A blog covering the health/care ecosystem and people.

Picture this scenario: you, the consumer, take a dollar and spend it, and you get 90 cents back. In what industry is that happening? Here’s the financial state of healthcare in America, explained in the 2016 Health Care Cost and Utilization Report from the Health Care Cost Institute (HCCI). We live in an era of Amazon-Primed consumers, digital couponing, and expectations of free news in front of paywalls. We are all in search of value, even as the U.S. economy continues to recover on a macroeconomic basis. But that hasn’t yet translated to many peoples’ home economics. In this personal

Concerns about health care are, by a large margin, the top domestic policy issue U.S. voters identified as they enter 2018. The proportion of Americans citing healthcare as the top public agenda priority grew by 50% since 2016, from 31% two years ago to 48%. Taxes rank #2 this year, garnering 31% of Americans’ concerned, followed by immigration, which has remained flat cited by about one-in-four Americans. The Associated Press (AP)-NORC Center for Public Affairs Research polled 1,444 U.S. adults 18 and over between November 30 and December 4, 2017 for this survey. While one-half of Americans would like the

As I am finalizing my schedule for meet-ups at CES in Las Vegas for early January 2018, I’m thinking about digital devices and wearable tech, connected cars, smart homes, and the Internet of Things through my all-health, all-the-time lens. My friends at TrendWatching write today about the automaker, Volkswagen, which has a division called MOIA started in 2016. VW, like most car manufacturers, is working on strategies to avoid being disrupted and made irrelevant as tectonic forces like autonomous cars and shared rides innovate and re-define the nature of personal transportation. MOIA is a brand and a self-described “social movement.”

Patients’ health consumer muscles continue to get a work out as more people enroll in high-deductible health plans and face sticker shock for health insurance premiums, prescription drug costs, and that thousand-dollar threshold. The 2017 Alegeus Healthcare Consumerism Index finds growth in patients’, now consumers’, interest and competence in becoming disciplined about planning, saving, and spending for healthcare. Overall, the healthcare spending index hit 60.1 in 2017, up from 54.4 in 2016. This is a macro benchmark that represents most consumers exhibiting greater healthcare spending engagement with eyes on cost as well as adopting purchasing behaviors for healthcare. Underneath that

The nation’s largest retail pharmacy chain signed a deal to combine with one of the top three health insurance companies. The deal is valued at $69 billion. I wrote about this inflection point for U.S. healthcare four weeks ago here in Health Populi. CVS is both the biggest pharmacy and pharmacy benefit manager in the U.S., as the first chart shows. In my previous post, I talked about the value of vertical integration bringing together the building blocks of retail pharmacy and pharmacist care, retail clinics, the PBM (Caremark), along with Aetna’s health plan member base and business. As Amazon and other

Yesterday, the FDA approved a “digital ingestion tracking system,” the first drug in the U.S. that has an ingestible (in other words, safely edible) sensor built into the pill. That sensor tracks that the medication was taken, which helps with adherence, meant to help ensure that patients who are prescribed the medicine do indeed take the regimen as prescribed. Once ingested, the sensor in the pill communicates to a wearable patch on the patient that then communicates information to a mobile health app that tracks the pill-taking via smartphone. Patients can allow their family and clinicians access to that information

  A response to Amazon’s potential moves in healthcare and pharmacy…strategic positioning for the post-Trump healthcare landscape…vertical integration to better manage healthcare utilization and costs…these, and other rationale have been offered by industry analysts and observers of the discussions between CVS and Aetna, for the former to acquire the latter. “A pharmacy chain buying a health insurance company?” many have asked me over the past few days. These inquiring minds include people who work both inside and outside of health/care. I ask back: in 2017 and in the future, “What is a pharmacy? What is a health plan?” See the

U.S. consumers feel positive about the roles of technology and social determinants in improving healthcare, but are concerned about costs, according to the 2017 Patient Survey Report conducted for The Physicians Foundation. The survey gauged patients’ perspectives across four issues: the physician-patient relationship, the cost of healthcare, social determinants of health, and lifestyle choices. Two key threads in the research explain how Americans feel about healthcare in the U.S. at this moment: the role of technology and the cost of health care. First, the vast majority of consumers view technology, broadly defined, as important for their health care. 85% of people

Healthcare and the economy tied for US voters’ top issue last week, as the prospects for repealing the Affordable Care Act faded by the weekend. This Morning Consult poll was published 28th September 2017, as it became clear that the Graham-Cassidy health reform bill would lose at least three key votes the legislation needed for passage: from Rand Paul, Susan Collins, and John McCain. Liz Hamel, who directs the Kaiser Family Foundation’s survey research, told Morning Consult that, “when people say ‘health care,’ they often are actually talking about the economic issue of health care.”          

