Walls that have historically protected workers from sharing more of the financial burden for health services may have also helped to block knowledge about how much their choices actually cost. Cracks now seem to be appearing in some of those bastions — large labor unions. Whether those openings will help to throw light on the subject remains to be seen.

At General Electric, unions staged a two-day strike last month over the company's insistence that workers pay more for health care. In addition, other major industries face similar labor unrest over coverage. U.S. automakers and the United Auto Workers union, and the International Brotherhood of Teamsters and trucking companies, will also be negotiating this year.

"Rising health care costs mean that health care benefits and who should pay for the increases are going to be an issue in almost every set of negotiations until those increases disappear," Rick Banks, director of collective bargaining for the AFL-CIO, tells the Washington Post. "And that's not going to happen anytime soon."

GE officials say that the company increased employee copayments by about $200 per person on Jan. 1. Those increases include a $10 rise for specialist visits to $25 per visit, and a new $150 copayment for inpatient hospital care.

Overall costs to GE workers will increase about 20 percent from the current $1,000 a year. The company says that its health care costs have increased about 45 percent from 1999 to 2002 ($965 million to $1.4 billion).

Companies expect health care costs to rise 14.6 percent this year, according to a recent poll by Mercer Human Resource Consulting.

As a result of such forecasts, many businesses are testing the limits of how much of the increase they can pass off to workers.

"From the point of view of many unions, what they see is an unraveling of what it has taken many decades to put together, which is the employer paying most of the cost of benefits," Harley Shaiken, a professor specializing in labor issues at the University of California at Berkeley, tells the Post.

Managed Care’s Top Ten Articles of 2016

There’s a lot more going on in health care than mergers (Aetna-Humana, Anthem-Cigna) creating huge players. Hundreds of insurers operate in 50 different states. Self-insured employers, ACA public exchanges, Medicare Advantage, and Medicaid managed care plans crowd an increasingly complex market.

Major health care players are determined to make health information exchanges (HIEs) work. The push toward value-based payment alone almost guarantees that HIEs will be tweaked, poked, prodded, and overhauled until they deliver on their promise. The goal: straight talk from and among tech systems.

They bring a different mindset. They’re willing to work in teams and focus on the sort of evidence-based medicine that can guide health care’s transformation into a system based on value. One question: How well will this new generation of data-driven MDs deal with patients?

The surge of new MS treatments have been for the relapsing-remitting form of the disease. There’s hope for sufferers of a different form of MS. By homing in on CD20-positive B cells, ocrelizumab is able to knock them out and other aberrant B cells circulating in the bloodstream.

A flood of tests have insurers ramping up prior authorization and utilization review. Information overload is a problem. As doctors struggle to keep up, health plans need to get ahead of the development of the technology in order to successfully manage genetic testing appropriately.

Having the data is one thing. Knowing how to use it is another. Applying its computational power to the data, a company called RowdMap puts providers into high-, medium-, and low-value buckets compared with peers in their markets, using specific benchmarks to show why outliers differ from the norm.
Competition among manufacturers, industry consolidation, and capitalization on me-too drugs are cranking up generic and branded drug prices. This increase has compelled PBMs, health plan sponsors, and retail pharmacies to find novel ways to turn a profit, often at the expense of the consumer.
The development of recombinant DNA and other technologies has added a new dimension to care. These medications have revolutionized the treatment of rheumatoid arthritis and many of the other 80 or so autoimmune diseases. But they can be budget busters and have a tricky side effect profile.

Shelley Slade
Vogel, Slade & Goldstein

Hub programs have emerged as a profitable new line of business in the sales and distribution side of the pharmaceutical industry that has got more than its fair share of wheeling and dealing. But they spell trouble if they spark collusion, threaten patients, or waste federal dollars.

More companies are self-insuring—and it’s not just large employers that are striking out on their own. The percentage of employers who fully self-insure increased by 44% in 1999 to 63% in 2015. Self-insurance may give employers more control over benefit packages, and stop-loss protects them against uncapped liability.