Yves here. While this article correctly calls out the cancerous growth in US health care costs, it sadly over-estimates the degree to which a Medicare-for-All program would be an effective counter. Consider the practice of the smaller drug buyer, the Australian Therapeutic Good Administration. TGA staffers read medical research relentlessly. They select, for most ailments, a single medication for treatment. They often reject the latest whiz bang improvements, such as a newer once-a-day slow release version versus a three-times-a-day original, because the newer formulations do not improve medical outcomes. But they do count as FDA “new drug applications” and allow for extension of patent life, as in preserving premium pricing.
The TGA, by concentrating its buys across fewer medications, winds up having much bigger orders for them. It then bargains hard.
Now one can argue that the result is less choice. But the result is effective medications purchased at much lower price than in the US.
Pom-pom waving for Medicare (and other big buyers of medical services in the US) ignores that too often they are price takers (or even worse, hostages of the corrupt scheme known as Pharmacy Benefit Managers).
This article mentions but does not adequately register the significance of its opening observation, that the big driver of the private insurance increases is the cost of cancer and super pricey GLP-1 medications, as in Ozempic and Wegovy.
So what is Medicare’s solution to their costs? Having requirements so that most patients can’t get it. From IM Doc via e-mail:
This may not warrant attention like the Iran War. But something is happening to regular citizens that is just making LOTS and LOTS of people overwhelmingly pissed off.
Imagine having your face filled with ads, social media, TV shows, etc for 4 years of all kinds of people taking a new drug. GLP-1s. To Lose weight. Imagine yourself going to your MD to get an Rx – only to discover it is $1400 a month – which was the cost just a few months ago. And your insurance and Medicare do not pay a dime. Imagine the rage.
Then your relief as it is announced that Medicare will cover these drugs starting July 1. Ads everywhere – Trump on TV stating THEY ARE FREE. ….. And then your MD gets the inclusion and exclusion criteria – for the “Medicare GLP-1 Bridge Program” – only to discover that added together – all the exclusion criteria pretty much excludes 95% of the population. In other words, fatso, go away and die. For example, if you have or EVER had a diagnosis of sleep apnea, you are disqualified. Since most obese patients have OSA – out they go.
This is the lamest thing I have seen in some time – and that is saying something. The amount of people absolutely pissed is just breathtaking. One of the biggest self-owns in the history of Pharma. And Trump is rightfully getting all the blame.
Just thought you would like to know. As soon as I can – I can send the CMS documents sent to us as practicing MDs.
I did not ask for the backup but I am sure it makes for instructive reading.
So the underlying issue is that many Americans are in less than very good health due to poor diets, too much stress and social engagement, too little exercise, not great sleep habits….even before getting to many are also on psychoactive meds to get thought the day in our precarious, predatory system. Those drugs often have health effects when taken long term, like the prototypical SSRI 10-20 pound weight gain. The impulse behind Make America Healthy Again is sound, even if the implementation showcases a lot of dodgy health fads. Having more American work normal and regular work days, as oppose to (for lower income workers) being subject to erratic schedules and the stress of precarity, and for higher income ones, 24/7 on call expectations, would make a marked dent in the health crisis. More free time would mean more ability to participate in social activities (a big stress reducer) and better care for families, exercise, and even perhaps prepare fresh food more often. But that means upending the neoliberal “no rights for labor” paradigm. Can’t have that!
By Brett Wilkins, staff writer at Common Dreams. Originally published at Common Dreams
US workers with employer-sponsored health insurance are expected to spend an average of $5,297 on health care this year, including premiums deducted from their paychecks, deductibles, and copayments, according to a new estimate from benefits consulting giant Aon reported Thursday by The Wall Street Journal.
That’s $388 more than last year, and the pain is expected to intensify in 2027. According to a survey conducted by WTW, another consultant, US employers anticipate their health care costs will soar 11.1% next year. That could be the steepest increase in more than two decades, and would mark the fifth consecutive year of rising employer health care costs.
As the Journal noted, expensive cancer treatments and widespread adoption of weight loss drugs are among the factors driving up spending—and costs. For workers, that means larger deductions from their paychecks, higher out-of-pocket costs, and, for some, abandoning insurance altogether.
“Employers are telling us that this is utterly unsustainable,” WTW population health leader Jeff Levin-Scherz told the Journal.
Jason Wilburn, co-owner of Paul Wissmach Glass Co. in Paden City, West Virginia—which employs 35 people—said that the company has endured double-digit premium increases every year since 2021, with health care costs now accounting for 5% of revenue. That’s a higher percentage than the company’s margin of profit.
To cope, Wissmach Glass Co. increased its biweekly payroll deduction from $40 to $50 per worker, even though the company is still paying about 90% of the total premium. The increase has resulted in some employees deciding to drop their coverage.
“It’s frustrating and sad,” Wilburn told the Journal. “Something’s got to change.”
Democrats cited the report in a statement Thursday, noting that President Donald Trump and Republicans “have spiked health care costs for millions of Americans.”
“First, they cut Medicaid by nearly $1 TRILLION—the largest cut to health care in history—to pay for tax cuts for the ultrarich,” the party said, referring to the so-called One Big Beautiful Bill Act signed by Trump last year. “Then, they refused to extend the enhanced Affordable Care Act premium tax credits, hiking premiums by an average of 58%.”
“Trump and Republicans’ cuts have already forced 3 million people to drop their coverage, with more expected to drop coverage in the coming months as premiums are expected to see another double-digit increase next year,” the Democrats’ statement continued. “More than half of Americans already could not reliably afford health care in 2025—a five-year low—and nearly 1 in 4 American workers report staying in unwanted jobs just to maintain consistent health insurance.”
“Donald Trump and Republicans’ endless cuts to health care have jacked up costs for millions of Americans,” Democratic National Committee spokesperson Jaelin O’Halloran said. “Everyday Americans are dipping even further into their savings and taking on record amounts of debt to afford a trip to the doctor’s office or lifesaving medicine—and Trump doesn’t care.”
“While Trump prioritizes his White House vanity projects and tax cuts for the rich, working families are pinching pennies to pay their medical bills or forgoing health care coverage because they can’t afford it—and they will hold Trump and Republicans accountable in November,” O’Halloran added, referring to the upcoming midterm elections.
While progressives have long argued that the solution lies in decoupling health insurance from employment, Democratic leaders remain loath to advocate Medicare for All or other universal health care options. Just this week, House Minority Leader Hakeem Jeffries (D-NY) reaffirmed his opposition to Medicare for All, a position at odds with 90% of Democratic voters surveyed in a new CBS/YouGov poll.
As Common Dreams recently reported, a recent Yale University study found that Medicare for All—as proposed in legislation introduced by Sen. Bernie Sanders (I-Vt.) and Reps. Pramila Jayapal (D-Wash.) and Debbie Dingell (D-Mich.)—would save over 114,000 lives annually and $1 trillion per year in US health care spending.
Rep. Ro Khanna (D-Calif.) cited that study in an interview on Sunday in which he refuted Jeffries’ stance.
“Medicare for All is arguably the most important priority,” Khanna said, calling for a vote on Sanders’ bill. “It would save money, and it would save lives.”
