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Old 01-04-2019, 08:48 AM   #21
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Did anybody notice that yesterday with the Dems in control of the house they announced they intended to start hearings about the possible cost/implementation of Medicare for all? Fasten your seat belts..it could happen as soon as 2020 if certain things happen in the next election.

People are going to be surprised at what that costs them it won't be free. I feel to get the insurance companies and such on board they will use the Medicare type plan where all people pay the same monthly and then shop for add on plans to cover OOP and drugs.
Hopefully, govt. will negotiate prices and pharma will come down to reality as to the cost of prescription drugs. And procedures will be better understood from hospital to hospital. We cannot continue in the dark about these costs.
I, thankfully, don't use expensive prescriptions. If that ever happens, I would gladly increase my monthly premiums to a few hundred $$. DH/me waiting at Walgreens for a flu shot in late Sept. There was a long line. Two separate gentlemen up to counter to get meds. We overheard $250 for a 30/day supply. One man responded with much anxiety, I gave you a coupon when I submitted this. They declined and suggested he go back to insurance or manufacturer and check. He walked away without prescription. Similar happened with next man. His cost was considerably higher. The cost of insulin (or should I say they're charging $500/month). A diabetic cannot live without insulin.
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Old 01-04-2019, 08:59 AM   #22
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Hopefully, govt. will negotiate prices and pharma will come down to reality as to the cost of prescription drugs. And procedures will be better understood from hospital to hospital. We cannot continue in the dark about these costs.
That will be the mother of all fights get some popcorn ready..Pharma will not go down without a fight. I've seen my DH EOBs from Medicare and if the hospitals got that little amount of money from everyone they'd go broke.

I personally believe the Medicare Advantage plans will be the blueprint for Medicare for all and it's the reason the marketing for Advantage has been so aggressive.
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Old 01-04-2019, 09:09 AM   #23
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Originally Posted by ivinsfan View Post
Did anybody notice that yesterday with the Dems in control of the house they announced they intended to start hearings about the possible cost/implementation of Medicare for all? Fasten your seat belts..it could happen as soon as 2020 if certain things happen in the next election.

People are going to be surprised at what that costs them it won't be free. I feel to get the insurance companies and such on board they will use the Medicare type plan where all people pay the same monthly and then shop for add on plans to cover OOP and drugs.
What happens to the ACA in the future is anyone's guess.

IMO, Medicare for all may be too extreme, but wouldn't mind Medicare for 50+ .
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Old 01-04-2019, 09:44 AM   #24
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That will be the mother of all fights get some popcorn ready..Pharma will not go down without a fight. I've seen my DH EOBs from Medicare and if the hospitals got that little amount of money from everyone they'd go broke.

I personally believe the Medicare Advantage plans will be the blueprint for Medicare for all and it's the reason the marketing for Advantage has been so aggressive.
+1
My household is the example.
DGF is on Medicare Advantage. I am on ACA.
We both had to see a Cardiologist. $35 co pay for her and $5 co pay for me.
I can see my internist for free 3x a year.
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Old 01-04-2019, 09:49 AM   #25
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It is indeed difficult to reverse the ACA. There are many provisions unrelated to insurance that are fully implemented. Many of the regulations affecting insurers are popular and seen by many as necessary.

Much of the disapproval or disagreement with ACA is really an issue with the high cost to insure, and that will not change. This is one reason why it is so difficult to replace. I think this is not so much kicking the can down to road as it is completely ignoring the real underlying issues.
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Old 01-04-2019, 10:09 AM   #26
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I think they killed it last year when they got rid of the mandate that everyone have insurance. With out the healthy in the pool the costs will eventually soar to the point it will be unaffordable.
I could work my MAGI to qualify for lower cost than my partially subsidized MegaCorp plan, but I think within another year a subsidized ACA plan will be more than my current and I worry Mega will not let me back on my current plan. My current is expensive, but very inclusive...even has a small dental component which turned out to be better than expected.
The key to making the ACA work was the deal by which pre-existing conditions could not be used to exclude coverage in return for the individual mandate requiring coverage to be bought by everyone. This is what made the ACA fairly stable. But with the individual mandate gone, this deal has been badly compromised as healthier people begin dropping out of the market, leaving a pool of sicker people facing higher rates than they would have faced otherwise over time.
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Old 01-04-2019, 11:43 AM   #27
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Couple of things.