Getting health insurance at work means also having prescription drug coverage; 99% of covered workers’ companies cover drugs, based on the 2017 Employer Health Benefits Survey released by the Kaiser Family Foundation (KFF). I covered the top-line of this important annual report in yesterday’s Health Populi post, which found that the health insurance premium for a family of four covered in the workplace has reached $18,764 — approaching the price of a new 2017 small car according to the Kelley Blue Book. The complexities of prescription drug plans have proliferated, since KFF began monitoring the drug portion of health benefits

In 2017, Americans’ relationship with prescription drugs can be characterized in three ways: cost-rationing, misuse, and abuse. Three new studies about medicines in America paint this picture, brought to light by the AARP, Truven Analytics, and Quest Diagnostics. First, let’s look at the cost issue covered by AARP. AARP tracks the cost of prescription drugs among its constituents, namely people 50 years of age and over. The data were published in AARP’s Rx Price Watch Report, Trends in Retail Prices of Specialty Prescription Drugs Widely Used by Older Americans, 2006-2015. The average annual cost for one specialty medication used for

Cost is the number one driver among consumers declining satisfaction with pharmacies, J.D. Power found in its 2017 U.S. Pharmacy Study. Historically in J.D. Power’s studies into consumer perceptions of pharmacy, the retail segment has performed very well, However, in 2017, peoples’ concerns about drug prices negatively impact their views of the pharmacy — the front-line at the point-of-purchase for prescription drugs. In the past year, dissatisfaction with brick-and-mortar pharmacies related to the cost of drugs and the in-store experience. For mail-order drugs, consumer dissatisfaction was driven by cost and the prescription ordering process. Among all pharmacy channels, supermarket drugstores

A 65-year-old couple in America, retiring in 2017, will need to have saved $275,000 to cover their health and medical costs in retirement. This represents a $15,000 (5.8%) increase from last year’s number of $260,000, according to the annual retirement healthcare cost study from Fidelity Investments. This number does not include long-term care costs — only medical and health care spending. Here’s a link to my take on last year’s Fidelity healthcare retirement cost study: Health Care Costs in Retirement Will Run $260K If You’re Retiring This Year. Note that the 2016 cost was also $15,000 greater than the retirement healthcare costs calculated

As we look for signs of stability in U.S. health care, there’s one stakeholder that’s holding firm: employers providing healthcare benefits. Two studies out this week demonstrate companies’ commitment to sponsoring health insurance benefits….with continued tweaks to benefit design that nudges workers toward healthier behaviors, lower cost-settings, and greater cost-sharing. As Julie Stone, senior benefits consultant with Willis Towers Watson (WLTW), noted, “The extent of uncertainty in Washington has made people reluctant to make changes to their benefit programs without knowing what’s happening. They’re taking a wait-and-see attitude.” First, the Willis Towers Watson 22nd annual Best Practices in Health Care Employer

The business and mission of pharmacies are being re-shaped by several major market forces, most impactful being uncertain health reform prospects at the Federal level — especially for Medicaid, which is a major payor for prescription drugs. Medicaid covered 14% of retail prescriptions dispensed in 2016, according to QuintilesIMS; Medicare accounted for 27% of retail prescriptions. “But if affordability, accessibility, quality, innovation, responsiveness and choices are among the standards that will be applied to any future changes, pharmacy has strong legs to stand on,” Steve Anderson, president and CEO of the National Association of Chain Drug Stores, said in the PoweRx Top 50

Between 2014 and 2015, death rates increased for eight of the ten leading causes; only death rates caused by cancer fell, and mortality rates for influenza and pneumonia stayed flat. The first chart paints this sobering portrait of Americans’ health outcomes, presented in the CDC’s data-rich 488-page primer, Health, United States, 2016. Think of this publication as America’s annual report on health. Every year, it is prepared and submitted to the President and Congress by the Secretary of the Department of Health and Human Services. This year’s report was delivered by DHHS Secretary Tom Price to President Trump and the

