Growing monopoly power of big hospital systems are spiking healthcare costs

Last month, only a couple of weeks after its big reveal, the American Health Care Act imploded before it could be voted on by the full House. Republicans have since engaged in a circular firing squad. Democrats wasted no time in patting themselves on the back. And pundits of all stripes have had a field day speculating on the implications of this failure on Trump’s agenda.

Interestingly, during floor debate and the media circus leading up to it, neither side’s rhetoric was complete and honest, therefore neither painted a clear picture of the gains and pains that American healthcare consumers are experiencing under the Affordable Care Act.

{mosads}It’s partly a function of our divided and divisive two-party system, and it’s partly the result of the incredibly complex set of issues that surround and make up what we call healthcare in our country.

It is true that the Affordable Care Act has been a godsend for people with pre-existing conditions, and serious and complex health conditions; the working poor; women; and many others. It is also true that an estimated 29 million Americans still lack any coverage, and too many are willing to pay a fine, rather than buy coverage they can’t afford. It’s true that more Americans have coverage than ever before.

It’s also true that premiums for employer-sponsored health insurance have increased three times faster than inflation, that deductibles have risen by 89 percent since 2010 (six times faster than wages), and that 31 percent of Americans skip needed care because of costs. 

A main reason that Congress can’t seem to have an informed debate about healthcare is that there’s a huge elephant in the room that neither the Republican nor Democratic leadership can talk about: prices. Because of core underlying problems in our healthcare system, including the growing monopoly power of big hospital systems and their takeover of doctors’ practices, and completely unchecked Big Pharma greed, costs are soaring for things like hospitalization and prescription drugs. 

It’s prices that are driving the unrelenting healthcare cost spiral, which in turn makes the status quo unsustainable. Neither party — through proposals or even talking points — has taken a credible approach to costs, because doing so would require them to take on powerful industries that spend a fortune on public relations and lobbying, namely, the hospitals, drug companies and insurance corporations.

Senator Sanders is poised to introduce Medicare for All, and there is no question that our system still needs major fixes. But short of that, there are a series of proposals that would begin to slow ruinous price increases, like repealing the Affordable Care Act’s tax on middle-class health benefits; making hospital and drug prices transparent; allowing Medicare to negotiate prescription drug prices and private insurers to reimport drugs; and capping and setting the rates that hospitals charge both for inpatient stays and visits to the growing number of doctors’ offices they control.

The ACA brought coverage to 20 million people, and instituted vital consumer protections for millions more, but the unspoken political strategy behind the ACA was to not inflict any pain on corporations and to wring cost-savings from working people instead.

The insurance industry got a trillion dollars in subsidies, and working families have a $79 billion tax (by conservative CBO estimates) hanging over their heads and driving up their deductibles.

Congress owes it to the American people to talk honestly about, and take on, the real culprits of America’s healthcare woes. The next phase of real reform will require something neither party until now has seemed willing to do: challenge the enormous corporations that dominate our healthcare system and squeeze American families. It’s possible for the ACA to be both a step forward and deeply flawed — it’s time for both sides of the aisle to acknowledge this and fix and strengthen the law.

D. Taylor is the president of UNITE HERE, a union that represents 270,000 North American workers.

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