A 2003 law passed by Big Pharma’s friends in Congress actually prohibits Medicare, which serves the elderly, from negotiating drug prices for the 52 million Americans in the program. Because of this cynical give-away to some important election funders, Americans pay an extra $16 billion a year more than is necessary for pharmaceuticals, whose cost, in America, is the highest in the world. Many of the poor elderly have to go without needed drugs as a result. The Veteran’s Administration and Medicaid (for the poor) already have the ability to negotiate with the drug companies, who still make a tidy profit out of it, but Medicare has to pay whatever the pharmaceutical companies say is the price.
As a former employee of a major pharmaceutical company I think that the huge amount of publicity given to their “high cost of research” is partly baloney. Half of all research costs are paid for out of taxes and carried out by the National Institutes of Health and universities. Margins, I can assure you from experience, are huge. Don’t cry for Big Pharma.
An Epicurean government (contradiction in terms!) would have a single payer system as in Europe and that single payer would negotiate prices – hard!
What about Medicare part D? Doesn’t that mean free or at least subsidised prescriptions?
I agree that America needs universal healthcare, but is single payer the best way to deliver it? The systems much of Europe are not single payer as such: there are lots of private insurers, but a big government component as well. The difference between Europe and the US is that the European ‘medicare’ will pay for anyone who cannot afford or doesn’t want private insurance, the US only pays for the elderly and subsidises low income people (Medicaid.) So are the single payer systems of the UK, Canada and the Nordic countries better than the multi payer systems of France, Germany and Switzerland? I’m not sure if they are.
I’m also sceptical of Obamacare, because it has failed to reduce costs. Although more people are insured now, there are still roughly 30 million people without health insurance. I don’t support Hillary Clinton’s promise to build on the successes of Obamacare. The whole system should be torn down and rebuilt from scratch.
The Medicare Part D coverage gap (informally known as the Medicare donut hole)
is a period of consumer payment for prescription medication costs which
lies between the initial coverage limit and the catastrophic-coverage
threshold, when the consumer is a member of a Medicare Part D Prescription drug program administered by the US government. The gap is reached after shared insurer payment – consumer payment for all covered prescription drugs reaches a government-set amount, and is left only after the consumer has paid full, un-shared costs of an additional amount for the same prescriptions. Upon entering the gap, the prescription payments to date are re-set to $0 and continue until the
maximum amount of the gap is reached: co-payments made by the consumer up to the point of entering the gap are specifically *not* counted toward payment of the costs accruing while in the gap”.
This wording is quite enough to persuade most people that the system is super-bureaucratic and difficult to understand. It gets a lot worse! It is only for old people, and by definition, fairly sick old people. There is no “donut hole” in, say, the British system. The government meets most of the cost and negotiates for the best prices with the drug companies. Because it is the principal purchaser it gets prices way below those of most Americans. Medicare in the US does not pay for everything – you have to have a secondary (private) insurance to pick up bits that Medicare doesn’t cover. There are so many exceptions and regulations and rules I doubt many people really understand it.
Obamacare is a huge compromise forced on the American people by the conviction that only privatised medicine and the profit motive can produce good service (please don’t laugh!). Excuse the length, but this is an excerpt from an article by Jonathan Cohn in the Huffington Post about how Obamacare is indeed reducing cost; You have io understand that Obamacare is quite new and it takes a long time for the effects to show up . But this is encouraging:
“In fact, America’s health care bill is turning out to be a lot smaller than economists thought it would be by this point.
That’s the conclusion of a new paper by John Holahan and Stacey McMorrow, researchers at the non-partisan Urban Institute. The aim of the paper is to tally up all the expenditures the country
will make on health care between 2014 and 2019, whether it’s through
private insurance, government programs like Medicare and Medicaid or
direct out-of-pocket payments from patients to doctors.
These are the numbers experts generally have in mind when they say things like “health care costs are bankrupting the country.” The fear is that spending more and more on health care will leave us with less and less money for other things, whether it’s stuff we buy for ourselves (everything from food and shelter to vacations and cars) or institutions we support and investments we make indirectly through taxes (like schools, the military and Social Security checks).
National health expenditures are almost always increasing from year to year and, generally, they have increased even more quickly than spending on other goods. When the Affordable Care Act became law, both its critics and quite a few independent analysts predicted the trend would only get
worse. As the logic went, every time one of those newly insured people walked into a doctor’s office, got admitted to a hospital or took an expensive drug, that person would be adding to the U.S. health care bill. Multiply that effect by a few million and, presto, you have an aggregate bill for medical goods and services that’s higher — probably a lot higher — than previously expected.
It was a perfectly reasonable prediction. But it doesn’t seem to be coming true.
In 2010, just after the health care law passed, the government’s official actuaries at the Centers for Medicare and Medicaid Services predicted that total national health spending for the five-year period starting in 2014 would be $23.6 trillion. Using the latest data, Holahan and McMorrow have calculated that spending over that interval will probably be $21 trillion — in other words, the total will be $2.6 trillion less than the government’s number crunchers thought it would be.
