Hey, Hey, New York Times: Just What Are the “Increasingly Blurred Lines” in Health Care?

I don't get it. 

Does anyone who really understands pharmaceutical pricing or compensation systems in commercial health insurance really think that health care hasn't had plenty of "blurred lines" for quite some time — try decades?  Or, does the New York Times mean that the blurriness that has long been present has finally risen to the surface? 

Like Austin Frakt, I do not lament the apparent beginning of the end for the stand-alone pharmacy benefit manager (PBM) industry but, unlike Austin Frakt, I am not optimistic that  migrating all that stand-alone PBM power into the hyper concentrated drug store and health insurance industries is necessarily going to benefit consumers. If the data on concentration in complementary industries in health care teaches us anything, concentration in ownership has not produced efficiencies  that have trickled down to the health care consuming public.  If the problems are little choice, no transparency, and conflicts of interest, how will this re-arrangement of the deck chairs change anything? 

I guess it is a good thing that we appear to be on the verge of a revival of interest in vertical mergers, if that is what is going on in the  AT&T – Time Warner challenge.  


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