The Depth of Anger Around Health Care Has Been Laid Bare. Cigna Seems to Recognize that Danger

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The U.S. health care system is in a crisis of confidence. This was made abundantly clear when an executive was killed in cold blood on the streets of New York City … and there was a wellspring of support for the killer. 

It’s not news that people dislike the health care system in the United States. We have long been an international outlier, spending more and getting less than similarly situated nations. But the reactions over the past two months suggest that the depths of that dislike, the extent of the anger, has probably been underestimated. 

The question now is whether the industry** recognizes the crisis of confidence. 

The evidence there is not good. United has been so public in defense of its models that it’s creating its own backlash. I listened to a lot of #JPM25 presentations and didn’t hear any awareness of the skepticism that pervades the body public. 

That’s why a recent flurry of releases from Cigna caught my eye. Because Cigna seems to get it. 

Just yesterday, the company announced that it would tie executive compensation to customer satisfaction. At the same time, it said it would work to smooth access to care, including prior auths, and make claim processing more efficient for physicians. 

They’re taking aim at exactly the kind of stuff that makes health care so miserable for patients and clinicians. It suggests that they understand where the pain points are. 

To be clear, I don’t know how much of Cigna’s announcements are window-dressing. There is probably good reason to take a gimlet-eyed look at the specifics.

But that’s almost secondary at this point. The acknowledgment that there is an issue at all is the big first step forward. 

** I’m using “industry” in the broadest, vaguest way possible. I’m thinking of everyone from insurers to biopharma to hospitals to telehealth companies to ambulance services, etc. etc.

• The tariffs on Mexico and Canada are off for now, but the trade war with China seems to be ramping up. Fierce has reporting that supply chain experts expect hospital costs to spike and pharmaceutical ingredient prices to rise 10%. 

• STAT has an op-ed suggesting that the National Cancer Institute should stop doing trials with industry molecules unless they’re focused on finding ways to lower what we spend. I don’t think it’s a particularly realistic set of proposals, but it underscores another set of concerns about pricing. 

• This is a good profile of Dr. Oz, though I’d argue that the 100 words or so on Medicare Advantage (and Dr. Oz’s financial entanglements with payers) is the most important part to read.

• A couple of new Health Affairs pieces further illuminate what happens when private equity gets involved in health care, including one study on how spending on staffing goes down when PE comes in and another article on how prices go up. Other than that, it sounds like a great model. 

• I have a growing pile of generic/biosimilars-related items to go through, but -- as a start -- here are AAM’s 2025 advocacy priorities. Not a lot of surprises here, but all noble goals. I feel like I should state the obvious: the one thing that the U.S. health care system has traditionally done better than anyone else in the world is pushing low-cost generic meds, and preserving that system is critical.

• It’s off-topic, but this is a fantastically reported WaPo piece on the advocacy group working to take down companies working to commercialize psychedelics. It’s a good reminder that being skeptical of everyone is a fine default position to take.

Cost Curve is produced by Reid Strategic, a consultancy that helps companies and organizations in life sciences communicate more clearly and more loudly about issues of value, access, and pricing. We offer a range of services, from strategic planning to tactical execution, designed to shatter the complexity that hampers constructive conversations. 

To learn more about how Reid Strategic can help you, email Brian Reid at [email protected].