Healthcare insurance and retirement - again!

[daylatedollarshort]

Children would be covered under CHIP if their parents were ignorant enough to forgo health insurance.

If someone is unemployed then it is likely that their lack of income would qualify them for continued coverage on Medicaid... they would just need to take the responsibility to sign up for Medicaid. Also, the solution that I envision would include some mechanism to make health insurance affordable low income people do not qualify for Medicaid similar to ACA subsidies.

Just like today:

That is true post-ACA but only in Medicaid expansion states. Otherwise people would have to spend down most of their assets to a few thousand dollars currently in order to qualify.http://www.ralphrobbins.com/Asset Test.htm

 

[pb4uski]

That is true post-ACA but only in Medicaid expansion states. Otherwise people would have to spend down most of their assets like retirement savings to a few thousand dollars currently in order to qualify.

In all states, Medicaid and CHIP are based on monthly income, and if someone is unemployed, presumably with no earnings their income would be low enough to qualify for Medicaid and CHIP until they become employed again.

Two-earner families with one earner unemployed might not qualify, but in such cases they would likely qualify for subsidized health insurance.

In either case, they should be able to continue coverage.

 

[eta2020]

I thought it was government regulations that prevented the cheaper drugs from getting imported.

Actually with your reasoning you should write that you like to pay 100 bucks for pill that costs 1 buck in Germany because you are getting second to none medical care. If you payed 1 buck you would feel it is not as good quality.

 

[daylatedollarshort]

In all states, Medicaid and CHIP are based on monthly income, and if someone is unemployed, presumably with no earnings their income would be low enough to qualify for Medicaid and CHIP until they become employed again.

Two-earner families with one earner unemployed might not qualify, but in such cases they would likely qualify for subsidized health insurance.

In either case, they should be able to continue coverage.

"As of September 2016, 19 states had not expanded their programs. Medicaid eligibility for adults in states that did not expand their programs is quite limited: the median income limit for parents in 2016 is just 44% of poverty, or an annual income of $8,870 a year for a family of three, and in nearly all states not expanding, childless adults remain ineligible."
Source:
The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid | The Henry J. Kaiser Family Foundation

The ACA also did away with asset tests (in states with expanded Medicaid):
"Essentially, the Medicaid expansion under the ACA will broaden Medicaid eligibility for low-income, non-elderly adults without regard to assets."
Bye-Bye Medicaid Asset Test* | The Incidental Economist

 

[NW-Bound]

That is sarcastic

But you will pay numerous times more for your medicine as compared to rest of world. That is on average 2-6 times more.

Pharmaceuticals cheaper abroad because of regulation - CNN.com

No, I was not sarcastic. I have read that it's the US regulations that keep the same drugs being imported into the US.

I admit I do not know all the details, but if people are allowed to import the same drug at a lower price, they would have done so. Why would people want to pay more for the same thing? Importers like to make a buck, and if they cannot do it, it is very plausible that there are some regulations against it. Or maybe it was levied excessive tariff?

Actually with your reasoning you should write that you like to pay 100 bucks for pill that costs 1 buck in Germany because you are getting second to none medical care. If you payed 1 buck you would feel it is not as good quality.

Did I say that? I was saying perhaps it is some regulations that make me pay $100 for something that I could have for $1. They somehow block the import of drugs. And blocking of imports is usually done with regulations.

 

[eta2020]

The drug prices are like that because in (for example) UK Drug Company can sell to UK Healthcare or not at all and UK Healthcare negotiates prices.

In US even Medicare is prohibited to negotiate with Pharmaceutical companies. Do not expect that that will change.

 

[NW-Bound]

In US even Medicare is prohibited to negotiate with Pharmaceutical companies. Do not expect that that will change.

There! That's the regulation I was talking about.

If we truly have a free market, good inexpensive drugs would flow from abroad to the US. Walgreens and CVS should be able to buy from Germany for $1 and resell here in the US for $2. I do not have to pay $100. Walgreens is happy to make $1. I am much happier saving $98.

 

[eta2020]

There! That's the regulation I was talking about.

