Healthcare insurance and retirement - again!

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And that I agree on. Read my previous post.
I did.

Countries have different ways of financing public welfare. With the US system, it looks like some unfortunate people fall through the crack, and we are looking for ways to help them, while also making sure nobody gets a free ride. It's not easy.

When other countries with a national health system see people taking advantage of their systems, they will crack down too. For example, see my posts #356 (Spain) and #358 (Alberta).
 
I'm looking for all citizens of the world to pay their share as determined in a competitive marketplace t regard to their ability to pay. There is absolutely no need for the USA to subsidize any other country on drug costs. And, of course, the other way around as well.
+1000 You've got my vote.

Regarding your statement of "ability to pay", I recall reading big pharmas' arguments that the US can afford to pay more than anybody else, and so we have to.
 
I did.


When other countries with a national health system see people taking advantage of their systems, they will crack down too

+1

There are population movements and demographic changes occurring in the world today that may very well drive countries to question what they can provide "no questions asked" to all comers.
 
Exporting drugs to Canada at low prices and either importing them back again or selling them direct retail to USA citizens just doesn't pass my common sense test on how to solve our cost of drugs problem. We need to find a way where commodity drugs sell for the same amount anyplace in the world (just like oil or wheat) and patent drugs sell at negotiated prices where the USA is at an advantage, not disadvantage compared to international customers.

Actually, the drug companies import them from China, and it just happened to kill a few hundred people. No big deal, everyone is still in business.

Chinese Heparin Sourcing Questions Resurface After ANSM Inspection | RAPS
 
Companies do negotiate drug pricing partly based on a country's wealth and ability for citizens to afford it. This is one reason why you see a Hep C cure pill so cheap in India compared to the USA. It isn't the *only* reason and for sure there can be reform from the price gouging.

I think there could also be some reform protecting drug developers from the many lawsuits brought on even after the FDA has overseen test results and approved their product. It is also crazy that a person can sue the original developer of a drug even though they were taking a generic version!
 
Just to be clear...... I'm not suggesting that the drug companies make less money. I do want them to have plenty to do research since drug development in the past few decades has been nothing short of amazing. They could no doubt get by with a bit less profit, but my intention would not be to have them become commodity manufacturers working on razor thin margins either. Someplace in the middle where profit would still be able to fund extensive R and D and return to investors.

I'm looking for all citizens of the world to pay their share as determined in a competitive marketplace without regard to their ability to pay. There is absolutely no need for the USA to subsidize any other country on drug costs. And, of course, the other way around as well.

Just so you understand that drug companies spend more money on marketing research than product R&D. Most of the basic drug development is paid for by the US via the NIH and the university system and by European governments. The pharmaceutical industry mostly just skims the cream.
 
Just so you understand that drug companies spend more money on marketing research than product R&D. Most of the basic drug development is paid for by the US via the NIH and the university system and by European governments. The pharmaceutical industry mostly just skims the cream.
Exactly, I was just going to point this out. The argument that if US drug costs were lower that little or no R&D would get done is nonsense.
 
But why not just provide universal coverage? Germany does it for more then 100 years.

When I was getting treated at Memorial Sloan Kettering in NY I spoke with many, many people from all over Europe. If the EU is medical nirvana why then were there so many getting treatment in NY? I'm sure they traveled far for inferior and more costly treatment. I'm sure they could have day tripped to Germany or Spain for far superior and less costly treatment.
Yup universal coverage the be all end all of treatment.
 
When I was getting treated at Memorial Sloan Kettering in NY I spoke with many, many people from all over Europe. If the EU is medical nirvana why then were there so many getting treatment in NY? I'm sure they traveled far for inferior and more costly treatment. I'm sure they could have day tripped to Germany or Spain for far superior and less costly treatment.
Yup universal coverage the be all end all of treatment.
You were talking to a self selected group that was not happy with their home country options. There are lots of Americans that travel to less developed countries for cheap, but adequate health care. Talking to them would generate another set of anecdotes.
 
I have no control on any of this so will just make decisions as things change. Hopefully people will stop taking so many drugs and try to live healthily.
 
I have no control on any of this so will just make decisions as things change. Hopefully people will stop taking so many drugs and try to live healthily.

And for those who cannot afford it: "Let them eat cake".
 
Exactly, I was just going to point this out. The argument that if US drug costs were lower that little or no R&D would get done is nonsense.

Exactly. Even if no US companies produced any additional new drugs because of lack of profits or whatever, there are plenty of other companies in countries that would develop them. France and Israel produce many.
 
