Plugging the Donut Hole: Help or Hype?
By Pat Racimora on June 24, 2009 at 6:01 PM in Health Care, Medicare
The pharmaceutical industry is having a half-off sale! President Obama just couldn’t gush over it enough.
Soon, seniors trapped in the so-called Medicare drug coverage donut hole will be able to purchase their medications for 50% off the usual outrageous rate. As of now, Medicare helps pay for seniors’ medications (75%) up to $2,700 and picks up again after $6,100. In between—that pesky $3,400– seniors are on their own. While jammed in that hole, some seniors on tight incomes probably cost the government more in the long run because they get really sick from taking only a fraction of their prescribed meds.
But, is this really a generous deal or a sneaky PR campaign with an intent to lull seniors into believing that the Obama administration and Big Pharma give a damn about them? (Hint: That my donut looks a little like a salty pretzel is no accident.)
First off, the pharmaceutical industry is not sacrificing here. Because we pay dollars for each little pill, we tend to forget that they cost only pennies to produce. So despite the fact that medications will be somewhat more affordable during the donut hole period, at 50% the profits will still be coming in. Known for their aggressive marketing techniques, the pharmaceuticals will also get more PR mileage from this half-off sale than any TV advertising featuring animated bees promising allergy relief, a butterfly in your face while you are trying to go to sleep, or a couple in individual bathtubs up on a cliff who are somehow going to now have sex.
Seniors may be so grateful to drug companies that they could become momentarily distracted from the real problems that are coming down the pike. Medicare does help those with a covered diagnosis (Alzheimer’s and dementia are not among them), but too many learn way too late that if they need assisted living or require skilled nursing for an extended period of time, Medicare does not help. Coming up with an average $4,000 a month for basic assisted living expenses or the $6,000 plus for nursing home care is not something most seniors can manage, even with Social Security benefits. Long term care insurance would be helpful, but it is very expensive.
Seniors should also be worrying far more about what else is in the health news that affects them directly. In 2008 President Bush proposed slowing down Medicare spending, and that notion was quickly shot down. President Obama, in yet another Bush II move, is now asking for the same thing and it’s still flying. Obama’s proposals:
Spending on Medicare prescription drugs would fall by $75 billion over a decade. And slowing projected increases in Medicare payments to hospitals and other providers – but not doctors – would save $110 billion over 10 years, the president said.
Obama called them “commonsense changes,” although he acknowledged that many details must be resolved. Some powerful industry groups called the proposals unwise and unfair.
So, in the larger context, donut hole relief looks more like a pinhole. The government saves nothing because it was spending nothing. And this fire sale fails to address the much larger problem of skyrocketing medication costs to all of us.
Sometimes I wonder if we could be headed towards becoming a “duty to die” society. Short of that might be the admonition that old people will just have to live with whatever ails them while younger people will have access to treatments for the same problems. There won’t be enough primary care treatment to go around if everyone who is not currently insured comes on board, so some form of rationing is looming.
Bottom line: Tough times ahead for Mom, Dad, Grandma, and Grandpa.
(Release: November 13)
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Too bad Obama doesn’t realize that one day, too, he will be a senior. Maybe he just figures that since both of his parents died at a young age, he will too? Who knows what the great usurper in charge thinks. what I find absolutely disgusting though is that if Obama wants something, everyone, in both parties, seems to want to make damn sure he has it. Why????
why????
Captain Kumbaya is a big celebrity now. He’ll be worth millions once he’s done screwing up the country. Why should he care about old people, especially typically white old people, like his grandmother?
My Dad has Alz & paid hundreds per month for his drugs under the medicare deal during his “donut hole” period. It was insane. Finally, I got him on the V.A. drug plan, the V.A. drs prescribed even the Alz meds for him & now he gets all his drugs thru the VA @ $8 per RX! Each RX is 30 pills. We’re probably saving a couple of grand a year, getting the drugs through the VA. You have to fill out some paperwork, and take the Senior for a couple of Dr appts at a local VA facility but it is so worth it. I hate the drug companies by the way!
Another option is Walmart – it’s $4 or $5 for a one-month supply, and $10 for a 3-month supply. This option isn’t available for every single drug, but the list of the drugs that are covered is suprisingly long. It’s available online. I’ve also heard that Target and Rite-Aid have similar programs, but I don’t know this for sure.
