PHARMA: Maybe the Dems are serious about drug pricing

Das Kapital

It’s hard to see how Medicare Part D as constructed can easily be changed for the government to go after prescription pricing, no matter how much Pete Stark et al may want to. But there are other drugs that Medicare buys directly under Part B, mostly for cancer and kidney care. And notice has been served that the tallest of those poppies may find itself trimmed a little — U.S. payments for Amgen drug criticized at hearing.

And if you thought you understand Part B’s “new” pricing schema, take a hint from JD Kleinke. You probably don’t

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10 replies »

  1. Changing the pricing structure under Medicare will be a monumental task, in view of the entrenched interests of the lobbyists for big Pharma, which overpower the will of almost every representative that has ever graced the halls of Congress. The pharmaceutical and insurance industry have taken over healthcare and are doing all that they can to take over the justice system, so that it will not be there for the victims of harmful drugs and harmful medical practices. Both the insurance industry and the pharmaceutical industry blame the patients for the high cost of medical care, in order to deflect attention from their huge profits and exhorbitant CEO salaries. While the average CEO of a drug company or insurance company makes 330 times the salary of its average worker, those companies want to limit the right of a person maimed by their products or services to compensation from the justice system, in order to “keep the costs down.” The legislation that has been passed in the past four years to exempt dangerous drugs, doctors and hospitals from liability, would provide a paralyzed or brain damaged victim a lifetime compensation equal to about one week of the salary of the CEO of the drug or insurance company. What a way to keep the costs down!!
    Michael Townes Watson, author of America’s Tunnel Vision–How Insurance Companies’ Propaganda Is Corrupting Medicine and Law.. http://www.StopMedicalError.com

  2. As for the idiot who said Ishould have been a tire changer or pro athlete instead of a doctor, well I really wish all physicians would take your advice and start a new profession. You do realize that the biz has changed since they first decided to go into healthcare? I can guarantee you that very few if any physicians are happy with the current scandal these insurance companies have pulled off, and government control is definately not the answer from a physicians point of view. Medicaid’s reimbursement is a joke. A regular sick office visit that takes 25-30 minutes is reimbursed $28.78, that won’t cover your expenses. I pay more to have my dog looked at, and you think that’s OK? So you want to see how the government handles things take a close look at their fee schedules. Let’s face it, everyone on this planet is self serving and self centered. I don’t care how much you love your job, if the money’s not right, you don’t stay happy for long. I know the guy who said you should have been this or that thought it was funny, but let me tell you something podnuh, my 17 year old son who, I am proud to say, will be the first person to graduate from his highschool with nothing less than a 100. That’s right perfection. He scored a 34 on his ACT and said he wanted to take it again because he did not have a calculator the first time, his freshman year. He has offers from all the ivey league schools, MIT, you name it. He has scholarship offers anywhere he wants. He wanted to be a surgeon, well after his old man showed him just how screwed up the healthcare biz was with no change in sight, he’s now leaning towards a legal profession. How many of America’s best and brightest are being dissuaded from entering med school? Yeah the government would bring healthcare prices down, but expect the quality to go with it. I do, however, agree that healthcare costs are insane, but if you take a close look at physician reimbursement I think you’ll see that they are underpaid. I went in the hospital for five days a couple of years ago, and I did not receive anything more than IV antibiotics and 5mg loritabs; my bill was $7600.00 The Dr.s portion was just under $750.00. That’s $150.00 a day, I can live with that, but $1400.00 a day for a bed and $10.00 worth of antibiotics. It really doesn’t take long to figure out where the problem is. As for “You should have chosen a different career path,” I’m not a doctor, I’m married to one. We will be closing her clinic in the near future, as the rewards are not nearly worth the liability. I own an oil and gas exploration company$$$$$$ ALL about them greenbacks.HA HA How ya like that $3.00 gas?

  3. Sorry for the double post. This one from the NHS list of core principles is much better:
    “The NHS will provide a universal service for all based on clinical need, not ability to pay
    Healthcare is a basic human right. Unlike private systems, the NHS will not exclude people because of their health status or ability to pay.”

  4. Jim, you ignorant sl*t (old SNL reference),
    Adam Smith coined the phrase, “Life, Liberty, and the pursuit of property”. (Damn Commie)
    The Declaration of Independence:
    “We hold these truths to be self-evident: that all men are created equal, that they are endowed, by their Creator, with certain unalienable Rights, that among these are Life, Liberty, and the Pursuit of Happiness.” (Thomas Jefferson – Damn Commie)
    “Public sentiment is everything. With public sentiment, nothing can fail; without it, nothing can succeed.” (Abraham Lincoln – Damn Commie)
    “The third is freedom from want–which, translated into world terms, means economic understandings which will secure to every nation a healthy peacetime life for its inhabitants-everywhere in the world.” (Franklin Roosevelt – Damn Commie)
    “The NHS is funded by the taxpayer and managed by the Department of Health, which sets overall policy on health issues. It is the responsibility of the Department of Health to provide health services to the general public through the NHS.” (www.nhs.uk – Damn Commies, every single one of them)

  5. Don’t tell me to move somewhere else, it is you who needs to move, I hear China is already a communist country. You will feel right at home.

