A merger “O.K.” with little delay

Cigna and Express Scripts have received their parents’ the Justice Department’s blessing to go ahead with their wedding merger. The health insurer and pharmacy benefit manager say they’re a good fit for each other since they’ll be able to share information about their customers’ medical expenses that will help them manage patient health better. But the announcement has got to sting a bit for CVS Health and Aetna, who have been waiting on DOJ approval for their merger since before the Cigna-Express Scripts deal was announced. Visual/meme representation of that here. You’ve gotta think that Amazon’s ever-threatening encroachment into the healthcare industry is driving some of these vertical mergers between health insurers and PBMs.

Not playing by your own rules

The well-known oncology researcher José Baselga has resigned his position as Chief Medical Officer at Memorial Sloan Kettering after an NYT/ProPublica investigation showed he failed to disclose millions in payments from pharma and healthcare companies in dozens of his research articles. The payments themselves aren’t at issue, it’s the fact that he didn’t make his ties explicitly known. Which is kinda funny since those financial reporting rules were set by the American Association for Cancer Research while he was president of the group. Critics say Baselga’s fall illustrates the bigger problem of the revolving door between academic research and industry, as well as a general laziness towards enforcing ethical standards from the academic community. Expect a rush of researchers who ‘forgot’ to include their financial ties in previous papers to quietly go add those in.

UK says “yes” to more taxes

Wait what? Yep, this refreshing portrait of self-awareness is brought to you by a recent survey of 1,000 adults across Britain. You might recall from a previous InsightCity article, the UK faces some serious shortfalls in providing for an aging population, not the least of which is a potential GP shortage. The Institute for Fiscal Studies (IFS) and the Health Foundation published a report in which they outline these pressures. Back to the survey. The data show 77% support or strongly support an increase in UK spending on public healthcare by 4% a year over the next 15 years and 82% support a ~4% spending hike for social care. This translates into each UK household “contributing” around £2,000. We’re not sure that figure was disclosed to the survey respondents when they were indicating their “support” for the increase in spending, so there’s that.

Shulkin is shuck off

The Secretary for the US Department of Veteran Affairs has been fired. Or resigned. That seems to be a point of contention. Aaaaanyway, David Shulkin is best known for taking charge of the department in 2015 after a scandal that exposed false record-keeping and wait times of over 115 days for veterans to get an initial primary care appointment. More recently he’s been pushing for the use of private health care in the VA system for routine things like getting hearing aids. But while he’s a fan of private-sector coordination he’s really against full on privatization, at least according to his NYT editorial published after his elective/non-elective dismissal. President Donald Trump has nominated White House head physician Ronny Jackson to take Shulkin’s place at the head of the VA’s 370,000 employees.

Apple and Amazon are all over healthcare

CNBC noticed Amazon quietly launched a partnership in August with OTC manufacturer Perrigo to create their Basic Care line of products. While Amazon may not be the ideal fix for when you need that bottle of cold medicine ASAP, the company could be in a good position to corner the market on products that are bought in bulk like nicotine gum. Apple’s healthcare foray is more tech-focused: they’re developing the next attempt at personal, electronic health records. The idea is to use patients’ smartphones as the unified repository for health records that could otherwise be scattered across healthcare providers. More complete records and data could drive recommendations for care, and could even translate into partnerships with pharma companies to pitch their products directly to consumers fitting a certain profile.

“It’s the prices, stupid”

That’s really the name of a 2003 paper that explains health care spending is so high in the US because the prices for health care are so high, stupid. 14 years later the story still rings true—the per unit cost of health services hasn’t shifted much. Vox, in an effort to get a scope of these prices across the nation, is asking readers to send in their emergency facility fee (think: what the hospital charges to keep their lights on waiting for you to break your toe) to crowdsource the cost of that specific unit price. It’s an interesting idea since hospitals don’t advertise their ED admission fees. Telling patients they have to pay at least $500 beforehand typically isn’t the best look after all.

Everything’s coming up Amazon

Amazon is working tirelessly to find more and more pots to stick its Amazon Prime fingers in. The e-commerce goliath’s newest focus is healthcare, and it has two projects aimed at pushing in that direction. One is a secretive venture with the goal of (tell me if you’ve heard this one before) revolutionizing electronic medical records. The other is an investment that Amazon’s using to position itself as the solution for storing insane amounts of human genetic data. The company invested in Grail, a start-up planning to use its technology to flag the earliest signs of cancer. That requires a ton of data storage and processing, and if Amazon and Grail can pull it off here, you can bet it’ll be a huge market for them.