And the worst part is that many of us kids cannot afford to step in an help our parents as we are barely taking care of ourselves. Truly, I feel guilty since they sacrificed for me.
You and me both! I want to take care of my mother, but am barely making ends meet as a single mother.
My wife is in the donut hole…It sucks!!!
$4350.00…All at once every year…
Very timely, astute article, Pat. This is just another sleight of hand, an attempt to lure people [in this case seniors] into an appreciative trance, while they get screwed by the “health care reform” being touted. Because seniors specifically will be on the top of the health care ration list. Why? The stats have been out there for many years. Something like 90% of healthcare costs are racked up in the last 12-18 months of life. Nursing home costs are astronomical as are many of the life-extending therapies.
From an accountant’s point of view, it’s simply not cost effective. But then, as a society we should be more than mere cost accountants when dealing with human life. I think there’s something clearly truthful in the idea that as a society we will be judged on how we care for the most vulnerable among us–children, seniors, the disabled and the poor.
The health care debate may bring this whole issue into disturbing focus. I watched my father die of Alzheimer’s. Not a pretty sight. His care was horrendously expensive and a good portion of what he’d worked so hard for over a lifetime was spent for that care.
But at least he received it and died with dignity. Would we write-off anything less for others? I sincerely hope not.
Just a couple of points:
The donut hole is the stupidest idea I’ve ever seen. It’s designed to stick it to seniors who are actually sick and NEED medicine.
Obama isn’t going to say bad things about any Health Care, Pharma, or Insurance Companies – he wants their co-operation up to the point where he can get his healthcare reforms on the table in Congress.
It might have been useful (and perhaps less misleading) if you’d mentioned that AARP also ‘gushed’ over this deal.
Yes, you are right about AARP. But, wait…AARP is an insurance company, you know!
That, I think is exactly my point….
As a Medicare “recipient” and AARP victim, the donut hole is more than a hype. I continue to pay the insurance premiums when the payments stop in the “hole”. This usually happens around July or August, and I don’t use too many drugs. So, for 6 months ea. year I have to pay full price for drugs, but continue to pay insurance for 12 months.
This is a royal screwing whose main backers were Tom DeLay,the GOP, and the Democrats who were paid off with jobs at drug companies paying them outrageous salaries. This disaster was perpetrated after midnight voting, and after 3 votes in the senate didn’t produce the desired result. Delay wrung hands and promised campaign funds and actual threats in order to get this atrocious bill through
The drug and insurance lobby will continue to buy off, obstruct, and perpetrate any frauds possible to deter any real helthcare/drug reform. Now Baucus is the Democratic point man for the Insurance lobby. He is trying very hard to obstruct any public healthcare
reform and is GOP’s best friend.
As long as we have Democrats unwilling to fight like hell, and sellouts like Baucus, it makes any real reform seem far away. So far I haven’t heard anything from Obama that is reassuring.
Simple cartoon, that kind of says it all. 50% off of nothing is how I feel about it. You know when a corporation is eager to come on board, it means that they will get more out of it then they are paying. In spite of that I do feel that it will help some seniors so in a way it is a win-win.
Rich
Obamacare has no use for anyone who won’t vote for him and who is not cost effective. So when your doctor starts asking you if you’re pro-Obama or anti-Obama you better say you ‘love’ your president otherwise you’ll be thrown on the dung heap.
“Sometimes I wonder if we could be headed towards becoming a “duty to die” society. Short of that might be the admonition that old people will just have to live with whatever ails them while younger people will have access to treatments for the same problems.”
What in the world makes you think that young people, other than minors, will have coverage? They’ll pay all their lives but their “benefits” will get cut and pushed back and they won’t see a freaking nickel of their money ever again. They don’t have a donut hole: they have a black hole. And every medical advance ups what they will be expected to cover–for others.
I am 43, a woman, and have no health problems. I could no longer afford health coverage and last month I dropped it: my last payment was $468/month, for just me. It wasn’t even good coverage and had a high deductible as well.
