An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

by Elisabeth Rosenthal

Medicare Part D worked just as intended to make drugs more affordable to seniors—but only for a very few years. The medical industry soon developed strategies to benefit financially from the policy, undermining its patient-centered ambitions. Basic drugs for common conditions in the elderly, such as high blood pressure and rheumatoid arthritis, had to be cheap in the decades before Medicare Part D picked up the tab. But once all seniors were guaranteed drug coverage and were paying only a co-payment, drug companies raised prices—a lot. Insurers then responded by charging higher-percentage co-payments to discourage use. Steve Carlson’s NovoLog insulin has become more and more expensive under Medicare Part D. It had previously been covered under another Medicare program and dispensed as a medical supply, at no cost. Now Mr. Carlson’s insulin, which set him back under $20 a month in the 1990s, costs about $700, a part of which he pays himself.