OK you kinda got me.

And who is better negotiator then some kind of US healthcare negotiating price for market of 330 million people ..... is what I am saying.

 

[travelover]

There! That's the regulation I was talking about.

If we truly have a free market, good inexpensive drugs would flow from abroad to the US. Walgreens and CVS should be able to buy from Germany for $1 and resell here in the US for $2. I do not have to pay $100. Walgreens is happy to make $1. I am much happier saving $98.

Isn't a little naive to think the laws are written to protect the consumer as opposed to the drug companies? A few years back in the Detroit area, they were literally running buses over to Canada filled with seniors that were getting their prescriptions filled for much less than here. The US government clamped down on the practice, but one can still use the internet to do the same thing, though you need to trust the intermediary to provide genuine drugs.

 

[Senator]

In US even Medicare is prohibited to negotiate with Pharmaceutical companies. Do not expect that that will change.

Actually, that is one of the first things I would expect would change.

I cannot imagine a top-notch negotiator leaving this easy one on the table. I am not sure if it will make a huge sent in healthcare costs, but it is likely to be a solid "feather in the cap" if it can be accomplished.

 

[aja8888]

The only reason I looked into getting VA healthcare is so I could get a veteran's ID card, so that I could get 10% off at Home Depot and Lowes.

Really Senator?

I get 10% off at those places just by showing a DD 214 (keep photo of it on my phone). And generally, I just tell them I am a veteran and they just give me the discount without asking to view the document.

 

[youbet]

If we truly have a free market, good inexpensive drugs would flow from abroad to the US. Walgreens and CVS should be able to buy from Germany for $1 and resell here in the US for $2.

I think the regulations you are thinking of involve the FDA and it's unwillingness to monitor and guarantee the quality of drugs imported from many and various manufacturers around the world. Even in the case of drugs manufactured in the USA and sold internationally, they cannot be returned to the USA for resale.

Whether this position by the FDA is there to truly foster safety for USA residents or is actually there to reduce competition for USA drug companies selling in the USA is the subject of debate.

 

[Senator]

Really Senator?

I get 10% off at those places just by showing a DD 214 (keep photo of it on my phone). And generally, I just tell them I am a veteran and they just give me the discount without asking to view the document.

The policy used to be you had to have an ID except for 4 holidays (Memorial day, July 4th, Labor day and Veterans Day. I used to bring in my DD-214 on those days.

It may depend on your store, or maybe I did not try it other than the four holidays.

Either way, I am glad I did not get the discount, as I would be paying for healthcare today if I did.

 

[eta2020]

Actually, that is one of the first things I would expect would change.

I cannot imagine a top-notch negotiator leaving this easy one on the table. I am not sure if it will make a huge sent in healthcare costs, but it is likely to be a solid "feather in the cap" if it can be accomplished.

They predict it would make a huge difference in prices. But there are lot and lot of money in a game.

As I said there is good reason why Pfizer and other drug companies went 5-10% up right after election. It will not change for at least 4 years.

I own lot of PFE. That was nice

 

[travelover]

...........Whether this position by the FDA is there to truly foster safety for USA residents or is actually there to reduce competition for USA drug companies selling in the USA is the subject of debate.

In the case I cited above, people were walking into Canadian drugstores, just like any Canadian would, and buying drugs at the counter. No one was asking the FDA to do anything except to butt out.

 

[NW-Bound]

... A few years back in the Detroit area, they were literally running buses over to Canada filled with seniors that were getting their prescriptions filled for much less than here. The US government clamped down on the practice, but one can still use the internet to do the same thing, though you need to trust the intermediary to provide genuine drugs.

Down here, a lot of seniors make "drug runs" to south of the border.

I just recall a few years ago, there was a man getting into trouble for bringing back some drugs from Mexico. I do not recall how much drugs he brought back. Maybe a suitcase worth? You are allowed to bring a 2 or 3-month supply if you have prescriptions.

And it's not like you can have unlimited drugs in Mexico either. There was a man who got arrested by the Federales for having a large quantity of Valium. He said it was for his wife.