I resent like hell being taxed to pay for old people’s freaking drugs especially since old people are by and large a great deal wealthier than younger people, and I also resent paying for people’s freaking children’s health problems. You have em, you pay for em.
All that money I pay out of my taxes for both groups are for programs that will be bankrupt when it’s “my turn” or that I will never use, since I don’t have and will not have children. F#ck all insurance, drug companies, Medicare, Medicaid, the Children’s Health Insurance Program, and people who take my money for their problems: every last one of them helped to make paying a doctor’s bill out of my reach.
Since I have to live with any health problem I ever get, I don’t give a rat’s @ss if people who took my money find themselves in the same boat.
Ohhh NomNomNom, You are harsh. But your point does not go unappreciated. It does seem like healthy folks should get some sort of break.
Yet caring for the sick is one of our basic values, part of what makes us human. As of now, I don’t think old folks and sick kids are your enemy. It’s the incredible profits made by Health, Inc. You were largely paying for big business, not compassionate health care for others.
And do remember that the stereotype of “useless” for old folks is unfounded. Churches, tutoring, and all sorts of volunteer efforts would collapse without them. Most are in the process of giving back as best and for as long as they can.
Finally, SOME old folks have a lot of money. Most do not, and they have no choice but to go with Medicare. Anyone with money at any age will always be able to have better health care.
Nomx3 seems to forget the she, too, will be old someday. The only exception will be if all that anger turns into cancer soon.
Yup, there is a connection.
I don’t have health coverage now, and I’m not old. All of these programs I pay for, I don’t get to use and won’t be in existence by the time I’m old enough to use them; the same for f#cking Social Security. I just want my money. I want you to keep your money too and allocate it however you see fit. Just don’t tell me what I owe strangers, when there won’t be anybody down the road doing the same for me.
Why there will be Obummer’s socialistic 40% of the nation that subsists on the taxes of the rich. The entitlement generation will not have to contribute.
Don’t you like Obama’s cure for slackers and career welfare participants? (SNARK)
how to Plug the Donut Hole
http://therealbarackobama.files.wordpress.com/2008/07/1-1-head-up-ass.jpg
Outstanding, Pat.
A couple of things: yes, we forget that the pharma companies pay only pennies per pill AND that, in most cases, WE paid for the research and development of those pills; long term care ins. is GREAT – if you can get it. People like my mom who had a liver transplant years ago was certainly not eligible for it; and yes, Medicare covers the first 100 days of nursing home care, but not 100% for the entire 100 days…
Thank you for this timely, informative post…
I’ve said it sincerely for some time: I want to die suddenly. I don’t want to watch myself speinding all I’ve saved for medical care, rather than for my kids. It’s a sad state of affairs. Thanks, Pat, for the post.
Yes, that is a fact. One of the big problems in cost is the overuse of new patented drugs in instances when the older generic one would do just as well. But that is why the pharma reps send the cheerleader types out to see the docs and why they give educational courses on Caribbean cruise ships to the docs who play the game. It is all about the damn game… everywhere the same game.
So true. And it’s my understanding that sometimes newer drug formulae are merely tweaked to get a new patent. Add to this the enormous expenditure on advertizing and it’s no wonder drugs cost so much.
On the other hand, a recently-deceased spinster aunt worked all her adult life for a large pharmaceutical company. Her job was basically clerical. She had no college education. But even after the major hits her portfolio took this last year, her estate was still worth over a million dollars. She was obviously paid well and had generous retirement benefits including very good health insurance coverage.
Nobody is saying it’s not a bang up business model. But then again, selling jugs of water for $20 apiece after a hurricane would be a bang up business model as well. Of course that would be profiteering. Whereas, marking some chemical somebody needs to live up by 1200% is just a good business plan evidently.
Okay, I am ready to get bashed for this, but I need to present a different perspective. I work for a specialty pharmaceutical provider (not a drug manufacturer). These specialty drugs are some of the most expensive drugs on the market. Our patients do not get turned away for lack of insurance or an inability to pay large deductibles and/or co-insurance. All the manufacturer’s we deal with provide Patient Assistance Programs and most of them are very, very generous. They provide free drug, assistance with co-insurance, deductibles, and support agencies that assist patients in obtaining insurance, paying premiums, appealing denials, etc. for those who financially qualify. The criteria to qualify for the various programs is varied, but in all cases, I can attest that is is extremely reasonable (more reasonable than what it takes to qualify for Medicaid for example). As providers we exhaust all options in order to find coverage for our patients. All the while accepting below cost reimbursement from the government payors such as Medicare and Medicaid. We could not survive as a provider on Medicare or Medicare or Patient Assistance program, if it were not for commercial insurance our company would simply become not profitable and I am sure cease to exist, therefore, denying access to our life-sustaining therapies to our patients.
