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HEALTH PLANS/POLICY: Underwriting–pernicious and ridiculous

Lisa Girion in the LA Times kicks butt and takes names, exposing the individual insurance market for the fake gong-show that it is. She found a member of the LA insurance commission rejected by all three major health insurers in the state because of asthma. Of course THCB readers got my own extremely personal perspective on this process last year when one insurer totally rejected me, while another gave me the best underwritten rate—while both were looking at the same information!  That’s even better proof that the current system is a lottery.

We need one pool.

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buy cozaar onlinebuy combivir onlinebuy colospa onlineLilyTom Leith Recent comment authors
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Guest

Not that there is anything rational about Medicare Part D, but taking the point of view of a single individual, it will save money for anyone whose annual medication costs are greater than the base premium + 1% of the base premium for each month he delays enrollment past his first date of eligiblity + his deductible amount (including the infamous donut hole). The math isn’t that hard — even an acupuncturist could do it. Oh, wait!! Maybe not. Pity I can’t draw a picture here.ilike this site.

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Guest

Not that there is anything rational about Medicare Part D, but taking the point of view of a single individual, it will save money for anyone whose annual medication costs are greater than the base premium + 1% of the base premium for each month he delays enrollment past his first date of eligiblity + his deductible amount (including the infamous donut hole). The math isn’t that hard — even an acupuncturist could do it. Oh, wait!! Maybe not. Pity I can’t draw a picture here.ilike this site.

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Guest

Not that there is anything rational about Medicare Part D, but taking the point of view of a single individual, it will save money for anyone whose annual medication costs are greater than the base premium + 1% of the base premium for each month he delays enrollment past his first date of eligiblity + his deductible amount (including the infamous donut hole). The math isn’t that hard — even an acupuncturist could do it. Oh, wait!! Maybe not. Pity I can’t draw a picture here.ilike this site

Lily
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I found a very good prescription discount card at http://www.rxdrugcard.com. You can see prices on the website. The membership fee is only $4.50 a month.

Tom Leith
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Tom Leith

> I fail to see how this Prescription Plan saves an > American, Senior or not, any money! Not that there is anything rational about Medicare Part D, but taking the point of view of a single individual, it will save money for anyone whose annual medication costs are greater than the base premium + 1% of the base premium for each month he delays enrollment past his first date of eligiblity + his deductible amount (including the infamous donut hole). The math isn’t that hard — even an acupuncturist could do it. Oh, wait!! Maybe not. Pity I can’t… Read more »

Barry Carol
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Barry Carol

Tim, Wal-Mart is selling generic drugs at a loss on a fully allocated basis in order to build traffic for the rest of its store. It claims it is making an average gross margin of 50% on the pills, but outside experts estimate its cost to fill the prescription (salary and benefits for the pharmacists and techs), allocated rent for the space, sophisticated information systems that support the pharmacy operation, etc. add up to a fulfillment cost estimated by outside experts at $6-$10 per prescription. Walgreens, the most efficient operator in the retail drug space, has an estimated fulfillment cost… Read more »

John Fembup
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John Fembup

“So then Medicare is just corrupt ”
Enthoven didn’t say that, either.

Tim
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Tim

So then Medicare is just corrupt and hoping people won’t figure out that a lot of generic drugs are available for much less somewhere else and easier to obtain as well? I get it now.

John Fembup
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John Fembup

“So Walmart is bigger than the Federal Government in terms of bargaining power?”
That’s not what Enthoven said.

Tim
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Tim

So Walmart is bigger than the Federal Government in terms of bargaining power?
I know that it’s all about patent protection. There’s a book out there by Marsha Angell that everyone should read. Big Rx is just as bad, if not worse, than the carriers and the State DOI’s.

John Fembup
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John Fembup

“Well then explain to me . . .” Tim, it’s Enthoven’s conclusion and here’s his rationale: “People often confuse market power with bargaining power. The thinking goes, the larger the share of the market that the buyer represents, the greater the bargaining power and thus the lower the prices negotiated. That line of reasoning fails with drugs however because the seller is frequently a monopolist with an exclusive patent. This means the seller cannot be threatened with replacement by a substitute. Instead, the only threat is that the two sides fail to agree and the drug is withheld from the… Read more »

Tim
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Tim

Well then explain to me how Walmart and other sources can offer a myriad of generic prescriptions for $4, and still make money. Seems that Medicare has the same market as Walmart for those age 65 and up, who take the majority of the medications.

John Fembup
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John Fembup

“Until Medicare is allowed the same kind of bargainig power as the major carriers, their drug plans will be somewhat of a joke.”
That’s one opinion. Alan Enthoven has a different opinion. Enthoven says
“empowerng the government to negotiate with pharmaceutical companies is not necessarily equivalent to achieving lower drug prices. In fact, neither economic theory nor historical experience suggests that will be the outcome.”

Tim
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Tim

There are a few exceptions out there with the Medicare drug plans. My parents are two of them. My mom just gets what she needs from Canadian Rx, and my dad has the VA plan. It costs them more to get on the plan and buy the drugs through Medicare, than it does to just buy them elsewhere. Also, since Walmart and others have introduced the generic drugs that they have for next to nothing in cost, many people can take advantage of that as well. The problem is, as they continue to get older and have a need for… Read more »

John Fembup
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John Fembup

“I fail to see how this Prescription Plan saves an American, Senior or not, any money! ”
Well if a person is not a senior Medicare will save them nothing. Please disseminate.
Also, two examples and two drugs, is not very persuasive. But if you want to drop the program, please do. After all, you found a better deal, all by yourself. Congratulations. Please disseminate.