Category Archives: Government Issues

the root of the problem

The Price of Medication

The Price of Medication

I have posted numerous times about the cost of RX in our country. Recently my lovely spouse passed along a link to an article that rekindled my ire on this topic. See the intro below:

“Why a patient paid a $285 copay for a $40 drug

Health Aug 19, 2018 11:42 AM EDT

Two years ago Gretchen Liu, 78, had a transient ischemic attack — which experts sometimes call a “mini stroke” — while on a trip to China. After she recovered and returned home to San Francisco, her doctor prescribed a generic medication called telmisartan to help manage her blood pressure.                                                                                                                                          Liu and her husband Z. Ming Ma, a retired physicist, are insured through an Anthem Medicare plan. Ma ordered the telmisartan through Express Scripts, the company that manages pharmacy benefits for Anthem and also provides a mail-order service.

The copay for a 90-day supply was $285, which seemed high to Ma.

“I couldn’t understand it — it’s a generic,” said Ma. “But it was a serious situation, so I just got it.”                                                                                                                                                                     A month later, Ma and his wife were about to leave on another trip, and Ma needed to stock up on her medication. Because 90 days hadn’t yet passed, Anthem wouldn’t cover it. So during a trip to his local Costco, Ma asked the pharmacist how much it would cost if he got the prescription there and paid out of pocket.                                                                                                 The pharmacist told him it would cost about $40                                                                                    “I was very shocked,” said Ma. “I had no idea if I asked to pay cash, they’d give me a different price.”                                                                                                                                                           Ma’s experience of finding a copay higher than the cost of the drug wasn’t that unusual. Insurance copays are higher than the cost of the drug about 25 percent of the time, according to a study published in March by the University of Southern California’s Schaeffer Center for Health Policy and Economics.                                                                                                                  USC researchers analyzed 9.5 million prescriptions filled during the first half of 2013. They compared the copay amount to what the pharmacy was reimbursed for the medication and found in the cases where the copay was higher, the overpayments averaged $7.69, totaling $135 million that year.

USC economist Karen Van Nuys, a lead author of the study, had her own story of overpayment. She discovered she could buy a one-year supply of her generic heart medication for $35 out of pocket instead of $120 using her health insurance.”

I act as guardian for my mother who has both Medicare & Tricare coverage. I just received a detailed account of my mother’s medications for RX this year. There is an “*” on each line item. The note at the bottom of the statement reads as follows: “You can use home delivery from the TRICARE Mail Order Pharmacy for this medication and receive a 90 day supply for less than the 30 day supply co-pay from a retail pharmacy. Shipping is free……..”

I am shocked by this. As a tax payer you should be also. Obviously planned overpayments to pharmacies (with possible collusion by insurance companies) is horrible and in my view constitutes both fraud and an additional “tax” to consumers. However, keep in mind that these are examples were the Co-pay is higher than the retail value of the drug. This is not merely an “overpayment” but outright theft. The attempt at explanations, in my view, are ludicrous. I encourage you to form your own view by reading the entire article at: https://www.pbs.org/newshour/health/why-a-patient-paid-a-285-copay-for-a-40-drug

 

 

Americaneeze

Americaneeze

I think we often forget that we have a “borrowed” language. Over time our use of English has evolved and probably not for the better. I am the first to admit that my language skills are lacking. Anyone reading this and other postings can testify to that fact. I’ve always been a bit better with numbers.

I am a reader and always have at least one book in process. Despite my exposure to great word smiths my writing talent is stagnant. I am in awe of published authors.

However, there are a couple of commonly used phrases that make my skin crawl and both involve “dangling” participles:

“Where are you from?” Not only the participle “dangle” but what does this really mean? Where do you live or where were you born or where were you just before where you are now or…….. How about “Where are you living?” of “Where is your home?”

“Where are you at?” What is it with the use of “at”. Why is it needed? Wouldn’t “Where are you” suffice?