Total prescription drug sales have been trimmed, based on calculations of EvaluatePharma which forecasts a $390 bn drop in revenues between 2017 and 2022. “Political and public scrutiny over pricing of both new and old drugs is not going to go away,” EvaluatePharma called out in its report. The intense scrutiny on pharma industry pricing was fostered by Martin Shkreli in his pricing of Daraprim (taking a $13.50 product raising the price to $750), Harvoni and Sovaldi pricing for Hepatitis C therapies, and last year’s EpiPen pricing uproar. A May 2017 analysis of prescription drug costs by AARP judges that, “Nothing

“Helping people on their path to better health” is the mission-mantra of CVS Health. Re-branded from its previous identity as CVS/pharmacy, the organization convened a Health Innovation Summit with its vendor partners whose products fill the front-of-store shelves to empower, inspire and support consumers to manage health and wellness for themselves and their families. I was grateful for the opportunity to provide the first talk for the day, setting the context for the evolving retail health/care landscape with the consumer at the center. The consumer is, at any point in a 24-hour day: a person wearing many hats (a worker,

Americans are overwhelmingly keen to use food for their health, and overwhelmed by the amount of nutrition information they face to make good shopping and eating decisions. Welcome to “food confusion,” a phenomenon gleaned from the 12th Annual Food and Health Survey conducted by the International Food Information Council Foundation (IFIC). This 12th annual survey from IFIC finds that most Americans take many steps to be healthy. In the past year, the most popular health-steps include drinking more for hydration, making small changes to achieve a healthier diet, consuming smaller portions, eating more fruits and vegetables, and eating more whole grains.

The top healthiest eating communities tend to circle the perimeter of the map of the lower 48 U.S. states. In these towns, more than 72% of health citizens report healthy eating. These areas are located in California, Florida, and Massachusetts, among others. Areas with the lowest rates of healthy eating are concentrated generally south of the Mason-Dixon Line, in places like Arkansas, Kentucky, and Mississippi, and other states. In these places, fewer than 57% of people eat healthy. Eating healthy foods in moderation is a mighty contributor to personal and public health, discussed in the report, State of American Well-Being

CNN called it, “the ancient perfume store you never heard of,” but the Officina Profumo-Farmaceutica di Santa Maria Novella had its literal roots in medicinal herbs. With scents wafting onto a 13th century Florence piazza, the Farmacia now operates as a pharmacy storefront for homeopathic and herbal supplements, along with perfumes and home scents. A visit to the pharmacy today is a journey into medicinal time-travel, back to the year 1221. I spent time in the pharmacy today to learn about the literal roots of the shop in medicinal herbs cultivated in a monastery garden and reformulated by monks into

Yesterday, the Tweeter-in-Chief President Donald Trump tweeted, “I am working on a new system where there will be competition in the Drug Industry. Pricing for the American people will come way down!” Those 140 characters sent pharma stocks tumbling, as illustrated by the chart for Mylan shares dated 7 March 2017. This is one issue that Americans across the political spectrum agree on with the POTUS. The latest Zogby poll into this issue, conducted for Prescription Justice, found 3 in 4 Americans agree that pharmaceutical companies are “getting away with murder,” as President Trump said in a TIME magazine interview

Over the past two weeks, we see two marketing campaigns emerge to market medicines: first, from the branded pharmaceutical association PhRMA, the #GoBoldly initiative with a theme of innovation and personalized medicine. Second, there’s a campaign from the Generic Pharmaceutical Association (GPhA), rebranding the organization as the Association for Accessible Medicines with the tagline, “keep medicines in reach.” What’s this all about? To put these marketing initiatives in context, let’s start with the publication of Express Scripts 2016 Drug Trend Report. “Drug trend” is short-hand for growth in prescription drug spending, year on year. The first graph illustrates the price index

Nine in 10 U.S. consumers think pharma and biotech put profits above patient interests, according to the latest Harris Poll studying reputation equity across organizations serving health care. Notice the relatively low position of the green bars in the first chart (with the exception of the impression for “strong financial performance); these are the pharma/biotech consumer impressions. The health industry stakeholders consumers believe would more likely place them above making money are health care providers, like doctors and nurses, hospitals, and pharmacists. Health insurance companies fare somewhat better than pharma and biotech in this Poll, although rank low on social