Thanks for this informative perspective, MBC. No bashing from me – your comment just highlights what a complex issue this whole thing is…
I’m with RRRA here and appreciate your perspective–
But I do know lots of folks who are struggling with their bills, including drug bills, and either they know nothing about these programs or do not qualify.
When I see the ads for assistance, the visuals of the living conditions of the people who are being helped appear to portray extreme poverty. How poor does one have to be to qualify?
Also, I was looking at the profits for drug companies for another story a while back and was stunned with how high they are. I know R&D is expensive and that not all tested drugs pan out, but as RRRA stated earlier much of that research is done on the government’s dime (e.g., NIH and Veterans Administration).
Finally, why do citizens in other countries get to pay less?
Because there is no real competition and there are not normal market forces at work in this country. The charge is whatever the market will bear… which means however much the insurance industry pays for drugs. That sets the fee. It has nothing to do with the cost to manufacture and distribute. If this were the business of picking up garbage, we would just call it a mafia and be done with it. The drugs are about one-fourth the cost in Mexico because they can’t afford to pay as much as we can afford to pay… which is fine because they are still making money. It is simple.
What the insurance company is willing to pay for the drug definitely does not determine the price. The manufacturer sets the price. The provider, distributor, wholesaler or retail chain negotiates a reimbursement amount with the commercial insurance companies. For government payors they either choose to accept or not Medicare or Medicaid reimbursement. If every insurance company paid like Medicare or Medicaid, the provider could not continue to provide. So, do we eliminate the provider and just let the government run the show. Cut out the middleman? Would it be more cost effective to have the government buy directly from the manufacturer and distributes it to the patient. How long do you think the lines will be?
Sure it does. If insurers will pay $100 for a prescription of a medicine, then the price charged for it will never be less than $100. You are making my point. The price is whatever the insurers pay, whether you have insurance or not. This is how hospitals charge $30 for a tylenol… because insurers pay that much, and to charge insurers that much they have to charge everybody the same, else it would be insurance fraud to have a dual fee schedule. There is no natural free market in the U.S. pharma market. The prices are set to whatever the market will bear. That price will never be less than what insurers are willing to pay. The insurers don’t care the cost they pass it on, and the bigger the pie the bigger their piece of it.
Not even. Just let people buy drugs from Mexico and Canada without the drug companies spreading fear that the drugs from there are somehow unsafe or inferior. They are all made in the same labs. Many of ours are made in Puerto Rico to begin with. It is false to say that drug companies care about people, they do not. They care about market share period.
Okay, Docelder, let the the government determine the reimbursement for drugs, healthcare, etc. Have you visited a VA Hospital lately? Are you on Medicare? Are you active military and have Tricare? The lines are long and the service is poor. Many providers just don’t accept patients with this insurance. For now, they manage with commercial insurance or private pay. If the government takes over all healthcare and regulates provider reimbursement, you will not have enough providers. Why would an MD or a drug company invest big dollars in either their education, staffing, office start-up or R & D to get reimbursed below cost for their services?
Exactly, they “cherry pick” the services government reimburses and find the sweet spots. Then they market to the sweet spots. Like diabetic testing supplies. There must be a mint to be made from that, you can’t watch the TV one night without seeing an ad for at least one of these companies. Times were diabetes patients checked their sugar one or two times a day. Now, they need to check it every few hours? Why, because now it’s easy and it doesn’t hurt? Or because the more supplies used the more the suppliers make. Yes, private insurers are subsidizing costs for everybody… so we already have a from of socialized care. Let’s be honest about it. That isn’t fair to the folks who buy insurance. But, the insurers don’t mind… a bigger pie means a bigger piece of the pie. It has grown to a point of being not only unsustainable, but broken. The tail is wagging the dog as the drug companies create the markets for the new marketable drugs instead of filling a need. There will be no cure for cancer when drug companies can get rich by coming up with new ways to charge more for the same old generic drugs we already have.
