Rising Cost of Medicine
AbelM...@webtv.net
April 28, 2000
Clinton and Gore Want to Help Elderly Americans Cover Drug Costs
President and Vice President cite drug price increase in "call for
adding a prescription drug benefit to Medicare."
President Clinton "unveiled a report showing that prices for the 50 most
commonly prescribed drugs for elderly Americans increased by nearly
twice the rate of inflation last year."
"'Seniors living on fixed incomes simply can't cope with these kinds of
price increases forever,' he said. 'That's why we should take action to
help them and do it now.'
Clinton's legislative proposal would allow Medicare recipients to buy a
drug benefit with an initial premium of about $26 per month, rising to
$50 in a few years. It would cover half of all drug costs, up to $2,000
at first, and eventually up to $5,000."
Vice President Gore also noted the need to "include prescription drugs
in Medicare" and said, "'At a time when prescription drugs are at the
forefront of modern medicine, we need a health care system that treats
them as a medical necessity, not an optional luxury.'" [Washington Post,
4/27/00
Herman Rubin
>April 28, 2000
It sounds good, but is it realistic? It will lose money
immediately just counting the cost of medicines and medical
supplies for the diabetics on Medicare.
Instead of people being able to invest for their future
medical expenses, the money has been siphoned off into
the promises of the government.
Politicians promise, but cannot deliver. To err is human,
but to foul things up takes a computer, and to make a total
mess takes a government.
--
This address is for information only. I do not claim that these views
are those of the Statistics Department or of Purdue University.
Herman Rubin, Dept. of Statistics, Purdue Univ., West Lafayette IN47907-1399
hru...@stat.purdue.edu Phone: (765)494-6054 FAX: (765)494-0558
AbelM...@webtv.net
>hru...@odds.stat.purdue.edu (Herman
>Rubin) wrote:
> It sounds good, but is it realistic?
>It will lose money immediately just
>counting the cost of medicines and
>medical supplies for the diabetics on
>Medicare.
If you study business, you will learn of a particular graph of price and
sales. As "X" curve, and a "Y" curve. As the price goes up, sales go down.
At the point where rising prices and declining sales intersect, that is where
the company will set the price. This is why we pay many times more for the
same exact medicines than other countries have to pay for. Pricing items at
the lowest possible cost is not the way to ensure maximum profits.
Pharmaceutical companies are gouging us for all they can, and the only reason
for that is because they can get away with it. For the same reason, Nike
will sell sneakers at a hundred dollars,or more, sneakers that cost no more
than $5 to make. I've heard people argue that we benefit from slave laborers
who give us cheap products. Nothing could be further from the truth. A
company will charge you to the maximum, it the maximum price is the maximum
price, regardless of how much money it cost them to make the product.
> Instead of people being able to invest
>for their future medical expenses, the
>money has been siphoned off into the
>promises of the government.
When you talk about "siphoned off" money, it is amazing that you let the
Pharmaceutical companies, and the Health Insurance Industry off the hook.
You are not an objective writer. If you want to eliminate government
corruption, that would be easy, let's start with campaign finance reform,
this way, our Leaders would represent us (you know, the millions of us who
voted for them) rather than the obscenely rich and corrupt big businesses who
bribe them.
> Politicians promise, but cannot
>deliver. To err is human, but to foul
>things up takes a computer, and to make
>a total mess takes a government.
Let me see. Clinton said he will balance the budget, and he did, and our
economy is prospering. He kept his promise there. Tell me where Clinton has
broken any of his other promises. Clinton's efforts to improve America's
health care is sincere. Why else would the trillions dollar Health Insurance
industry and the trillions dollar Pharmaceutical industry be investing so
much of their money to help beef up GOP candidates? Because they know that
Clinton's efforts to improve America's health will bear fruit, and they are
only trying to maintain their monopoly, profiting from the misery of hundreds
of millions of Americans who are being price-gouged to death when it comes to
Health care.
Abel, from California
Sent via Deja.com http://www.deja.com/
Before you buy.
amp_sp...@my-deja.com
AbelM...@webtv.net wrote:
>
> >hru...@odds.stat.purdue.edu (Herman
> >Rubin) wrote:
>
> > It sounds good, but is it realistic?
> >It will lose money immediately just
> >counting the cost of medicines and
> >medical supplies for the diabetics on
> >Medicare.
Abel - thank you for your review of Econ 101. Perhaps the concepts of
price elasticity of demand, marginal cost and marginal revenue, and
consumer surplus are topics that will be covered in Econ 102 next
semester. Market segmentation, price discrimination, monopsony,
competition, and risk adjusted return on capital are economics and
finance topics - classes that only the upperclassmen can take - so
you'll have to wait a couple more years.