Source: Urban Institute
That’s a pretty big windfall. You can think of it as $2.6 trillion that the country had expected to spend on health care but will likely have available for other purposes.
The finding is consistent with other recent data, like the Kaiser Family Foundation/HRET annual survey of employer-sponsored premiums (which have been rising at very slow rates) and the government’s official data on overall health care spending from 2010 through 2012.
The question is why this slowdown is happening. The economy is the most obvious factor.
The lingering effects of the recession have left people with less money to spend and less enthusiasm for spending what they have. Overall, Americans have cut back on medical care, just as they’ve cut down on allconsumption.
But the economy isn’t the whole story. The out-of-pocket expenses that come with private insurance are getting bigger. For better or for worse, that’s given people financial incentive to think twice before seeking medical help. There’s been a relative dearth of expensive new technologies, although that may be changing just now with the introduction of some pricey blockbuster drugs.
Meanwhile, the government has reduced what it pays hospitals, insurers and some other parts of the health care industry, in an effort to scale back what many experts consider a thinly veiled form of corporate welfare via Medicare.
Most intriguing — and, over the long run, probably most important — is that the providers of medical care are changing the way they do business, in ways that should both make people healthier and make the system as a whole more efficient. Hospitals,for example, appear to be doing a much better job of preparing patients for discharge and then following up with those patients afterward.
Those patients are less likely to get sick and need costly readmission within 30 days.
Does Obamacare have something to do with this? Probably. Notwithstanding President Barack Obama’s (foolish and misleading) campaign promise to reduce the average family’s premiums by $2,500, the Affordable Care Act’s supporters never said that national health care spending would go down per se. They simply predicted that it would grow more slowly than it had in previous decades — that they would “bend the curve” on health care costs. It would happen, they said, because of a series of modifications to Medicare and to tax policies that the law contains.
Early signs, like that dramatic drop in hospital readmissions, suggest strongly that those efforts are having an effect. In the new paper, Holahan and McMorrow agree that the Affordable Care Act has helped, although they caution that it’s too soon to assess the law’s influence definitively — or to say whether, right now, the savings are sufficientto offset the new spending the law has caused.
“Obamacare is increasing health spending as more people get insurance,” Larry Levitt, senior vice president at the Kaiser Foundation and a close observer of the health care system, told The Huffington Post. “But it’s also helping to push spending down by encouraging greater efficiencies. That second effect is looking like it might be bigger than the government bean counters expected when the health law passed.”
I would like to quote Bernie Sanders on healthcare:
A large single-payer system already exists in the United States. It’s called Medicare and the people
enrolled give it high marks. More importantly, it has succeeded in providing
near-universal coverage to Americans over age 65 in a very cost-effective manner.
So I want to go over some facts with you and ask that you take action on this important issue:
Right now, because of the gains made under the Affordable Care Act, 17 million people have health care who did not before the law was passed. This is a good start, and something we should be
proud of. But we can do better.
The truth is, it is a national disgrace that the United States is the only major country that does not
guarantee health care to all people as a right. Today, 29 million of our sisters and brothers are without care. Not only are deductibles rising, but the cost of prescription drugs is skyrocketing as well. There is a major crisis in primary health care in the United States.
So I start my approach to health care from two very simple premises:
1. Health care must be recognized as a right, not a privilege — every man, woman and child in our country should be able to access quality care regardless of their income.
2. We must create a national system to provide care for every single American in the most cost-effective way possible.
I expected to take some heat on these fundamental beliefs during a general election, but since it is already happening in the Democratic primary, I want to address some of the critiques
made by Secretary Clinton and Rupert Murdoch’s Wall Street Journal directly:
Under my plan, we will lower the cost of health care for the average family making $50,000 a year by nearly$5,000 a year. It is unfair to say simply how much more a program will cost
without letting people know we are doing away with the cost of private insurance and that the middle class will be paying substantially less for health care under a single-payer system than Hillary Clinton’s program. Attacking the cost of the plan without acknowledging the bottom-line savings is
the way Republicans have attacked this idea for decades. Taking that approach
in a Democratic Primary undermines the hard work of so many who have fought to
guarantee health care as a right in this country, and it hurts our prospects
for achieving that goal in the near future. I hope that it stops.
Let me also be clear that a Medicare-for-all, single-payer health care system will expand employment by lifting a major financial weight off of the businesses burdened by employee
health expenses. And for the millions of Americans who are currently in jobs
they don’t like but must stay put because of health care access, they would be
free to explore more productive opportunities as they desire.
So, what is stopping us from guaranteeing free, quality health care as a basic fundamental right for all Americans? I believe the answer ties into campaign finance reform. The truth is, the insurance companies and the drug companies are bribing the United States Congress. I want to make health care a right for every American. The health care industry doesn’t like that very much, so they’re flooding my opponents with cash.