Consolidation in the health system and health insurance industries has been a focus for years. But a new report sheds light on how the “bigger is better” mantra has taken hold in companies that make syringes, X-ray machines or other healthcare products

The report, prepared by the Open Markets Institute using data from IBISWorld, shows a small handful of companies dominate their respective markets in certain healthcare sectors that tend to get less of a spotlight than their payer and provider counterparts.

Transparency, though essential, is not sufficient to bring down health care costs. Nor does it always need to be legislated. Laws aren’t required to force sellers of food, computers or clothing to post prices. That information is driven by consumers who actively seek value for their money. The most compelling motivation for doctors and hospitals to post prices would be the awareness that they’re competing for price-conscious patients.

The Department of Veterans Affairs on Thursday will begin allowing a broad section of its nine million enrollees to seek medical care outside of traditional V.A. hospitals, the biggest shift in the American health care system since the passage of the Affordable Care Act nearly a decade ago.

While department officials say they are ready, veterans groups and lawmakers on Capitol Hill have expressed concerns about the V.A., which has been dogged for years by problems with its computer systems. They worry that the department is not fully prepared to begin its new policy, which Congress adopted last year to streamline and expand the way veterans get care.

The Medicaid Drug Rebate Program (MDRP) was created by Congress nearly 30 years ago. It requires drug manufacturers to pay a rebate for all out-patient drugs dispensed to Medicaid beneficiaries. The percentage for this rebate varies by type of drug, with brand-name drugs requiring the greatest rebate and generics the least. In addition, the rebate must rise until it ensures that the net (of rebate) price of the drug matches the best price available to anyone in the private market. (MDRP is often referred to as the Medicaid “best price” policy.) Finally, there is an inflation penalty — an additional rebate equal to the amount by which the price increase exceeds the rate of inflation, measured by the Consumer Price Index for All Urban Consumers (CPI-U).

 

More than 1 in 4 Americans say they or a family member went without needed health care in the past two years because they felt they could not afford it, according to a new poll.

The survey from Monmouth University released Monday finds that 27 percent of adults say they or a member of their household have avoided necessary medical care in the past two years because of cost. That figure is down slightly from 2017, when 31 percent said they had skipped care.

Nine years after Democrats passed the Affordable Care Act and more than a year after Republicans failed in their effort to repeal it, health care promises once again to be a major issue in the 2020 elections.

Drug costs are rising, as are insurance premiums. Rural hospitals are closing. Even as an estimated 20 million people have gained coverage under the ACA, widely known as Obamacare, nearly 30 million people remain uninsured. Surveys consistently find that Americans see the health-care system as broken.

Americans cited health care as the top issue for the federal government to address, ahead of the economy, immigration, national security and other issues, Wall Street Journal/NBC News polling found this month.

The financial burden of health care was of particular concern for American families, according to a new Gallup poll released last week, trumping worries linked to wages, college expenses, housing and taxes.

For generations, the prices that hospitals charge patients with private insurance have been shrouded in secrecy. An explosive new study has unlocked some of those secrets. It finds that employers and their insurers are failing to control hospital costs, increasing calls for transparency into insurer-hospital agreements. The analysis, by Chapin White and Christopher Whaley of the RAND Corporation, finds that hospitals are charging the privately insured 2.4 times what they charge Medicare patients, on average. The authors were able to access the actual contracted prices used by employers representing four million workers.

The number of uninsured climbed by 1.4 million from 2016 to 2018, according to a report out last week from the Congressional Budget Office. Naturally, this led those on the left to blame the Trump administration for its Obamacare “sabotage.” But the data in that report—which was released on the same day the Mueller report came out and largely ignored—tell an entirely different story. All of the increase in the uninsured over the past two years—all of it—is the result of the massive rate increases that Obamacare’s mandates and regulations caused. According to the Health and Human Services Dept., premiums in the individual insurance market doubled from 2013 to 2017. They shot up again in 2018.

Expanding Medicaid in the remaining non-expansion states would crowd millions of able-bodied adults out of private insurance coverage and shift them into taxpayer-funded Medicaid. In fact, nearly two-thirds of these adults either have private coverage already or have access to very low-cost coverage through the ObamaCare exchange. Even worse, this expansion could also shift more than one million kids who currently have private insurance into Medicaid.

Ultimately, ObamaCare’s Medicaid expansion means taking resources away from those who truly need Medicaid in order to fund a welfare expansion for those who already have private coverage.

Dominant hospital systems use an array of secret contract terms to protect their turf and block efforts to curb health-care costs. As part of these deals, hospitals can demand insurers include them in every plan and discourage use of less-expensive rivals. Other terms allow hospitals to mask prices from consumers, limit audits of claims, add extra fees and block efforts to exclude health-care providers based on quality or cost.