> If you study business, you will learn of a particular graph of price
and
> sales. As "X" curve, and a "Y" curve. As the price goes up, sales go
down.
> At the point where rising prices and declining sales intersect, that
is where
> the company will set the price. This is why we pay many times more
for the
> same exact medicines than other countries have to pay for.
And why physician salaries, hospital per diems, lab tests, and living
standards are all higher in these countries? Yeh, right. (Chime in
any time George and tell us how much better the quality of care is, ok?)
>Pricing items at
> the lowest possible cost is not the way to ensure maximum profits.
> Pharmaceutical companies are gouging us for all they can, and the
only reason
> for that is because they can get away with it.
I say boycott those gougers - all in favor?
-Snip caution-
>Why else would the trillions dollar Health Insurance
> industry and the trillions dollar Pharmaceutical industry be
investing so
> much of their money to help beef up GOP candidates?
How much - pharma sales in 1999 in the US - about 120 billion - lose a
decimal somewhere? And about this lobbying thing, compared to the gun
lobby, the tobacco lobby, the .... lobby? And only GOP??
>Because they know that
> Clinton's efforts to improve America's health will bear fruit, and
they are
> only trying to maintain their monopoly, profiting from the misery of
hundreds
> of millions of Americans who are being price-gouged to death when it
comes to
> Health care.
Price gouged to life, I suspect - dead patients don't buy too many
drugs or pay too many premiums.
Abel - you need to read the reports quoted before you go off on this
tirade. Basing your rhetoric on an article in even the most predigious
of all dailies, the Washington Post, is a bit simplistic.
amp
Victor Pavski
> Clinton's efforts to improve America's health care is sincere.
If you want to find out how Clinton's health plan came into being and why
it failed the way it did, check out "The Road to Nowhere; The Genesis of
President Clinton's Plan for Health Security" by Jacob S. Hacker (1999;
Princeton U Press). It's a fantastic piece of institutional analysis
about health reform in America this past century, but a good specific
piece about the Clinton plan. I think it's about $20 at amazon.com
Vic
Marian
Overall Medicare per capita spending has dropped over the last
10 years. Much of that must be because of improved new
medications that are keeping people healthier. The hospital
costs - covered by medicare are being pushed over to
medications - not covered by Medicare. Why not have a drug plan,
with a premium like part B. With the quantity buying power of
the federal government the cost should not "break Medicare".
Marian
seniorhealth.about.com
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Don Sterner
<seniorhealth....@about.com.invalid> wrote:
>Medicare already pays for diabetic supplies, insulin etc.
>Overall Medicare per capita spending has dropped over the last
>10 years. Much of that must be because of improved new
>medications that are keeping people healthier.
I'm not at all certain that the above is a valid assumption.
Could the reduction in drug spending be cause because more and
more charges are being turned over to patients who can't pay the
fees - so go without? Or that doctors are being pressured by
insurance companies to prescribe only those drugs which the
insurance company can obtain at low cost? The last might be OK if
the resulting care is the same, but I sometimes doubt that it is.
There's something terribly wrong when my doctor has to get out a
booklet issued by my insurance company (he has lots of these from
different companies) to see what drug he's allow to prescribe.
amp_sp...@my-deja.com
Don Sterner <dste...@yahoo.com> wrote:
> On Sat, 06 May 2000 16:04:26 -0700, Marian
> <seniorhealth....@about.com.invalid> wrote:
snipped
Don points out that:
> Or that doctors are being pressured by
> insurance companies to prescribe only those drugs which the
> insurance company can obtain at low cost? The last might be OK if
> the resulting care is the same, but I sometimes doubt that it is.
Why do you have these doubts (just curious).
> There's something terribly wrong when my doctor has to get out a
> booklet issued by my insurance company (he has lots of these from
> different companies) to see what drug he's allow to prescribe.
The "book" is called a formulary and it list the drugs that the insurer
will reimburse - prescribing freedom is only limited by the market
availability of drugs - not be reimbursement eligibility. In the US
currently) the cost of a medication is not a barrier to market entry -
only its proved safety and efficacy. Cost is a likely determinant of
market success, however, which results in competition as opposed to
rationing as a mechanism to ensure cost-control.
Which is a very important point to remember in that in national health
insurance programs in Canada, Europe, Australia among others, the
"national" formulary also limits the market avialability. The
monopsony power to control prices comes directly from this limitation.