  6. 1. Become an attorney it’s a free country.
    2. Become a flat fix guy it’s a free country.
    3. Don’t give out your home number.
    4. They should hire and pay doctors to do it.
    5. Support single pay govm’t insurance – 1 code 1 fee.
    6. See # 5.
    7. See # 6.
    8. Support annual performance reviews for docs.
    9. See # 7
    10. Maybe he’s a better CEO and wants to be paid more, just like you want more to be a good doc.
    11. Maybe your using, “someone with no college education or medical background” to submit your claims.
    12. See # 9
    13. See # 12
    14. Fraud potential? Just guessing.
    15. Become George Lucas, Oprah, Bruce Willis, a race driver, etc it’s a free country.
    16. Move to Africa, Afghanistan, South America, Mexico, they certainly don’t think healthcare is a right.
    17. Let’s just sterilize the little f****rs.

  7. Jim, You’re at the wrong blog. Whiny doctors with a sense of entitlement and little respect for the actual facts are over at KevinMD. Thoughtful discussion of health care policy for people who can see that the system is broken and who understand economics is here. Please adjust your browser accordingly.

  8. What the @#$!?
    1. Why is it that when you call your attorney, or any other professional for that matter, you get billed for the time spent during the phone conversation for every minute, but when a physician gets called they don’t get a dime?
    2. Why is it that when you have a flat on your car at 3 AM with no spare, the guy that comes to fix your flat gets paid more than a pediatrician who goes for an emergency at the hospital at the same time? How much time and money was spent on the flat changer’s education?
    3. Why do people feel like they can bother their doctor in the middle of the night to ask a question? If it is serious enough to call at 3AM then it’s serious enough to go to the ER.
    4. Why does an insurance company have someone with no college education or medical background determine what diagnosis goes with what procedures a physician performed?
    5. How can one insurance company pay $112.00 for a particular code and another pay $46.00 for the same code?
    6. Why does Medicare pay almost three times as much as Medicaid for the exact same procedure? Are younger human lives worth a third of a mature human beings life?
    7. Why can’t insurance companies have a magnetic strip on their insurance cards that can be swiped at the Dr’s office to enable us to see the patient’s eligibility and the conditions of their insurance? Like a credit card. The way it is now, a receptionist has to call the insurance company (average call lasting 10 to 15 minutes; it’s like calling the phone company ) to get this info because they won’t put this info on their website either. Why?
    8. What incentive is there to be a good physician, since you get paid the same as a bad physician by the insurance companies? The big insurance in this country has taken capitalism completely out of healthcare.
    9. Other than catastrophic, why do people feel they need insurance? By the time you add the costs of copays, deductibles, and your annual insurance premiums, the total is much higher than you pay if you paid for your physician office vistits + catastrophic insurance. These so called health discounts that the insurance companies are starting to offer, are nothing more than the discount you would receive for paying cash anyway. Just another scam they came up with to rob the American public. Why not just start your own health savings plan and eliminate the $300,000,000.00 man at United Healthcare.
    10. How did the CEO of United Healthcare make $300 million last year? Do you think somebody got screwed? Who? Someone either overpaid their premiums or physicians where underpaid.
    11. If the body shop that fixes your car has a transposed part number on one of the parts, does the insurance company deny the claim? Why not, they will if a physician’s office makes a mistake? Why is it so different with auto insurance? Maybe physicians should start giving estimates.
    12. How can insurance companies get away with all these subsidiaries insurance companies; each with different
    payer ID’s, with no clear indication who is responsible? The card will have the name of every company that is involved, adding to the confusion of who is going to pay.
    13. If a patient has paid their premium, there should be no excuse for any unpaid claim, period.
    14. Why is it a physician’s responsibility to prove to the insurance company they are owed money each time a patient has a procedure performed?
    15. According to Forbes, George Lucas makes $250 million a year. Oprah Winfrey makes $150 million. Bruce Willis? $70 million. Did you know that Martin Lawrence — Martin Lawrence! — makes $33 million? Narrowing the focus to sports figures, we find race car driver Michael Schumacher ($59 million), golfer Tiger Woods ($53 million) and boxer Mike Tyson ($48 million) How many lives did these people save? Ever hear of any Dr. making this kind of jack?
    16. When are people going to realize that healthcare is not a birth right, just like food and shelter is not a birth right. Or at least it wasn’t until Kennedy. Take care of yourself or die, worked for many years. If we want to help the less fortunate, we can, but don’t mandate the help. Once mandated, it is no longer charity and the less fortunate feel it is owed them, and it’s not. Maybe when people see their kids starving, they’ll get off their couch and go to work.
    17. Who is going to pay for all these social programs the government has mandated, considering that responsible people don’t start breeding until their late twenties early thirty’s, and the population that relies on these social programs have five kids by the time they are twenty five or younger? Do the MATH!!!!

  9. Time will tell. The $100 million the drug industry spends in lobbying and campaign cash goes to both parties. Don’t look for miracles.

  10. Another example of a system that creates a hopeless conflict of interest, in that certain forms of drug treatment are much more remunerative than others. ASCO and other fraternal organizations have never felt the need to perform clinical trials to determine whether or not treatment outcomes and patient satisfaction are altered by profit incentives.
    The much needed reforms to the system, which are currently ongoing, are occurring over the fight to the death opposition of a profession which is vastly more concerned with protecting the selfish monetary interests of its members than in promoting the well-being of its patients.
    The new medicare bill virtually changed nothing. If anything, it’s worse. The only thing it does is to give the government a little bit of protection against being egregiously gouged on individual drugs. It doesn’t change the basic incentives to give one form of drug treatment over another, or whether that drug treatment is in the best interests of the patient.