Good morning. A fun fact about me is that both my parents are horse veterinarians. I won't tell you their take on the Kentucky Derby results, but I will say that they never expected the derby to become a political controversy.
The health care services that rack up the highest out-of-pocket costs for patients aren't the same ones that cost the most to the health care system overall.
Why it matters: Americans likely have a distorted view of what is costing them the most, which affects where consumers direct their ire after receiving expensive medical bills.
What they're saying: "What you pay for health care is often more influenced by your health insurance than the actual cost of the service," Avalere's Chris Sloan said.
Yes, but: Insurance was designed in part to shield patients from high health care bills, which typically are largest when a patient goes to the hospital. But most people don't go to the hospital in any given year.
The bottom line: The health care costs that are hitting patients' pocketbooks hardest aren't the same ones that are driving health care spending through the roof, meaning that political action to address costs may be somewhat divorced from our long-term problems.
Tennessee is plowing ahead with its plan to become the first state to adopt Medicaid block grants. But, Axios' Sam Baker notes, there's no guarantee that the Trump administration will end up playing along.
Driving the news: The state legislature on Friday passed a bill authorizing the new financing structure, and Gov. Bill Lee is expected to sign it.
Details, via Nashville Public Radio: Tennessee's block-grant proposal would lock in the current rate of federal Medicaid funding — which could be a problem if either enrollment or costs ever increase.
Yes, but: The Trump administration has urged states on in a handful of efforts to roll back Medicaid, and block grants would be the most aggressive of those efforts by far. But it hasn’t yet provided a clear framework about what it believes it can approve, within its legal authority — meaning all of this could still fizzle out.
Three years ago, Gilead Sciences was generating record sales and profits on the back of its hepatitis C pills.
The big picture: Gilead's drugs were a major reason why pharmaceutical spending shot up in 2014 and 2015, as patients flocked to the high-priced pills that cure the disease for a vast majority of people.
Between the lines: AbbVie has been the leading hepatitis C drugmaker for 2 consecutive quarters, as its Mavyret medicine has outsold Gilead's options, led by Epclusa and Harvoni.
What we're watching: Whether more state Medicaid programs follow Louisiana and adopt a subscription approach to purchasing hepatitis C medications.
As the threat of drug-resistant infections rises globally, small and large drug companies are giving up on antibiotics because they don't turn enough profit, Bloomberg reports.
By the numbers: Only 5 of 16 antibiotics introduced between 2000 and 2015 made $100 million or more annually in U.S. sales.
The bottom line: While public health experts have ideas about how to fix the incentives around developing antibiotics, for now things aren't looking good.
Have a great day!