In Canada and Australia (and soon Norway) cost-effectiveness is a
"fourth hurdle". In the UK, a government agency (NICE) has been put in
place for the same purpose. Other countries have similar types of
approaches.
A government managed drug benefit for Medicare could take on these
types of characteristics. Are you ready to accept these limitations in
freedom of choice?
Pixie
>In article <49n9hsgq0rrlaocf1...@4ax.com>,
> Don Sterner <dste...@yahoo.com> wrote:
>> On Sat, 06 May 2000 16:04:26 -0700, Marian
>> <seniorhealth....@about.com.invalid> wrote:
>
>snipped
>
>Don points out that:
>
>> Or that doctors are being pressured by
>> insurance companies to prescribe only those drugs which the
>> insurance company can obtain at low cost? The last might be OK if
>> the resulting care is the same, but I sometimes doubt that it is.
>
>Why do you have these doubts (just curious).
>
>> There's something terribly wrong when my doctor has to get out a
>> booklet issued by my insurance company (he has lots of these from
>> different companies) to see what drug he's allow to prescribe.
>
>The "book" is called a formulary and it list the drugs that the insurer
>will reimburse - prescribing freedom is only limited by the market
>availability of drugs - not be reimbursement eligibility. In the US
>currently) the cost of a medication is not a barrier to market entry -
>only its proved safety and efficacy. Cost is a likely determinant of
>market success, however, which results in competition as opposed to
>rationing as a mechanism to ensure cost-control.
>
Amp, you know very well that many oranizations have removed items from their
formulary strictly based on the cost of such items. As an example, one HMO
locally removed the most popular estrogens from coverage reinstating them ONLY
after their members began screaming to the media and to the state insurance
department.
pixie
amp_sp...@my-deja.com
I never said any different - but has the FDA removed that item from the
market? As long it is approved for marketing by FDA the physician is
free to prescribe it and the patient to use it. It also follows that a
managed care organization can limit reimbursement for it no mater what
reason - but at no time can they force docs not to prescribe it (in the
US).
Or do you disagree with me on this, too.
Pixie
Certainly not, Amp, you're absolutely correct about the freedom to prescribe,
and despite what you may think I don't disagree with you as a matter of
practice, but simply because I don't agree with your thoughts about certain
aspects of the industry you represent.
But having the freedom to prescribe a particular drug and having the ability to
purchase that drug out of pocket are totally different issues, and my
disagreement is that the unrealistic high prices for most prescription items in
the U.S. forces individuals to do without that item. Why then, do you think
that many are treking north... to Canada, or south, to Mexico, to obtain their
drugs?
If, by some magic act, the pharmaceutical industry were required to charge no
more than what is paid outside the U.S. for any drug the industry wouldn't fail,
nor would their R & D efforts decline one iota. Yes, they'd take a hit in the
bottom line, and some of their major stockholders, etc., would complain, but
that would be the limit of the problem. They've been gorging themselves on the
profits of their activities in the U.S. and it's time to put an end to that.
pixie
amp_sp...@my-deja.com
You are entitled to your opinions - but you tend to throw around the
word "fact" when its simply an opinion. Look at the comments you make
at the conclusion of this post.
>
> But having the freedom to prescribe a particular drug and having the
ability to
> purchase that drug out of pocket are totally different issues, and my
> disagreement is that the unrealistic high prices for most
prescription items in
> the U.S. forces individuals to do without that item. Why then, do
you think
> that many
How many, and who? The busload on 20/20 (the political stunt trip)?
>are treking north... to Canada, or south, to Mexico, to obtain their
> drugs?
>
> If, by some magic act, the pharmaceutical industry were required to
charge no
> more than what is paid outside the U.S. for any drug the industry
wouldn't fail,
How much less do people pay outside the US versus what people inside
the US pay? As a percent of their salary? As a function of their
other expenses? As a component of GDP? Compared to what they pay for
food? Are Canadians pissed off because they pay twice as much for a
gallon of gas?
> nor would their R & D efforts decline one iota.
OK - this one requires a little evidence - care to support this with
any kind of documentation?
>Yes, they'd take a hit in the
> bottom line, and some of their major stockholders, etc., would
complain, but
> that would be the limit of the problem. They've been gorging
themselves on the
> profits of their activities in the U.S. and it's time to put an end
to that.
>
Gorging - care to explain how you know this and what evidence you have
to support that the profitability of the industry is perceived by the
business commnity to somehow be out of line with business in general?
> pixie
Claude Sharpe
Don Sterner wrote:
>
> On Sat, 06 May 2000 16:04:26 -0700, Marian
> <seniorhealth....@about.com.invalid> wrote:
>
> >Medicare already pays for diabetic supplies, insulin etc.
