Testimonies, Speeches and Comments

The NCPA has a highly effective office in Washington, D.C. that sponsors Capitol Hill briefings, conferences and testimony by NCPA experts before congressional committees. The NCPA serves as a source of "outside the Beltway" thinking for Capitol Hill deliberations.

  • Sep 21, 2016

    Regulations and Bureaucracy Boosted EpiPen Prices

    Chairman Chaffetz and Members of the Committee, I am Devon Herrick, a health economist and senior fellow at the National Center for Policy Analysis, a nonprofit, nonpartisan public policy research organization dedicated to empowering Americans by advancing liberty through free market solutions. Thank you for allowing me the opportunity to share my views.

    People with severe allergies and asthma often carry an epinephrine auto-injector with them or have one readily available at all times. The most common model by far is the EpiPen, sold by drug maker Mylan. It enjoys an 85 percent market share. The price of the EpiPen has increased by more than 400 percent in less than a decade. 

    Mylan bought the rights to the nearly 30-year old EpiPen in 2007. At the time one EpiPen sold for about $57. By August 2016, Mylan had raised the price of each EpiPen to more than $304. As health plan deductibles steadily rose over the past 10 years, families increasingly had to bear more of the cost out of pocket. Higher cost-sharing made it more difficult for Mylan to mask its price increases. This is an example of why it important to use cost-sharing to enlist consumers in the battle to control drug spending. Without consumers complaining about their share of the cost, there would be little public outcry to stop many of the more egregious price hikes.

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  • Sep 19, 2016

    Letter to the House Armed Services Committee and Senate Armed Services Committee

    On behalf of the National Center for Policy Analysis (NCPA), we are writing to express support for several amendments currently under consideration for the National Defense Authorization Act (NDAA). The NCPA is a non-profit, nonpartisan public policy research organization dedicated to developing and promoting private alternatives to government regulation and control. We do not endorse specific pieces of legislation. Nevertheless, we believe that certain policy recommendations within the House-passed version of the NDAA align best with our ideals.

    Over the past two years, the president demanded America’s military forces be downsized to their lowest levels in generations. The Obama administration and some in Congress plan to use the NDAA to further diminish the capability of our military to protect our country. In an increasingly unstable geopolitical environment, now is not the time to weaken America’s defenses. We at the NCPA firmly believe we can achieve a fiscally responsible military that has the capabilities to keep America safe.

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  • Jul 13, 2016

    First, Do No Digital Harm: Regulating Mobile Health Apps for the 21st Century

    Introduction. Chairman Burgess, Ranking Member Schakowsky, thank you for the opportunity to submit this testimony on the impact of mobile health apps on American Health Care. On a bipartisan basis, the Energy and Commerce Committee has taken the lead in ensuring the United States can take full advantage of innovation in mobile apps to improve cost, quality, and convenience in American health care. The 21st Century Cures Act, passed by the House in 2015 with overwhelming bipartisan support, is forward thinking. If passed into law, the policies it would implement would lead to a responsible and responsive regulatory environment for mobile health apps.

    However, misguided policies could also derail the benefits of apps and other digital health technologies. Policies on payment and regulation, well intentioned proposals to move things along quicker, could have the unintended consequence of allowing these digital technologies to be swallowed by an unreformed health system that remains expensive, sluggish, and of uneven quality. The risk of Congress doing too much is at least as great as the risk of doing too little. The principal guiding Congress should be: First, do no digital harm. There are three areas in which Congressional action could have such unintended consequences: State licensing of physicians, interoperability of health data, and Medicare payment for telehealth.

    State Licensing of Physicians. Historically, the practice of medicine has been regulated by the states. As telehealth has emerged, this has led some interested parties to conclude state licensing is (to some degree) obsolete. If technology permits a radiologist in Texas to read an image of a patient taken in any state, should that radiologist have to be licensed in every state? A short cut to solve this problem would appear to be to legislate a federal “safe harbor” for Medicare patients. This would comprise federal overreach that would be constitutionally suspect and unnecessary, because states are already solving this problem.

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  • Jul 13, 2016

    Why Are Co-Ops Failing?

    Chairman Jordan, Ranking Member Cartwright, and members of the committee, thank you for the opportunity to submit written comments about the challenges facing COOPs.  I am Devon Herrick, a senior fellow at the National Center for Policy Analysis.  We are a nonprofit, nonpartisan public policy research organization dedicated to developing and promoting private alternatives to government regulation and control, solving problems by relying on the strength of the competitive, entrepreneurial private sector.

    Many supporters of progressive health reform wanted a public plan option to compete with the private insurers offering insurance in the state and federal health exchanges. To draw support from progressives, proponents of the Patient Protection and Affordable Care Act (ACA) proposed creation of a type of nonprofit health insurance cooperative that would compete with established health insurers. Consumer Operated and Oriented Plans, or health insurance COOPs, as they are commonly known, were a political compromise during the health care debate, primarily serving as an alternative to the public plan option many progressives wanted.

    COOPs are not traditional health insurers. Rather, the organizations are taxpayer-funded, nonprofit health insurance cooperatives established under the ACA. COOPs borrowed funds from the government for start-up costs and solvency reserves. Twenty-four applicants were selected out of a pool of 147 applications. Just over $2 billion was loaned to the 23 applicants that began operations prior to January 1, 2014.

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  • Jul 12, 2016

    Barriers to Entrepreneurship: Access to Credit

    Before the financial fallout of 2008, the process of entrepreneurs accessing credit was fairly simple. A potential entrepreneur would design his pitch and take it to the loan officer at his local bank. The bank would stand to gain the most if the loan was repaid and thus would not give out a loan unless they believed it would be repaid. Then the originator of the loan would likely sell it to a master servicer within minutes of completing the underwriting process. If the borrower defaulted, the master servicer would then sell the loan to a special servicer, who could renegotiate terms or seize the collateral. This model generally worked.

    With community banks, the loan process is built on familiarity between parties. Creditors have better knowledge of those they loan to; while borrowers understand the stigma earned and the hardship they would cause to the bank by not paying their debts. Because of this culture of trust, there are lower default rates, and banks are able to serve clients who wouldn’t make it through a more corporate vetting process.

    Since the 2008 Financial Crisis and the implementation of Dodd-Frank in 2009, sources of business capital for low-income innovators and entrepreneurs have diminished. In the 2014 survey of 1,242 companies conducted by the Kauffman Foundation, 45 percent of new companies cited lack of credit access as a business challenge. This number remained unchanged from 2013 and 2012. Supporters of the Dodd-Frank Act sold it as promoting soundness and stability by reining in Wall Street and the big banks. Instead, much of Dodd-Frank is broad enabling act grating power to executive – agency bureaucrats to write specific regulations that reduce the access to credit for entrepreneurs through these community banks. How did this happen?

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