Pharmaceuticals, Hospitals, Nursing Homes, Drug Store Chains, and Pharmacy Benefit Manager/Insurer Integration

Abstract

This chapter examines the continuing corporatization in the American healthcare system. First, the upsurge in consolidation is revealed through the merger and acquisition activity of each segment of the industry: pharmaceutical firms, insurers, hospitals and health systems, and the more recent intensely pharmacy benefit managers. Ongoing federal subsidizations are examined to show the attractiveness for investment in health care for mighty lucrative returns. This incentive structure remains even while Republican efforts to restrain spending are chiefly targeting the indigent, seniors, and seriously ill rather than the connected, powerfully entrenched vested interests in health care. Employer reactions to persistent cost escalation are also examined with implications to workers’ benefits and further rationalization of medicine and health care. Lastly, the huge recent incursions by information technology firms suggest that the American healthcare system may be on the verge of a further corporate takeover, instead of resolving issues of access, quality, cost, and accountability through a progressive public health approach.