Follow-up to "A Carefully.."

[kayofcircles]

I asked a question almost a month ago about meds in A Carefully Worded Question (http://www.pcguide.com/vb/showthread.php?s=&threadid=16494) . First, I want to say a public "THANK YOU" to RKBA for his most helpful links in that thread.

Foof's mother recently came out of the hospital taking a bunch of new meds..some of them very expensive. What would have cost $1030.59 for three months from her pharmacy is only $502.24 every quarter (and in some cases that is a 100 day supply rather than 90 day) from Canada. In most cases, it is the exact same medicine from the exact same manufacturer. If there is a Canadian generic, then one sees a much bigger difference..as for one med is $27.52 a quarter rather than $177.87 from an online US pharmacy.

The reason I am sharing this is because I think many of us have parents whose quality of life can be improved IF they can afford to take their meds. And because I have been hearing from some politician's commercials that they're considering trying to have Medicare cover prescription costs. Well, that "sounds" wonderful..but, just for curious, Foof looked up a medicine her husband is taking. The pharmacy charges the insurance company $107.39 for the med..which costs $55.06 in Canada. Seems to me that if Medicare tries to do anything similar to that..then Medicare will just go belly up that much faster...unless they order in bulk from Canada!

Budfred said:
"I agree that this is the capitalist system we live in, but that doesn't mean that we have to accept it. We can support legislators who try to make things better and vote out the ones who dance for the rich and powerful. I am no longer young and idealistic enough to believe that this will ever be complete, but I believe that talking with each other and those who have the power can lead to some changes."

The only thing I would add to that is that we need to keep "asking" our legislators about things like Medicare and Social Security. We had a public debate on health care and such 10 years or so ago..and now our politicians are acting like Medicare and Social Security are "fixed"..no more problems..which I seriously doubt. As far as I know, there have been no real changes that effect either..and they're both still scheduled to "hit the fan" a few years down the line. Probably about the time that WE need them, huh?

[Budfred]

If Medicare truly takes over payment of medication, they will not pay what the other insurance companies pay for 2 reasons. One is that they are big enough to bring a great deal of bargaining clout to the table. Second is that they tend to say what they are willing to pay for whatever service and the companies can either agree or leave. The bad side of this is that a lot of medical people are leaving by refusing to take Medicare patients that they have to see at a loss. The good news is that they can probably rein in medication costs and it will be harder for the pharmaceutical companies to keep charging as much for their meds everywhere.

Now the rest of the bad news. The Republicans have already passed a Medicare bill that would mandate that private HMOs would provide the medication coverage for seniors and others on Medicare. They say this is fixing the problem, but it is only shifting it since many HMOs will still limit or refuse to provide the medication coverage. The Democrat proposal gives the responsibility to Medicare directly, but it is going to be a real stretch to get it passed unless the Dems win a majority in both houses in November.

Budfred

[YODA74]

The Democrat proposal gives the responsibility to Medicare directly, but it is going to be a real stretch to get it passed unless the Dems win a majority in both houses in November

Fat chance of that :D Al couldn't tie his own shoe

You can vote and vote and vote until your blue in the face it just encourages them to run for office.

I say oust the damn gov. and start fresh it's about time for a good revolution to straighten GD the polititions out.They forgot who they work for and just pass more laws and make excuses to cover there own gains and screw the people.I love my flag and i love this land but i cannot stand this D&%^ Government.

But anyho glad to hear your getting the same medicine at a CHEAPER Price Kay (no matter what it takes)just do it.

[NiroTToriN]

That's all we need! More power to the HMO's!! As it is, they're starting to limit the care that physicians provide because they won't pay the physican even the cost of the procedure. Say a procedure costs $100, the HMO says, ok, we'll pay you $85. If the doctors are LOSING money on the operation, do you think that they're going to perform it?

Translation: patient care declines and less doctors can remain solvent. Not a good situation.

However, turning it over to the government is not the solution either. For example, Canada has state sponsored/funded medicine. My uncle was put on a huge waiting list for a hip replacement. It's a relatively simple procedure and quickly done here in the US. So for months he had to struggle along with a bad hip. AFTER the operation, the pain killers that were best for him (ie. most effective) were unavailable. The hospital just gave him a generic medication and said, "too bad..."

