Ep 35 | Healthcare at a Breaking Point: Costs, Policy Gridlock, and What 2026 Holds

Описание: In this episode of the Only Healthcare Podcast, hosts Michael Navin and Randy Vogenberg welcome back healthcare policy veteran Deborah Williams for a candid conversation on why 2025 became such a difficult year for employers, patients, and policymakers alike.

Coming off government shutdown tensions and escalating healthcare costs, the discussion breaks down what is actually driving premium increases, prescription drug spending, hospital consolidation, and benefit design changes. Deborah draws on decades of Washington experience to explain why many policy ideas keep resurfacing, why they continue to fall short, and what risks lie ahead as the system moves into 2026.

From direct-to-consumer drug pricing and PBM reform to political gridlock and consumer backlash, this episode explores where healthcare policy may realistically land next and why affordability remains the unanswered question.

Key Topics Discussed
• Why employer healthcare costs outpaced exchange inflation in 2025
• Hospital consolidation and cost shifting pressures
• Prescription drug spending trends and policy spillover effects
• Direct to consumer drug pricing and deductible portability
• PBM reform debates and unintended consequences
• Political gridlock, populism, and healthcare affordability
• What employers, plans, and consumers may face in 2026

Chapters with Time Stamps
00:04 Welcome and episode framing
00:44 Deborah Williams background and policy perspective
01:44 Why 2025 was a brutal year for employers
03:34 Hospital consolidation and cost shifting
04:35 Prescription drug costs and market pressure
07:15 Consumer behavior, adherence, and affordability
09:00 Political realities and exchange subsidies
12:08 Insurers, public sentiment, and misinformation
14:03 Drug pricing models and global comparisons
16:41 Employer leverage and failed market solutions
17:49 Emerging therapies and future cost risk
20:24 What could improve in 2026
24:26 Populism and the next policy inflection point