JUANA SUMMERS, HOST:
Health care companies are ending 2024 in the hot seat. The killing of UnitedHealthcare CEO Brian Thompson brought to light widespread consumer anger over denied claims and the high costs of care. Now Congress and President-elect Donald Trump are threatening more regulation of the industry. NPR business correspondent Maria Aspan joins us now. Hi there.
MARIA ASPAN, BYLINE: Hey there.
SUMMERS: Maria, it seems like everybody is kind of just piling onto these big health care companies right now. Tell us what the latest is.
ASPAN: Well, we have found the thing that can bring our divided country together, and it seems to be hating big health care. We've seen some real bipartisan agreement on that in the last week. Senators Elizabeth Warren and Josh Hawley are sponsoring legislation to break up these companies, including UnitedHealth, the parent company where Brian Thompson was an executive. And then this week President-elect Trump also put them on blast. He singled out their pharmacy benefit managers. These are businesses that essentially control what we pay for prescriptions at the pharmacy. The three big ones are owned by UnitedHealth, CVS and Cigna, and together they process 80% of U.S. prescriptions. This is from Trump's press conference on Monday.
(SOUNDBITE OF PRESS CONFERENCE)
DONALD TRUMP: They don't do anything except they're a middleman. We're going to knock out the middleman.
ASPAN: Now, I contacted these companies, which mostly wouldn't comment on Trump's remarks. A CVS spokesperson did say it makes prescription drugs more affordable. But Trump spooked investors in big health care. Shares in those companies sold off for a couple of days, and they're all down for the year.
SUMMERS: Maria, you've referred to these companies as big health care. Help us understand. Just how big are they?
ASPAN: They're enormous. UnitedHealth and CVS Health are among the 10 largest companies in the world. They own doctors offices, insurance companies and the middlemen that Trump criticized. I talked about this with Lovisa Gustafsson. She's at the Commonwealth Fund, a health care research nonprofit.
LOVISA GUSTAFSSON: You see these big conglomerates that are just these massive organizations that have - you know, they do everything under the sun, almost, when it comes to health care. They've got their tentacles everywhere.
ASPAN: And now we're seeing this growth actually cause some business problems for these companies.
SUMMERS: Like what?
ASPAN: Well, investors are worried the companies aren't making enough money. For example, UnitedHealth is spending a lot on providing Medicare benefits, which has spooked investors. They're even more disappointed with CVS, which owns Aetna and other health care operations on top of its pharmacies. In October, CVS abruptly replaced its CEO. Julie Utterback covers health care for Morningstar.
JULIE UTTERBACK: Yeah. I mean, it's been a tough year, right?
ASPAN: She's especially worried about what Trump and other lawmakers are saying now.
UTTERBACK: But I think what people and most investors are really focusing on is what could come down the regulation pipeline this year.
ASPAN: At a time when we've seen a lot of consumer frustration with these companies, it's kind of striking that even the investors who are making money from them aren't happy.
SUMMERS: I don't mean to be flip about this, but I've got to ask, why should we care if investors aren't happy?
ASPAN: It's a good question, but what I've been wondering this year, is who is happy with this system? I mean, health care is such a crucial part of the U.S. economy. It's almost a fifth of our GDP, and it's so tied into our physical health and our lives. Even Andrew Witty, who runs the overall UnitedHealth Group, acknowledges that the system is flawed. He wrote in a New York Times op-ed last week that we understand and share the desire to build a better health care system that works better for everyone. For better or for worse, we have a health care system that's dominated by for-profit entities. So when even the people making money from this system aren't happy with it, what does that mean for the rest of us?
SUMMERS: That is NPR's Maria Aspan. Maria, thank you.
ASPAN: Thank you. Transcript provided by NPR, Copyright NPR.
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