Fortune: Big Hospitals vs. Big Pharma: Which industry is most to blame for soaring health care costs?

Smith, steaming, is having none of it. “The program was solely created because of the high drug prices that [drugmakers] and they alone set,” she says. “And then when they’re upset that such a program got set up because of their egregious pricing practices, they come after it. They’re making hand over fist in profits. But, you know, anything that cuts into their bottom line …”

America’s hospital industry and pharmaceutical industry—combined 2019 revenues: $1.6 trillion—are feuding more sharply and publicly than ever, and for good reason. One political party currently controls both the legislative and executive branches. And when that happens, especially in a new President’s first two years, big changes tend to follow. That’s how the Tax Cuts and Jobs Act became law under President Trump and how the Affordable Care Act got passed under President Obama. Now President Biden and the Democrats who control Congress have come to power with ambitious plans to reform U.S. health care and stem the ever-rising costs—and Big Hospitals and Big Pharma could be in the crosshairs.