Senate Republicans blocked a bill last week that would have allowed Medicare to negotiate prices with pharmaceutical companies. But as Senate Majority Leader Harry Reid, D-Nev., noted: “HMOs can negotiate. Wal-Mart can negotiate. Why in the world shouldn’t Medicare be able to do that?”
The House passed a similar bill in January, which President Bush threatening to veto. Sen. Pat Roberts, R-Kan., helped block the legislation. Sen. Sam Brownback, R-Kan., was not present for the voting but supported the block.
Republicans, who tend to receive large donations from pharmaceutical companies, have argued that, because of its size, Medicare could in effect be able to impose price controls if it were able to negotiate. And that might hurt the ability of pharmaceutical companies to cover their research and development costs. But it should be possible to build those costs into the pricing.
Posted by Ross Stewart
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94 Comments
How about a financial accountability of the pharmaceutical companies?I wonder how they spend the money, what do they spend the money on?Are they lavishly buying yachts, big houses, fancy cars, gold plated golf clubs and throwing big expensive parties?The baby boomers are a good sizeable chunk of population that might pull some weight against any politicians that do not favor the older ones.
How about a financial accountability of the pharmaceutical companies?I wonder how they spend the money, what do they spend the money on?Are they lavishly buying yachts, big houses, fancy cars, gold plated golf clubs and throwing big expensive parties?The baby boomers are a good sizeable chunk of population that might pull some weight against any politicians that do not favor the older ones.
More pandering to the drug companies by the Republicans. They don’t mind using tax dollars to pay for prescriptions, just want to make sure they get to use alot of unnecessary tax dollars.
OH now they want to act like real Republicans and not interfere having the government negotiate on behalf of the people. “No sir ree bobby its the free market and prices are set by supply and demand!”.So where was this true Republican believe when it was about the American people starting to buy more and more of their drugs from Canada? Boy the “Big Government Republicans” came out of the wood work on that one! “Got to stop that! for… for yeah for the public’s good, yeah that’s it!”. What was that ole forgotten term that those silly minded Fiscal conservative use to say Free marker? Free mark-down, free rebate? Oh hell its for the public’s good!
Drugs, medical care, food and shelter should be the “give me’s” of any civilized society. ( damn I make have a streak of Compassionate conservative in me yet) It should be the duty of any conservative to want to save a dine instead of spending a dollar. When it is the private sectors money the government should be using restrain when interfering. But when it is public money, tax dollars it is the Republicans who should be leading in the battle to save money. Oh where is Barry Goldwater when you need him? I know dead, like fiscal conservatism.
Only Republicans think this way. Sheesh.
“Sen. Pat Roberts, R-Kan., helped block the legislation. Sen. Sam Brownback, R-Kan., was not present for the voting but supported the block. Republicans, who tend to receive large donations from pharmaceutical companies, have argued that, because of its size, Medicare could in effect be able to impose price controls if it were able to negotiate. And that might hurt the ability of pharmaceutical companies to cover their research and development costs. But it should be possible to build those costs into the pricing.”
Hopefully when these 2 are up for reeelection — their opponents will use this type of info to show who is “Waging a War” on the middle class and . The rest of the nation will most likely give Kansas more credibility when these 2 are working full time for some lobbyists and not be getting pay checks from taxpayers AND lobbyists.
Seems they are saying the negotiating of drug prices will do what big oil has been doing for years without much FTC supervision —
I still have some respect for Roberts because of his Marine Corps Service, and his staff does at least try to attempt to address the issue I present, but they always seem to be doing a tap dance around it.
For instance, in the 06 appropriations bill for the war, I sent emails to all of my reps in the KS delegation, asking why as a part of the bill did they allow 2 billion removed from the Military Personnel Programs budget — Roberts office replied in essence, they are still getting 300 billion (or whatever the number was – in the hundreds of billions) so in essence it’s ok to take away that 2 billion. Doesn’t sound like they support our troops !!
B’back sent a thank you note, and the PR rep for Boeing in Congress — Tiahart sent nothing —
One of the points that was made in the book “What’s the Matter With Kansas?” was that Kansas Christian conservatives were in essence duped by these 2 Senators (and other far right conservative candidates in other states) into believing that they were going to be the “tip of the spear” (my words) in thier battle on the issues of abortion, gays, prayer in school etc ….. and actually have done little or nothing in 12 – 14 years to accomplish the Christian Conservative goals in these issues, but have supported legislation and programs that has done little to help and in some cases hurt the economies of farmers, middle class etc … while allowing meat packing plants, big business to take over and continue the demise of rural communities and the influx of undocumented (illegal) aliens, ….
seems a few of the CC organizations have come to realize that and are looking at other potential candidates to achieve CC goals — could be scary, they might find some one further to the right and out of touch with the rest of the population …………..
if you have to elect a republican — at least elect a moderate ….. some one who can serve not only the CC interests …
will be an interesting election …
This is truly Orwellian. We have runaway health care cost and yet we have Republicans like Roberts blocking potentially one of the most efective means the government has to hold down its own healthcare spending. It’s either that, or ensure that our growing middle class elderly population will have second and third class health care services.
. . . and with the republicans one would expect anything else? Follow the money and you will always find a republican.
Despite the message communicated by the November elections, the national Republican Party still doesn’t see the light . . . they still don’t care to manage the federal budget in a businesslike manner, and they are still the most profligate spenders of our tax dollars in the history of this countrty . . . the size of the federal deficit has almost doubled since Gerogie Porgie was elected.
kelly – they are accomplishing their goal – to make government look bad.
.. as well as making themselves look bad in the process —-
Eagle Editors and uninformed bloggers:
“Aetna receives rebates from the manufacturers of many drugs, including many on the Preferred Drug list. These rebates do not reduce the amount you pay for an individual prescription drug. However, they help control the overall costs of prescription drug coverage.”
The above disclaimer is found in an Aetna Medicare Pard “D” Explanation of Benefits.You will find nearly identical language in every Part D plan brochure.
Competition MEANS competition. Government price controls do NOT bring competition.
The quantity discount, “rebate” system DOES help to keep prices down.
Also, the drug companies negotiate the various “tier levels” like “generic, non-prefered generic, brand name, specialty.”The tier ranking of the various drugs, along with precertification requirements for some drugs, also forces price negotiations between drug manufacturers and insurance companies.The system is working.I have sold more of these plans than anyone else I know.YOU DO NOT KNOW WHAT YOU ARE TALKING ABOUT!
The quantity discount, “rebate” system DOES help to keep prices down.Posted by: Econ101 | April 22, 2007 at 10:21 AM
LOL. 4 sentences previous to the one above, you posted:
“Aetna receives rebates from the manufacturers of many drugs, including many on the Preferred Drug list. These rebates do not reduce the amount you pay for an individual prescription drug. However, they help control the overall costs of prescription drug coverage.”
So the insurance plans you sell get a rebate, but they don’t pass it on to the policy holder?
LOL
What a GREAT deal…for the insurance companies!!!
What you’re defending seems to be set up for the benefit of insurance companies, not elderly Americans.
That’s hilarious. Aetna taking the effort to reassure its policy holders that prices are being lowered, and thanking itself for pocketing the rebate as a public service.
Now THAT’s chutzpah!
LOL
“have sold more of these plans than anyone else I know.YOU DO NOT KNOW WHAT YOU ARE TALKING ABOUT!”
Posted by neo-con101.
hahahahahahahahahahahahahahahahahah
PedantCompetition between the insurance companies DOES keep prices down.This is the practice in every other company.Your building contractor gets a quantity discount for sheet rock or concrete or lumber, if that contractor buys enough.That contractor can then outbit other contractors due to reduced costs.
