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As part of its plan to lower prescription drug prices, the Trump administration wants to restructure pharmacy benefit managers' business models. It wants them to profit from flat fees, rather than the complex rebates they rely on now.
Yes, but: This transition to a new business model is already happening on its own, my colleagues Caitlin Owens and Bob Herman note. And drugs' list prices are not coming down.
The bottom line: "One can call something a rebate, a flat fee or an elephant. It still represents a lucrative flow of money, and the influence that goes along with it,” said Robin Feldman, a UC Hastings law school professor who recently wrote a book exploring these deals.
The Trump administration hasn't changed any other part of the health care system as much as it has changed Medicaid. And yesterday, it was fighting in court to preserve that legacy while also foreshadowing where it wants to go next.
Driving the news: Judge James Boasberg, who put Kentucky's Medicaid work requirements on ice last year, still seemed skeptical about the policy during oral arguments yesterday, the Lexington Herald-Leader reports.
What's next: Boasberg said he would rule before April 1, when Kentucky's rules are slated to take effect.
What's after that: HHS Secretary Alex Azar confirmed to a Senate committee yesterday that the department has talked with state officials about even steeper Medicaid cuts, including block grants and per-person spending caps.
Employers cover more Americans than the government does, but with a lot less cost control. For years, their primary tool for keeping their health care spending in check has been to simply shift more of the bill onto workers.
Some of the largest companies in the U.S. are starting to ditch their insurers and contract directly with providers, believing they can get a better deal going it alone.
Yes, but: Direct contracting is only a tool for big employers — small companies simply don't have the leverage to drive the kind of bargains Walmart can.
Go deeper: I wrote last year about employers turning inward as they look for health care savings.
Beto O'Rourke in Iowa. Photo: Chip Somodevilla/Getty Images
This tells you a lot about what matters to Democratic primary voters: "1st question for Beto O'Rourke as a 2020 candidate is on health care," NBC's Alex Seitz-Wald reported yesterday from Iowa.
What he's saying: O'Rourke didn't sign on to single-payer legislation when he was in the House, but he made some Medicare-for-All-adjacent comments early in early his Senate run, but he's not talking about Medicare for All now.
Flashback: The Wall Street Journal dug back into O'Rourke's first campaign for the House, in 2012, and you can expect to hear this a couple million times over the next year.
He voted consistently against the myriad repeal bills once he was in the House.
In the aftermath of a sudden tragedy — like a natural disaster or political violence — the world generally has a system in place to quickly mobilize an army of doctors and nurses. But there's usually no such structure in place to help people cope with the mental health effects of those calamitous events.
Good news, courtesy of The Economist: It's easier than a lot of people thought.
After the razing of slums in Zimbabwe's capital left some 700,000 people homeless, one local psychiatrist "decided to train elderly women already known for some kind of community work in aspects of cognitive-behavioural therapy," dispatching them to sit on designated benches where locals could turn for some help.
This won't work for everyone, of course — police can't replace mental health professionals. But it's a promising tool for emergencies.