Powerful health care companies shape the informational environments around their products. As part of this playbook, companies avoid or thwart the generation and dissemination of accurate information on the true value of their products. Consequently, Americans spend too much on health care with dubious or even negative value.
Though heralded as a policy innovation, value-based payment has not succeeded in lowering costs and has instead fueled corporate consolidation, as many physicians are ill-equipped to assume the financial risk that the payment model requires. Embodying the core tenets of neoliberalism, VBP is ultimately a failure of policymakers to equitably and efficiently administer a public health care program.
For the half-million people in the U.S. with kidney failure, survival rests in the hands of two powerful corporations — DaVita and Fresenius — that control over 70% of the outpatient dialysis market. But the history of dialysis isn’t a simple narrative of corporate consolidation; it’s a case study of how public funding can entrench private power in health care.
Private equity firms are acquiring dominant shares of physician practices, creating conflicts between shareholder value and physicians’ professional and ethical duties. While longstanding state laws that prohibit lay ownership of medical practices have been under-enforced and evaded, recent litigation and legislative proposals suggest they could be revitalized to address today’s forms of corporatization.
From the dialysis market to the pharmaceutical industry, health care is seeing growing consolidation and corporatization. Over the next month, this symposium will explore the financialization of various health care industries and begin to sketch the contours of a progressive pushback—how law, policy, and regulatory action can help erect guardrails to protect us from both illness and insolvency.
New Uber-style firms like CareRev and Clipboard Health use algorithmic scheduling, staffing, and management technologies to match understaffed medical facilities with nearby nurses and nursing assistants looking for work. These companies, while promising flexibility, are facilitating a race to the bottom among healthcare workers and contributing to the erosion of America’s already-strained health care system.
With summer just around the corner, are you looking to indulge in some juicy, page-turning scholarship? As always, the Blog has you covered with our biannual roundup of some of our favorite forthcoming LPE and LPE-adjacent articles.
The persecution of transgender people, though often treated as a niche concern, is central to today’s political and economic realignments. These attacks are not ancillary but entangled with broader efforts to reassert control over race, gender, and migration.
The Trump Administration’s anti-trans policies should be seen as central, rather than peripheral, to the creation of what Melinda Cooper has called “an anti-social state” — a state that would abandon every duty to serve its citizens and residents, whose sole purpose would be to amplify presidential executive power.
The Manhattan Institute’s obsessive focus on trans medicine is a part of its broader effort to erode public trust in medical professionals and federal health authorities.
Much as Reagan invoked the welfare queen as a diversion to absorb public outcry against devastating cuts to the social safety net, Trump today offers trans people – with their supposedly abundant, easily accessible healthcare – as scapegoats to justify a broader conservative health policy agenda.
According to recent judicial decisions, the state can criminalize homelessness, ban abortion, and restrict gender-affirming care, all in the name of public health, yet it cannot mandate vaccines nor pause evictions. How should we understand this asymmetry, and how might we realign public health jurisprudence with the pursuit of equality?
In the midst of the chaos, an ambitious policy agenda beckons. Elizabeth Wilkins, Chiraag Bains, Bharat Ramamurti, Samuel Bagenstos, Shilpa Phadke, and K. Sabeel Rahman reflect on how to rebuild, rather than merely reproduce, what came before the wreckage.
Is the power wielded by interests groups ultimately good or bad? To answer this question, we need to distinguish ordinary interest groups from super-groups, like the American Medical Association, whose legal empowerment makes them legitimate targets for democratic contestation and provides a principled basis on which to assess their political influence.
Religious liberty challenges to the Affordable Care Act often appear narrowly focused on exempting specific employers from covering particular types of care, such as contraceptives, sterilization, or gender-affirming care. However, closer examination reveals that such claims should be understood as a major new vector in the campaign against social insurance in the United States.
