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What We're Reading: Fact Checking Medicare-for-All Savings; PBMs and Drug Prices; Immigrants and Health Costs
Senator Bernie Sanders, I-Vermont, has claimed his Medicare-for-all plan will cut healthcare spending by $2 trillion, but fact checking shows that's unlikely; CVS' CEO defends its pharmacy benefit manager against claims rebates are driving up drug prices; researchers have found that immigrants have healthcare costs that are half to two-thirds of the costs of people born in the United States.
Fact Checking Sanders’ Medicare-for-All Claims
Senator Bernie Sanders, I-Vermont, has made big claims about the savings Americans will enjoy under his Medicare-for-all plan, but he might be overlooking some facts. The Associated Press fact checked Sanders’ claims and noted that his claim that the plan will cut $2 trillion from the country’s healthcare bill is reliant on a scenario of significantly lower payments to hospitals and doctors for most patients. The reality is that if providers are paid the same under the plan, spending would increase by more than $3 trillion.
CVS CEO Defends Against Drug Cost Blame
The Trump administration has criticized high drug prices and rebates paid to pharmacy benefit managers like Caremark, owned by CVS Health, for driving up prices. Larry Merlo, the CEO of CVS, is defending against the blame, noting that prices of drugs with smaller rebates are actually rising the fastest, reported The Wall Street Journal. Merlo said that 98% of the tens of billions of dollars his company has generated through rebates are passed through to clients—insurers, companies, and groups that pay for medicines.
Immigrants Have Lower Healthcare Costs Than Those Born in America
Researchers from Harvard Medical School and Tufts University have found that immigrants have healthcare costs that are half to two-thirds of the costs of people born in the United States. According to The Hill, immigrants make up 12% of the population, but they account for only 8.6% of the country’s healthcare spending. Undocumented immigrants, who make up 5% of the population, account for only 1.4% of total spending.
Prices for care at hospital trauma centers vary across hospitals; drug shortages reached a record high during the first quarter of 2024; although 3 of the biggest makers of asthma inhalers pledged to cap out-of-pocket costs for some US patients at $35, these do not apply to daily inhalers used by the youngest kids with asthma.
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Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
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The Biden administration recently launched the Global Health Security Strategy, a new effort to combat the spread of infectious diseases; lawmakers zeroed in on the risks of massive consolidation in health care during the first congressional hearing on the Change Healthcare hack; the FDA recently announced the recall of a pair of heart devices linked to numerous deaths and injuries.
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Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
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