Ed Haislmaier: Impact of Business Coalitions on Healthcare Costs

Ed F. Haislmaier, the Preston A. Wells Jr senior research fellow at the Institute for Family Community, and Opportunity at The Heritage Foundation, talks about the impact of new business partnerships on healthcare costs.

What impact do you see of recent nontraditional mergers and partnerships – CVS-Aetna and Amazon-JP Morgan-Berkshire Hathaway – having on healthcare costs?
I’m keeping an open but skeptical mind about both of those partnerships. I’m not sure about the CVS-Aetna partnership as really creating that much synergy. I’m willing to be persuaded but it just doesn’t seem to be a synergistic approach. The question about Amazon and Berkshire and JP Morgan Chase—that is even less clear. It does seem to have the feel of large employers getting together to finally figure out how to buy smarter, which is something we’ve seen happen before with mixed results.

We’ve had business coalitions on healthcare and things like that. Both of those are very early stages and I’m willing to say that something might happen, but I’m skeptical on both.

The Center for American Progress recently released a framework called Medicare Extra for All, similar to Senator Bernie Sanders’ own proposal – what is your take on these types of proposals?
The basic problem that they’re trying to address is the so-called uninsurance. I’m not sure how many uninsured people we actually have left because functionally most of the people, if people are technically insured, a lot of them are functionally insured. In other words, they have access to care, they’re just not in an insurance program.

This is kind of interesting because we’ve seen this with the Affordable Care Act is we’ve seen people get the Affordable Care Act insurance when they need medical care and then drop it. So, do you count those people as insured or uninsured? Because once they’ve been treated, they drop the insurance.

I think the goal of insurance for everybody, while it sounds nice, is really a secondary. The primary goal I think we need to focus on are people getting access to the medical care that they need. How we do that, how we pay for it, becomes a secondary issue.
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