Tell me a business that does not have quantity discounts from the wholesaler?Walmart was used in the opening of this thread.Did the government have to negotiate Walmart’s prices for them?The Medicare Prescription Drug plan is saving thousands of dollars in drug costs for hundreds of thousands of retired people.It is a competition driven system.Do you think the government does a good job buying hammers?Do you think the government does a good job managing the VA?The various drug companies must present a premium to the public based on their cost projections.That premium takes into account these rebates.That premium takes into account all copays.
Medicare is so large and so vast that it drawfs the Veterans Affairs, Wal-Mart, or even HMO’s can negotiate.
We are talking about trillions of trillions of dollars and having Medicare set prices will be price control.
The dirty little secret that the Party of God isn’t telling you that Medicare buys pharmaceuticals at the same price if not better than HMO’s, Wal-Mart and even the Veterans Affairs.
But Democrats want Medicares vast wealth to even get drugs cheaper than everybody else. Because they know Medicare is the forerunner for Soviet Health Care, which is their plan to enact.
But if they cannot get things cheaper under Medicare, they know that Soviet Care will be a tough sell to the public. We cannot afford it.
One thing the Party of God can think about. They can force the Nationalization of Pharma companies.
Econ seens to think if the insurance companies were to get even bigger rebates, which “doesn’t lower the cost the consume pays”, prices will go down even more for the consumer. No wonder he’s econ 101!
Tell me a business that does not have quantity discounts from the wholesaler?Posted by: Econ101 | April 22, 2007 at 10:59 AM
And the bigger the quantity bought, the bigger the discount, right?
See, that’s my point.
The economics behind health care insurance says that all costs are minimized when there is one payer.
A single payer system could kill 2 big birds with one stone.1) A single payer system would cover all Americans.2) A single payer system would minimize costs.
If our goal is to keep insurance companies in business — if that’s the overall policy goal — then the president’s Medicare Part D plan is the right plan.
If our goal is to insure all Americans at a minimized cost, then Medicare Part D is the wrong plan. That’s a job for a single payer plan.
SteveThe rebates lower OVERALL costs, not the individual costs, Macro vs Micro.Get a clue would you?
And, dont misquote me, this is what YOU said not what I said, so why the quotation marks:—–”Econ seens to think if the insurance companies were to get even bigger rebates, which “doesn’t lower the cost the consume pays”, prices will go down even more for the consumer. No wonder he’s econ 101!
Posted by: steve | April 22, 2007 at 11:08 AM
PedantYou prove my point.Liberals hate Part D because Part D solves a huge problemw with market forces.You hate the market.You want socialized medicine.
If you want price control (which is illegal in America) then let Medicare negotiate.
Large companies have the ability to control and dictate price because of their buying power. Who do you think is the biggest purchaser of drugs and health care? That’s right the government is.
“The dirty little secret that the Party of God isn’t telling you that Medicare buys pharmaceuticals at the same price if not better than HMO’s, Wal-Mart and even the Veterans Affairs.”
WRONG!!!Medicare is forbidden by law to negotiate lower drug prices. If that was not the case, why in the hell would democrats try to make it so medicare could negotiate. Joe, you are dead wrong on that one. Ask the Canadian government about that, or ask the average American citizen why they have also been forbidden to buy drugs from Canada via the internet.
Or are you implying the pharmaceutical companies set the lowest price for our government, and a different one for Canada? Would you then extrapolate we, the American citizens, are subsidizing Canada’s lower drug prices? Or are you totally in the dark about who pays what and how and why for either, and are just shilling rush and company?
Humira is advertised on television all the time.Lots of people take it.It is for Rheumatoid Arthritis.It actually helps people keep their fingers and toes!The stuff costs over $1,200 a month. it is expensive to produce, it is refrigerated, it has a very short shelf life, it must be sent overnight mail in a special package.I have clients who are paying less than $305.00 a month in total drug costs, with Humira included.By the way, the vast majority of RX research breakthroughs happen in competitive economies.
Part D solves a huge problemw with market forces.Posted by: Econ101 | April 22, 2007 at 11:21 AM
Only if the problem is that insurance companies are necessary to American health care.
I note, too, that you admitted upthread that you sell these policies, so your opinions about Medicare Part D and American health care in general aren’t worth a big ball of spit here. I mean, it’s not like you’re unbiased.
“If you want price control (which is illegal in America) then let Medicare negotiate.”
That is NOT price control, but a contracted price for drugs. You want price control? Look at any group of gas stations in a localized area. Same price at any of them, what? Are you going to sit there and tell me there is no collusion between oil companies, even though their operating expenses are widely varied?
Price negotiation is an active part of business, and is not price control. Sheesh, you and neo-con101 must have graduated from the same internet paper factory.
JMI buy drugs over the internet all the time, it is cheaper than MY own health plan, sometimes. (I am not on Medicare.)Canada Drug is still open, in Wichita, on West Street.Nobody has prohibited anything.Beyond that, Canada has lower drug costs in part because Canada outlawed class action law suits against drug companies and Canada allows competition between Pharmacies.
Yeah! We did make a mistake by letting insurance companies cover health care.
Funny that we use insurance (a security blanket for low probably events) to a system for which they provide health coverage.
There should be a difference between health insurance and health coverage. Health insurance should be for accidents and catastrophe events. Health Coverage should be out-of-pocket. Like Routine doctor visits and prescription drugs.
But since Democrats want Insurance Companies to provide basic health care coverage (most all insurance companies are in Democrat controlled states), they just take on high bills for everybody, because your average American family is paying for the Democrat who got drunk and got into a car accident.
We shouldn’t be spreading health care cost to all Americans in this quazi Socialist system we have now. If you think it is expensive now, wait until government takes full control of it. It will be like government schools, the government will choose what doctor you can see and what hospital you can go to and how many times in your life you can use ambulance services and time and place were you have to pick up your drugs. It’s bad! Real bad!
If you want Market forces. Make everybody, each individual family, pay out of pocket for health care.
PedantWRONG again.I would guess that I am barely making minimum wage on these part D plans.I do them as a public service.It is a ton of work.I make maybe $40 gross each time I sell one.I only sell 50% of the plans I present.It takes hours to explain and that buys me several hours of service.It is “pro bono” work for insurance agents, pure and simple.
If you want Market forces. Make everybody, each individual family, pay out of pocket for health care.Posted by: Joe Williams | April 22, 2007 at 11:30 AM
That would not minimize costs and it certainly wouldn’t maximize the overall level of health in this country.
You’d fight doctors and insurance companies to get it done, too.
Yeah, you insurance agents are reknowned for your pro bono stuff.
I was born at night, but not LAST night.
PedantYour bias is showing.There are decent people in most professions who try to do a good job.By the way, one pro-bono service I provide my clients:I stear them clear of Social Security offices that make frequent Medicare enrollment mistakes. There are some smaller cities in Kansas where Medicare Part D premium “penalties” of 10% per year are routinely leveled against people who had group, “creditable coverage” until age 70 or whenever they retired. This is a huge mistake. These people are exempt from any penalties.I carry preprinted privacy waivers for various members of Congress with me.A Congressional inquirey usually gets the problem fixed.Insurance agents like me help keep the government in line!
Sorry, CorrectionI meant to say”Medicare Part B premium penalties” Not part D,Above.However, CMS frequently overcharges for both B and D, when no justification exists.
Ok, Econ101, you’re the one in a million insurance agent who’s Batman by night.
But you’re still biased because you earn income from selling these policies. You say it’s not much and you say you’re Batman, so what do I know.