More Americans are worried about their out-of-pocket health care costs than they are about repealing the Affordable Care Act (ACA), according to the Kaiser Family Foundation (KFF) Health Tracking Poll published 6th January 2017, the first KFF poll for the new year. Cost worries fall into two buckets of concerns: the cost of health care, and the cost of prescription drugs. Managing the opioid epidemic falls in third place after health care costs. Repealing the Affordable Care Act? It’s #4 on Americans’ health care priorities as of mid-December 2016, followed by shrinking the Federal’s government’s role in and spending on

Based on a TIME magazine interview conducted today with President-Elect Donald Trump, the pharmaceutical and life science industries may expect to find coal in their Christmas stocking, and tougher pricing constraints in 2017. “I’m going to bring down drug prices,” Mr. Trump said, quoted on the TIME website naming him Person of the Year. “I don’t like what’s happened with drug prices.” As CNN put it, “Trump put the entire drug industry on notice on Wednesday in an interview with Time.” In fact, Donald Trump’s campaign website talked about drug importation as one potential tactic consumers could potentially use to

Spending on health care in the U.S. hit $3.2 trillion in 2015, increasing 5.8% from 2014. This works out to $9,990 per person in the U.S., and nearly 18% of the nation’s gross domestic product (GDP). Factors that drove such significant spending growth included increases in private health insurance coverage owing to the Affordable Care Act (ACA) coverage (7.2%), and spending on physician services (7.2%) and hospital care (5.6%). Prescription drug spending grew by 9% between 2014 and 2015 (a topic which I’ll cover in tomorrow’s Health Populi discussing IMS Institute’s latest report into global medicines spending). The topic of

I attended CES Unveiled in New York this week, which is a preview of what will be featured at the CES in Las Vegas in January 2017. CES, previously known as the Consumer Electronics Show, is celebrating a 50 year anniversary, having been born in Manhattan in 1967 when transistor radios, stereos, and black-and-white TVs were all the rage. Today, CES is the world’s largest innovation event, and the longest-lived. 10 of the original 1967 exhibitors still show at CES, including 3M, Philips, Sharp, SONY, Toshiba, and Westinghouse, among others. Meet George Jetson, who might have been an attendee at

The greater a person’s level of health engagement, the better their health outcome will be. Evidence is growing on the return-on-investment for peoples’ health activation and how healthy they are. That ROI is both in survival (mortality) and quality of life (morbidity), as well as hard-dollar savings — personally bending-the-healthcare-cost-curve. But people are more likely to engage in “health” than “healthcare.” We’d rather ingest food-as-medicine than a prescription drug, use walking in a lovely park for exercise, and laugh while we’re learning about how to manage our health insurance benefits. Thus, Campbell’s Soup Company and Hormel are expanding healthy offerings,

60% of Americans are currently trying to lose weight. So it shouldn’t be a surprise that when asked, “what’s the most serious health problem in the United States?” Americans say it’s obesity, tied with cancer, and ahead of heart disease and diabetes. Overweight and obesity are top-of-mind for most Americans, according to research conducted by the American Society for Metabolic and Bariatric Surgery (ASMBS) and NORC at the University of Chicago. This research has created two reports which can be accessed at the link. The survey, conducted among 1,509 consumers in August and September 2016, found that Americans’ understanding of

While American workers appreciate the benefits they receive at work, people are concerned about health care costs. And consumers’ collective response to rising health care costs is changing the way they use health care services and products, like prescription drugs. Furthermore, 6 in 10 U.S. health citizens rank healthcare as poor (27%) or fair (33%). This sober profile on healthcare consumers emerges out of survey research conducted by EBRI (the Employee Benefit Research Institute), analyzed in the report Workers Like Their Benefits, Are Confident of Future Availability, But Dissatisfied With the Health Care System and Pessimistic About Future Access and

Existing healthcare industry players – the stakeholders of hospitals, physicians, pharma/life sciences, medical device manufacturers, and health plans – are operating in a whirlwind of change. While there are many uncertainties in this period of transition, there’s one operational certainty: learn to do more with less payment. That’s due to the growing pursuit of payors paying for value, not on the basis of volume or what’s “done” to a patient in care delivery. At the same time, another force re-shaping healthcare is interest and focus on wellness and health management. Combined with the growing health economic value proposition, wellness and

