Biden administration officials often say they believe in competition and hate monopolies. It’s a message that comes from the top. In an executive order from July 2021, President Joe Biden wrote, “Robust competition is critical to preserving America’s role as the world’s leading economy.”
He went on to bemoan consolidation in various business sectors and industries, such as agriculture, technology and the internet, telecommunications, and healthcare. Pointing his finger at drugmakers and hospitals, he wrote, “Americans are paying too much for prescription drugs and healthcare services — far more than the prices paid in other countries. Hospital consolidation has left many areas, particularly rural communities, with inadequate or more expensive healthcare options. And too often, patent and other laws have been misused to inhibit or delay — for years and even decades — competition from generic drugs and biosimilars, denying Americans access to lower-cost drugs.”
Biden’s stated worries about consolidation in the healthcare industry are notable as his administration followed through on his executive order. During Biden’s term, the Federal Trade Commission has tried to block numerous hospital mergers, with several calling off their deals in lieu of fighting the FTC in court.
The irony in all these pronouncements of concern about “competition,” especially as it relates to healthcare, is the Biden administration, along with other Democrats, ultimately wants as little competition as possible in the industry. Its goal is to have the government control nearly all of it, with the big prize for the progressive Left eventually being a single-payer healthcare system, where private insurance no longer meaningfully exists.
It started with the Affordable Care Act. While former President Barack Obama and his deputies have denied their signature domestic legislative achievement was a first step in that direction, it was then-Senate Majority Leader Harry Reid who said in 2013 that he thought the country must “work our way past insurance-based healthcare.” He went on to say, “What we’ve done with Obamacare is have a step in the right direction, but we’re far from having something that’s going to work forever.”
It is true Obamacare was not some underhanded, secret plot designed to lead purposely to a single-payer system. Subsidies and mandates for private insurance were an important part of the law. But the legislation did not live up to its name or the promises of its supporters and cost far more than projected. For example, Medicaid expansion, initially incentivized with the carrot of the federal government covering all costs for two years and 90% of the costs after that, has put policymakers in a real bind. States have endured sign-up rates at twice what was expected, and costs have exceeded estimates by as much as 76%.
Healthcare premiums have increased significantly in the individual and employer-sponsored markets. Another promise was that Obamacare would increase competition in the health insurance market. According to a 2023 report by the American Medical Association, the commercial market became more concentrated between 2014 and 2022. Additionally, the plan for the Obamacare exchanges was to get younger, healthier people to sign up. However, that did not happen. The law does not allow insurers to consider preexisting conditions. Insurers cannot consider individual health status when pricing that insurance. The result is younger and healthier getting charged higher rates to compensate for the lower costs of older and less healthy enrollees.
So, contrary to the aims of Obamacare, healthcare costs are still expensive. Thus, the call by progressives, including Sens. Bernie Sanders (I-VT) and Elizabeth Warren (D-MA) and Rep. Pramila Jayapal (D-WA), to push “Medicare for All.” When introducing the latest legislation in May 2023, Jayapal said in a statement, “We live in a country where millions of people ration lifesaving medication or skip necessary trips to the doctor because of cost. Sadly, the number of people struggling to afford care continues to skyrocket as millions of people lose their current health insurance as pandemic-era programs end.”
She also said, “Every American has the right to health care, period.”
Biden said he would veto “Medicare for All” legislation during the 2020 campaign. However, two months after the bill was introduced, the president posted on X, “On my watch, health care is a right not a privilege in this country,” echoing the language of those who support a government-controlled system. Biden has often capitulated to his left flank while trying to maintain a reputation as a “moderate.”
Prescription drugs is another area where the president and other Democrats claim the government must “do something,” claiming their efforts will bring prices down. The problem is it is entirely artificial, with central planning at the forefront. They operate under the pretense that a lack of competition drives up drug prices, so the government must step in.
The first volley was the misnomer legislation, the Inflation Reduction Act. Supporters, with a generous assist from most media outlets, claim it allows the government to “negotiate” drug prices with manufacturers for Medicare recipients. However, there is zero negotiation. The government sets the maximum price it will pay. The manufacturer can either choose to sell the drug at that price or not. If they are noncompliant, they are subject to excise taxes that, according to the Tax Foundation, could reach as high as 1,900%.
Democrats boast the “negotiation” reduces government spending by $102 billion over a decade. However, that cost comes at the expense of the drug manufacturers, who will reduce research and development spending, as well as abandon the development of experimental drugs, thereby reducing the availability of new drugs and new treatments.
The Biden administration also wants to take commercial patents away from drug companies that developed drugs with taxpayer funds, if the government determines the price of their drug is not “reasonably available.” Biden made this pronouncement in a post on X following his ludicrous declaration that 25 drug companies having 70% of the market denotes a “lack of competition.” The failure point in such a plan is it would not affect Eli Lilly, Merck, or Pfizer. Those are the companies that would enjoy the spoils of getting the patents the administration would take from startups and smaller manufacturers, who make up 70% of the businesses that receive federal dollars.
Finally, the Biden administration is taking steps to ruin a program that has broad support among seniors: Medicare Advantage. The program, known as Medicare Part C, is a health plan offered by private companies that contract with Medicare to provide Medicare parts A and B benefits. Most of them include prescription drugs (Part D) but also benefits not covered by Medicare alone, including vision, hearing, and dental services. Nearly half of all those eligible for Medicare are enrolled in Medicare Advantage plans.
The Biden administration, while routinely and falsely claiming that Republicans want to cut Medicare, is reducing payments to insurers to administer the plans. The result will be reduced benefits for those enrolled. KFF, in a snapshot of those covered by Medicare, noted, “Compared to traditional Medicare beneficiaries in 2021, Medicare Advantage enrollees were more likely to be Black or Hispanic, have incomes below $20,000 per person, live in urban areas, and have lower levels of education.”
Sen. Rick Scott (R-FL) said in a statement, “This Medicare Advantage benefits cut will result in the 2.8 million Florida seniors currently enrolled in Medicare Advantage, many of whom live on a fixed income, having their supplemental benefits reduced by $33 per month, or $396 per year.”
The administration is doing all of it quietly, hoping seniors who enroll in the fall don’t notice the changes before going to the polls in November. Senior citizens are a reliable voting bloc and could be the key to the rematch between Biden and former President Donald Trump.
It’s difficult to believe these moves are not by design. Increased burdensome regulations, barriers to competition, and laws that give the advantage to the government, all in the name of “competition,” are doing exactly the opposite — increasing costs, reducing the availability of drugs, and keeping new healthcare players from entering the market.
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All of it leads to a desired result: Democrats declaring the private healthcare system “broken” and giving the final push to what they really want, which is a government-run, single-payer healthcare system.
You might call that a monopoly.
Andrea Ruth is a contributor to the Washington Examiner magazine.
