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Illustration: Aïda Amer/Axios

Private health insurance is a conduit for exploding health care spending, and there's no end in sight.

The big picture: Most politicians defend this status quo, even though prices are soaring. And as the industry's top executives and lobbyists gathered this week in San Francisco, some nodded to concerns over affordability — but then went on to tell investors how they plan to keep the money flowing.

Where it stands: More than 160 million Americans get private insurance through an employer or on their own, and per-person spending in that market rose by almost 7% in 2018, the highest annual growth rate in 14 years.

  • "Prices are definitely going up," Owen Tripp, CEO of health tech startup Grand Rounds, told me this week during the annual J.P. Morgan Healthcare Conference.
  • His company's vast amount of commercial health data shows big increases in what companies are spending on hospitals, doctors, specialty drugs, devices and out-of-network services.

What they're saying: Many in the industry admit price inflation has been hammering the commercial markets for years.

  • "Cost per unit is the primary driver," Cigna CEO David Cordani said. He did not mention the exploding costs of administering health insurance.
  • One hospital system at the conference acknowledged that "the number one cause of personal bankruptcy is our industry" — before going on to tell investors about the hospital's strong margins.

Multiple hospital executives claimed they charge commercial plans higher prices to make up for the lower rates they get from Medicare and Medicaid.

  • "Every health system I know of loses money on every Medicaid and every Medicare patient," Amy Compton-Phillips, a top clinical executive at Providence St. Joseph Health, told me.
  • But the evidence overwhelmingly shows that hospitals' explanation doesn't hold water.

Drug spending has risen at a slower rate than hospital and physician spending.

  • But in the commercial market, drug companies also have tripled their spending on programs that cover all or part of patients' out-of-pocket costs, then bill insurers for the full freight.
  • "It's an intriguing theory," said Stephen Ubl, CEO of PhRMA, the pharmaceutical industry's main lobbying group. "But I would be shocked if we were a significant contributor" to the increased private spending.

The bottom line: The private market is the main pot of money that everyone is chasing at the J.P. Morgan conference, and most in the industry don't see the ballooning spending within that market as a problem.

Go deeper

Chris Cuomo accuser: On-air "hypocrisy" spurred report

Journalist Chris Cuomo. Photo: Gilbert Carrasquillo/GC Images

A woman who accused fired CNN journalist Chris Cuomo of sexual misconduct said Sunday she decided to come forward after learning of his comments about women who made similar accusations about his brother. He denies her allegations.

Why it matters: Her attorney Debra Katz said in a statement that she heard "the hypocrisy" of his on-air words about his brother, former New York Gov. Andrew Cuomo, and was "disgusted by his efforts to try to discredit these women," so "retained counsel to report his serious sexual misconduct against her to CNN."

Updated 4 hours ago - Politics & Policy

Omicron dashboard

Illustration: Shoshana Gordon/Axios

  1. Health: CDC director says number of U.S. Omicron cases "likely to rise" — Two years of COVID-19 — Prior coronavirus infections may not protect well against Omicron.
  2. Vaccines: Data demonstrates most-vaccinated counties less vulnerable to worst of COVID — Omicron adds urgency to vaccinating world — Omicron fuels the case for COVID boosters.
  3. Politics: Nevada to impose insurance surcharge on unvaccinated state workers — New Jersey GOP lawmakers defy statehouse COVID policy — Oklahoma sues Biden administration over Pentagon vaccine mandate.
  4. World: Vaccine mandates lose steam in the U.S. while Europe doubles downWHO: Delta health measures help fight Omicron — COVID cases surge in South Africa in sign Omicron wave is coming.
  5. Variant tracker: Where different strains are spreading.

Vulnerable Democrats: Less Trump talk

Illustration: Aïda Amer/Axios

Vulnerable House Democrats are convinced they need to talk less about the man who helped them get elected: President Trump.

Why it matters: Democrats are privately concerned nationalizing the 2022 mid-terms with emotionally-charged issues — from Critical Race Theory to Donald Trump's role in the Jan. 6 insurrection — will hamstring their ability to sell the local benefits of President Biden's Build Back Better agenda.

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