That said, there is no inherently good reason for insurance companies to inject their way as a 3rd party into a transaction between a health-service provider and a health-service consumer. Insurance companies don’t need to be anywhere in that transaction, their “presence” just adds cost.
PedantYour “logic” is the reason why Communist countries dont like to put two restaurants or two gas stations across the street from each other.You are a “planned economy” guy, not a free market guy.—-The biggest arguement against government run health care?The quality of health care will decline!We would not have the current medicines available if not for the free market system.There is huge room for improvement in all aspects of health care delivery.That fact does NOT justify more government involvement!Those of us who work in the system see CMS (Center for Medicare and Medicaid services) take MONTHS to answer simple questions or to process simple paperwork.In a “mixed” system, where someone close to the client/patient, the AGENT, can detect problems and fix them, is the best system we can hope for.If the government ran everything, no one would have an incentive to fix anything. Nobody would even alert the 70 year old that they were paying Part B premiums that were 50% too high!
Canada Drug of Kansas can’t be used for Part D coverage, but they are open for business:
352 S. West St Ste 300Wichita, KS 67213316-945-6337
Again, Canada outlawed class action lawsuits, so if you buy drugs from Canada, you can’t take the manufacturer to court through a class-action process.
The biggest arguement against government run health care?The quality of health care will decline!We would not have the current medicines available if not for the free market system.Posted by: Econ101 | April 22, 2007 at 12:23 PM
I disagree.
Look, in the US today we have on the whole a system of remedial care. In the USA we spend tons on doctors after we get sick, and your Medicare Part D income is based in part on the fact that we Americans consume a ginormous amount of drugs which are designed to provide remedial care.
There is little or no incentive for insurance companies to pay for preventive care. This incentive doesn’t exist because insurance companies work for their stockholders who in turn demand maximized free cash flow. Obviously if you’re cash is tied up in paying for preventive care, when there is absolutely no evidence of illness, your stockholders are unhappy. There is no incentive to invest in the PATIENT’s long run for insurance companies.
One of the biggest sources of savings for France, for example, is that their particular model is focussed on preventive care. In France it is government who has stepped in as a single payer interested in the PATIENT’s long run.
Cost reduction is a by produce of focussing on preventive care. The costs are passed to the French in the form of reduced taxes.
Here, by your example of insurance companies operating with a remedial or reactive medical strategy, any rebates are pocketed by insurance companies selling drugs.
The biggest problem we have in the US is our focus on remedial rather than preventive care. Changing that would drive down remedial care costs excepting perhaps end of life costs (which may also fall as a result of life long investment in preventive care).
Only a single payer system has incentive to focus on preventive care.
France may not be the best example since a similar system probably isn’t politically feasible here in the US.
For example, French doctors’ mean income is about US$55.000/yr, while the mean American doctor income is about US$194,000/yr.
So again, from a policy standpoint you’d be fighting insurance companies and the AMA.
No Pedent. There are plenty of people who pay out of pocket for their health care. You still can do that in this country without having to hold an insurance card.
I did that for years when I was young. Doctor visits were like $40 and any antibiotics were $50.
Now! I pay around $12,000 a year for health insurance and only use a fraction of that, even with the birth of the children.
I’m paying for the drunk bastard who rotted out his liver and now needs a transplant.
“If you want Market forces. Make everybody, each individual family, pay out of pocket for health care.”
. . . and the people who can’t afford it for whatever reason?
Typical republican bs. Let em die, just make sure they can pay for their own funeral. You freakin’ neo-cons are some heartless bastards.
“Again, Canada outlawed class action lawsuits, so if you buy drugs from Canada, you can’t take the manufacturer to court through a class-action process.”
That would work here. After all, God is the only one who doesn’t make mistakes. The republicans are the mistake.
No Pedent. There are plenty of people who pay out of pocket for their health care. You still can do that in this country without having to hold an insurance card.Posted by: Joe Williams | April 22, 2007 at 01:38 PM
Huge mistake if you get routed to a hospital stay. Patients who pay out of pocket routinely see markups of 40-50% over the same stay if billed to an insurance company.
Probably a good idea to buy your insurance plan if you’re going to start a family.
Walker, you beat me to it up thread!
“Government price controls do NOT bring competition.”
Government price controls? WTF? NOWHERE is that proposed or happening. In fact, I think NIXON was the last preznit to use price controls.
Now if you are talking about purchasing power in the freemarket running others out of business…
…walmart anyone?
I just love how republicans love the free market. Except when then dont! Hehehehehheh!
Econ101 has reportedly sold a lot of health plans. He’s a salesman.
Healthcare doesn’t fit business principles. No doubt, it can make some people a lot of money, and these people consider it a business, but they’ve transmogrified it.
When people are sick, particularly very sick, the latter being the cause of our healthcare funding crisis, as it involves hospitalization, high-tech surgical and medical technology application, and multiple medicines, they aren’t in a position to “shop for the best deal”. They just want somebody else to assume a trustee/fiduciary responsibility for their lives, somebody who has knowledge and skills that they themselves lack.
They’re under what lawyers (Vaughn can expand on this) call “duress”. In addition, they often suffer other forms of “diminished capacity”, such as being disoriented (almost always the case for nursing home patients taken to hospitals), semi-conscious or unconscious when they arrive at hospitals for emergency care.
A recent report on an Asian billionaire woman’s change of will, leaving everything to an astrologer, will probably be voided, because she was suffering from terminal cancer, and was being medicated.
All doctors, nurses and other healthcare providers are trained using federal tax dollars. In addition, when they are trained in non-profit hospitals, those hospitals don’t pay local property or state or federal income taxes. This a form of subsidy, because if they did pay taxes, then they’d share a tax burden with businesses and individuals, which would lower the latter’s tax rates. Ergo, the taxpayers are subsidizing nonprofit hospitals.
And there’s nothing wrong with this, the community in this way is supporting healthcare.
There is also nothing wrong with every Ph.D. drug designer and bioengineer having gotten his or her advanced education through federal National Science Foundation and National Institutes of Health grants.
All the new-generation drugs have their genesis in government-funded basic research. The drug companies just didn’t have the money, talent or risk-taking attitude to discover what DNA, RNA, and proteins were, or how they worked.
It’s not an accident that most biotech companies have been founded by former research professors. Their ideas come from their federally-funded research working in universities.
I recall a young biotech company that took a. in vitro mouse protein synthesis procedure for a done under Australian government funding, and b. an American university researcher’s $100,000/yr federal grant-supported attempt to do this with the human protein, and concluded, “We see where she (the American) is going. She does too. But we can pump $20 million into this, and do what she plans to do, but a lot faster.”
So the company did it, published its results in Science, got a patent, and made $1 billion annually over the next 20 years.
People received the protein, at a per-patient cost of over $10,000/yr. Most of the recipients were Medicare patients.
So two national governments paid for 90% of the research, and for the resulting drug, at enormous costs. A small group of people who did 10% of the work, which was “no brainer” stuff, got rich, a few fabulously rich.
Healthcare is a social service. It does not correspond to the voluntary transactions that represent business. It doesn’t correspond to “private enterprise” in terms of who is paying for the training of its practitioners and the scientists and engineers who give us marvelous products.
I believe that some parts of medicine should be free enterprise. Like if some people want to pay $15,000 to have their boobs enlarged, or to remove facial wrinkles or have their “cellulite” fat sucked out, that should be left to the private market. But severe-illness medicine is entirely different.
Patents are not A NATURAL RIGHT. They are government-granted LICENSES.
The universities can compete for drug invention. They can be paid and their inventing professors can be paid decent royalty shares for patents owned by We the People who fund the research.
Then we sell manufacturing licenses to private enterprises. Let them compete. The most efficient manufacturers win.