Or better yet, why not Walgreens located in Canada? Fill the prescription via the Internet and deliver the drugs via the mail. No shady characters involved.

Walgreens does not operate in Canada.
 
I think Travelover used "Walgreens" to mean any generic drug store.
 
If someone is classified as 20% disabled, they should be getting a monthly disability check. And healthcare.

I think at one time the healthcare benefit was indeed different. When I had corporate heath insurance, the VA billed the insurance company and I did not have to pay any deductible or any unpaid amounts.

My benefit is pretty standard if you have at least a disability 10% rating, which is the minimum.

Like Rodi-I am surprised that you are covered 100% with a 10% rating as well. It is my understanding that unless you are rated 100%, you ate not gauranteed 100% coverage by the VA. They will cover you for health issues related to the rated disability but are not obligated to cover a vet for non rated health issues. DH is rated 100% (times two actually) and he can use the VA for everything if he chooses. He chooses not to however prefering to rely on his federal retiree insurance and the luxury of using his preferred providers. He does use the VA to provide all of his meds. I notice however that the VA files a claim with his FEHB retiree policy for the meds and they are reimbursed for all but the deductible, which they do not pass on to him. I recall when he was first rated 90% in 2008, that the VA is not legally obligated to cover vets rated below 100% for non rated illnesses, but the vet might receive 100% coverage if the VA had the excess resources to do so. In other words "no gaurantee". As I recall the VA stated that the higher the VA rating the greater the likelihood that the VA would cover aoo health issues, so i think you are fortunate to be covered 100% with a 10% rating.
 
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Just so you understand that drug companies spend more money on marketing research than product R&D. Most of the basic drug development is paid for by the US via the NIH and the university system and by European governments. The pharmaceutical industry mostly just skims the cream.

The R&D is nothing. The costs are in the phase I to III trials. A couple of college interns being paid $20 an hour might discover a molecule but it takes at least $500 million to bring it to market and more like $2 billion if you average it out amid failures.
 
All I want is a low cost catastrophic plan until I qualify for Medicare. By low cost, I am thinking about $200.00 per month.

Looking like Medicare won't survive unscathed:

First, Ryan claims that Obamacare has put Medicare under deeper financial stress. Precisely the opposite is true. And it's so straightforward Ryan unquestionably knows this. The Affordable Care Act actually extended Medicare's solvency by more than a decade. Ryan's claim is flat out false.

Second, I've heard a few people say that it's not 100% clear here that Ryan is calling for Medicare Phase Out. It is 100% clear. Ryan has a standard, openly enunciated position in favor of Medicare Phase Out. It's on his website. It's explained explicitly right there.

Ryan says current beneficiaries will be allowed to keep their Medicare. Says. It's the cord is cut between current and future beneficiaries, everything is fair game. For those entering the system, Ryan proposes phasing out Medicare and replacing it private insurance with subsidies to help seniors afford the private insurance. That is unquestionably what it means because that is what Ryan says. So if you're nearing retirement and looking forward to going on Medicare, good luck. You're go on to private insurance but you'll get some subsidies from the government to pay the bill.

http://talkingpointsmemo.com/edblog/ryan-plans-to-phase-out-medicare-in-2017
 
Since you want to go down this road . . .
It's no secret that there was considerable light between Speaker Ryan and Donald Trump during the runup to the election. This was nowhere more evident than in the area of entitlement reform. So >perhaps< it's a bit over-the-top at this point to declare "Medicare won't survive unscathed." In truth, Medicare >can't< continue on its present path. The Medicare Part A fund will be insolvent in 11 years. Doing something about it now, rather than when the last penny in the fund has been spent, is the responsible course of action.
 
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Like Rodi-I am surprised that you are covered 100% with a 10% rating as well. It is my understanding that unless you are rated 100%, you ate not gauranteed 100% coverage by the VA. They will cover you for health issues related to the rated disability but are not obligated to cover a vet for non rated health issues. DH is rated 100% (times two actually) and he can use the VA for everything if he chooses. He chooses not to however prefering to rely on his federal retiree insurance and the luxury of using his preferred providers. He does use the VA to provide all of his meds. I notice however that the VA files a claim with his FEHB retiree policy for the meds and they are reimbursed for all but the deductible, which they do not pass on to him. I recall when he was first rated 90% in 2008, that the VA is not legally obligated to cover vets rated below 100% for non rated illnesses, but the vet might receive 100% coverage if the VA had the excess resources to do so. In other words "no gaurantee". As I recall the VA stated that the higher the VA rating the greater the likelihood that the VA would cover aoo health issues, so i think you are fortunate to be covered 100% with a 10% rating.

