Why Competition Doesn't Work To Lower Prices In Branded Specialty Drugs

Arthritis Drugs Show How U.S. Drug Prices Defy Economics by Julie Appleby.  KHN.  December 22, 2017. 

Mergers Aim To Capture Patients In Competitive Environment

Hospital Giants Vie For Patients In Effort To Fend Off New Rivals by Reed Abelson.  The New York Times.  December 18, 2017. 

F.T.C. Settlement Indicates Determination To Increasing Competition In The Pharmaceutical Industry

Teva Settles Cephalon Generics Case With F. T.C. For $1.2 Billion by Rebecca R. Ruiz And Katie Thomas.  May 28, 2015. 

Quest For Integrated Approach To Health Attracts Many Including Celebrities

Here's To Good Health (But No Toast) by Bee Shapiro.  The New York  Times.  December 4, 2013.

A profile of Dr. Frank Lipman whose appeal illustrates a strong desire by many for an integrated approach to medicine and health.

Safety Net Programs, Such As Obamacare, Seen As Key To Transition To Entrepreneurial Econmy

Why I (Still) Support Obamacare by Thomas L. Friedman.  The New York Times.  November 9, 2013.

(1)  According to Friedman why is "the high wage, medium-skilled job over?"

(2)  The only high-wage jobs that will support the kind of middle-class lifestyle of old will be _________________ requiring _________________________.

(3)  Explain what Friedman means expanding how we think about employment?

(4)  Work may have to be thought of as a _____________________________.

Multi-State Health Insurance Option Unveiled For Obamacare Exchanges; U.S. And Blue Cross Collaboration

U.S. Plans To Unveil New Insurance Options by Robert Pear.  The New York Times.  September 29, 2013.

(1)  This plan was conceived as an alternative to a ___________________ when it was authorized in 2010.

(2)  The Blue Cross and Blue Shield Association will offer this plan in exchanges in _________ states.

(3)  In many of the products offered by Blue Cross, consumers will have access to a ____________
network of doctors and hospitals.

(4)  The availability this program will increase ____________ in states such as New Hampshire and West Virginia which would otherwise have just one carrier in their exchanges.

FromFrom Hospital Consolidation To Lack Of Competition To Higher Costs

Health Care's Overlooked Cost Factor by Eduardo Porter.  The New York Times.  June 11, 2013.  Opinion piece

Read the above article and test your retention with the following questions.

(1)  According to the piece, an overlooked factor in controlling health care costs is the lack of ____________________ in America's biggest business---accounting for almost _____% of the nation's GDP.

(2)  The search for ways to slow spending has so far focused mostly on _______________.

(3)  One of the best-know causes of high costs is excessive ___________________.

(4)  There have been more than __________ hospital system mergers since the mid-1990s.

(5)  In 2002 doctors owned about ______________ physician practices.  By 2008 more than _________ were owned by hospitals.

(6)  Market concentration drives __________ and ______________ down.

(7)  Some studies have found that hospital mergers increase the number of__________.

(8)  Recent evidence suggests that costs are not being drive by ________________ as much as by _______________________.

(9)  While the rate of increase in health care spending has slowed, the rate still outpaces __________ by a significant margin.

(10)  According to the Health Care Cost Institute, health care spending has been entirely driven by ______________ not by more use.

(11)  The ______________ is the government agency worried about hospital competition.

(12)  How could accountable care organizations prove anticompetitive.

Consumer Reports Study Finds Dramatic Retail Price Differences For Drugs

Shopping Around Brings Steep Prescription Drug Savings, Report Finds.  Health.  March 28, 2013.

Consumer Reports looked at five medicines that have recently gone generic.  For a one-month supply there was a $749 difference between the highest and lowest stores.  Among the recommendations from Consumer Reports:  "A consumer can't assume that the price of their prescription medication si s set in stone."  "...ask for the best price and see if your pharmacist will work with you."

Antitrust Law Applies In Albany Hospital Ruling Of Supreme Court

A Stunning Blow To Albany Hospital Merger by Andy Miller.  Georgia Health News.  February 19, 2013.

Supreme Court Gives F.T.C. Win On Hospital Mergers by Andrew Pollack.  The New York Times.  February 19, 2013

In a unanimous decision, the Supreme Court accepted the concession of the 11th U.S. Circuit Court of Appeals that the merger of Phoebe Putney and Pamyra Hospitals in Albany, GA would lessen competition.  The high court viewed this concession as determinative in light of what the Court felt was
a Georgia's lack of a "clearly articulated and affirmatively expressed" policy to hospital acquisitions that substantially lessen competition.

What Does A Hip Replacement Cost? Who Knows?

Report:  Hip-Replacement Cost Hard To Pin Down by Kathryn Smith.  Politico.  February 12, 2013.

The survey of hospitals found a tremendous range of quoted price in those cases when the prices were provided at all.  The price mystery presents a problem for those who argue that when patients are required to shop for the best healthcare deals there will be market pressure on hospitals to reduce costs.

State Efforts May Restrain Competition In Biological Drugs

Biotech Firms, Billions At Risk, Lobby States To Limit Generics by Andrew Pollack.  The New York Times.  January 28, 2013.

The 2010 Affordable Care Act called for competition for biotechnological drugs.  However actions in the states legislatures  may have significant impact on the degree of competition and the amount of savings to be realized under ACA from prescribing biosimilars.

How biological drugs are made is outlined here.

ZocDoc Upends Traditional Medical Practice

Paging ZocDoc For the Future of Medicine by Michael Wolff.  USA Today-Media.  December 30, 2012.

ZocDoc allows a patient to identify doctors in an area who treat a particular malady as well as appointment availability.  The writer recounts an experience using this service when his personal doctor was away.  He identified a doctor 10 minutes from his house, established an appointment that day, and was treated in 15 minutes.  He merely entered his ZIP code, malady, an insurance and was provided a list of available physicians.  The writer envisions the time when all medical professions will join a ZocDoc-type service extending competition and resulting in price cuts.  ZocDoc, the writer asserts, presents an opportunity to wring out profits from health care's "ridiculous inefficiencies."

Hospital Merger Illustrates Trends

Michigan Hospital Systems in Merger Talks by Matthew Dolan and Christina Rogers.  The Wall Street Journal.  October 31, 2012.

The planned merger of two of Michigan's largest hospital systems illustrates broad trends impacting hospital nationwide.

(1)  The shift from inpatient to outpatient care;

(2)  Deterioration of robust growth resulting from erosion of employee benefits;

(3)  Increased competitive pressure and pressure on the bottom line from unpaid bills nd charity cases

(4)  Expansion of coverage coupled with reduced reimbursements under Medicare resulting from the Affordable Care Act;

Nationwide Health Insurance Plans Under New Health Care Law

U.S. Set to Sponsor Health Insurance by Robert Pear.  The New York Times.  October 26, 2012.  

Two nationwide insurance plans operated under contract with and under the sponsorship of the federal government will be offered to consumers in every state.  These multistate plans are established under the provisions of the President Obama's health care law and will compete directly with private insurers. Premiums and benefits are to be negotiated by the US Office of Personnel Management which establishes benefits for federal employees.  The plans would be offered through state insurance exchanges.  Issues in underwriting, licensing, abortion services, and state regulation are discussed in the article.