In the early 2000s almost all aerosolized products in the United States—from hairsprays to spray paints to asthma inhalers—had to eliminate their CFC propellants under the Montreal Protocol, a global treaty to protect the ozone layer. The price of paint and hairspray didn’t change much, if at all. But drug manufacturers seized on the opportunity to

The American College of Radiology changed its tax status from 501(c)(3) (a charity) to 501(c)(6) (a nonprofit business league) in 2002 so it and its members could more directly make political contributions. The goal of such groups “is toward the betterment of business conditions for a particular trade or community. Contributions to 501(c)(6)’s are

An OTC switch makes products available to a wider audience of buyers. But manufacturers have to lower prices dramatically because insurance is no longer involved; they also have to establish brand recognition with consumers. Many pharmaceutical firms lacked expertise in selling an off-the-shelf product.

Then, in August 2014, WellPoint announced that it planned to change its name to Anthem Blue Cross (pending approval by shareholders), presumably to take advantage of whatever nostalgic good feelings patients had retained toward the Blues, before raising premiums on some of its California ACA policies by 25 percent in 2015.

In the 1960s Medicare arrived to cover hospital payments. Between 1968 and 1980 the number of Americans under sixty-five covered by good private insurance was at its peak (about 80 percent, compared with about 67 percent in 2007). Because patients were no longer directly forking out cash or writing checks for their care, hospitals began charging

The ACA banned lifetime limits on insurance payouts, which had been potentially deadly for patients with chronic illness.

Through the 1990s, these foundations and their patients often held the increasingly prosperous U.S. pharmaceutical and device industries at arm’s length. Groups like ACT UP, activists for AIDS treatment, saw drugmakers as adversaries. But in recent years, patient disease groups and pharma have found common ground, as the industry wooed disease

Before 2010, there was little pretense of specific accounting—hospitals could just attach some brochures to their tax returns to illustrate what they were doing. But in 2010, despite fierce hospital protests, a provision of the Affordable Care Act started requiring the IRS to collect each hospital’s quantitative enumeration of charitable activities

all the parties in the pharmaceutical supply chain knew exactly how much they were paying, but no one was willing to give him their data. “The pharmacy benefit managers, the pharmacies, the drug companies, the insurers all have a vested interest in keeping this secret,” said Mr. Buck.