Fact-esque

Ben Nelson Protects Medicare Advantage (And Big Pharma)

Prime Blue Dog Ben Nelson, who hasn't made many non-Republican friends lately - or ever - has just sold the New York Times a Bridge to Nowhere, convincing one Robert Pear that, really, Medicare Advantage isn't a huge giveaway to Big Pharma that costs seniors A LOT of $$$ they wouldn't otherwise have to pay for their drug treatments, it's..well, let him tell it in his own inimitable way.

The bill taken up this week by the committee would cut Medicare payments to insurance

companies that care for more than 10 million older Americans, including nearly one million in Florida. The program, known as Medicare Advantage, is popular because it offers extra benefits, including vision and dental care and even, in some cases, membership in health clubs or fitness centers.

Yuh. At 3X normal rates. And of course health clubs and fitness centers are very well known for the massive numbers of senior citizens who go there to work on their abs and get shinier, more healthy quads, running on treadmills and bench-pressing free weights. And since when is there no vision or dental care with Medicare? When did that happen? Or does "extra" mean they pay for rhinestones on the hornrims?

The First Step Toward Killing SocSec?

The "We can't afford it!" crowd of conservatives, Pub and Dem, have apparently won the first round in their War on Social Security. For the first time in 34 years, there will likely be no cost-of-living adjustment (COLA). With inflation currently in negative numbers, that may not sound like much of a hit but there are a couple of things to consider. First, food prices are going up above the inflation level, and energy prices, while lower than last year (the biggest reason the inflation level is considered low), are still pretty goddam high for people on a fixed income and projections are that energy prices won't stay depressed through the winter. Those are two of the biggest three expenses seniors face. The third, of course, is health care, and the biggest chunk of their health care expenses is drugs. Thanks to Medicare Part D, they're going to be paying more out of their pockets for those drugs.

Medicare Part D Cont'd: Obama Re-Ups Bush Giveaway to Big Pharma

I missed this last week but Robert Reich didn't. The Obama Admin has just promised to continue the abortion called Medicare Part D - a Bush program that has proven to be a bonanza for greedy drug makers and a nightmare for seniors who need those drugs - in exchange for their active support on his healthcare reform package.

Last week, after being reported in the Los Angeles Times, the White House confirmed it has promised Big Pharma that any healthcare legislation will bar the government from using its huge purchasing power to negotiate lower drug prices. That's basically the same deal George W. Bush struck in getting the Medicare drug benefit, and it's proven a bonanza for the drug industry. A continuation will be an even larger bonanza, given all the boomers who will be enrolling in Medicare over the next decade. And it will be a gold mine if the deal extends to Medicaid, which will be expanded under most versions of the healthcare bills now emerging from Congress, and to any public option that might be included. (We don't know how far the deal extends beyond Medicare because its details haven't been made public.)

Let me remind you: Any bonanza for the drug industry means higher healthcare costs for the rest of us, which is one reason why critics of the emerging healthcare plans, including the Congressional Budget Office, are so worried about their failure to adequately stem future healthcare costs. To be sure, as part of its deal with the White House, Big Pharma apparently has promised to cut future drug costs by $80 billion. But neither the industry nor the White House nor any congressional committee has announced exactly where the $80 billion in savings will show up nor how this portion of the deal will be enforced. In any event, you can bet that the bonanza Big Pharma will reap far exceeds $80 billion. Otherwise, why would it have agreed?

In return, Big Pharma isn't just supporting universal healthcare. It's also spending lots of money on TV and radio advertising in support. Sunday's New York Times reports that Big Pharma has budgeted $150 million for TV ads promoting universal health insurance, starting this August (that's more money than John McCain spent on TV advertising in last year's presidential campaign), after having already spent a bundle through advocacy groups like Healthy Economies Now and Families USA.

(emphasis added)

It's a lousy trade for more reasons than I have the space to explain here, not the least of which is that big drug companies have already reaped $Billions$ from Part D and now stand to reap many $Billions$ more, so $150Mil is, like, a drop in the bucket. It's like promising to replace your neighbor's broken window - the one you just winged a rock through - but only if he'll buy you a Ferrari.

But it isn't so much that this is yet another lousy deal made by Democrats where massive goodies go to corporate sleezebags in return for almost nothing so much as that it is a prime example of business-as-usual in a fascist state: extortion, blackmail, and self-serving lies.

Joining the Great Ponzi Scheme!

