The Affordable Care Act II - Because Mr. Obama Loves You All

[Magox]

It's quite simple, as Nanker's post below shows. Drug prices are relatively unfixed in the US compared to the rest of the world. When the rest of the world is paying less, it means we have to pay more to keep companies in the green/fund their R&D departments. Which makes the average American subsidizing the creation of new and better drugs directly by having to pay more per pill.

 

Thanks for assist.

 

I understand, but that alone doesn't explain the huge disparity between drug prices in the U.S and abroad. If somehow you were able to reduce the cost of R&D to levels that wouldn't include subsidization of other countries prescriptions (not sure how you could do that), that still wouldn't reduce the prices to levels seen abroad.

 

I rarely advocate for silver bullet solutions to complex problems and this is no different. I believe that the reforms necessary to bring down drug prices would need to include a multi-thronged approach, which would have to include the reduction of time for drug patents, and somehow promote more competition, specially with generics. Reducing the patent time in itself would probably bring out more producers of generics.

 

Unfortunately Big Pharma has got a strangle hold of congress and that relationship between the two would need to sever in order for these reforms to come through.

[FireChan]

 

I understand, but that alone doesn't explain the huge disparity between drug prices in the U.S and abroad. If somehow you were able to reduce the cost of R&D to levels that wouldn't include subsidization of other countries prescriptions (not sure how you could do that), that still wouldn't reduce the prices to levels seen abroad.

 

I rarely advocate for silver bullet solutions to complex problems and this is no different. I believe that the reforms necessary to bring down drug prices would need to include a multi-thronged approach, which would have to include the reduction of time for drug patents, and somehow promote more competition, specially with generics. Reducing the patent time in itself would probably bring out more producers of generics.

 

Unfortunately Big Pharma has got a strangle hold of congress and that relationship between the two would need to sever in order for these reforms to come through.

The disparity exists because they fix prices. It's really that simple.

 

How do you reduce R&D costs without reducing their research effectiveness? How do you increase competition in an industry dominated by a handful of billion-dollar corporations? Mom and Pops aren't breaking into the heart medication game.

Edited May 4, 2016 by FireChan

[Magox]

The disparity exists because they fix prices. It's really that simple.

 

How do you reduce R&D costs without reducing their research effectiveness? How do you increase competition in an industry dominated by a handful of billion-dollar corporations? Mom and Pops aren't breaking into the heart medication game.

 

Price fixing plays a role, at least that is what studies show but is that what we want to do? Of course not, because it dampens innovation.

 

That's the crux of that particular issue, how do you reduce R&D without reducing the effectiveness of research?

 

The most viable market based solution I see is to reform the patent laws, if you reduce the time then I believe you will see an increase in generic makers.

[B-Man]

UNEXPECTEDLY:

 

Study Finds Employers Are Hiring More Freelancers To Avoid Obamacare.

 

 

 

And building more robots to avoid minimum wage hikes.

 

 

Who could have predicted such developments?!

[B-Man]

Humana is considering following the lead of United Health and dropping out of Obamacare exchanges in some states. Reuters reports:

 

 

Here is the key paragraph from Humana’s press release:

 

Humana is in the process of finalizing plans for its ACA-compliant individual commercial medical market offerings in 2017. Humana anticipates proposing a number of changes to retain a viable product for individual consumers, where feasible, and address persistent risk selection challenges. Such

changes may include certain statewide market and product exits both on and off exchange, service area reductions and pricing commensurate with anticipated levels of risk by state

.

 

 

 

 

Meanwhile, NPR published a story yesterday showing what Obamacare plans are really like for some families:

[Renee Powell] shopped for insurance through the Obamacare exchange and learned that rates in her new area were much higher than they had been in Oklahoma City. She bought a health plan from

Blue Cross and Blue Shield of Oklahoma

for $750 a month

with a manageable deductible.

Then last year Blue Cross eliminated that plan — which is pretty common as insurers adjust to the Obamacare markets — and Powell was forced to buy the more expensive policy with a deductible of $3,000 for each person in her family. The insurance pays for checkups and prescriptions, but if anyone gets sick, Powell has to pay the full doctor bill until the deductibles are met.