I don't understand this comment, if you get VA healthcare, you get VA healthcare...A disability rating my reduce your co-pay to zero. Yes if you have any type of other insurance, the VA will bill your insurance. As a matter of fact, VA encourages you to use the healthcare to stay in the system, they recommend a visit every 12 to 18 months so that you stay qualified as a regular user.
 
Just so you understand that drug companies spend more money on marketing research than product R&D. Most of the basic drug development is paid for by the US via the NIH and the university system and by European governments. The pharmaceutical industry mostly just skims the cream.

Regardless of your opinion I'd rather not risk a sharp and sudden cut to Pharma revenue as you suggest. Reducing USA prices to be more in line with those asked of international customers would be a start. If product development and FDA qualifications continue unscathed, then further domestic reductions. Eventually Pharma might be reduced to a breakeven, highly competitive manufacturing business with no R and D or product trials at all. Those could be handled by the funding sources you mentioned. These changes need to be phased in.
 
Regardless of your opinion I'd rather not risk a sharp and sudden cut to Pharma revenue as you suggest. Reducing USA prices to be more in line with those asked of international customers would be a start. If product development and FDA qualifications continue unscathed, then further domestic reductions. Eventually Pharma might be reduced to a breakeven, highly competitive manufacturing business with no R and D or product trials at all. Those could be handled by the funding sources you mentioned. These changes need to be phased in.

I don't even understand what you are saying here. You think any private company or investor is going to touch Pharma if there is no profit and only risk? The FDA would perform the product trials? Their budget would need to be increased tenfold at least. Who would people watching mid day tv sue because their hair fell out when taking a chemo drug? The FDA?
 
60 Minutes interviewed the President-elect and one of the questions related to repeal and replacing the PPACA. The President-elect indicated he would continue to support the idea that pre-existing conditions will not impact eligibility for health care insurance. He also indicated the new law (if enacted) will not force anyone to be uninsured but rather allow individuals to transition from PPACA plans to the new plans. Yes, the discussion was vague - there are lots of details to be considered - but it was interesting to hear his comments.
 
Like Rodi-I am surprised that you are covered 100% with a 10% rating as well. It is my understanding that unless you are rated 100%, you are not guaranteed 100% coverage by the VA. They will cover you for health issues related to the rated disability but are not obligated to cover a vet for non rated health issues. DH is rated 100% (times two actually) and he can use the VA for everything if he chooses. He chooses not to however preferring to rely on his federal retiree insurance and the luxury of using his preferred providers. He does use the VA to provide all of his meds. I notice however that the VA files a claim with his FEHB retiree policy for the meds and they are reimbursed for all but the deductible, which they do not pass on to him. I recall when he was first rated 90% in 2008, that the VA is not legally obligated to cover vets rated below 100% for non rated illnesses, but the vet might receive 100% coverage if the VA had the excess resources to do so. In other words "no guarantee". As I recall the VA stated that the higher the VA rating the greater the likelihood that the VA would cover aoo health issues, so i think you are fortunate to be covered 100% with a 10% rating.

You are probably thinking of old school programs. It may even have something to do with the ACA. The VA provides the healthcare form 1095B that indicates I have coverage that meets the ACA. The the VA care must meet the same law as any other insurance. They have to cover all preventative care and other items that are typical with any other insurance, including emergencies. Premium and tax free to me. So I have the same coverage at the VA as anyone that pays for coverage with a private insurer.

I think there are some programs that are limited to only service connected disability. Perhaps being able to use a non-VA facility for a service connected disability, but I am not sure.


If I’m enrolled in a VA health care program, do I meet the requirement for health care coverage?

Yes. If you are enrolled in any of VA’s programs below, you have coverage under the standards of the health care law:
Veteran’s health care program
Civilian Health and Medical program (CHAMPVA)
Spina bifida health care program

ACA Frequently Asked Questions -- VA, Affordable Care Act and You
 
I don't even understand what you are saying here. You think any private company or investor is going to touch Pharma if there is no profit and only risk? The FDA would perform the product trials? Their budget would need to be increased tenfold at least. Who would people watching mid day tv sue because their hair fell out when taking a chemo drug? The FDA?

I was just trying to describe the scenario travelover and AllDone were calling for but with a "one step at a time" approach. Eventually we could have the private sector participating only in a highly regulated drug manufacturing industry and the government handling R and D and trials.

R and D direction and priorities could be redirected each election! :rolleyes:
 
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