What we’ve had is a knowledge transfer that drug companies have gotten for free, and then hit consumers with exorbitant prices.
In Medicare healthcare plans, we don’t have a cost-minimizing goal for taxpayers and patients. We have an insurance-industry enriching program, to give bazillions annually of tax dollars to middlemen who wouldn’t know how to save the life of a heart attack victim if their own lives depended on it.
Our manufacturers, being beset by aging workforces who need medical care, are squeezed. Pay these exorbitant medical costs here, or move to China, where we can hire young workers who don’t need medical care, and then dispose of them when they age and begin needing expensive medical care.
This is a failure model.
Pendant”Preventive Care” is often not much more than a meaningless buzz word.The truth is, true preventative care often INCREASES drug use.For instance, Congress recently increased “Preventive Care” under Medicare.This enhancement includes Diabetes Screening and Heart screening.These things are no longer considered “routine physicals” and are therefore covered or will go towards teh $131.00 Part B deductable.The most frequent result of such screening?High Blood Pressure meds.Cholesterol meds.
MarkOne of the largest “drivers” in medical costs is “cost shifting” — Medicare and Medicaid do NOT pay a fair price for many proceedures.The medical providers then pass these unpaid costs on to those who do not have such government benefits.
JMMedical malpractice is a sad fact of life.However, the biggest portion of the cost in many drugs is the price of malpractice insurance coverage.We all deserve to know, should something go terribly wrong, that we will be fairly compensated for true malpractice.However, the fear of lawsuits is the reason why “Thalamid” is over $7000.00 a month.This is the old “Thalidamide” the drug that caused “flipper babies” and gross birth defects in England.Our FDA, in a true triumph, did not allow thalidamide in the US, due to some testing requirements.England paid a heavy price for bringing the drug to market too early.The drug prevents morning sickness in pregnant women, but severaly damages the baby.It also prevents nausea in cancer patients going through Chemotherapy.Chemo patients who take the drug dont lose nearly as much weight, but they must be orally tape recorded, prior to each purchase, stating that NO ONE else will be allowed to handle their meds and that no pregnant woman will be allowed near the medication. Even touching it can absorb enough through the skin to cause birth defects.(I am bald today, partly because I dont want to take Propecia, it is similarly but not as severly, bad for pregnant women.)Anyway, Liability is a huge issue.
It is the Democrat Party that does not allow any reasonable tort reform.The cost of liability insurance and fear of liability is the leading driver in many medical costs.
By the way, this person on Thalamid can pay 33% of the cost, or $2,310 for the first month, $1,540 for the second month, and then $350 a month, (or 5%, for ALL drugs, not just Thalamid), for the rest of the year.That is $7,350 in annual costs for a drug that would ordinarily be $84,000.00.On top of this, a plan premium of around $42.00 depending on your State.Not a bad deal, huh?But the “greed” here is caused by the trial lawyers, who will NOT grant a good-faith exeption or liability cap to humanitarian distribution of dangerous drugs.The profit margins of the drug companies are not out of line at all.
The truth is, true preventative care often INCREASES drug use.For instance, ….The most frequent result of such screening?High Blood Pressure meds.Cholesterol meds.Posted by: Econ101 | April 22, 2007 at 02:38 PM
Yes, as I said private insurers have no incentive to offer preventive care.
In fact, the strongest argument for preventive care by a private insurer is to gather information about the policy holder in order to exclude the patient from remedial care.
By the way, this leads to another problem with multiple payers. The problem is that the name of the game is to attract relatively healthy policy holders and exclude less healthy ones. This is a big game insurance companies play called “who can hold the healthiest policy holders while excluding the less healthy — and getting our competitor to insure the less healthy.” A single payer system means that all comers are insured. The rule of large numbers isn’t diluted and becomes yet another source of cost savings over a multiple payer system.
Private insurers have their own long term at interest, not the patient’s. This is natural, it’s what business does after all.
But what’s best for health care insurance companies is often not what’s best for health-care consumers.
Thalidamide was the cause of birth defects in two people I know here in the states. It was either available here, or smuggled in.
When mistakes are made, then the mistakes need to be studied and corrected. When pharmaceutical companies cook the books in an effort to bring drugs to the market quicker, they should be jailed like any other crook. Why aren’t the morons who did that with the arthritis medications, which proved to be harmful to the heart, not in jail? Republicans. They are owned, lock, stock and barrel by them.
Tort reform will come when congress gets big business out of the picture. And that will only take getting rid of most of the republicans in congress. Maybe then we can get real medical reform.
O, and the Canadians? Socialist country with social medicine? Seems the Canadians are pretty happy with their country and their medical coverage (Universal, by the way). The latest report says they do it better and cheaper. But maybe it’s because they don’t go around invading every country they don’t like. Sure saves them a bunch of money to spend on people who need it rather than the arms manufacturers.
PedantYou just embarrased yourself.
Congressionally mandated “preventive care” applied DIRECTLY to a government program: MEDICARE!
The net result of that government-mandated “preventative care” was more drug use.
The idea is that catching diabetes or heart disease sooner will reduce catastrophic problems or emergency care.
—Probably a good idea. But this idea WILL require preventive drugs like BP meds, cholesterol drugs and the like.
Unless you want the government to take over the job of mom, dad, wife, husband, gym coach or Drill Instructor, the government is not well equiped for “preventive care.”
Do you want the Feds to tell you how much and what you can eat? How much to exercise?
How about a “twinkie tax”??
Does your support for “preventive care” mean you want your golf green fees and health spa dues paid for by the rest of us?
Also, Part D and part B of Medicare dont charge higher rates for smokers.
That just shows you how “effecient” government programs can be!
JMAmerican Doctors who live in border states clean up, due to CASH PAYING Canadians who dont want to wait months for routine proceedures!And, the Canadian prescription drug program is NOT government owned, and price competition is ALLOWED in Canada!
Sure, in a health system dominated by remedial care the first steps at offering preventive care may well increase costs in the short run.
Americans aren’t used to seeing a doctor until after they’re already sick, after all.
If Americans were to embrace and adopt preventive care, then remedial care costs decrease.
That’s the cost savings.
Also: it’s funny, but I’m not even remotely embarrassed.
And, the Canadian prescription drug program is NOT government owned, and price competition is ALLOWED in Canada!Posted by: Econ101 | April 22, 2007 at 03:28 PM
And does the Canadian health care system negotiate drug prices for Canada’s national health care?
Because I believe they do.
Allowing Medicare to use its considerable buying power to negotiate drug prices would significantly lower drug prices to Americans. It’s a no brainer. Your rebate? It would go to US taxpayers, not insurance companies.
Ross is correct. Negotiating drug prices is just low hanging fruit.
Econ having worked on the actuarial side of the ins. industry for 10 years I understand what you are saying about the rebates not going back to the insurees. But they actually do because when figuring the premiums for the next year these rebates are taken off the top of the expenses paid for a specific group. In this way when premiums are figured all factors, total paid claims and census age are considered and then a reasonable overhead margin is calculated and a fair premium is arrived at. If the claims are higher during the next year then that is where the risk side of insurance comes in. The Insurance company loses money. This overage comes out of the reserves an insurance company is required to maintain.
By taking these same steps, Medicaire Parts A, D & B would by existing factors (older participants, more per capita usage) be some of the highest premiums around. Because the government has interdeeded the premiums are kept relatively low by cutting back on the allowable amount paid for each procedure. Clinics, doctors and hospitals take the hit on this.
I am a senior on Part D for 2006. I can tell you it was much better insurance that the BC/BS I had before retiring. The drug companies give rates according to the volumn they are expecting to sell to Part D recipients.
