous will of all citizens of Allegheny County, that they want to commemorate the immense contributions you’ve made to Pennsylvania."

"They specifically mentioned how you slashed the prices of life-saving drugs, saving countless families. Bowman believes that only by naming the city’s largest transportation hub after you can the people’s gratitude be expressed."

Leo’s expression showed no change.

"I’m still breathing. I sit here and sign dozens of documents every day. Only dead people need to be commemorated this way."

"Why don’t you turn on the TV and see for yourself?" Ethan shrugged. "By the time this notice got to me, they were probably already hanging the new signs in the airport terminal."