My son just got his first paycheck.  He paid $8.37 into Social Security and $1.97 into Medicare.   I asked him how he felt to pay into Social Security for the first time.  "Cheated!" he said.  He was kidding.  He's a good boy and I'm very proud of my working class guy. 

Medicare Part D Sucks

If you want to have an article on hand to share with people who tell you that Medicare Part D is just swell, this one would be a good choice:

Part D offers a disturbing window on the future of health care. For conservatives, it represents the sharp end of the stake they hope to drive into Medicare at large, destroying the largest and best single-payer health care program this nation has ever known. For progressives, it demonstrates the vast shortcomings of any health program—no matter how "universal"—that fails to defy Big Pharma and the insurance companies. For myself, perhaps the key lesson from dealing with Part D has been that the new plan doesn't have that much to do with ensuring drug access for seniors, but a great deal with securing the vested interests of the stakeholders—from the Bush administration and the pharma industry, all the way to groups like aarp.   (via Corrente)

Happy Birthday Medicare!

Medicare is 43 years old today. It isn't easy to find mention of that happy fact in the corporate media but there are some celebrations happening hither and yon.  The AFL-CIO blog notes that the Alliance for Retired Americans has organized cake deliveries to members of Congress as well as press conferences and rallies in at least five states.   It looks like PA State Senator James Ferlo joined forces with the Teamsters to host an in-district party at noon today.   Healthcare-Now, a single-payer fan, has organized parties around the country.   And there is a terrific article in the Jasper Newsboy, (from Jasper, Texas, home of Traudney Byerly) that warns seniors against losing what Medicare was set up to do:

In an Overwheming Defeat BushCo Medicare Veto Overidden After Republican Filibuster Broken

That's the sort of headline I wanted to see today.  Instead we got stories like this one from the pro-war WaPo.  You only need to read the mindless regurgitation of BushCo's  baseless position on the Medicare Advantage boondoggle, which suffered a small setback in this bill, to know that you should be looking elsewhere for information:

Bush said the cuts to insurers would harm the managed-care program, which his administration sees as giving seniors more choices and eventually leading to lower health costs for the federal government.

I see eating two cups a day of Edy's Grand Ice Cream as giving me all the calcium I'll ever need and eventually leading to lower body mass and toned abs.  See the problem?

The Center on Budget and Policy Priorities released a good statement on the veto.  From it:

Under the bill, overall enrollment in Medicare Advantage (the program through which Medicare beneficiaries  can elect to receive coverage through private insurance companies instead of regular Medicare) would still climb by 25 percent over the next five years, according to the Congressional Budget Office.

Also, enrollment in private fee-for-service plans within Medicare Advantage would still be expected to  increase by 39 percent by 2013 — even though it costs the federal government 17 percent more to cover a   beneficiary under private fee-for-service plans than under       regular Medicare, on average, according to Congress's expert  Medicare Payment Advisory Commission.                  

The bill would, however, require private fee-for-service plans to establish adequate provider networks and collect data on the quality of health care they provide, as other Medicare Advantage plans already must do.  By making them compete on a more equal basis with other private plans, the bill would slow their explosive and thus costly                   enrollment growth.  This, in turn, would produce part of the savings that offset the bill’s overall cost, while improving access to care among beneficiaries enrolled in these              plans.                  

There's an easy way to produce $157B in savings over ten years: end Medicare Advantage overpayments completely.  But, you know, babysteps.   Plus BushCo had his butt handed to him.  So it was a good day.

 

Patients Pay $Thousands$ for Drugs Even When They're Insured

I don't know how long ago it was that Rob began warning about the new Medicare regulations promulgated by the Bush Admin but it was years at least. The NYT is reporting that Rob's dire predictions are coming true and they're worse than we imagined.

Health insurance companies are rapidly adopting a new pricing system for very expensive drugs, asking patients to pay hundreds and even thousands of dollars for prescriptions for medications that may save their lives or slow the progress of serious diseases.

With the new pricing system, insurers abandoned the traditional arrangement that has patients pay a fixed amount, like $10, $20 or $30 for a prescription, no matter what the drug’s actual cost. Instead, they are charging patients a percentage of the cost of certain high-priced drugs, usually 20 to 33 percent, which can amount to thousands of dollars a month.

The system means that the burden of expensive health care can now affect insured people, too.

No one knows how many patients are affected, but hundreds of drugs are priced this new way. They are used to treat diseases that may be fairly common, including multiple sclerosis, rheumatoid arthritis, hemophilia, hepatitis C and some cancers. There are no cheaper equivalents for these drugs, so patients are forced to pay the price or do without.