Very few people could tell you how much healthcare would have cost them if they had no insurance. It is this head in the sand attitude and the malpractice debacle that have increased premiums to the rates we see today.
There is much more to this than the Dems want the general public to know. I would challenge all here to do some research and educate themselves and others before getting to het up over this.
“The net result of that government-mandated “preventative care” was more drug use.”
Only if you’re selling insurance. The whole point of PREVENTATIVE medicine is to PREVENT catastrophic medical emergencies. That may not require ANY drugs, but lifestyle changes: Eat your veggies and exercise. We are a nation of FAT people. Preventative medicine hopes to reduce that by diet and exercise, NOT drugs.
So how is that going to drive the cost of drugs up? You make no sense whatever, except to another salesman. As a genius friend told me one time, “Their selling insurance today and light bulbs tomorrow.” Your reputation precedes you.
In all of this I still wonder why generally speaking drugs seem a lot less expensive in Canada / overseas? Does their gov’t health care system negotiate prices? Can’t seem to get a simple answer through google …
Not disputing anything here — just asking
JMWhen you cant win, you simply insult me, as is your custom.Every law office has to sell itself to the public.Our hospitals sell themselves to the public.Compeititon is a great thing.I am proud to be in sales.I am good at it.I am the first to turn other salespeople in to the authorities if I think they have done something wrong.Very few professions have a code of ethics as tough as mine.
It takes intellegence to sell something.It takes character to refuse to sell the wrong thing to the wrong person.
Ken,In answer to your question, I do not believe that Canada negotiates drug prices. I will do more research on the subject, however, my understanding is that competition and malpractice reform have played a major role in Canadian drug prices.I know for a fact that you CAN find the same drug sold at several different prices in Canada.
And, JMJust how do you propose that our federal government involve itself in forcing us all to eat fewer twinkies, watch less tv, do more walking, drink less beer, etc?
As stated previously:Private insurance gives a premium break to NON SMOKERS!
Part B of Medicare does NOT give a price or premium break to non-smokers.
Part D Prescription coverage does NOT allow a price break for non-smokers.
Where is this great “preventive care” in a system invented by Democrats?
Before you get Uncle Sam involved in measuring my height and weight and lifestyle, why dont we get goverment to do what the private sector does best?
Ken before I qualified for Medicare Part D, I did purchase some of my prescriptions from Canadian Drugs on West St. In most instances there was no problem and I did save money. What I did find out was that some of my drugs didn’t come the same mfg. as those purchased from American companies. I had to wait longer and they came from Asian mfg. usually.
What I found out was that there wasn’t the same quality control of these drugs and my cardiologist cautioned against using them because the strengths had been tested to be different in some cases. For something as sensitive as a heart medication this could be disasterous.
American have been spoiled with our expectations. We want Cadillac quality at VW prices. The threat of lawsuits is non-existent in Canada. This in itself allows the price to be lower.
As I said earlier – There are many things driving drug prices. We have been pressured by AARP to sign petetions demanding the gov. get into negotiations for lower priced drugs.
I have also read alot about the large expense of researching and developing a new drug. You have all this cost up front when you are getting no value from the drug being evaluated.
We can make a decision. Do we want the cheapest drugs, do we want to put a damper on new development of breakthrough drugs, do we want to give up the ability to sue over a drug that is harmful, do we want to lower our standards in the quality of our drugs? All of these things together or separately would lower the cost of prescriptions.
Socialized medicine is not the answer in MOHO. Please everyone research. Find your own answers. Don’t trust any politician to give you a straight answer. It just isn’t in the nature of politicians.
My apologies,Canada does have a price ceiling on drugs, but many companies sell drugs BELOW these ceilings.Liability is a huge issue.The legal liability is much, much lower in Canada.Take note, the standard of living between Canada and the US used to be the same.These days, Canadians are 20% to 30% BEHIND the American standard of living.(Could socialized medicine have caused the economic decline of Canada????)
http://www.aims.ca/library/MPPI_pharma-revised_.pdf
Canadians are poor, so everything is cheaper in Canada:
http://www.ncpa.org/iss/hea/2002/pd091902f.html
http://goliath.ecnext.com/comsite5/bin/pdinventory.pl?pdlanding=1&referid=2750&item_id=0199-867034#abstract
My apologies,Canada does have a price ceiling on drugs, but many companies sell drugs BELOW these ceilings.Liability is a huge issue.The legal liability is much, much lower in Canada.Take note, the standard of living between Canada and the US used to be the same.These days, Canadians are 20% to 30% BEHIND the American standard of living.(Could socialized medicine have caused the economic decline of Canada????)
http://www.aims.ca/library/MPPI_pharma-revised_.pdf
Canadians are poor, so everything is cheaper in Canada:
http://www.ncpa.org/iss/hea/2002/pd091902f.html
http://goliath.ecnext.com/comsite5/bin/pdinventory.pl?pdlanding=1&referid=2750&item_id=0199-867034#abstract
Having worked as a salesman once, and dealing with them for most, if not all, of my professional career, I know salesmen can change from one product or service at a drop of a hat. My problem is: changing from one to the other, I find most salesmen are more interested in the sale than the product. Maybe you’re one of the exceptions, but your saying so does little to change my perspective.
It doesn’t take intelligence to sell anything. It takes a talker who should know his or her product. I have seen salesmen sell fireworks to the blind. Yep. they got my vote . . . not.
I’ve had salesmen try and sell me added mechanical insurance on a car guaranteed for 100,000 miles. Yep, they got my vote. I’ve had salesmen try to pressure me to buy a vacuum cleaner by telling me my son was in danger of getting ill if I didn’t. He didn’t get my vote; he got his ass kicked out the front door and all the way to his car.
I have run into a few real professionals, but they have been few and far between. Like the ones who sell “lifetime” light bulbs, most have my door slammed in their face.
If you consider that a character assassination, be my guest. If the screen door don’t open, No flies can get in. The last thing I need is a sales puke telling me what I need, and I expect most people are intelligent enough to figure that out on their own.
I stated my arguments on the Medicare problem. If you can’t or won’t understand that, I could care less. So far what I have read from you amounts to typical repub rhetoric, which is feed the rich, starve the poor.
By the way, I used to drive my parents to Tijuana to buy prescription drugs 4 times a year. They saved an average of $900 over the cost in the states. Drugs made in exactly the same place the drugs in the states were made.
Tell me the drug companies in the states are competing and are NOT cheating the people here, and I will be more than glad to call you either a liar or one who knows not what he is writing about.
Medicare needs to be able to negotiate prices, and your party is stopping that because of their bedroom fixation on the almighty dollar. Republicans should change the motto from in God we trust to in gold we trust.
J M while you were driving them to Mexico to buy cheaper drugs did you ever check the expiration dates on those drugs. The last time we were in Cozumel I did check dates and most were at least 3 years past their expiration dates. Some might think this is ok but I have reservations. Also not to long ago drugs purchased in Mexico were tested against the original drugs and fell way short of the content. One I remember was Zocor – a statin drug for lowering cholesterol. It had less than 25% of the major ingredient.
Something you might want to think about.
I didn’t have to think about it. The expiration dates were well within when we bought them. They also never gave my parents any problems, and their doctor told them it was a good deal. He is a stateside doctor. The labels were the same ones on stateside drugs.
Provide a reputable link to this so-called testing and I might believe it. I expect it will prove to be nothing more than propaganda supplied by the drug makers to keep poor people from buying cheap drugs.
By the way, there are stateside pharmacies selling inferior drugs as well. They made the news not too long ago. So there are morons in all countries selling doctored drugs. You want to think about the stateside pharmacies you buy from as well?
