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Retail Alliances - Not Washington - Will Save the U.S. Health Care System

The BriefGet Up To Speed

Last year, Intelligence Squared U.S. and the Mayo Clinic brought to the stage a bold inquiry about whether health care in the United States is terminally broken. And this year, we’re picking up where that discussion left off, against the backdrop of corporate behemoths announcing mergers that, they say, are sure to shake up health care – from the Amazon, Berkshire Hathaway, and JPMorgan Chase venture, to the CVS-Aetna deal, to the Humana-Walgreens partnership, and more. But while these superpower alliances are making a splash in the headlines, will they actually be able to disrupt, and save, U.S. health care? Proponents argue that the bargaining power and data competencies of these retailers will squeeze middlemen out of an inefficient supply chain and bring more transparency to health care pricing. But others argue that the promise of these novel efforts is overstated or misguided, particularly because U.S. health care is so complex and deeply rooted. Will consumer-focused models and employer-led initiatives lead to better and less expensive outcomes?

Background: General

“Over the past decade, healthcare providers and health insurance companies have been in a consolidation arms race, as providers have merged and formed healthcare networks to better negotiate with health insurance companies, which have grown rapidly.”

Thursday, February 15, 2018
Jack Curran

“The blue chips of Silicon Valley — Amazon, Apple, Google, Uber — have announced in the past few weeks they’re interested in disrupting an industry that has bedeviled us with rising costs and inefficiencies for decades.”

Tuesday, March 6, 2018
Dylan Scott

“From 2012 to 2017, the number of deals involving retail health companies—those that operate freestanding health-related outlets like dental clinics or urgent care facilities—has soared, increasing at a compound annual rate of 34% in the North American market.”

Wednesday, May 9, 2018
Nirad Jain, Jeremy Martin, Kara Murphy

"Health care spending in the United States greatly exceeds that in other wealthy countries, but the U.S. does not achieve better health outcomes."

Tuesday, March 13, 2018
Irene Papanicolas, Liana R. Woskie, Ashish K. Jha

“Medical prices are expected to increase more rapidly after historically low growth in 2015 of 0.8 percent to nearly 3 percent by 2025.”

Wednesday, February 15, 2017
Centers for Medicare & Medicaid Services
Background: Amazon, Berkshire Hathaway and JPMorgan Chase

“The companies said the venture would be ‘free from profit-making incentives and constraints’ and would develop technological solutions to provide simplified, high-quality health care for their hundreds of thousands of U.S. workers.”

Tuesday, January 30, 2018
Anna Wilde Mathews, Emily Glazer, Laura Stevens

“Gawande said the venture will seek to target three kinds of waste in the health-care system: administrative costs, high prices, and improper health-care usage.”

Sunday, June 24, 2018
Zachary Tracer

“[The deal] might provide cheaper, better care for all Americans while facing fewer political hurdles and requiring fewer jarring changes to the system.”

Thursday, February 8, 2018
Guian McKee

“Employers – even big ones like Amazon – can’t solve our Category 5 cost crisis because they’re actually supporting highly inflated (and federally subsidized) commercial pricing.”

Sunday, February 4, 2018
Dan Munro

“While the three companies bring successful management, technological expertise and substantial capital to the venture, many health industry experts expressed doubts about whether their results would match their ambition.”

Tuesday, January 30, 2018
Margot Sanger-Katz, Reed Abelson
Background: Amazon and PillPack

“The acquisition adds to recent moves by Amazon to wade deeper into health care, from pushing supplies for hospitals to helping form a nonprofit aimed at addressing rising costs.”

Thursday, June 28, 2018
Sharon Terlep, Laura Stevens

“In the future, patients could log into their Amazon accounts to track their prescription history, helping them better track their own health care.”

Friday, June 29, 2018
Faye Flam
Background: CVS-Aetna

“The proposed deal is the latest and most dramatic sign of how the lines between traditional segments in health care are blurring as companies, saddled with mature businesses and in many cases restricted from buying rivals, enter new areas in search of growth.”

Sunday, December 3, 2017
Sharon Terlep, Anna Wilde Mathews, Dana Cimilluca

“The AMA has come to the conclusion that this merger would likely substantially lessen competition in many health care markets, to the detriment of patients.”

Tuesday, June 19, 2018
Nathaniel Wexel

CVS Health CEO Larry Merlo said, “We're pleased with how that's all progressing, and we expect the transaction to close later this year.”

Thursday, June 21, 2018
Michelle Fox

“CVS Health has agreed to buy Aetna for about $69 billion. The merger, if completed, would be the largest health insurance deal on record and would combine the biggest US drugstore chain with the third-largest health insurer.”

Monday, December 4, 2017
Emily Stewart

“Through the proposed merger, CVS would become a one-stop shop for healthcare services, providing a template for future deals. That could all lead to greater consolidation in the healthcare services sector, and, ironically, toward a free market version of a single payer-like system.”

