Big Will Win, If We Let It

As the coronavirus pandemic unfolds, so far it appears #BigWillWin in health care (in other areas too, but we focus on health policy at M2!).

For example, spending on primary care in the U.S. is comparatively low, accounting for 5 to 7% of total U.S. spending, and primary care practitioners are among the lowest paid specialties. The combination of already low payment and patients’ inability to use telehealth as a substitute for face-to-face visits has meant nearly half of primary care practices in an April survey said they are experiencing “financial strains threatening practice closures.”

But Walmart Health is expanding, as “physician practices face cash crunch.” Teladoc saw a 50% week over week coronavirus surge in March, even though it already provides access to 50,000+ medical experts for more than 36 million patients.

More broadly, private equity was spending record amounts buying U.S. health care entities even before the pandemic, and 2019 marked the first time “employed physicians outnumber[ed] self-employed physicians.”

As a policy matter, #BigWillWin in health care if we let it, but are we thinking enough about whether that’s a good idea?