[…]

Powell has spent about $4,400 so far this year in premiums for that Blue Cross policy, and she said the plan has only paid a few dollars for antibiotics one of her boys needed when he was sick.

“I felt like we were paying money to the insurance company so that they could just sit on it and put it in stock,” she said.

 

 

 

 

As the NPR story makes clear, Powell is now spending more on “affordable” insurance than on her rent and yet she is seeing almost no real benefit.

 

It’s a lot of money to pay for what amounts to a catastrophic insurance policy.

[B-Large]

Humana is considering following the lead of United Health and dropping out of Obamacare exchanges in some states. Reuters reports:

 

 

Here is the key paragraph from Humana’s press release:

 

Humana is in the process of finalizing plans for its ACA-compliant individual commercial medical market offerings in 2017. Humana anticipates proposing a number of changes to retain a viable product for individual consumers, where feasible, and address persistent risk selection challenges. Such

changes may include certain statewide market and product exits both on and off exchange, service area reductions and pricing commensurate with anticipated levels of risk by state

.

 

 

 

 

Meanwhile, NPR published a story yesterday showing what Obamacare plans are really like for some families:

[Renee Powell] shopped for insurance through the Obamacare exchange and learned that rates in her new area were much higher than they had been in Oklahoma City. She bought a health plan from

Blue Cross and Blue Shield of Oklahoma

for $750 a month

with a manageable deductible.

Then last year Blue Cross eliminated that plan — which is pretty common as insurers adjust to the Obamacare markets — and Powell was forced to buy the more expensive policy with a deductible of $3,000 for each person in her family. The insurance pays for checkups and prescriptions, but if anyone gets sick, Powell has to pay the full doctor bill until the deductibles are met.

[…]

Powell has spent about $4,400 so far this year in premiums for that Blue Cross policy, and she said the plan has only paid a few dollars for antibiotics one of her boys needed when he was sick.

“I felt like we were paying money to the insurance company so that they could just sit on it and put it in stock,” she said.

 

 

 

 

As the NPR story makes clear, Powell is now spending more on “affordable” insurance than on her rent and yet she is seeing almost no real benefit.

 

It’s a lot of money to pay for what amounts to a catastrophic insurance policy.

 

 

Uh yes, the insurance company is stocking your money to pay for the other really sick people in their risk pool. Do Americans really not know now insurance works? Do they realize when they get run over by a truck and spend 90 days in ICU and draw 400-500K in expenses that other premiums payors not using services provided that money to pay their bills?

Edited May 4, 2016 by B-Large

[/dev/null]

I was talking to a coworker today who is about hit 60. He was lamenting his plans from 10 years ago to retire by 60. He had a nice plan in place that would have worked out to where he would be retiring soon. But that was before Obamacare jacked up the insurance market.

 

Now he's looking at working another 2 or 3 years, maybe even up to 65

[Chef Jim]

I was talking to a coworker today who is about hit 60. He was lamenting his plans from 10 years ago to retire by 60. He had a nice plan in place that would have worked out to where he would be retiring soon. But that was before Obamacare jacked up the insurance market.

 

Now he's looking at working another 2 or 3 years, maybe even up to 65

 

Oh he's breaking my heart. Most of the people I see that are able to retire pre-65 work for the government.

[B-Large]

I was talking to a coworker today who is about hit 60. He was lamenting his plans from 10 years ago to retire by 60. He had a nice plan in place that would have worked out to where he would be retiring soon. But that was before Obamacare jacked up the insurance market.

 

Now he's looking at working another 2 or 3 years, maybe even up to 65

My aunt retired at 60, she was able to buy insurance for herself for the first time in 2010. Had she not had an inconclusive Mri many years ago for headaches which became a red flag in her mr, she may have sold her company earlier. Depends whom you ask I guess.

Oh he's breaking my heart. Most of the people I see that are able to retire pre-65 work for the government.

Unless you have a pension, or a 403b with a fortune in it, most people hold out for Medicare to hedge their reiterment. I hope I die in my 70's working- retirement sounds terrible, honestly.