Healthcare is business. I don’t believe every healthcare provider is on the up and up or acts in an ethical and moral manner. Just like any other industry. However, I do not begrudge business from making a profit. It’s called capitalism. It is what has produced the world’s greatest source of innovation, inspiration, motivation and wealth. Without these things you have a society on the dole waiting for the government to hand them something.
You keep on making my points for me. Yes, it is a “business”. It should be a “service”. It is not. What if food companies got together and charged what the market would bear for food… disregarding the world market for food… just charge them what they have for it. How much can they afford to eat? That would be immoral. We need health care the same as we need food to live. It is just as immoral to profiteer from that industry as it would to profiteer for food. Profit is fine… profiteering is immoral.
They’ll do it with water and food any day now.
On recurring topic of water:
http://www.azzaman.com/english/index.asp?fname=news\2009-06-13\kurd.htm
Yes and there is that large aquifer under Uruguay and Paraguay that the Bush family just bought the land on the top of. Yes, water is the next oil. We have ADM controlling a large portion of world food grains. What if they decide to charge based on how much we can afford to eat… or afford not to eat. Immoral as it will be, it will be no more wrong than what health care companies have done with medicines and medical services. If business comes first every time then we might as well get ready for “Bartertown” because road warrior days can’t be that far behind us.
Sorry Docelder, you don’t answer the questions and you insist I am making your point, when I am not. I have concluded you don’t agree with the benefits of capitalism and how they outweigh the disadavantages. In my opinion, not everything should be provided by the government unless you want to like the Venezuelians. Food and Water providers are businesses too and last I checked, were all making handsome profits.
Maybe the answer is to loosen the rules and make it easier to be a pharmaceutical manufacturer. Maybe instead of protecting us, the FDA is protecting the drug makers by limiting competition. There are a lot of ways to change this. Becoming socialized isn’t the only one of them, it may be the only one that is doable though. Something has to be done, what we have is not equitable and it is not sustainable.
To learn about the programs available for a particular therapy, drug or condition, the best place to start is with the manufacturer. They should start with the website, but of course not everyone has internet access, so a call to the MD office should get them at least a phone number. Also, there are organizations such as A.C.C.E.S.S. which is an acronym for Agency for Chronic Conditions Entitlements and Social Services. There are many, many organizations such as this that assist patients in learning about their entitlements, assist them in obtaining insurance if they do not qualify for entitlements, etc. These organizations are staffed by clinicians, attorneys, etc. and many are supported by drug manufacturers, physician groups, etc. Many of the assistance programs I am familiar with start at 300% of the poverty level and take household size and expenses into consideration.
Yes, some drug manufacturers profits are excessive, but some are not. When Bill Clinton asks for free drug for HIV victims in Africa, he has to have someone with money to ask. If the drug companies don’t make money, they tend not to be generous.
Also, like Velcro which was developed for NASA, many drugs are developed for one purpose and found to be extremely effective for another less profitable purpose, but life-saving. For example, the generic form of Viagra is used to treat patients with Pulmonary Arterial Hypertension. A chronic life-threatening condition. There are only five drug treatments available for this condition and all but one involve either continuous infusion or potential serious side effects. The one that doesn’t is Viagra (or now known as Revatio). If it were not for a drug company trying to make some money to find a way for old men to keep it going, there are many PAH patients now that would not be living better lives.
Drugs in other countries may cost less, but like anything else they don’t have our access and/or variety.
Obama doesn’t need we seniors anyway, so why pour out more money to those who aren’t really contributing anything (in Obama’s mind)to society anyway?
If Obama had his way, this country would be nothing but 18-30 year olds.
Too bad they aren’t the biggest voting block.
“Too bad they aren’t the biggest voting block.”
Well, if Obama manages to push through his health care plans, 18-30 year olds may be the only ones to survive it, but only for a while.
Great toon Pat -
my bet is that it is a slight of hand PR gimmick. I still think Obama and the dems are going to “reform” medicare and social security” to to help pay for all this health coverage mess.
