Is CVS-Aetna a game-changer or just more of the same?

If there’s one persistent trend in health care over the past few decades, it’s that institutions have gotten bigger and bigger. But perhaps not better.

As the Washington Post describes it,

Over the past 20 years, drug companies have been busy merging with rival drug companies, hospital chains have been aggressively gobbling up hospitals, health insurers have bought other health insurers, and pharmacy giants have gone around the country buying up every independent drugstore they can get their hands on.

And with what result? Less competition and higher prices. So do we assume the proposed CVS-Aetna merger is more of the same? Perhaps not.

Can CVS change health care shopping?

Deborah Gordon, in The Observer, thinks CVS’ detailed understanding of how customers shop might be a game-changer:

Retailers like CVS understand consumer shopping behavior in fine detail—who buys what when and where, down to the aisle and the minute. Wrapping this level of consumer awareness and engagement around health insurance could lead to improved health plan design including what is covered, what share consumers pay, what form that cost-sharing takes and which doctors and hospitals consumers can access.

Donna Rosato, in Consumer Reports, describes the flip side of the CVS-Aetna coin—how CVS stores might be transformed into community health care hubs. In addition to services provided today, like prescription filling and flu shots,

[t]he companies envision offering lab tests, vision and hearing services, weight loss and nutrition counseling, follow-up nursing care at home and medication management.

We need fundamental health care redesign

Such changes could certainly improve the convenience factor for consumers. Whether they result in lower prices is another question. Ultimately, to achieve the twin goals of improved care and cost reduction, I think the health care system will have to undergo a more fundamental redesign—most likely by players outside today’s health care landscape.

I’m talking about Apple, Google, Amazon, Facebook—consumer technology companies. Chunka Mui, in Forbes, discusses several reasons why such companies might succeed in health care where others have failed. The biggest reason? They’re not stuck in the mire of our current system. They are free to devise solutions from scratch.

To me, starting from scratch is a good way forward.

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