Indstead of bandying about buzz words such as “Socialized Medicine,” how ’bout defining the term; telling us exactly what it is you’re against.
Things have worked out okay for “socialized” water systems, for “socialized” sewer systems, for “socialized” air traffic control, for “socialized” fire departments…
(If you want a quick lesson as to the advantages of cost between the Private Sector and “socialism,” go buy a pint of water at Quik Trip.)
There are plenty of items and services that should be determined by market forces. Pick McDonald’s or Burger King or Wendy’s and let them battle it out for the hamburger market share. Buy a Ford or a Chevy or Toyota or choose to ride a bus; it’s the marketplace at work.
But there are some basics to life in a developled nation that are too important — to individuals as well as to society as a whole — to be commercial commodities.
Health care is one of those basics in a nation as advanced as the United States of America.
And we’re already of a moral bent to grant the highest-level (and most expensive form of medical care) to all comers. A gangstah gets shot, or a motorcyclist crashes, or a bum on the street has a heart attack and they’re immediately treated by EMTs, trauma surgeons, every possible resource available to modern medical science, regardless of the patients’ ability to pay.
We already have “socialized” medicine. What we don’t have is universal coverage. Because a pill or a stent might have prevented that bum’s heart attack. An anti-biotic for an ear infection might prevented a child’s deafness and a life of government-subsidized living.
Elderly people are the largest consumers of health services. I read somewhere that 80% of the average American’s total lifetime healthcare expenses are consumed in the last 12 months of life. So what does America do? We subsidize the oldest, most expensive patients. It’s like an automobile insurance program that covers only drunk drivers.
Universal health coverage would, indeed, shift how an individual’s dollars are spent. Instead of that huge deduction from your paycheck for private health insurance, it’d show up as “higher taxes.” But without marketing expenses of private insurers, and stock dividends, and perks for CEOs, and commercials on TV… the money would go to healthcare, rather than corporate perks.
For younger and poorer uninsured workers, the tax “increase” would be nominal, thanks to the established standard that Medicare claims cost adminstrators about 3% of the total “medical” bill; with private for-profit insurance as much as 27% of each premium dollar goes for “administrative costs,” which include insurance salesmen’s commissions, CEO perks, television and other marketing expenses and, especially, to the legions of corporate bureaucrats whose only job is to deny payment for coverage.
Infant mortality under the present system has, according to a report this weekend, skyrocketed in America because Republicans fight so hard for “the right to life,” right up until a baby is born, and ignore that baby’s right to healthcare thereafter.
Pharmaceutical companies collect huge government-financed grants to research cancer drugs, potions for cardio-vascular disease, etc… and are free to use the huge profits they generate from those diseases to address *really* profitiable issues such as erectile dysfunction and toenail fungus. You’ve seen the ads, right?
Conservatives haul out the old tropes of the marketplace when talking about healthcare. If it were your daughter or grand-daughter who needed heart valve surgery, would you really put off the operation until you could find the cheapest surgeon?
Hell, I’d attempt it for a tenth of the price a *qualified* surgeon might charge you. (And you’ll agree you can’t sue me for malpractice, thanks to your hatred of “trial lawyers,” right?) I’ll soak my Swiss Army knife in alcohol and everything. I’ve watched surgeries on television. Sure, I might not be trained or qualified, but you’ll *SAVE 90%!!*
JM
“It takes intellegence to sell something.It takes character to refuse to sell the wrong thing to the wrong person.”
Well said — I think it says a lot to the debate about background checks for buyers, buying weapons from private owners —
contrary to other comments — it does take intelligence as well as smarts to be a good salesman, (with the rare exception of those things that sell themselves ). Not only does a good salesperson have to (should) know the product, he has to know how to overcome objections, more than a little about human relations as part of that sale, mental acuity in math for complex financial transactions such as real estate, stock market etc …..
MRage
Stating the obvious — but thanks for the reminder:”Don’t trust any politician to give you a straight answer. It just isn’t in the nature of politicians.”
I thought in the furor about crossing the Canadian border to buy meds, they were manufactured / sold by the same co’s that we purchased here — minimizing the risk? …. and that’s what made the trip attractive … sounds like not so much ….
In your research on drug research did you come across any stats that showed how much and what types of drugs that the Government subsidizes — When I lived in Chicago, I remember reading that Abott Labs a huge grug research / manufacturing facility in the North Burbs had received some research funding for a heart drug (I think it was a heart drug) from the government.
J M I really don’t have an agenda here. I do remember having this discussion with my cardiologist. I looked for an article on it and haven’t located it yet. I’m surprised that none of the dates you looked at were outdated because everyone we looked at were. They told us that those paticular drugs didn’t lose potency and had a longer shelf life that the drug manufacturer stated. You are indeed right about deception by companies in the US. These are not the original mfg but knock offs who copy the packaging and sell inferior products to people looking for a medication they can afford.
I know there are a lot of people needing medications who are under 65 with no insurance and not old enough for Part D. There are several programs such as samples that are given free from your physician. I am not defending drug companies but need to point out that large drug mfg. give out tons of free samples just for this reason.
I have two daughters in law that work in the medical field. One in a private clinic and one in a state office. Both tell about the freebies dropped off by salesmen. I’m sure this happens in every industry.
There is so much more to be said for both sides but econ isn’t to blame anymore than you or I are. We are all in a position to find a solution but a fractured populace won’t make anything better. The solution won’t come from Washington – regardless of which party is in power. This is just my opinion.
I have looked at the health care systems in Canada and England. Many problems abound. I urge you to look at it with an open mind because someday in the very near future we will all be called upon to find a solution and we will do this by the votes we cast.
JMWE ARE ALL SALESPEOPLE
Some people just suck at it.
You sold yourself to your employer,, and to your employerss customers.
KenI think you complimented me, not JM — since you copied his copy of my original.Oh well.Thanks.
Long Time you are giving me all of the old talking points for healthcare administered by the government. Show me one instance where they have been successful in doing this.
Have you ever been on an HMO. My grandson was for two years. He tore his knee up and his primary physician wouldn’t refer him to a specialists because that would have cost him money. After two years his parents were able to change to a self referral plan and at long last a specialists saw him. Over 75% of the minicus had been destroyed. He now has a knee that will probably have to be replaced by the time he is 40. These are the things you will see in socialized healthcare. Long waiting periods to see a physician (check waiting times in Canada), seeing a specalists only if the doc will let you.
A real downside to this whole thing will be the dumbing down of the people who become doctors. The stats presented today show that the average income for docs will fall to $55,000 from $194,000. The best and brightest will not be going into the medical field. They will follow the money. The big drug labs will be put under price ceilings and without the budget to attract skilled researchers we will no longer attract the kind of people who will find tomorrows cures for cancer, aids or many other diseases we can’t cure today.
Again I say don’t take my word for it. Look at both sides of the argument and take all the facts into consideration then make up your own mind without listening to either parties talking points.
A fractured populace? How did that happen? Newt Gingrich said today on one of the morning news shows that LIBERALS were at fault for the Va Tech disaster. Limbaugh calls a 13 year old Chelsea Clinton “the White House” dog. Ann Coulter says that “liberals now know that they too can be killed.” Disgraced Republican Comgressman Randy “Duke” Cunningham called for “liberals and Democrats to lined up against a wall and shot.” The then President of the Senate Trent Lott said of Bill Clinton that “we can support the troops but not the president.” Republican Representative Dan Burton of Indiana called our twice elected President a “scumbag.”
Right wing posters on this forum proudly and regularly refer to moderate and left wing posters as traitors, seditionist and cowards.
A fractured populace? How did that happen?
By the way,Since we are talking about medical malpractice AND sales, want to know something about insurance and investment malpractice?