 

[youbet]

Isn't a little naive to think the laws are written to protect the consumer as opposed to the drug companies?

See my post above.

A few years back in the Detroit area, they were literally running buses over to Canada filled with seniors that were getting their prescriptions filled for much less than here. The US government clamped down on the practice, but one can still use the internet to do the same thing, though you need to trust the intermediary to provide genuine drugs.

I think the FDA needed to either take steps to guarantee the safety of Canadian provided drugs (even if they were made in the USA) or tell people they can't buy them. Folks, if harmed by some drug imperfection or perhaps by a counterfeit drug, would certainly hold their gov't to blame, no?

 

[NW-Bound]

Ideally, the drug price should be the same, so that there's no need to "arbitrage" across the border. I don't know what it would take, but that's the real solution.

Well, Canadians are known to make "booze run" down to the US too. Alcohol is really a "controlled" substance, no?

 

[youbet]

In the case I cited above, people were walking into Canadian drugstores, just like any Canadian would, and buying drugs at the counter. No one was asking the FDA to do anything except to butt out.

People harmed by a Canadian-purchased drug will surely demand their USA gov't to do something about it, probably compensate them. The FDA needs to say "don't do it" and then if some dufus USA citizen gets poisoned or takes placebo's instead of the real deal, too bad, so sad.

I purchased an allergy drug from a Canadian web site for years to get lower prices. It had gone generic in Canada but was still prescription in the USA. But I was prepared to NOT complain to the USA gov't if I got duped.

 

[aja8888]

The policy used to be you had to have an ID except for 4 holidays (Memorial day, July 4th, Labor day and Veterans Day. I used to bring in my DD-214 on those days.

It may depend on your store, or maybe I did not try it other than the four holidays.

Either way, I am glad I did not get the discount, as I would be paying for healthcare today if I did.

From Home Depot's military policy if you do not have a card:

Your DD 214 Will Prove Military Service

The easiest way to prove your military service without one of the above ID cards is with a DD Form 214, which is the document which serves as your service record.

 

[daylatedollarshort]

California had Prop 61 on the ballot to try to control at least some drug prices in the state. The big pharma companies spent a record breaking $100M to defeat it:

"Big pharmaceutical companies have poured more than $100 million into defeating a state referendum in California that seeks to control soaring drug prices by limiting how much state agencies pay for the prescription drugs they buy on behalf of patients....The proposition would prohibit state agencies from paying more than the price paid by the federal Department of Veterans Affairs, which uses its buying power to negotiate lower prices with the companies. "

From Marketwatch -
Drug companies spend $109 million to block vote to lower drug prices - MarketWatch

 

[eta2020]

People harmed by a Canadian-purchased drug will surely demand their USA gov't to do something about it, probably compensate them. The FDA needs to say "don't do it" and then if some dufus USA citizen gets poisoned or takes placebo's instead of the real deal, too bad, so sad.

I purchased an allergy drug from a Canadian web site for years to get lower prices. It had gone generic in Canada but was still prescription in the USA. But I was prepared to NOT complain to the USA gov't if I got duped.

Yea right like Canadians are getting poisoned left and right with low quality drugs and somehow miraculesly have much better longevity then Americans.

 

[travelover]

People harmed by a Canadian-purchased drug will surely demand their USA gov't to do something about it, probably compensate them. The FDA needs to say "don't do it" and then if some dufus USA citizen gets poisoned or takes placebo's instead of the real deal, too bad, so sad.............

It has been going on for a long time. Can you cite a single case where anyone complained to the FDA about a Canadian purchased drug? The much more likely explanation is that drug companies would rather sell the drug here for $100 than via Canada for $10.

 

[NW-Bound]

Why not let Walgreens import the drugs to resell? If Walgreens does not do diligence and resell counterfeit drugs, they get their ass sued by the customers. For their effort, Walgreens would know how much more to charge to make it worthwhile.

 

[travelover]

California had Prop 61 on the ballot to try to control at least some drug prices in the state. The big pharma companies spent a record breaking $100M to defeat it:
.............

Well, yea, but they were only trying to protect the public.