1. NJ has passed an individual mandate law imposing penalties for lapses in coverage. Other states are expected to follow.

2. Pharma are raising prices, just did with the New Year.

https://arstechnica.com/science/2019...reds-of-drugs/

They have no fear of legislative action, probably because they figure they can get enough votes to protect their interests or doesn’t see Congress passing any new major laws, given how split it is.
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Old 01-04-2019, 11:50 AM   #28
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Couple of things.

1. NJ has passed an individual mandate law imposing penalties for lapses in coverage. Other states are expected to follow.

2. Pharma are raising prices, just did with the New Year.

https://arstechnica.com/science/2019...reds-of-drugs/

They have no fear of legislative action, probably because they figure they can get enough votes to protect their interests or doesn’t see Congress passing any new major laws, given how split it is.
Pharma is going to get while the getting good, I firmly believe that someday their spigot of income is going to be cut severely.
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Old 01-04-2019, 07:09 PM   #29
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Pharma is going to get while the getting good, I firmly believe that someday their spigot of income is going to be cut severely.

Sure and when that happens, their R&D spending will decline. If you were hoping for a new drug for your somewhat rare condition or just a better drug for your common condition hopefully with fewer/milder side effects, you will be SOL. And when the current generation of antibiotics is no longer effective against the super bugs, tough luck.


I think the US heath care system has been subsidizing drug development for the whole world. We do not want the spigot cut off, but other countries could pick up more of the tab.
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Old 01-04-2019, 07:32 PM   #30
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They spend more on marketing than R&D and they’re hiking prices on drugs developed decades ago.

They’re not even pretending that the hikes are to recoup R&D or for future R&D.

They’re practically saying “because we can.”

The other villains are the pharmacy benefit managers taking their own cuts.
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Old 01-04-2019, 07:34 PM   #31
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Originally Posted by Svensk Anga View Post
Sure and when that happens, their R&D spending will decline. If you were hoping for a new drug for your somewhat rare condition or just a better drug for your common condition hopefully with fewer/milder side effects, you will be SOL. And when the current generation of antibiotics is no longer effective against the super bugs, tough luck.


I think the US heath care system has been subsidizing drug development for the whole world. We do not want the spigot cut off, but other countries could pick up more of the tab.
We should model a law on a most favored customer clause the govt puts in contracts. US should pay no more than other developed nations. If a med is $5 in Europe it should be $5 here.
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Old 01-04-2019, 07:49 PM   #32
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Old 01-04-2019, 09:11 PM   #33
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- The Texas court ruling will be overturned
- The ACA will stay pretty much as it until the next election
- Premiums will rise less than many folks anticipate

I believe we aren't supposed to discuss politics, so I'll leave it at that.
I think you are right.... especially on the last part... the penalty of $0 will have a minimal impact on premiums as people will continue to need and buy health insurance... the penalty was so minor it was not an affective deterrent to those who did not want to buy health insurance.

The recent rise in premiums has nothing to do with ACA but is more increases in the cost of health care services which are at least 80% of premiums by law... when the cost of those health care services goes up premiums follow.
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Old 01-04-2019, 09:37 PM   #34
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....healthier people begin dropping out of the market, leaving a pool of sicker people facing higher rates than they would have faced otherwise over time.
I disagree. Penalties were negligible before and we still saw healthy people buying health insurance.... because they wanted it and needed it even though it is expensive.