Insurers say the new system keeps everyone’s premiums down at a time when some of the most innovative and promising new treatments for conditions like cancer and rheumatoid arthritis and multiple sclerosis can cost $100,000 and more a year.

But the result is that patients may have to spend more for a drug than they pay for their mortgages, more, in some cases, than their monthly incomes.

The system, often called Tier 4, began in earnest with Medicare drug plans and spread rapidly. It is now incorporated into 86 percent of those plans. Some have even higher co-payments for certain drugs, a Tier 5.

(emphasis added)

This was almost inevitable with the way the Bush prescription drug plan was written - and sold. He as much as told Big Pharma that they could start charging more and there would be no consequences. So they did.

What you need to keep in mind is that bogus use of the word "costs". When Big Pharma reckons "cost" what is supposed to be a number made up of the costs of materials and manufacturing becomes instead a number made up of the costs of the research they didn't pay for, grossly inflated (most of these drugs were developed by universities and the NIH - one on govt grants & the other a govt agency, both of them paid with our taxes - and given to the companies by either the administration or the Republican Congress), the tests of the drug they may not even have done, the costs of faking those tests if they didn't pass the first time (sorry but Big Pharma considers that a legitimate expense and pays the people who do it), and the costs of their advertising to doctors and hospitals.

That advertising, btw, is some of the most expensive in the world. It includes paying reps to travel the country selling hospitals on the efficacy and availability of the drug, gifts to doctors and hospital administrators (and we're talking expensive cars and all-expense-paid Caribbean vacations, not refrigerator magnets and tiny bottles of white-out), and a potential multi-layer media blitz of standard ads on tv and in trade publications.

Finally, there is this: when Big Pharma measures its "costs" it includes the markup. That's right, campers. When it assesses its costs for the purposes of discounting, it includes the profit it would have made if the drug had been sold at full price. So on top of the rest of their cost scam, they add the 40%+ they would have added if they'd sold the drug on a theoretical "open market".

This is what they've shown consumer advocates when they've been challenged about their pricing, and negotiators around the world (except in the US, where Medicare is forbidden by law from such negotiating) have used these facts to push drug prices down from the stratospheric prices charged in the US to the bargain basement prices charged overseas. Which low prices they then report as "charitable contributions" and get the difference written off on their taxes.

It's not by accident that Big Pharma's profits are second only to the record-breaking profits made by Big Oil since Bush became president (remember, Rumsfeld used to be a Big Pharma CEO). It's by design.

Bush Design.

Happy Override BushCo Day!

Woo hoo!  It's Override BushCo Day!   I do a lot of complaining about the state of the State because, you know, I'm conscious.    But here's something cheery - some Rep. Allyson Schwartz (PA-13), a longtime leader on SCHIP, to start your Override BushCo Day.

And yesterday Rep. Schwartz asked what BushCo has done to help America's uninsured children and reminded us who's stopping progress when it comes to keeping our kids healthy:

The vote is scheduled for around 11:00am.  I'm not expecting a good outcome but on the bright side, I'm always wrong. 

SCHIP Rally in Philly

Over 300 people showed up yesterday evening in Philly's Rittenhouse Square Park to rally for Children's Health Care.   The American Medical Students Association, god bless'em, were out in force so there were white coats and scrubs everywhere.   SEIU Healthcare PA were there to lead some chants and get the energy up.  Of course the response from passing cars and pedestrians was overwhelmingly positive, which is what you would expect when every poll shows that Americans do not support BushCo's cruel and unnecessary veto of the bi-partisan, compromise reauthorization of SCHIP.    More photos here.  See if you can find me!   

I don't expect the veto to get overridden on Thursday.   The Party Over County party won't let their boy suffer any embarrassment - especially at the hands of the irrelevant Congress no matter which party controls it.     And the insurance industry, as much as it likes getting checks from SCHIP, would like to see the specter of Universal Single Payer health care take a hit.     Plus, the middle class has to be knocked back too - taught another lesson in exactly what they deserve from this economy.  To  paraphrase Tim Curry, they ask for nothing and they shall get it in abundance. 

What will be particularly painful is waiting to see if the Dems, no friends of the middle class, will compromise with Dear Leader to get what they would wrongly consider to be a legislative win.  Will they weaken the SCHIP bill itself or throw the Constitution under the Authoritarian bus by going along with the destruction of FISA?  Hey, since we're talking about the Dems here, who knows?   It could be both of those plus a promise to fully dissolve the party by the end of the year.    If you see them capititulate on SCHIP, you'll know that they're almost there.