I Tried Price Shopping for Health Care. It Isn’t Worth It – Not Yet.
The author tried to price‑shop a CT scan after a back injury and discovered that the lowest‑cost, in‑network provider didn’t offer the needed service, forcing a longer trip to a pricier location. The experience highlights how inaccurate provider directories, opaque insurance cost structures, and misaligned incentives make price shopping cumbersome for patients. With U.S. out‑of‑pocket health spending at $1,632 per capita in 2024, consumers could benefit from transparent pricing, but the current system limits effectiveness. The article proposes a “savings‑sharing” model that rewards members with rebates or dividends when they choose lower‑cost providers, borrowing from retail loyalty programs.
Dual-Eligible Patients Fall Through the Cracks in Substance Use Disorder Treatment
Dual‑eligible Americans—about 12 million who receive both Medicare and Medicaid—face stark gaps in substance‑use disorder (SUD) treatment. Roughly 1.5 million of these high‑need patients have SUD, yet Medicaid covers only about half of guideline‑recommended services and Medicare’s recent outpatient expansion omits telehealth...
If Gene Therapies Are so Revolutionary, Why Does No One Want to Pay for Them?
Gene therapies promise one‑time cures for diseases like sickle‑cell and inherited blindness, but their price tags—often $1 million to $3 million per patient—clash with the U.S. insurance model. More than half of new cell and gene therapies face coverage restrictions because insurers...
FDA’s New Program Injects Politics Into Drug Approval
The FDA has introduced the Commissioner’s National Priority Voucher (CNPV) pilot, offering ultra‑fast approval pathways for drugs that align with the current White House policy agenda. The program could slash review times for qualifying products, giving participating companies a market...
The Promise and Problems of Hospital Price Transparency
In 2021 CMS mandated hospitals to publish machine‑readable price lists for 300 common services, hoping transparent pricing would spur competition and lower costs. Five years later, health spending still outpaces inflation and the rule’s impact remains minimal. Low public awareness,...