The E and O or Errors and Omissions Insurance of attorneys and CPA’s does NOT cover investment advice.
The malpractice insurance of attorneys and accountants gives limited coverage for limited insurance advice.
Every stock broker is a salesman.It pains me to admit that we arent all honest, but the fact is, the average intelligence of most stock brokers is much higher than that of the general public.
The failure rate for the series 7 license test is comparable to the bar exam or to CPA tests.
Many CPA’s and attorneys who take the Series 7 test fail it the first time.
State insurance tests arent nearly so hard, but the continuing education requirement in insurance and in investments is very stiff.—-By the way, since “Preventive Care” was brought up —
Buying a NEW vauccum cleaner usually increases the health of the household.I have never sold vacuum cleaners, but new, HEPA filter cleaners WILL dramatically improve the health of asthmatics and allergy sufferers.Maybe you should not have been so hard on that vaccuum salesman.He was telling the TRUTH!
Absent in this debate — maybe it will be in another thread — is the viability of alternative forms of treatment, chiropracty, far east medicine etc and the reluctance for the medical community to embrace some of the methodologies …… that don’t entail narcotics or expensive intrusive procedures — of course there is no replacement for taking responsibility for our own well ness by doing those healthy things we know to do —
In the Kansas senior times there is an article about a 95 y/o woman who is graduating from Fort Hays State (FHS) this spring, setting international records for oldest person — and was named Kansas Woman of the Year — she looks about 50-55 —- I can only hope to look as good and have half the mental acuity she has when I’m 95 (god willing).
Econ –
My apologies — well said
I am having one of those sr. moments tonight — well maybe it’s a little longer than a moment — hard for me to remember who said what when — my apologies if I inadvertently attributed comments to the wrong people — seemed like a reasonably sane discussion here today — didn’t see any name calling etc ….. good jobs kids — have a cookie and off to bed — nighty night –
Well, a single payer system in the USA could actually accomplish more than just providing all Americans with healthcare at a reduced price.
Although that would be a major, HUGE positive for the US.
One other thing, and this probably can’t be overstated.
If you’re paying attention, Econ101, you’ll note that the US Congress was won back by the Democrats in 2006. Things are looking very good for the Dems in 2008, too (for example, it looks like Missouri’s 6th will be in play for the Dems in 2008, despite Rep. Graves’ 64% in 2004 and 62% in 2006 as they’ve recruited KC mayor Kay Barnes to run; looks like the Dems are already recruiting extremely high quality candidates to run heads up all over Red America in 2008). The bottom line here is that global free trade is likely in serious jeopardy come 2008.
One of the biggest reasons it’s in trouble is that under Republican leadership the gains from free trade have not been shared equitably. Wages are stagnant, bankruptcies are up, the housing market is slowing everywhere, and middle-income Americans are hurting. And it’s well known that the top 1% of US income earners is shooting lights out.
Providing Americans with the considerable safety net of1) Potable health care, and2) Taking the threat of personal bankruptcy off the table for uninsured hospital stays…
…Both these could be by-products of an American single payer system…and together they just might ward off what’s sure to be a growing anger over a perceived inequitable sharing of the gains from global trade.
Think about it. Just as a new and valuable safety net called SS saved American capitalism by placating angry Democratic voters in 1935, so could a single payer system placate voters’ anger over an increasingly volatile stream of personal income.
Remember, business law is an ecologic system. A key input is citizen approval, and disapproval often results in new laws which hamper our economy. If enough Americans get angry, change’ll come sure as the sun in the morning.
You sell insurance so I’m sure you see the value in a single payer system as a “ensured laissez faire” policy for Wall Street.
You know Pendant I could set here and refute every point you made but I think Ken had the best idea. It is off to bed with a cookie and some warm milk. Have a great night. We will live to fight another day. Good thread
PedantThe biggest obstacle to a “single payer” system is organized labor.
You can’t get labor to sign off on benefits lower than what they get now.
You cant get the taxpayers to pay for benefits that are higher than, say, Medicare.
Medicare Part A, taxpayer subsidized premium, cost is at least $410.00, a month. ONLY 1% of the population must pay this premium directly, but most people pay NOTHING:
GAPS DEDUCTABLES AND COPAYS(your cost)
Hospital Staysday 1-60 $992.00PER ADMISSION, so can and does happen more than once a year!
Days 61-90 $248 per day91-150 $496 per day
Skilled nursing care “free” first 20 days.Skilled nursing care, days 21 to 100, $124.00 per day
Medicare Part B, for outpatient or non hospital services.Current premium $93.50 — this premium is about 25% of the actual cost of Part B. (in other words,taxpayer cost is 93.5 X 3 or $280.50. If part A costs are added, the beneficiary is receiving a taxpayer subsidy of $280.50 plus $410.00 = $690.50 per month.)
GAPS, COPAYS AND DEDUCTABLES IN PART B COVERAGE:
Annual deductable: $131.00
After that, most services are80% Medicare/20% patient
This can be HUGE for a chemo, radiation, or kidney dialysis!
Also, most surgery is now done outside the hospital.
There are other issues, foreign travel is NOT covered at all, Home Health Visits will not pay for custodial care etc.—-Why would the over 65 crowd stand idle if the under 65 crowd was given BETTER care? It wont happen.
Why would the Union crowd stand idle and allow their benefits to be reduced under a “single payer plan”? That, likewise, wont happen.
I think we MIGHT see a system that allows the under 65 crowd to “buy into” Medicare.
That would cost $784.00 per person, using age 65 rates.
Medicare DOES insure many of the disabled, who are under 65. Those claims probably would be close to many who would “buy in” to Medicare.
One other thing.
The baby boomers are rightly worried about Medicare and about Social Security.
The boomers will be sensitive to expansion of government obligations, since a broke government cant pay for the boomers!
Pearl Harbor was 65 years ago. The boomers are already startting to retire, even though the “boom” has not yet hit 65.
So Paul, if boomers should be concerned about a broke government, why aren’t the Republicans concerned about deficit spending, after all the natinal debt is now projected to be about $11 trillion by 2012.
On the statement that hospitals overcharge non-Medicare/Medicaid, insured patients to cover M/M shortfalls, I don’t think that’s true.
When I started practicing medicine, Medicare reimbursements were about 70% of traditional insurance reimbursements and Medicaid reimbursements were about 50%. But I made a decent income, and enjoyed serving my patients.
Importantly too, insurance companies began lowering their reimbursements when the Kaiser HMO concept was adopted widely. I provided privately-insured care to many large-corporation-employed patients at Medicaid reimbursement rates. Traditional insurance reimbursements were nice, no question, but they became progressively fewer and farther between.
With an aging population, most major-intervention care will be delivered to Medicare recipients. In terms of healthcare-delivery costs to providers, we are probably already there.
We’ve seen major cost-cutting. It started with Congress passing laws allowing Third-World-eduated doctors to come here, and receive residency training using federal taxpayer dollars, beginning in the 60s. This was done to break the “medical monopoly” of American-citizen physicians. Also antitrust/ collusion lawsuits were filed against physicians for devising uniform reimbursement rates. Some, like my specialty, came up with Relative Value of Service (RVS) point scales, without specific prices attached. This was allowed.
Then the courts began welcoming malpractice suits for honest mistakes made by competent physicians (nobody can ever do a perfect job), whereas previously the courts only took cases that represented egregious negligence or willful misconduct, which was pretty rare. The new regimen created a lucrative legal field, medical malpractice, generating wealth for both plaintiffs and defense attorneys. This led to hyper-”defensive medicine” which jacked up costs, most of the money enriching diagnostic-test labs, pathologists, radiologists, and the manufacturers of New and Improved testing technology.