Obama’s health care plan is right out of Tom Daschle’s 2008 book “Critical:What We Can Do About the Health-Care Crisis.1.a new bureaucracy,the National Coordinator of Health Information Technology, will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. 2.the Federal Coordinating Council for Comparative Effectiveness Research, this board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly. Daschle continues,”health-care reform will not be pain free. Seniors should be more accepting of the conditions that come with age instead of treating them.”
“Commonsense changes” without the details being resolved??? By what definition is that not stupid? Best to check what campaign contributors for Obama that will profit highly from this.
Great ‘toon, Pat, as well as a lively discussion following….but that’s what your ‘toons are for..right?
You wrote:
“As of now, Medicare helps pay for seniors’ medications (75%) up to $2,700 and picks up again after $6,100. In between—that pesky $3,400– seniors are on their own.”
It depends on what kind of program in which seniors are enrolled. I am on Medicare and a state retirees plan, which is expensive, but in the long run, it has more than paid for my several surgeries and hospitalizations. My drug plan has a varying scale for Rx drugs, depending on “Brand”, or “Generic”, paying 75%, 55%, 35%, and for some they don’t pay anything, unless the condition causes additional or further medical conditions. The latter requires Prior Authorization and/or Appeal. I’ve just been prescribed a medication for a condition which is considered “cosmetic” by the drug plan, but isn’t cosmetic for me! and after I paid $72 for a short supply, I’m informed that the new Rx has an interaction with a necessary drug for the last 30+ years, and I may have to alter the necessary drug. It’s being considered by my specialty physician to see if/and/or how the two could be compatible.
I would be very inquisitive of pharmacies within discount businesses, or as “add on” money-maker within a grocery or other chain, charging a flat $4 for a generic Rx. My approved Generic meds can cost me less than a 1$ for a month’s supply, while the chains charge $4.
I heard by TV that one of the considerations of Obama’s plan is to cut off Medicare approval of payment for seniors’ expensive medical procedures. In other words, just let seniors live and die with their worn out knees, hips, etc. instead of being replaced for the seniors’ continued years of productivity and comfort. It scares me, whether I have one day or one/ten years of life.
Me thinks the medical systems, including pharmas, are like the oil companies…make money for their shareholders….!
End of rant!
So, you think pharmaceutical companies should be non-profit?
He’s going to cut Medicare and give us crumbs. It’s analogous to losing millions of jobs and saying you saved 150,000.
I didnt watch ABC last night but did hear a part of what Obama said about seniors. He said something like “Your mother may not need that surgery and just take pain meds instead”. Poor mom she wont have a chance. Now with the donut hole mess she might not even get those meds.
Well isn’t the significant amount of insurance money spent during an individuals last year of life? If so, then we can understand Obama’s plan to cut care then so to save money. It already happens in Canada and England with long waiting lists for elderly patients. They aren’t denied the procedure, just put on a list. I think it’s hoped maybe they’ll die before their name comes to the top or their overall medical condition will change and as such, no longer be eligible for the specific procedure. To assume the same things won’t happen here in America if we go to a government paid program is naive.
How do we know this isn’t the fact when the doctor doing the surgery has been told to keep the o.r. busy. People assume doctors are running things, they are not. They have become cogs in the machine… maybe personable cogs, but cogs nonetheless. Back to the point, weighing quality of life against projected life span isn’t such a bad idea. Would it make sense that somebody in their last year of life spends the bulk of that year in rehab for a joint replacement surgery? Maybe it doesn’t make so much sense. Maybe if profit was removed from the equation, everything would be more clear. How do we know unless we try?
Not exactly on topic, though with insurance companies you never know: marker put up in NC for eugenics sterilization victims
http://www.wral.com/news/local/story/5406081/
Any sort of passed health plan won’t affect Obamas and other rich people who will decide for us “average” folks what’s good enough. From the ABS special last night:
Dr. Orrin Devinsky, a neurologist and researcher at the New York University Langone Medical Center, said that elites often propose health care solutions that limit options for the general public, secure in the knowledge that if they or their loves ones get sick, they will be able to afford the best care available, even if it’s not provided by insurance.