Federal healthcare program costs are the largest component of mandatory spending in the U.S. budget, according to An Update to the Budget and Economic Outlook: 2016 to 2026 from the U.S. Congressional Budget Office (CBO). Federal spending for healthcare will increase $77 billion in 2016, about 8% over 2015, for a total of $1.1 trillion. The CBO believes that number overstates the growth in Medicare and Medicaid because of a one-time payment shift of $22 bn to Medicare (from 2017 back into 2016); adjusting for this, CBO sees Federal healthcare spending growing 6% (about $55 bn) this year. The driver

If you’re retiring in 2016, you’ll need $260,000 to cover your health care costs during your retirement years. In 2015, that number was $245,000, so retiree health care costs increased 6% in one year according to Fidelity’s Retirement Health Care Cost Estimator. The 6% annual cost increase is exactly what the National Business Group on Health found in their recently published 2017 Health Plan Design Survey polling large employers covering health care, discussed here in Health Populi. The 6% health care cost increases are driven primary by people using more health services and the higher costs for many medicines — specifically, specialty

As consumers gain more financial skin in the game of paying for health care, we look for more retail-like experiences that reflect the Burger King approach to consuming: having it our way. For health are, that means access, convenience, transparency and fair costs, respect for our time, and a clear value proposition for services rendered. That doesn’t happen so much in the legacy health care system — in hospitals and doctors’ offices. It has already begun to happen in retail health settings and, especially, in the changing nature of pharmacies. Retail Health 2027, a special supplement to Drug Store News

Retail clinics are a growing source of primary care for more U.S. health consumers, discussed in a review of retail clinics published by Drug Store News in July 2016. There will be more than 2,800 retail clinics by 2018, according to Accenture’s tea leaves. Two key drivers will bolster retail clinics’ relevance and quality in local health delivery systems: Retail clinics’ ability to forge relationships with legacy health care providers (physicians, hospitals); and, Clinics’ adoption and effective use of information technology that enables data sharing (e.g., to the healthcare provider’s electronic health records system) and data liquidity (that is, securely moving

Health care payment responsibility continues to shift from employers to employee-patients, More of those patients are morphing into financially burdened health consumers, according to TransUnion, the credit agency and financial risk information company, in the TransUnion Healthcare Report published in June 2016. Patients saw a 13% increase in their health insurance deductible and out-of-pocket (OOP) maximum costs between 2014 and 2015. At the same time, the average base salary in the U.S. grew 3% in 2015, SHRM estimated. Thus, deductibles and OOP costs grew for consumers more than 4 times faster than the average base salary from 2014 to 2015.  In

The growth of health care costs in the U.S. is expected to be a relatively moderate 6.5% in 2017, the same percentage increase as between 2015 and 2016, according to Medical Cost Trend: Behind the Numbers 2017, an annual forecast from PwC. As the line chart illustrates, the rate of increase of health care costs has been declining since 2007, when costs were in double-digit growth mode. Since 2014, health care cost growth has hovered around the mid-six percent’s, considered “low growth” in the PwC report. What’s driving overall cost increases is price, not use of services: in fact, health care

  “Our goal is to create an aware and engaged, irritating set of patients who create a dialogue with health care providers once they’ve had a [blood] clot,” explained Randy Fenninger, CEO of the National Blood Clot Alliance (NBCA). NBCA’s tagline and hashtag is “Stop the Clot.” Welcome to the multi-stakeholder community involved with deep vein thrombosis (DVT) and, clinically speaking, Venous Thromboembolism (VTE). We’re talking blood clots, and the public health burden of this condition is big: it’s a leading cause of death and disability. One in 4 people in the world die of conditions caused by thrombosis. I had

“Health comes to your local store,” explains the recently-launched portal, GoHealthEvents. This site is a one-stop shop for health consumers who are seeking health screenings and consults in local retail channels like big box stores, club stores, drug stores, and grocery stores. Events covered include cholesterol, diabetes, heart health, nutrition, osteoporosis, senior health, vaccinations and immunizations. By simply submitting a zip code, a health consumer seeking these kinds of services can identify where and when a local retailer will provide it. I searched on my own zip code in suburban Philadelphia, and found the following opportunities taking place in the

The top reason people in America over 50 don’t fill a prescription is the cost of the drug, according to the AARP 2015 Survey on Prescription Drugs. Eight in 10 people 50+ think the cost of prescription drugs is too high, and 4 in 10 are concerned about their ability to afford their medications. Thus, nearly all people over 50 think it’s important for politicians (especially presidential candidates) to control Rx drug costs. Older consumers are connecting dots between the cost of their medications and direct-to-consumer prescription drug advertising: 88% of the 50+ population who have seen or heard drug

