Monopoly

By Phillip Longman for Democracy Journal - Compared to the discourse in the other party’s nomination process, the debate between Hillary Clinton and Bernie Sanders over health-care reform may have seemed thoughtful and on point. Clinton argued that Sanders’s “Medicare for all” plan was too expensive to ever become law and was also a threat to the progress achieved by the Affordable Care Act (ACA). Sanders criticized Clinton for compromising the progressive goal of a single-payer system that would make health care a right. Eventually, Clinton moved Sanders’s way a bit, announcing in May that she had her own plan for letting people buy into Medicare, and then in July that she supported a public option insurance plan. Unfortunately, however, both sides scored mostly moot points, because both ignored a mega-trend in the business of health care: its increasing control by corporate monopolies. The massive increase in concentrated ownership occurring throughout the health-care sector could, at least in theory, lead to better coordinated care delivered at lower prices. This is the supposition behind key provisions of the ACA that directly and indirectly encourage health-care providers to merge. But experience has shown that consolidation, far from “bending the cost curve,” instead leads to higher prices, for the simple reason that mergers reduce competition.