Given U.S. regulatory agencies’ recent pivot toward more aggressive antitrust enforcement, the Justice Department’s launch of a probe into health insurance and service giant UnitedHealth Group should come as no surprise.
The probe is intended to uncover whether UnitedHealth’s business operations, management practices and acquisition of various doctors’ groups have harmed rivals and consumers.
While asking such questions is important, the DOJ must remain focused on the consumer and not take any enforcement actions without careful consideration. A failure to acknowledge possible repercussions could have unintended consequences for consumers and the healthcare market.
UnitedHealth Group is a major player in the health arena. The Minnesota-based company made $372 billion in revenue last year and owns a vast network of doctors’ groups, healthcare units, and major billing and analytics businesses.
Perhaps most troubling, UnitedHealth’s service arm, Optum, owns the nation’s third-largest Pharmacy Benefit Manager, Optum RX.
In recent years, PBMs — industry middlemen who negotiate drug prices and manage benefits on behalf of health insurers, employers and others — have rightly been criticized for leveraging information to extract excessive profits for themselves at the expense of everyone else. Research suggests that, through various shady business practices, PBMs are primarily responsible for escalating prescription drug prices.
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Nate Scherer is a policy analyst with the American Consumer Institute, a nonprofit education and research organization. For more information about the Institute, visit us at www.TheAmericanConsumer.Org or follow us on X @ConsumerPal.