How can digital technologies enable self-healthcare in novel ways? This was the theme of a meeting sponsored by Pfizer Consumer Healthcare and hosted by Google, with the title, “Advancing Consumer Health through New Technology and Next Generation OTC Healthcare” held on 12th April 2016 at Google offices in Manhattan’s Chelsea neighborhood. Pharmaceutical brand drugs switching to over-the-counter packaged goods, the Cellscope Otoscope used by parents checking their young children’s earaches, connected shoes and earbuds for athletic enhancement, and omni-channel retail shopping….these are a few of the signals we see emerging to enable consumers’ to drive healthy behaviors, wellness and self-healthcare. Speakers

Prices for the most commonly used branded prescription drugs grew from a base index of $100 in 2008 to to $264 in 2015, based on the Express Scripts 2015 Drug Trend Report. This is illustrated by the upwardly-sloping blue line in the chart. In contrast, the market basket of the most commonly used generic drugs fell from the $100 index in 2008 to $29.73, shown by the declining black line in the graph. The $112.05 is calculated from a market basket of commonly purchased household goods which cost $100 in 2008, a relatively flat line which puts the 264% rise in

As consumers’ growing financial skin in the health care game compels them to seek care in lower-cost settings, the pharmacy business recognizes the opportunity to provide healthcare services beyond the core business of filling prescriptions. This month, Drug Store News (DSN) published a special section called which profiles several pharmacy companies’ expanding reach into retail health – in particular, re-defining the concept of the “health fair.” A health fair is “an educational and interactive event designed for outreach to provide basic prevention and medical screening to people in the community,” according to the latest Wikipedia definition. But the health fairs described

The rising cost of health care for Americans continues to contribute to self-rationing care in the forms of not filling prescriptions, postponing necessary services and tests, and avoiding needed visits to doctors. Furthermore, health care costs are threatening the livelihood of most American families, according to the Pioneer Institute. “What Will U.S. Households Pay for Health Care in the Future?” asks the title of a study by the Institute, noting that health care costs for an American family of average income could increase annually to $13,213 by 2025 — and as high as $18,251. Pioneer calculates that this forecasted spend will

It’s time to get the tea leaves out and mash up trends in my world of health, health care, technology, policy and people for 2016. We’ll start with the central player: people, consumers, patients, caregivers all. Health consumerism on the rise.  People – call us patients, consumers, caregivers – will take on even more financial and clinical decision making risk in 2016. Growing penetration of high-deductible and consumer-driven health plans will push (not just nudge) people into the role of health care consumers, and the emerging businesses and programs serving the transparency market for price and quality will gain traction

Prescription drug costs have become a front-and-center health benefits cost issue for U.S. employers in 2015, and in 2016 the challenge will be directly addressed through more aggressive utilization management (such as step therapy and prior authorization), tools to enable prescription intentions like DUR, and targeting fraud, waste and abuse. Consumers, too, will be more financially responsible for cost-sharing prescription drugs, in terms of deductibles and annual out-of-pocket limits, as described in the PBMI 2015-206 Prescription Drug Benefit Cost and Plan Design Report, sponsored by Takeda. The Pharmacy Benefit Management Institute has published this report for 15 years, which provides neutral, detailed survey

“What’s in a name?” Juliet asked in Shakespeare’s play. For medicines consumers in the U.S., not much. Most Americans prefer generics products, according to The Harris Poll’s survey. 7 in 10 U.S. adults choose generics over brands when given a choice. 3 in 10 people say they would “always” choose generics, whether a prescription drug or an over-the-counter product (store brand, private label). While most people across all age groups would choose generics over brand ames for meds, parents with children in the households would more likely choose a brand  name (36% with vs. 28% without kids). Still, 66% of

Most Americans support price controls on drug and medical device manufacturers, hospitals, and payments to doctors, along with allowing Medicare to negotiate drug prices. U.S. health citizens, now consumers, have been experiencing sticker-shock when it comes to prices on medical bills upon hospital discharge, leaving the doctor’s office, filling a prescription at a pharmacy or receiving a specialty drug recommended for a serious medical condition. The HealthDay/Harris Poll of 5 November 2015 quantifies their observation that Americans Want Bold Steps to Keep Health Care Costs in Check. The topline of the Poll shows that: 73 percent support price controls on