I put in a family of 4 with household income of $100,000 for both place where I live and in each case the penalty was nil because the cost of health insurance was unaffordble. If I double the income to $200,000 in each case the penalty was $4,468. In each case bronze level coverage would be over $16,000 a year so I think if someone was health and really didn't want insurance they would just pay the penalty.... or better yet they could manage their withholdigns and estimated payments so they owed money and pay the tax but not the ACA penalty since the IRS had no collection authority to chase people for the penalty.
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Old 01-05-2019, 11:35 AM   #35
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They spend more on marketing than R&D and they’re hiking prices on drugs developed decades ago.

They’re not even pretending that the hikes are to recoup R&D or for future R&D.

They’re practically saying “because we can.”

The other villains are the pharmacy benefit managers taking their own cuts.
Or they're busy buying up companies to create drug monopolies then slashing R&D while jacking prices.

See: Documentary 'Drug Short' about Valeant Pharmaceuticals

Congress could fix this, but money talks.
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Old 01-05-2019, 12:08 PM   #36
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I disagree. Penalties were negligible before and we still saw healthy people buying health insurance.... because they wanted it and needed it even though it is expensive.
That's not what insurers here in New York thought when they filed their 2019 rate increases back in June. I posted this link to begin the long thread last year about 2019 rate increases.

https://www.dfs.ny.gov/about/press/pr1806011.htm

Insurers filed for a 24% increase overall, with half of that (12%) due to the repeal of the mandate and the other half (12%) separate from the repeal of the mandate.

Back in 2010-2011, before the ACA, I saw increases of 20% and 25% in those 2 years (50% overall) before I finally dropped that policy and opted for, temporarily, a bare-bones, hospital-only policy to get me to 2014 when the exchanges came in. My rate for a Silver plan dropped to less than what I was paying in 2009. The mandate surely dropped the rates because there were more healthier people like me (this was before I got sick in 2015) were back in the main insurance pool.
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Old 01-05-2019, 12:41 PM   #37
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Can a U.S. doctor prescribe a med to be purchased in a different country? I understand U.S. citizens go to Canada to get meds, but do they do it illegally or do they know the name of the drug/dosage amount and buy it?
If I told my doc to send my prescription to a Canadian pharmacy, can he do that?
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Old 01-05-2019, 12:52 PM   #38
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They spend more on marketing than R&D and they’re hiking prices on drugs developed decades ago.

They’re not even pretending that the hikes are to recoup R&D or for future R&D.

They’re practically saying “because we can.”

The other villains are the pharmacy benefit managers taking their own cuts.
One reason they spend so much on marketing is the relatively short life of a drug patent before generics wipe out all profit.

It is not like they have 30 years to recoup the R&D costs. Plus other companies will jump on the bandwagon once a type of drug is proven with their slightly modified formulation.

But feel free to sink your next billion or three into a pre clinical trial drug which has a 99% chance of failing and burning up all your cash.
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Old 01-05-2019, 01:10 PM   #39
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One reason they spend so much on marketing is the relatively short life of a drug patent before generics wipe out all profit.

It is not like they have 30 years to recoup the R&D costs. Plus other companies will jump on the bandwagon once a type of drug is proven with their slightly modified formulation.

But feel free to sink your next billion or three into a pre clinical trial drug which has a 99% chance of failing and burning up all your cash.

There is no way to depict pharma as economically struggling in any way.

Their CEOs are taking in 8-figure compensation annually.

https://medium.com/@RosenthalHealth/...o-a5ce444c9bf6

So spending a billions on marketing and clinical trials still result in a lucrative business.
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Old 01-05-2019, 01:14 PM   #40
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There is no way to depict pharma as economically struggling in any way.

Their CEOs are taking in 8-figure compensation annually.

https://medium.com/@RosenthalHealth/...o-a5ce444c9bf6

So spending a billions on marketing and clinical trials still result in a lucrative business.

The CEO of Microsoft makes over 25 million per year. The CEO of Boeing makes 18.5 million per year. The CEO of Kroger makes 11.7 million per year.

What was your point again?
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