Showing archive for: “Insurance & Financing in Health Care”
Bad Medicine: Why Breaking Up Big Health Care Could Make It Worse
Washington has found its latest villain: “Big Medicine.” The proposed fix? Break it up and hope the pieces behave better than the whole. Americans have real reasons to be frustrated about high health care costs, and large conglomerates rank somewhere between unpopular and reviled—roughly where Microsoft’s “Clippy” sat in the 1990s. So it’s no surprise ... Bad Medicine: Why Breaking Up Big Health Care Could Make It Worse
The FTC, Express Scripts, and the High Cost of Lower Copays
Nearly 17 months after the Federal Trade Commission filed suit against the nation’s three largest pharmacy benefit managers (PBMs), the agency has reached a settlement with one of them: Express Scripts. The complaint alleged that PBMs harmed competition and patients by inflating insulin prices. PBMs negotiate drug prices with pharmaceutical manufacturers and pharmacies on behalf ... The FTC, Express Scripts, and the High Cost of Lower Copays
Antitrust at the Agencies: PBM Madness at the FTC, Part 2
As I noted in my last post, the Federal Trade Commission (FTC) announced Sept. 20 that it had filed a complaint: against the three largest prescription drug benefit managers (PBMs)—Caremark Rx, Express Scripts (ESI), and OptumRx—and their affiliated group purchasing organizations (GPOs) for engaging in anticompetitive and unfair rebating practices that have artificially inflated the ... Antitrust at the Agencies: PBM Madness at the FTC, Part 2
The FTC Takes On Pharmaceutical Benefit Managers
The Federal Trade Commission (FTC) announced Sept. 20 that it was suing the three largest pharmaceutical benefit managers (PBMs)—Caremark Rx, Express Scripts (ESI), and Optum—alleging competition and consumer-protection law violations. This commentary provides information on controversies surrounding the economic effects of PBMs that led up to the suit. A follow-up commentary will assess the lawsuit ... The FTC Takes On Pharmaceutical Benefit Managers
The FTC Case Against PBM Rebates
About a month ago, the Wall Street Journal reported that the Federal Trade Commission (FTC) was preparing an antitrust suit against the nation’s three largest pharmaceutical benefit managers (PBMs), the intermediaries who negotiate drug prices on behalf of insurers and who manage benefits for nearly nine in 10 insured Americans. This development followed a two-year ... The FTC Case Against PBM Rebates
Critics of health insurance mergers misapply the evidence and misinterpret the market
As regulatory review of the merger between Aetna and Humana hits the homestretch, merger critics have become increasingly vocal in their opposition to the deal. This is particularly true of a subset of healthcare providers concerned about losing bargaining power over insurers. Fortunately for consumers, the merger appears to be well on its way to ... Critics of health insurance mergers misapply the evidence and misinterpret the market
Sharing the Wealth: Gig Economy Moves Toward a Portable Safety Net
Today, thirty-nine different companies and policy experts from a wide swath of the political spectrum signed a letter urging lawmakers to create a “portable benefits” platform that will enable sharing economy companies to continue innovating while simultaneously providing desirable social safety net benefits to workers. This is well timed, as there is a growing consensus ... Sharing the Wealth: Gig Economy Moves Toward a Portable Safety Net
What Would the Consumer Financial Protection Bureau Say About Healthcare.gov?
In yesterday’s hearings on the disastrous launch of the federal health insurance exchanges, contractors insisted that part of the problem was a last-minute specification from the government: the feds didn’t want people to be able to “window shop” for health insurance until they had created a profile and entered all sorts of personal information. That’s ... What Would the Consumer Financial Protection Bureau Say About Healthcare.gov?
The Administration’s Rigorous Defense of the Affordable Care Act
In yesterday’s Washington Post, Health and Human Services Secretary Kathleen Sebelius makes an impassioned plea for skeptics to reconsider the Affordable Care Act. Secretary Sebelius argues that the Act will bring down health care costs by, among other things, assisting those who cannot afford health insurance coverage. Although expanding health insurance coverage is a worthy ... The Administration’s Rigorous Defense of the Affordable Care Act
The non-constitutional problem with a health care mandate
There’s been much teeth-gnashing following yesterday’s ruling by a Virginia judge that the “individual mandate” portion of Obamacare is unconstitutional. Among many other places, see the ongoing discussion at The Volokh Conspiracy. I have a quick, non-constitutional response. It seems to me that there is a basic, deep problem with prohibiting citizens from opting out ... The non-constitutional problem with a health care mandate
Carl Shapiro on BCBS and the New Merger Guidelines
?Carl Shapiro’s (DOJ) speech at the ABA Fall Forum contains (at least) two interesting tidbits worth highlighting for TOTM readers. The first is a discussion of the DOJ’s case against Blue Cross Blue Shield, which as discussed here, turns on an economic analysis of the use of most-favored nations clauses in contractual arrangements with hospitals: ... Carl Shapiro on BCBS and the New Merger Guidelines
DOJ v. Blue Cross Blue Shield of Michigan
This should be an interesting case to watch. As I’ve discussed, if one excludes policy speeches and restricts focus to enforcement action and activity, it has been thus far difficult to distinguish the Obama Antitrust Division from the Bush II Antitrust Division when it comes to single firm or allegedly exclusionary conduct. But the DOJ’s ... DOJ v. Blue Cross Blue Shield of Michigan