As time passes Americaneeze evolves. I have tremendous admiration for the language employed by our founding fathers. They had the ability to effectively and concisely convey thoughts and actions. The following is an excerpt from President Washington’s farewell address and concerned the dangers of the two-party system. (I sited this in an earlier post and it is well worth repeating)

“The alternate domination of one faction over another, sharpened by the spirit of revenge, natural to party dissension, which in different ages and countries has perpetrated the most horrid enormities, is itself a frightful despotism. But this leads at length to a more formal and permanent despotism. The disorders and miseries, which result, gradually incline the minds of men to seek security and repose in the absolute power of an individual; and sooner or later the chief of some prevailing faction, more able or more fortunate than his competitors, turns this disposition to the purposes of his own elevation, on the ruins of Public Liberty

Without looking forward to an extremity of this kind, (which nevertheless ought not to be entirely out of sight,) the common and continual mischiefs of the spirit of party are sufficient to make it the interest and duty of a wise people to discourage and restrain it.

It serves always to distract the Public Councils, and enfeeble the Public Administration. It agitates the Community with ill-founded jealousies and false alarms; kindles the animosity of one part against another, foments occasionally riot and insurrection. It opens the door to foreign influence and corruption, which find a facilitated access to the government itself through the channels of party passions. Thus, the policy and the will of one country are subjected to the policy and will of another.

There is an opinion, that parties in free countries are useful checks upon the administration of the Government, and serve to keep alive the spirit of Liberty. This within certain limits is probably true; and in Governments of a Monarchical cast, Patriotism may look with indulgence, if not with favor, upon the spirit of party. But in those of the popular character, in Governments purely elective, it is a spirit not to be encouraged. From their natural tendency, it is certain there will always be enough of that spirit for every salutary purpose. And, there being constant danger of excess, the effort ought to be, by force of public opinion, to mitigate and assuage it. A fire not to be quenched, it demands a uniform vigilance to prevent its bursting into a flame, lest, instead of warming, it should consume.”

We need more immigrants from Norway

We need more immigrants from Norway

Some of the info in this posting is taken from the link below:
https://www.npr.org/sections/goatsandsoda/2018/01/12/577673191/trump-wishes-we-had-more-immigrants-from-norway-turns-out-we-once-did
In the January meeting in which President Trump complained about “having all these people from shithole countries come here” — and singled out Haiti, El Salvador and Africa as examples — he also added that, “we should have more people from Norway.”
In fact, there was a time when we did!

From 1870 to 1910 a quarter of Norway’s working-age population emigrated, mostly to the United States. You read that right — one-fourth of its workers left the country.

Back then Norway was quite poor. Wages were less than a third of what they were in the United States. And the wave of emigration out of the country quickly benefited those who remained. That’s because it reduced the supply of workers in Norway, so those left behind could demand higher wages. And this helped narrow Norway’s wage gap with the U.S. by 25 percent over that same 40-year period, putting Norway on the path toward its status today as one of world’s most prosperous nations.

Those are the findings of a paper published in European Review of Economic History back in 1997 by two economists. It’s considered a seminal work because the authors — Alan Taylor of the University of California Davis and Jeffrey Williamson — then of Harvard University, now professor emeritus at the University of Wisconsin, Madison — combed through paper archives to piece together the first truly comprehensive picture of wage differentials across European countries and the United States during that time.

“They were the pioneers really — the first to do that,” says Michael Clemens, an economist at the Center for Global Development, a D.C. thinktank, who specializes on the role of migration in reducing poverty.

What is keeping Norwegians from applying for the American dream today?

Well, the following chart may at least be a partial explanation:

HDI rank Country Human Development Index (HDI) Value Life expectancy at birth (years) 2014 Expected years of schooling (years) 2014 Gross national income (GNI) per capital (2011 PPP $) 2014
1 Norway 0.944 81.6 17.5 64,992
2 Australia 0.935 82.4 20.2 42,261
3 Switzerland 0.93 83 15.8 56,431
4 Denmark 0.923 80.2 18.7 44,025
5 Netherlands 0.922 81.6 17.9 45,435
6 Germany 0.916 80.9 16.5 43,919
7 Ireland 0.916 80.9 18.6 39,568
8 United States 0.915 79.1 16.5 52,947
9 Canada 0.913 82 15.9 42,155
10 New Zealand 0.913 81.8 19.2 32,689