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Obamacare keeps pharmacy middlemen on life support 1/13/15 via Watchdog

Discussion in 'Other Health News and Research' started by *GG*, Jan 18, 2015.

  1. *GG*

    *GG* Senior Member

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  2. minkeygirl

    minkeygirl But I Look So Good.

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    *GG* likes this.
  3. Dufresne

    Dufresne almost there...

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    From your link:
    "Obamacare gives big tax breaks to and few regulations for PBMs. As a result, the PBMs have become a darling of Wall Street."

    @ggingues, so I guess Obama should start taxing and regulating these guys, eh? If only your conservative friends could see you now. :)
     
  4. acer2000

    acer2000 Senior Member

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    I don't know if the ACA has made this situation worse or not, but I can tell you that my experience with Express Scripts (the largest PBM - and one used by many Medicare drug plans offered to those with ssdi) has been nothing short of horrific. They are worse than Comcast.

    I tried to fill one simple prescription with them last year and they overcharged me, sent me other people's prescription (and charged me), didn't apply my co-pay correctly, sent the wrong quantity and strength of the medication I was prescribed and then even after 30 phone calls and a complaint with Medicare wouldn't fix the situation. The whole time this was going on they raised the price of my medication substantially to the point where it was somehow cheaper to buy it with cash than to use my insurance.

    I am told this problem got worse when they were allowed to buy Medco, giving them 60% of the PBM "market". Whatever the reason, this article is correct in that there is no transparency or competition and we are all literally paying price for it as taxpayers and in our insurance premiums.
     
    Last edited: Jan 19, 2015
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  5. *GG*

    *GG* Senior Member

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  6. barbc56

    barbc56 Senior Member

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    I will state up front that I am a sopporter of Obama and the Affordable Health Care act. I lea

    I have several frinds who have not been able to afford health insurance for many years. They are now covered. This has made a positive change in their lives.

    I have a feeling this is more of a libertarian issue but certainly overlaps with conservative ideology.

    Barb
     
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  7. Dufresne

    Dufresne almost there...

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    How is this a libertarian issue? To me, this is straight forward conservative economic ideology. Libertarians, though tending to be conservative in many ways, can be mixed when it comes to economic policy. Libertarians' primary focus is on individual freedom. They're far less concerned with the freedom of big business and corporations or how much these organizations give back to their country, etc.

    I absolutely agree with you on the Affordable Health Care act. The opposition to it has been ridiculous. Not only was it thought up by a conservative organization, it was essentially first implemented by a conservative in the state of Massachusetts. ...thank Fox News and right wing radio.

    We've a conservative government in power here in Canada and they've a solid base, but I don't think you could find 5% of our citizens that would want to part with our socialized medicine. We don't have polarized cable news networks.

    American ideology is out of control; it's my team against yours. It's certainly not about what makes sense, and watch out if there are moneyed interests involved.
     
    Last edited: Jan 20, 2015
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  8. barbc56

    barbc56 Senior Member

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    I think there is a case for using either word. When I think libertarian, I think no government interference. Like you said
    this could also be a conservative point of view.:D;)

    Barb
     
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  9. Valentijn

    Valentijn The Diabolic Logic

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    I've never known or heard of a Libertarian who wasn't 100% in favor of business/corporate "freedom" (from taxes). My general perception has been that they combine economic liberalism with social liberalism. Whereas Republicans tend toward economic liberalism with social conservatism.

    So basically they're like Republicans in many ways, but without the Republican hypocrisy inherent in claiming to oppose regulations while frequently supporting restrictions regarding how people choose to live their private lives. It's a saner alternative, but still quite unrealistic in expecting charity to replace government social programs (assuming that expectation is genuinely held, and not just lip service).
     
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  10. acer2000

    acer2000 Senior Member

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    I have observed that a main issue with the healthcare "market" in general is that it isn't a functioning market. Everyone tends to focus so much on who pays the bill - be it individuals, insurance, or government. On some level that is vitally important - people need health coverage. You have to be able to show up to get care. But beyond that, we have to start thinking about how to optimize the system so its more transparent in cost and outcome data. Only then can we start to even see what the best treatments are at the lowest costs.

    Right now, like the article states, it's so convoluted that many middlemen are able to exploit the system to extract huge amounts of money in a way that ads almost no value to either the patients or the providers. It's one of the reasons health care is so insanely expensive in the USA, and despite the advantages our system provides in a lot of ways, we pay way more for the same (or less) outcomes than we should.

    There have been so many articles about this lately. Try to find out the actual cost of a treatment or medication and pair it with the outcome data so you can make a rational decision as a consumer about what to do. It's nearly impossible in them current system - no matter who is signing the check.
     