> >Overall Medicare per capita spending has dropped over the last
> >10 years. Much of that must be because of improved new
> >medications that are keeping people healthier.
>
> I'm not at all certain that the above is a valid assumption.
> Could the reduction in drug spending be cause because more and
> more charges are being turned over to patients who can't pay the
> fees - so go without? Or that doctors are being pressured by
> insurance companies to prescribe only those drugs which the
> insurance company can obtain at low cost? The last might be OK if
> the resulting care is the same, but I sometimes doubt that it is.
> There's something terribly wrong when my doctor has to get out a
> booklet issued by my insurance company (he has lots of these from
> different companies) to see what drug he's allow to prescribe.
***************************************************************
I agree with that last sentence ONLY if you made it clear
to the doctor that you only wanted to get the HMO approved drug.
I am sure that the doctor would give you any needed drug if you
made it plain that you were going to pay for it yourself......
U S doctors, who make the highest salaries in the world,
are choosing between practicing medicine and maintaining their
income level... The insurance company makes it known, up front,
when you buy the policy, that some things will not be covered.
In a free market, you gets what you pays for,( maybe ).
The defense that doctors use, "the insurance company made me
do it", sounds like the old Flip Wilson line " the Devil made
me do it...."...... In fact, with an average salary of over
$160K a year in the U S, and upwards of a million for some
specialists, it is very much in a doctor's vested interest to
do whatever he/she can to keep the prices of EVERYTHING higher,
so it won't look like they are raking too much in.....
The solution would be to eliminate government and private
insurance, killing the "cash cow" that lets doctors and
care providers charge higher and higher prices. ( Have you
notices that the non-insured charges are ALWAYS higher than the gov
or insurance allowance??) The reason is that once the
gov set a price for a certain procedure, that becomes the
LOWEST price that a doctor will charge, knowing full well
that a patient will always come up with an additional
$20 or $30 dollars without too much complaint..... That
carries over to the charges to the uninsured, which have to
"make up for the losses" that occur when treating patients
who don't have the free medical care, excuse me, insurance .....
A solution:
Either insure EVERYBODY or eliminate insurance altogether.
Either will bring the price to competitive market levels.
After all, what people are complaining about is not
lack of medical care, but lack of FREE medical care.....
Andy in Dallas (who will now rest.... )
Pixie
>In article <4q1jhs8bbqcgf9f6d...@4ax.com>,
> Pixie <gle...@edge.net> wrote:
>> amp_sp...@my-deja.com wrote:
>>
>> >In article <5kuehssfp5vf6p7qk...@4ax.com>,
>> > Pixie <gle...@edge.net> wrote:
>> >> amp_sp...@my-deja.com wrote:
>> >>
>> >> >In article <49n9hsgq0rrlaocf1...@4ax.com>,
>> >> > Don Sterner <dste...@yahoo.com> wrote:
>> >> >> On Sat, 06 May 2000 16:04:26 -0700, Marian
>> >> >> <seniorhealth....@about.com.invalid> wrote:
>> >> >
>> >> >snipped
>> >> >
>> >> >Don points out that:
>> >> >
>> >> >> Or that doctors are being pressured by
>> >> >> insurance companies to prescribe only those drugs which the
>> >> >> insurance company can obtain at low cost? The last might be OK
>if
>> >> >> the resulting care is the same, but I sometimes doubt that it
>is.
>> >> >
>> >> >Why do you have these doubts (just curious).
>> >> >
>> >> >> There's something terribly wrong when my doctor has to get out a
>> >> >> booklet issued by my insurance company (he has lots of these
>from
>> >> >> different companies) to see what drug he's allow to prescribe.
>> >> >
Good God, Amp. Isn't the fact that people on both the northern and southern
borders of the U.S are flocking over the line to purchase their pharmaceuticals
sufficient evidence that something is terribly wrong with the pricing of drugs
in the country? Why do you think these people do that???
You can blather on as long as you wish, but facts are facts. a) Drug prices are
too high in the U.S. and b) There's a groundswell that just starting that's
going to generate some massive changes to this issue.
pixie
Jacqueline V. Thomas
Senators to exempt themselves from the laws they make that they would be on
Social Security, Medicare and stop them from not filing and paying their
income taxes things might change. The Medicare Prescription plan is another
example of pulling the wool over peoples eyes, how many people who can't pay
for their prescription drugs are going to have a tax refund large enough to
pay for prescription drugs????? Jackie
Pixie <gle...@edge.net> wrote in message
news:ghrlhs0sgo1en0l1d...@4ax.com...
