Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

How special interests won big and consumers lost big

Robert Laszewski
Policy
December 20, 2019
Share
Tweet
Share

As the year winds down and must-pass year-end spending bills are completed — and with that, any chance of attaching and approving health care legislation — the special interests have won big, and consumers have lost big.

Employers, unions, and insurance companies won big with the repeal of the “Cadillac” tax on high cost-benefit plans at a cost of $200 billion over ten years as well as the repeal of the health insurance tax (HIT), and the 2.3 percent medical device tax sales tax.

The total cost for repealing just these things will add about $400 billion to the deficit over a decade and are part of a mammoth $1.4 trillion spending bill larded up for lots of different interests.

The HIT and the medical device tax were made a part of the Affordable Care Act (Obamacare) to help pay for the coverage expansion. The idea was to let the insurance companies and medical device companies, benefiting from more people buying insurance and medical devices, pay for part of the expansion.

The “Cadillac” Tax on high-cost health plans was intended to encourage plan sponsors to control their costs in order to avoid the big tax on excess cost as well as raise revenue to pay for Obamacare. About every health care economist I know of welcomed our finally getting this big incentive to control costs.

Advocates for the tax repeals will say those taxes would have been ultimately borne by consumers. All business taxes are ultimately borne by consumers. If you think the special interest pressure here was out of concern for regular people, you just fell off the turnip truck.

While the powerful health care special interests won big this month, consumers lost.

The bipartisan drug price control bill authored by otherwise powerful Senate Finance Chair Charles Grassley (R-IA) and ranking member Ron Wyden (D-OR), and supported by President Trump, went nowhere this year in the face of drug company opposition. The bill would cap senior drug costs and would limit drug price increases to the rate of inflation.

And, a bipartisan compromise bill to deal with the surprise medical bill issue authored by Senate Health Committee Chair, Lamar Alexander (R-TN), House Energy and Commerce Chair Frank Pallone, Jr. (D-NJ), and ranking member Greg Walden (R-OR), that would have literally and artfully split the differences on the issue between plan sponsors and health care providers, also stalled in the face of special interest opposition.

So, let’s summarize:

  • The big health care special interests wanted to get rid of the Obamacare taxes at a price to taxpayers of $400 billion, and they are getting what they want.
  • The big health care drug special interests didn’t want a bill to aimed at limiting the price of drugs, and they got what they wanted.
  • The big health care payer and provider special interests refused a reasonable compromise on surprise medical bills, and they got what they wanted.

Special interests four hundred billion – consumers zero. In fact, the special interests are so powerful the $400 billion price tag isn’t paid for — just added to the deficit.

Think about that. The same week the partisanship on Capitol Hill was so bad the House impeached the president, Republicans and Democrats were able to come together to overwhelmingly agree to please the special interests and diss the consumer.

Who says Washington can’t get along?

Robert Laszewski is president, Health Policy and Strategy Associates and blogs at Health Care Policy and Marketplace Review.

ADVERTISEMENT

Image credit: Shutterstock.com

Prev

Doctors: Always be prepared to suture wounds

December 20, 2019 Kevin 1
…
Next

A paradoxical fix to physician burnout: more patients, less supervision

December 20, 2019 Kevin 2
…

Tagged as: Public Health & Policy, Washington Watch

Post navigation

< Previous Post
Doctors: Always be prepared to suture wounds
Next Post >
A paradoxical fix to physician burnout: more patients, less supervision

ADVERTISEMENT

More by Robert Laszewski

  • Inside the $1.9 trillion coronavirus stimulus bill is a political time bomb for Republicans

    Robert Laszewski
  • What does Kelly Loeffler’s health plan do to coverage for preexisting conditions?

    Robert Laszewski
  • Joe Biden won. What does that mean for health care?

    Robert Laszewski

Related Posts

  • Money will be lost in health care. This is true no matter how we describe it.

    Edwin Leap, MD
  • Why the health care industry must prioritize health equity

    George T. Mathew, MD, MBA
  • Why this physician teaches health policy in medical school

    Kenneth Lin, MD
  • Health care workers need policy changes, not just applause

    Yuemei (Amy) Zhang, MD
  • Health care is not a service commodity

    Peter Spence, MD, MBA
  • Democracy and the health of a nation 

    Audrey Shafer, MD

More in Policy

  • Online eye exams spark legal battle over health care access

    Joshua Windham, JD and Daryl James
  • The One Big Beautiful Bill and the fragile heart of rural health care

    Holland Haynie, MD
  • Why health care leaders fail at execution—and how to fix it

    Dave Cummings, RN
  • Healing the doctor-patient relationship by attacking administrative inefficiencies

    Allen Fredrickson
  • The hidden health risks in the One Big Beautiful Bill Act

    Trevor Lyford, MPH
  • The CDC’s restructuring: Where is the voice of health care in the room?

    Tarek Khrisat, MD
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Why the heart of medicine is more than science

      Ryan Nadelson, MD | Physician
    • How Ukrainian doctors kept diabetes care alive during the war

      Dr. Daryna Bahriy | Physician
    • Why Grok 4 could be the next leap for HIPAA-compliant clinical AI

      Harvey Castro, MD, MBA | Tech
    • How women physicians can go from burnout to thriving

      Diane W. Shannon, MD, MPH | Physician
    • What a childhood stroke taught me about the future of neurosurgery and the promise of vagus nerve stimulation

      William J. Bannon IV | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Why the heart of medicine is more than science

      Ryan Nadelson, MD | Physician
    • How Ukrainian doctors kept diabetes care alive during the war

      Dr. Daryna Bahriy | Physician
    • Why Grok 4 could be the next leap for HIPAA-compliant clinical AI

      Harvey Castro, MD, MBA | Tech
    • How women physicians can go from burnout to thriving

      Diane W. Shannon, MD, MPH | Physician
    • What a childhood stroke taught me about the future of neurosurgery and the promise of vagus nerve stimulation

      William J. Bannon IV | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

How special interests won big and consumers lost big
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...