Devinsky asked the president pointedly if he would be willing to promise that he wouldn’t seek such extraordinary help for his wife or daughters if they became sick and the public plan he’s proposing limited the tests or treatment they can get.
The president refused to make such a pledge, though he allowed that if “it’s my family member, if it’s my wife, if it’s my children, if it’s my grandmother, I always want them to get the very best care.
“There’s a whole bunch of care that’s being provided that every study, that every bit of evidence that we have indicates may not be making us healthier,” he said.
Gibson interjected that often patients don’t know what will work until they get every test they can.
“Oftentimes we know what makes sense and what doesn’t,” the president responded, making a push for evidence-based medicine.
http://abcnews.go.com/Politics/HealthCare/story?id=7919991&page=1
See, Obama says the health care options & treatment we get now are expensive and not always necessary (which we know is true sometimes. The question is who should make that decision? A patient and his doctor or the insurance company?). It just sounds like Obama is justifying denying treatments (or putting the patient on a never ending waiting list) since it’s not fiscally sound. And why should he care? It’s never going to affect him either way.
Still Obama is not willing to abide by the plans decision when it concerns his family. I still feel if the programs not good enough for him and his loved ones, why should it be good enough for the taxpayers?
O.K. this link has been scrubbed… so here is the internet archive from it.
http://web.archive.org/web/20050316092358/http://www.wxyz.com/wxyz/ys_investigations/article/0,2132,WXYZ_15949_2635151,00.html
50% off in the donut hole just means you take longer to get through the donut hole to catastrophic coverage.
If you never make it through the donut hole anyway, this is a good savings. But for seniors getting through to catastrophic, this doesn’t sound like any savings at all — a complete illusion. Their annual out-of-pocket is the same, it just takes longer to get there. So only one group benefits — seniors who never get out of the donut hole. Seniors who don’t reach the donut hole — nothing. Seniors with catastrophic drug needs — nothing. Maybe it saves a little interest if they charge the donut hole to their credit card. But it’s a good step towards closing the ridiculous donut hole.
You gotta watch the doctors. My doctor asked me if I ever have shortness of breath. I said yeah, when I climb twelve flights of stairs. So she sends me for a stress test? The guy at the stress test says, ’so you have shortness of breath and chest pains?’ Huh? What a racket!
Email to Lisa Rapaport/Bloomberg re Baucus/Obama/AARP VICTORY?????
Lisa–Your Bloomberg article on Obama’s health plan (6/23/09) seems to miss some subtle but crucial points. It suggests that the pharmas will forego some profits and contribute to Obama’s health plan. Most readers will not concur with your understanding.
The pharmas are merely establishing a 10-year commitment to lock in their lucrative Part D plan that they got through G. Bush. As I understand the agreement, drug companies will still unilaterally set MSRP’s to maintain rising profit ratios, benefit from Government penalties on seniors who try to stop out, continue to enlarge the donut hole, continue to raise premiums, still collect premiums even when seniors stop using the plan, and not negotiate drug prices on the open, global market. Given all of these negatives, how can you report that the plan is a step forward?
I still buy all generics from Walmart, K-Mart or Target because their prices are less expensive than Government-sponsored plans. And even if some drugs get cheaper in the donut hole, my wife will have problems with some that cost $1300 for a 30-day supply. She gets in the donut hole after three months. My first two non-generic prescriptions were REJECTED by my insurer who recommended alternatives. I was already on them. They seem to attempt practicing medicine online and stifle the Part D program which was allegedly designed to help seniors have access to drugs at reasonable costs.
Part D Medicare is so politicized and costly because of the well-known, corrupt, process that brought it about. The Congressional pay-offs are a matter of record and any simple plan to modify it will fail. I’m afraid that the Baukus/AARP/Obama plan is a dismal attempt to foist a mythical solution on an unsuspecting public. The press needs to uncover such games and at least present all of the pertinent facts for readers to digest.
Do you really believe that the pharmas will forego any real profits? If Bush would have allowed negotiated prices 6-8 years ago, more than $96 BILLION would have already been saved by the seniors using Part D. How does this compare to the far-fetched, remote possibility of some $80 billion over the next decade? It’s a paper transaction that will not materialize; it’s politics at its worst; it is not real change. It is not a step forward.