Monday, December 4, 2017
Steve Brozak

“The idea that price competition will protect consumers of health services is laughable.”

Friday, December 15, 2017
Steven Pearlstein

“Three important efficiencies promised by this merger are obvious: a reduction in the cost of clinical care and emergency room visits, improved care coordination for patients and an increase in the customer base for the CVS MinuteClinic walk-in system for basic care.”

Wednesday, June 6, 2018
Benjamin Zycher
Background: Walmart-Humana

“A Walmart-Humana deal could potentially transform the health care market for seniors, a demographic that is critical for both companies.”

Monday, April 2, 2018
Jed Graham

“Walmart has its work cut out for it with a Humana deal. But the strategic rationale is there, and the financials aren’t too disconcerting.”

Friday, March 30, 2018
Tara Lachapelle, Max Nisen

“One obvious rationale lies beneath these talks: Retailers have an urgent need to maintain foot traffic. Pharmacies can help.”

Friday, March 30, 2018
Charley Grant

“There is an undeniable synergy between health care companies and retailers.”

Friday, August 10, 2018
Arick Wierson

“Nearly 20% of Americans live in areas without sufficient access to primary care doctors, according to the U.S. Health Resources and Services Administration.”

Friday, August 8, 2014
Laura Lorenzetti
Background: Walgreens-Humana

“The Humana-Walgreens clinics, which will open this fall, will complement Walgreens pharmacy services and Humana’s Partners in Primary Care centers that opened last year in Kansas City, the companies have said said.”

Wednesday, August 1, 2018
Bruce Jaspen

“While small, the experiment could help Walgreens posture itself to care for seniors in more ways than it currently does through its pharmacies. Serving the elderly is an increasingly important battleground for health-care companies as baby boomers age.”

Tuesday, June 19, 2018
Angelica LaVito
Background: Apple

“Apple is preparing to launch a network of medical clinics for its employees and their families, in what could be a way for the tech company to test out its broader ambitions in healthcare.”

Tuesday, February 27, 2018
Tim Bradshaw

“Most of the team hired so far aren't doctors. In fact, the hires skew toward wellness professionals like nutritionists, exercise specialists and nurse practitioners.”

Tuesday, February 27, 2018
Christina Farr

“Employers are offering more complete employee coverage, such as health and wellness programs that can save money on care further down the road.”

Monday, March 12, 2018
Constance Gustke

“The partnership and its results will not solve all our health care problems. But they could really shake things up. And that is what the U.S. health system needs.”

Friday, March 23, 2018
David Blumenthal, Aneesh Chopra
Background: Uber

“Over 100 healthcare organizations in the U.S, including hospitals, clinics, rehab centers, senior care facilities, home care centers, and physical therapy centers have started using Uber Health in a beta test of the new system.”

Friday, March 2, 2018
Susan Morse
For the Motion

“We’re seeing major consumer companies such as Apple, Google and Amazon investing in healthcare, national shopping chains opening retail clinics, health systems opening grocery stores and pharmaceutical companies developing apps for patients to track symptoms and improve compliance.”

Monday, February 13, 2017
Zane Burke

"Consumers are starting to exert their power by making more demands on the health care provider-patient relationship and expecting to be treated in much the same way they are accustomed to being treated in their daily interactions with retailers." 

Wednesday, October 1, 2014
Against the Motion

“Consolidation often limits competition, and when that happens in market-based systems especially the result, says good research, is often that the cost of health care goes up.”

Tuesday, January 30, 2018
Timothy Hoff

“As the online retailer expands into new industries — cloud computing, drones, tech gadgets, moviemaking and now health care — some privacy experts say the company’s increasingly dominant role in our lives raises concerns about how personal data is collected and used.”

Tuesday, January 30, 2018
Abha Bhattarai
Changing Patient-Doctor Relationships

“Is the doctor in? In this new medical age of urgent care centers and retail clinics, that’s not a simple question.”

Saturday, April 7, 2018
Reed Abelson, Julie Creswell

“With the bar set fairly low for in-person interaction, something like a walk-in clinic—where you won’t know the doctor but you’ll at least get fairly quick service—becomes more appealing.”

Tuesday, June 26, 2018
Molly Callahan
Big Data and Health Care

“Will the benefits of making data more widely available outweigh such risks? The signs are that they will.”

Thursday, February 1, 2018

“These companies are all sophisticated, data-centric organizations looking to transform every part of the health care ecosystem. Even supply chains, with companies like Amazon in the fray, will be disrupted.”

Friday, July 6, 2018
Gary Bloom
Drug Pricing

“Although there are many winners in the pharmaceutical market, to date there is only one clear loser: our patients.”

Tuesday, April 10, 2018
Natasha Bhuyan, M.D.