The original floodgate opening to foreign medical graduates (aka international medical graduates) was done to lower doctors’ fees when doctors’ fees constituted the largest single cost-sector in medicine.
Today prescription costs far outweigh doctors’ costs. It’s time for government to intervene. Maybe that could mean importing drugs made in China. It could mean issuing 20-year patents for low-production-volume drugs for relatively rare “orphan” diseases, while shortening patents to 5 marketing years (after drugs get FDA approval) for mega-sales blockbuster drugs.
It could mean, and should mean changing an obsolete-concepts-based FDA drug-approval system to allow manufacture of new drugs with equivalent therapeutic efficacies to already-approved drugs, rather than mandating BETTER efficacies. Let equivalent-efficacies manufacturers compete on price. Moroever, people have different amino-acid sequences in their same-function proteins. Some drugs work better in some people than other drugs. So a new drug being FDA Phase I/II/III testing that generates as good, but not better statistical results as an already-approved drug, may be BETTER than the already-approved drug for SOME patients. It may be helping a subset of patients that the already-approved drug isn’t helping.
I remember when IV salt-sugar solution bags cost hospitals $1, and yet hospitals charged $20. For generic commodities. Insurance companies today pay far less than they once did. But uninsured patients are charged the outrageous price.
The same phenomenon holds for outpatient drugs. So, if some people want to do the right conservative/libertarian thing and pay for their own drug costs, they get punished. Where’s the outrage here? For example, recombinant human insulin is out of patent. It is manufactured for less than $5 per vial. Under insurance, patients pay $10, the insurance company pays another $10. For self-payors, the cost is $180. Think about shopping for a Windows XP, non-Vista PC, and the cost being $10,000 to individuals, but $500 to corporations and their employees.
Our healthcare system is corrupt. I think it was Douglas Adams’ “Hitchiker’s Guide to the Galaxy” that described middlemen being transported to prison colonies. Medical insurance companies and their salesmen are exorbitantly costly middlemen.
Home-run-or-bust drug companies are working under a bad paradigm. The FDA is corrupt. I filed a complaint against a company that published imaginary data in “reputable” journals, up to and including the New England Journal of Medicine. For example, the company reported mouse-life-saving properties for a human-recombinant drug. Itt was only later determined by university researchers that the human drug didn’t bind mouse receptors, and was biologically inactive in mice. This wasn’t what they expected, or sought to prove, it just happened. But the FDA refused to examine the drug company’s research fraud. Nothing was done in response to my communications to the FDA. Such as infants receiving putative anti-infection-fighting drugs in FDA phase I/II trirals who were not infected with any organism. Their parents were told their children had infections–they were lied — in order to get “informed consent”. The actual reason for the research was to create a ruse to harvest potentially highly-valuable growth factors RNA. The biotech companies started out isolating cancer-tissue-emitting growth factors. But they figured out that the “motherload” of growth factors was contained in young humans. How fast do infants grow? But laws then and now prohibited “mining” people. So an egregiously fraudulent pretext was created to do and end-around the law.
What happened in my complaint? Unfortunately, five-figure-earning federally-employed “regulators” were looking down the road to being hired at fat 6-figure salaries and bonus packages by drug companies they were supposed to regulate. This is called the “revolving door” in the beltway. The so-called regulators understood which side of the bread they needed to butter.
Today, we have drug companies facing patent expirations for drugs that generic manufacturers want to make and sell for lower prices. The original drug companies have been unable to invent new blockbuster drugs. Very stressful. They’d be far better off with reasonable-profit manufacturing and marketing licenses. It’s time to move beyond “boom or bust” thinking.
I want my “cookie” too, but another thought, since I know what pendant will say next:
Dont tell me a “single payer” system will reduce costs.
It CANT.
Cost shifting does come from several sources.Cost shifting is underinsured or uninsured costs being transfered to those who have insurance.
By definition, those who have Medicare are ACTUARILLY underinsured.
Medicare Assignment is the term CMS uses for its approved charge for all medical services.
Medicare Assignment is almost always BELOW market cost. The “loss” providers suffer is passed on to those of us who are under 65. We see the governments heavy hand as our costs go UP!
Those over 65 consume a HUGE amount of medical care. The over-65 group will be a higher and higher percentage of our total population due to longer life expectances (due to our GREAT health care system) and due to the boomers hitting retirement.
There is NO mathematical way for government to push its dead-beat “cost shifting” model if the government can no longer shift its program costs to anyone else.
If we are all in the same plan, the government will be forced to CUT BENEFITS AND SERVICES, or ration care, in order to cut costs.
Please do some cost shifting research:
http://www.parapundit.com/archives/003498.html
http://www.hcfo.net/pdf/dobson.pdf
Econ101,
In India, Westerners get cataract-removal and lens-implant surgery for $200. Hip replacement for $1000.
You may say, “They get crappy medical care.”
But I’ve spent a lot more time in operating rooms, and working with Indian-educated doctors as colleagues than you have. I’ve learned that smart people can be trained to do anything well. So if you are really a “free market” guy who believes that “comparative advantages” are true, you should be lobbying your employer to send high-cost surgery patients to India.
ksgrm asked me:
“Have you ever been on an HMO?”
And she used it as an argument against “socialized” medicine, a term she refused to define.
I think I speak for most thinking people when I say, “Huh?”
Your argument against single-payer health coverage is one of the most aggregious offenses of *private-sector* for-profit insurance?!
Hell, yes, your HMO was more concerned with corporate profits than with health care! What part of “corporate profits” do you not understand?!
What is the Republicans obsession with higher medical costs? Health only for those who can afford it? No doubt our Kansas senators have received quite the lump of bribe money to keep throwing taxpayer money to the drug companies. I wonder if they can call themselves fiscally responsible and pro-life without laughing to themselves.
“JMWE ARE ALL SALESPEOPLE
Some people just suck at it.
You sold yourself to your employer,, and to your employerss customers.”
hahahahahahahahahaha!!!!!!
Where’s my freakin commission?
For the record:I do not like HMO’s — I try very hard to avoid them.I will not sell a client an HMO plan and I will argue against the use of one, to any family member, friend or client.
Furthermore,The medical advances in America were financed, in large measure, by the insurance industry.If not for the deep pockets of insurance companies, much of the progress we have experienced would not have happened.This is not, necessarily, an arguement against change.However, there is a naturual love/hate relationship between insurance companies and doctors.
They want us to pay claims.
They dont want to be told what to do.
Any good agent has, at times, been forced to be an advocate for a client/patient.
There are mistakes made by doctors and by attorneys and by the clerks and claims adjusters who process the paperwork.
I am in a position to see mistakes made by everyone. I have been involved in fixing government and medical provider billing and claims mistakes on several occssions.
In all humility, sometimes I am not perfect, as well.
An adversarial system checks and balances all of us to some extent.
When the government runs everything, the government will pass laws limiting liability and capping damages.
There will no longer be an incentive for the plaintiffs bar.
There will be no “adversary” to keep anyone in line.
Well, maybe there will be. Anything the government does will have “gaps” and there will be private insurance, still, to fill those gaps.
Just try to find an agent that knows how to check the codes for “stress tests” (more than 13 proceedure codes, I think, for treadmill tests, and the most common error on an Medicare Claim.)
Try to find an agent that knows how to document and fight government premium overcharges.—Me?I see lots of problems in the status quo. I am not an apologist for the current system, I just have not heard a viable alternative, just an awful lot of venting. Most of that venting is very ill-informed (no pun intended).
MarkThere is a female Dr Schooley at Via Christi St. Joe Neonatal.I respect her very much.
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