Finally, a friend who is a physician in Canada only works for half the year because that's as much as he can get paid for. Any more work and the government won't pay. So, he does his quota, and the rest of the time, he teaches at a local University. Even tho he's a skilled and gifted surgeon, he's limited in the care he can provide. Hence the long waiting lists, etc...

Ok, I've rambled enough... Kinda opinionated about this, sorry!

[Budfred]

The HMOs are not as bad as Medicare in paying less than the procedure costs. Unfortunately, every one who pays for meds pays pretty much what the pharmaceutical companies want because they can't make them do otherwise. This may change if Medicare takes over med payment for seniors and begins insisting on better deals.

Budfred

[kayofcircles]

I could be wrong, but I think our root problem is lawsuits in this country. The drug companies do pay enormous amounts in "testing", then more in other operating costs, including perqs to doctors, advertising, and "insurance." (Remember the company driven out of business by the breast implant lawsuits?)

So, you go to the doctor. The HMO has to pay enormous amounts of money for malpractice insurance. The doctor pays a ridiculous amount and that has to be included in your appointment cost. Then he/she gives you a prescription to fill. The pharmacy, no doubt, also carries insurance, as does the drug company itself. So, all along the chain there are costs for insurance. And before someone objects..it's not just in the health field that we pay "extra" for insurance against lawsuits. It's probably included in almost every product we buy.

A "non-medical" example. My son was driving in ABQ. A car pulls abruptly in front of him and "stops" to turn left. My son hit the car. Okay, no one was disputing that it was my son's fault because he did rear end the car. Our insurance company paid for the damages to the car. Months later, the couple involved in the accident began calling our ins company and asking for money for "whiplash" injuries. Our ins company informed them that they don't "do" that..that the couple should see a doctor and if there were injuries, the ins company would pay the doctor bills. The couple consulted a lawyer, then went to the doctor. The lawyer begin the procedure to sue our ins company. Our ins company has a lawyer on retainer for just this sort of thing, and the suit was so obviously bogus that our ins company was confident of winning the lawsuit, BUT after weeks of negotiation, our ins company "gave" the couple $25,000 to "go away" and told me that it was cheaper to do that than to go through a lengthy court battle. I think that's a good example of what's wrong with our current system..and you know that everyone sees a increase in their insurance premiums to pay for that kind of bs.

I saw a Senate debate on CSpan probably 10 years or so ago where there was a bill to limit the amount of the "pain and suffering" portion. And something about if there was a "penalty/fine" imposed..it wouldn't go to the lawyer(s), or even the client..would go to the state. There was no restriction on getting fair recompense for damages involved in the actual whatever (past or future), just on the nebulous "pain and suffering" that often goes into the millions without any real reason. That bill was defeated...because, well, hey..most of our legislators are lawyers. My thinking is that this problem could be at least partially fixed in our country by doing the above...limiting the "pain and suffering" awards. Does anyone really think that someone "deserves" millions of dollars for getting a coffee burn???

[Budfred]

One correction: the HMOs generally do not pay for malpractice insurance because they are generally shielded from being sued for malpractice, even if it was there decision to refuse payment that led to severe consequences for an individual.

As for limiting the awards for "pain and suffering"; if you can figure a way to make sure that companies are responsible in producing their products so that people don't have to experience pain and suffering, then I am all for it. Unfortunately we have a long history of companies choosing to pay fines or even justifiable damages for loss of life rather than producing safe products. The punitive damages have been one of the only ways that some companies have gotten motivated to improve the safety of their products. That story about the cup of coffee is a good example. The sound bite sounds ridiculous, but when you here some of the details you learn that the person was severely injured and that the coffee was sold at an extremely high temperature. McDonald's has since altered procedures to avoid a repeat of the problem, but the person injured still has to live with the consequences of severe burns. I don't know the answer. I would prefer if all the frivolous lawsuits could be turned around and the people pressing them be made to pay. But then the lawsuits for people who were legitimately hurt by irresponsible companies, doctors, or whatever would have no recourse.

Budfred