Alice Wagner
pay, for testing supplies........Alice
Claude Sharpe
be required to do their own personal income taxes, and not be allowed
to hire professional help. After all, they pass the laws and ,
supposedly are educated people, so they should be able to do their
own.....
Andy in Dallas
(who is amazed by the amount of time it takes to report
selling a house on an income tax form )
*************************************************************\
Jerome Bigge
wrote:
>And another thing, I think that Congresscritters and Senatori should
>be required to do their own personal income taxes, and not be allowed
>to hire professional help. After all, they pass the laws and ,
>supposedly are educated people, so they should be able to do their
>own.....
>
>
> Andy in Dallas
>
>(who is amazed by the amount of time it takes to report
> selling a house on an income tax form )
>
>
Of course you must consider all the businesses who are
in the business of completing income tax forms, and the
people they employ to do this work. Not counting the
people who write the computer software that they use...
These people have a vested interest in seeing to it that
the 1040 is just as difficult as possible. Steve Forbes
had the idea of greatly simplying things. The person
from H&R Block I talked to was totally opposed to
his ideas. Most likely because she'd be out of a job.
Jerome Bigge
Supporter of National Health Insurance
CompTIA A+ Certified Computer Technician
Author of the "Warlady" & "Wartime" series.
Download at "http://members.tripod.com/~jbigge"
Herman Rubin
Jerome Bigge <jbi...@novagate.net> wrote:
>On Fri, 12 May 2000 08:17:17 -0500, Claude Sharpe <jungl...@hotmail.com>
>wrote:
>>And another thing, I think that Congresscritters and Senatori should
>>be required to do their own personal income taxes, and not be allowed
>>to hire professional help. After all, they pass the laws and ,
>>supposedly are educated people, so they should be able to do their
>>own.....
>>(who is amazed by the amount of time it takes to report
>> selling a house on an income tax form )
>Of course you must consider all the businesses who are
>in the business of completing income tax forms, and the
>people they employ to do this work. Not counting the
>people who write the computer software that they use...
>These people have a vested interest in seeing to it that
>the 1040 is just as difficult as possible. Steve Forbes
>had the idea of greatly simplying things. The person
>from H&R Block I talked to was totally opposed to
>his ideas. Most likely because she'd be out of a job.
It is not Form 1040 which is so difficult. It is even
the problem of deciding income. This is a major problem.
Also, CPA's are not that expensive. They are likely to
save someone with a reasonable amount of income from
business or form investments, or with a reasonable amount
of charitable deductions (I am opposed to the standard
deduction; I believe in private charity, and that money
given to it should not be taxed) is likely to end up
saving money by using someone who understands the law.
It is much like going to doctors instead of treating
yourself, only cheaper.
Marian
fuel to the fire.
Most Medicare beneficiaries are on traditional fee for service
Medicare. If their physician prescribes a FDA approved drug the
pharmacy will fill the prescription. Who pays for it depends on
the situation. They may have private drug coverage which may
come with restricitions which would be outlined in the plan
information that the company supplying the coverage MUST provide
when coverage is bought. They may pay for it with cash. If they
are in a Medicare HMO that has a formulary they are also
informed of that when they agree to the policy. In both cases if
they are covered under these plans they recive information on
the coverage which includes limitations etc. All states regulate
insurance - including health insurance and any information sent
to the covered person must conform to their regulations.
Medicare HMO's are also governed by the federal government and
must adhere to those regulations also. I guess I don't
understand why people who already have the coverage are suprised
when a drug or procedure are denied, under the limitations of
the policy. Would you be suprised if you wrecked your Honda
Accord and your car insurance would not give you enough money to
replace it with a BMW? Would you be shocked if you had flood
damage to your home and your insurance denied the claim because
you did not have flood insurance? Why do people who sign up for
HMO's (that their employer pays the lions share of) that clearly
state that all specialty care must be preauthorized by their
primary care physician act suprised when they have coverage
denied when they don't follow the rules? Why do people on
Medicare join a Medicare HMO? To save money of course! Why then
would they be upset when they lose the freedom of choice of
traditional Medicare? The plan regulations are clearly staed in
the coverage information they recived on joining (per HCFA
regulation). Where do those booklets that spell out the coverage
and limitations go? I am willing to bet most go in the trash, or
unread and lost in some drawer. I am not saying the health
insurance industry is entirly without blame- they are out to
make a buck and we all know money can corrupt, but the covered
population must take some responsibility. Most probably know
more about the love lives of the cast of "Friends" than they do
about their health insurance policies.
As I promised-food for thought.