POLITICS Drug Prices

Discussion in 'Politicants' started by Indy, Feb 8, 2019.

  1. Volst53

    Volst53 Super Moderator

    Then you don’t have faith in people that’s what businesses and corporations are made of same as government.


    They do it because they know that there’s little to no chance a competition can enter the market due to government regulations and the current system in place.
     
  2. Volst53

    Volst53 Super Moderator


    Which is why a lot of it is in such a mess.
     
  3. IP

    IP Grusader Knight Errant of the 8th Order

    this is cart before the horse kind of thinking.
     
  4. Volst53

    Volst53 Super Moderator

    That's your view point.
     
  5. droski

    droski Super Moderator

    You are ignoring the risk of the two business models.
     
  6. vols4sure

    vols4sure Member

    According to the article, the medication is not even effective and believed to only be prescribed by doctors that were receiving illegal kickbacks. How did this ever get approval for Medicare reimbursement and how would Medicare-for-all prevent this situation?
     
  7. IP

    IP Grusader Knight Errant of the 8th Order

    single market price negotiation would have not accepted a 97,000% increase.
     
  8. vols4sure

    vols4sure Member

    I honestly do not know how this works. Can Medicare not just deny the price increase independently of what private insurance does? According to this study, Medicare "spent more than $1 billion on [Acthar] between 2011 and 2015, including more than $500 million in 2015 alone, making it one of Medicare’s most expensive drugs." I would have thought that the price increase and it becoming one of Medicare's most expensive drugs would have provided reason to investigate long before the whistleblower lawsuit. I even believe the linked study was published prior to the lawsuit.
     
  9. IP

    IP Grusader Knight Errant of the 8th Order

    comparing Medicare in the US to a single payer Medicare for all is apples and oranges. compare it to other universal coverage programs in Canada and Europe.
     
  10. vols4sure

    vols4sure Member

    Let's try this again. If my understanding is correct, the outrageous price increases of Acthar was paid in full through Medicare. However, it was offered to people with private insurance at a lower price through a commercial co-pay program that was not available for patients having government funded health insurance. You want more government bureaucracy in charge of healthcare. I get that fraud was involved but it sounds like the fraud was paid out in this instance by Medicare more than private insurance. My question is how does this price increase get approved by Medicare for such a long period of time without investigation given the facts discovered by the independent study I linked? If you do not think the price increase would be covered in a universal coverage system in the US, please explain why you think it was approved by Medicare within the current system but would not have been approved in a universal coverage system.
     
  11. IP

    IP Grusader Knight Errant of the 8th Order

    let me confirm I understand what you are asking. are you asking how can a universal public option prevent private doctors from committing fraud at the elaborate orchestration of a private pharmaceutical company?

    I'm not sure, but the current system didn't, and only caught it due to whistle blowers. I'm told government can't do anything and regulation is bad, and the example is a weak, limited public care, weak and toothless regulators, and billion dollar private firms? I just don't see the damning spin on this other than for the current status quo.
     
  12. vols4sure

    vols4sure Member

    Yes, that is generally what I am asking. I don't get why the astronomical price increases of certain drugs are used as examples by proponents for universal health care. This company specifically targeted the Medicare reimbursement system with its price increases by repurposing the drug to be used to treat elderly conditions and has so far been able to get away with it for over five years.
     
  13. Volst53

    Volst53 Super Moderator

    Because the companies abusing the system also are writing very nice checks for election campaigns.

    So they get protected from competition in the market place while also gouging the public through Medicare abuse.

    Then when people get upset about the cronyism. Blame the free market. Add more regulations and subsidies from the government side, then rinse and repeat on the writing checks to elections.
     
  14. Poppa T

    Poppa T Well-Known Member

    Medicare is not allowed to negotiate drug prices or tell doctors what drugs to prescribe. This inability to negotiate drug prices lays at the feet of Congress.

    In addition to bribing doctors to prescribe (increasing customer base), this corporation also lied to the FDA so it could broaden it's application (again, to increase sale volumes).
     
  15. Ssmiff

    Ssmiff More fragile than Mr. Glass

    Medicare may not exactly tell drs what to use, but drs cant prescribe or use many drugs and products for medicare patients due to them not being "covered".
    Its all been a mess
     
    justingroves likes this.
  16. IP

    IP Grusader Knight Errant of the 8th Order

    Fair question, Poppa T's post identifies a clear problem. What I was attempting to communicate is that the medicare system we have is not the same as what is being pushed for. The current one is not robust enough in terms of not just coverage, but ability to negotiate.
     
  17. Poppa T

    Poppa T Well-Known Member

    It definitely is not easy to navigate. I have to go through it every year. The insurance companies are the ones who control what drugs are covered in their plans, not "Medicare".

    Medicare drug plans are offered through Medicare-approved private insurance companies. Each Medicare Prescription Drug Plan will provide different types of prescription drug coverage. It’s the insurance company that ultimately decides which drugs to cover under its prescription drug plan and at what benefit level.

    I blame the Insurance companies, not "Medicare".
     
  18. kmf600

    kmf600 Has VIP access/energy vampire

    This might be a completely separate discussion, but I've seen videos on YouTube about people waiting in line at the clinics and hospitals. Then they explain you have to wait months to not just see a doctor, but just to get a doctor. A couple of people told one guy, if you have cash, you can go see so and so at this address. I just don't see how that is better than what we have now. I have insurance now, which hates paying for anything, but I still have to wait a month or more for an appointment. If there is something really wrong, I go to urgent care or the ER
     
  19. IP

    IP Grusader Knight Errant of the 8th Order

    it's like that some places. here, we can find people who only get to see a doctor when they're critical. heck, we can find people that have to wait to see doctors too.
     
  20. Ssmiff

    Ssmiff More fragile than Mr. Glass

    all good info. However, I believe medicare still has to approve the company or product, so it's not always up to the private company. They can be told no, especially if there are already multiple drugs of the same category approved.

    Just another example of the mess: Say you tear your rotator cuff. You could get to the surgery center, owned partly by surgeons, at 6 am and be home by 10. A few years ago, medicare "covered" the surgery at the outpatient SC and reimbursed a few hundred (I don't know what it is now), which ended up being a loss after time, equipment and implants. Instead of them taking a loss on the surgery, you instead were told to go to the hospital next door and more than likely stay overnight, home the next afternoon. Cases are slower and you may have a urology specialist handling instruments during a lunch break, and turnover between cases is slower. However, medicare reimbursed $2500 to the hospital, then covered the overnight stay. All a ridiculous dance.
    More recently I carried a horse pericardium used during surgery as a bridge, but more specifically for burn units and diabetic patients with awful sores or stumps from limb removal due to diabetes. Medicare wouldn't cover at the burn or diabetic center in a process doctors could perform in a few minutes in a sterile setting. Yet check the patient into the hospital, send them to surgery, have them stay overnight and Medicare covered the patch. Waste of time and money, especially with OR time costing $30/minute
     

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