The Cost of Health Care: a Renewed National Focus

The high cost of pharmaceuticals may be the current national focus, but make no mistake, the overall high cost of health care in the United States is being targeted by the Trump Administration and Congress. No one really argues against the fact that pharma costs are through the roof - both name brand and generic. But hospital and physician costs are also under serious discussion within HHS, CMS and Congress, especially in light of the new Medicare trustees report. And let's not forget about the high cost of insurance.

• HHS’ Office of the Inspector General found a 62% spike in federal spending in Medicare Part D — even after accounting for rebates and discounts, and even though the total number of prescriptions declined over the same time period. Click here for the report.
• The premium for an average "benchmark" plan is 34% higher this year than in 2017, according to the Congressional Budget Office. CBO expects premiums for the same set of plans to go up another 15% for 2019, then to level out at about 7% per year after that. Click here for the CBO report.
• Medicare's primary fund is expected to be depleted by 2026, three years earlier than health care officials expected last year, per the 2018 report from Medicare's trustees. Click here for the report.

As consumers are forced to pay more out-of-pocket, politicians will look for ways to bring down those costs. Already states are acting to curb "surprise" ED bills (click here.) And, click here for the new data on how much more covered employees are paying for their health care today. Democrats are talking publicly about single payer or Medicare for all - perhaps looking at the Maryland total-cost-of-care model (click here for the latest) as part of the solution. Some are suggesting that single-payer would not be a big negative financial hit to physicians. Click here. While Republicans are backing away from Obama-era solutions driven by CMS/CMMI and talking about more private-public sector answers. And some in the Administration are still pushing Obamacare repeal, including actions that challenge pre-existing conditions protections. Click here.