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  11. jimells

    jimells Senior Member

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    American ideology is a giant distraction, and the establishment media is a giant distraction dissemination machine. While Dummycrats and Repugnants pretend to hate each other, they are in agreement on the Really Big Issues, like smashing societies, bragging about torture, maintaining the world's biggest prison system, and doing whatever will enrich their handlers.

    The funny thing is, Americans actually support the biggest "socialist" program in the US, a program that even has "Social" as the name! Of course Social Security will become "Wall Street Security" when (not if) they get their hands on the Social Security Trust Fund.

    Most Americans will deny to their dying day that they would ever support any kind of "socialism" while demanding more support for Evil Commie Socialist programs like public schools and libraries.

    It's at least a fortuitous accidental outcome, if not by design, that some folks will benefit from Obamacare while others get screwed. While people are fussing over who got the the bigger cookie, no one seems to notice the real beneficiaries of the Insurance Executive Guaranteed Bonus Act.
     
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  12. acer2000

    acer2000 Senior Member

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    I also suspect that the "rise of the PBM" is in part a response to the decisions that were made when the Medicare Part D program went into effect. The US government was prohibited by law from directly negotiating prices on drugs on behalf of Medicare (go figure). So a lot of the individual Part D plans turn to PBMs to get scale in negotiation with drug companies. The problem, as we have seen, is there isn't any visibility into the process and the PBM "market" (if you can call it that) is distorted by one, maybe two large players. So ironically, in effort to indirectly get lower prices from drug companies, a middle man was inserted into the process, they got too big and powerful, and is now likely abusing their market position and raising prices/keeping excess profits.
     
  13. Dufresne

    Dufresne almost there...

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    I agree with you. I can at least respect the libertarian's philosophy. And, true, most american libertarians have adopted free market capitalism. However libertarians have not always existed in the incarnation most commonly found in the US these days. From wikipedia on the economics of libertarianism:

    "Libertarians are divided on economic issues: right-libertarians are economic liberals of either the Austrian School or Chicago school and support laissez-faire capitalism,[68] while most left-libertarians (social and individualist anarchists, libertarian Marxists, and left-wing market anarchists) argue in favor of socialist theories such as communism, syndicalism, and mutualism (see Anarchist economics)."

    Also when I think of libertarianism I think of the challenge to all authority, not just the state. I believe this brings them into conflict with what laissez-faire capitalism engenders: Wall St, establishment, aristocracy, etc. Moreover a complex market system necessitates a lot of rules to hold it in place, and this seems at odds with what I believe libertarianism is all about. Though I admit this may be an outdated connotation.
     
  14. August59

    August59 Daughters High School Graduation

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    I know people that couldn't afford health insurance get insurance with subsidies, but I know people that had good insurance that that lost it and either paid the same for a horrible plan or paid twice as much for a similar plan. The only few people that I know that weren't drastically affected were people I consider to be "wealthy". The "wealthy" pay more, but the impact was not drastic.

    It seemed to help low income, but hurt the middle income.
     
  15. Valentijn

    Valentijn The Diabolic Logic

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    I thought the stats showed that prices had gone down in general? Some companies did take advantage of the Republican opposition to Obamacare as a pretense to reduce benefits for their employees, but that seems to have been a completely different issue.

    Most employers didn't even bat an eye. And my guess would be that the ones who jumped ship (and tried to lead everyone else to do the same), will be sheepishly climbing back aboard when when they realize that their employees can get better benefits elsewhere.
     
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  16. jimells

    jimells Senior Member

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    In states that refused to expand Medicaid (like where I live), poor people are really taking it on the chin, but no one in power gives a damn. Folks *below* the "poverty line" can not receive subsidies by law, they can not receive Medicaid unless they are in some group that "deserves" access to health care, and they sure as hell can not afford insurance premiums without the subsides. The idea that someone is too poor to receive help simply defies logic.

    But it's OK, since logic and rational thinking have no place in health care policy, or, apparently, any other public policy.
     
  17. xks201

    xks201 Senior Member

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    One concrete result of Obamacare is the doubling to tripling on average of private health insurance rates as they attempt to compete with the government who obviously has unlimited resources. Private health insurance companies really failed to negotiate their survival into Obamacares mysterious thousand page contract.

    My insurance went from 200 to around 500 a month. From what others have told me, unless you are dirt poor Obama care isn't cheap. Doctors are now forced to pay back money if a patient comes back for any reason within a given visit.

    Let's just not fool ourselves by pretending that competition will survive obamacarE. It will take over the market. Do you want the government in charge of your treatment model?

    The death panels are real. I know a doctor who says that his hospital and all others are now implementing protocols to prematurely take patients out of the ER and other units to hospus wards based on outcome. It's managed care. It's canada. You can claim you love it until you have to wait years to get the treatment you need, if that treatment is even provided for by the government. Minimally invasive heart surgery I still don't think exists in caNada. As of last time I checked they still were busting rib cages open to do it. Maybe that's why their leaders come here for treatment.
     

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