[DC Tom]

 

 

Uh yes, the insurance company is stocking your money to pay for the other really sick people in their risk pool. Do Americans really not know now insurance works? Do they realize when they get run over by a truck and spend 90 days in ICU and draw 400-500K in expenses that other premiums payors not using services provided that money to pay their bills?

 

No, they don't understand that. Plus, they were explicitly told this would increase access to care and decrease cost...and don't understand why that was a lie.

[B-Large]

 

No, they don't understand that. Plus, they were explicitly told this would increase access to care and decrease cost...and don't understand why that was a lie.

 

We expect elite medical care from birth to death, and people actually think cost of care would do down? If people believe that, I'm not sure what to say to them. I have a 78 year old that is on Medicaid that has been here for a month getting eye surgeries to save sight in 1 eye because he didn't address his glaucoma for decades- his current tab is 300K and counting. We can't deliver care like that to people at the end of their rope and expect prices to go down. Healthcare is paid for through subsidizing those who have nothing with those who have something. There is no other way around it unless we are willing to make hard choices about 300K bills for 78 year olds (among other hard choices)... the only way to truly reduce cost is to set a National spending cap on care, or go to a truly free market, cash payment system. Any plan, ACA, GOP plans, single risk pool (without a cap) are the same smoke and mirrors cost shifting game while splitting hairs politically.

 

Everybody can't have it all, all the time until they die- its just not reality.

[Chef Jim]

 

Unless you have a pension, or a 403b with a fortune in it, most people hold out for Medicare to hedge their reiterment. I hope I die in my 70's working- retirement sounds terrible, honestly.

 

That's what I meant. Pensions are pretty much gone unless you work in the public sector. For some reason they still exist there. Why is that I wonder??

[B-Large]

 

That's what I meant. Pensions are pretty much gone unless you work in the public sector. For some reason they still exist there. Why is that I wonder??

 

Workplace recruiting or retention incentive? We have a pension (that is part of our comp plan), and a qualified contribution plan. When my wife worked at the State, she had the choice of a Defined benefit versus Defined Contribution plan. To me, the future is too uncertain to make a promise today that will be fulfilled 25-30 years from now.

[Chef Jim]

Just a thought. If we go single payer how many people will drop out of the work force because they don't have to work to have "affordable" insurance. How many people hold out until 65 just for Medicare?

[B-Man]

ObamaCare Insurers Considering Dumping Bronze Plans.

[IDBillzFan]

ObamaCare Insurers Considering Dumping Bronze Plans.

 

All according to plan.

 

Well done, SoProgs. Well done.

[Observer]

 

The most viable market based solution I see is to reform the patent laws, if you reduce the time then I believe you will see an increase in generic makers.

 

Pharma patents don't take that long to prosecute except by choice of the companies. The US Patent and Trademark Office deals with pharma applications faster than other technologies on average. So scratch that issue off the list.

 

EDIT: I think you mean the term of a patent once issued. That's the entire reason companies do R&D. Not likely to change that.

Edited May 6, 2016 by Observer

[Magox]

 

 

EDIT: I think you mean the term of a patent once issued. That's the entire reason companies do R&D. Not likely to change that.

 

It should have been pretty clear that is what I was saying. And yes it could be changed, just need to have a presidential candidate make that a campaign issue, win an election and make that as one of his priorities once elected while he/she has some political capital.

 

Right now they have 20 years, and big Pharma is making gobs of dollars, I don't know how much it should be reduced just that it should be.

[Observer]

 

It should have been pretty clear that is what I was saying. And yes it could be changed, just need to have a presidential candidate make that a campaign issue, win an election and make that as one of his priorities once elected while he/she has some political capital.

 

Right now they have 20 years, and big Pharma is making gobs of dollars, I don't know how much it should be reduced just that it should be.

 

Some people complain about the time it takes to get a patent. Some people complain about the time it takes a patent to expire.

 

"I don't know how much it should be reduced just that it should be." Bernie couldn't have said it better.

[Magox]

 

"I don't know how much it should be reduced just that it should be." Bernie couldn't have said it better.

 

Only a dumb ass would throw out an arbitrary figure without sufficient research behind making such a projection.