Democrats are running on Medicare for All—or extending the seniors’ program to the merely middle-aged—or resurrecting a ‘public option’. Republicans say Medicare expansion would mean government intrusion and inefficiency. But politics aside, how would these Medicare expansions work?
Bereft of his own connections, President Trump recruited from conservative think tanks to fill health care positions in his administration. Many of them have Koch brother connections, and their agendas often run counter to Trump campaign rhetoric—and his impulses.
It is often an on-again, off-again disease, distressing partly because it is so unpredictable. It may defy the conventional wisdom about adherence and early treatment. And escalating prices have undercut cost-effectiveness arguments for the drugs that can keep it in check. Multiple sclerosis is a managed care nightmare.
Pharma and Trump administration officials decry them as backroom deals. But payers and PBMs say rebates are an important negotiating tool with drugmakers. Take it away and drug expenditure will go up even faster.