Author Topic: The Politics of Health Care  (Read 755885 times)

Crafty_Dog

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ET: New Transplant Methods Raise Difficult Questions
« Reply #1850 on: November 14, 2022, 11:04:59 AM »
Strange New Organ Transplant Methods Raise Urgent Questions
New techniques use organs from partially resuscitated people and look toward genetically modified pigs
FEATUREDBIOTECHNOLOGY
Martha Rosenberg
Martha Rosenberg
Nov 12 2022

If you or a loved one has needed an organ transplant, you know the problem firsthand: There are not enough organs for those who need them and there is a long waiting period.

That desperate need, and potential profits, have fueled a Frankenstein-like effort to find or create organs to give recipients a longer lease on life.

The need for organs can be a matter of life or death. In the United States, more than 105,000 people sit on the national waiting list, and every nine minutes, a new name is added. Seventeen people die every day while waiting for an organ transplant in the United States, according to the government’s organ donor website.

The most common transplant operations are for hearts, kidneys, livers, pancreases, lungs, bone and bone marrow, skin, and intestines; some such transplants come from living donors, but most are obtained after a donor is deceased.

Different organs remain viable for different amounts of time after the patient has died, or after the organ has been taken from the deceased.

According to Donor Alliance, the liver can remain viable for transplant for up to 12 hours, and kidneys for up to 36 hours. But for other organs, such as the heart or lungs, that window is much shorter, in the range of 4 to 6 hours.

With so few organs available for so many in need, there’s tremendous pressure on scientists and industry to push the boundaries of medical ethics with products and procedures that can sound like mad science.

These vanguard developments raise fundamental questions about human life, the commodification of the human body, and the very definition of “human.”

Let’s put aside the obvious horrors of forced organ harvesting from prisoners of conscience in China, including Tibetans, Uyghurs, and, most notably, Falun Gong practitioners, “the primary victims of this cruel practice,” according to the U.S. Human Rights Commission.

Everyone can agree that this practice is abhorrent, but there are other new practices that raise more complex questions, including a new practice that some fear is being used to curb the dead donor rule.

That rule requires that a patient be dead, and often for several minutes, before their organs are taken. This ensures organs only come from the deceased.

Reviving the Dead—Partially
Doctors are using a relatively new procedure called NRP-cDCD (“normothermic regional perfusion with controlled donation after circulatory death”) to widen the window on organ transplants and make more organs available.

In this procedure, terminal patients are allowed to die and then be partially resurrected. Their blood is circulated with the help of machines that warm it, but the arteries that feed the brain are clamped off and starved.

Writing in the journal Cureus in 2022, pro-NRP researchers say that the method “is an emerging technology, a cost-effective alternative in donation after circulatory death (DCD), and will increase the pool of donors in heart transplantation.”

Among other advantages, NRP “restores heart function” and allows “continuous warm blood perfusion,” the researchers write.

Until now, transplant surgeons wouldn’t remove the organs of patients who are not brain dead, even if they couldn’t survive without life support. The procedure raises questions about what can be done with the body after death and how “death” itself is defined. Other procedures challenge the definition of the human body.

Transplants from Genetically Modified Animals

Scientists are in a race to develop genetically humanized animals for their organs. For example, scientists are currently trying to grow human organs in genetically altered pigs and other animals, and in 2017, the creation of what’s claimed to be the first part-human, part-pig hybrid was announced.

Xenotransplantation—using animal organ donors—is far from new. The first pig-to-human corneal transplant, for example, was performed in 1838, according to the journal EMBO Reports, but xenotransplantation was beset with failures until recently.

With the advent of CRISPR gene editing (clustered, regularly interspaced, short palindromic repeats) and stem cell science, an otherworldly new form of “chimeric” animals boasting human organs has made xenotransplantation viable.

Doctors had all but given up on such procedures after too many experiences like Dr. Keith Reemtsma’s in the 1960s.  Reemtsma, a transplant surgeon at Tulane University, inserted rhesus monkey and chimpanzee kidneys into humans, but the transplants all failed.

“An infant known as Baby Fae received a baboon heart at the Loma Linda University Medical Center in California in 1984 but died of rejection 21 days later,” wrote Dr. Joshua Mezrich, a transplant surgeon writing in The Wall Street Journal.

After more mishaps, transplant doctors stopped work with animal organs altogether, Mezrich wrote, and “only implantation of inert tissue from animals, such as heart valves, continued.”

A major risk with transplantation is the human immune system attacking and rejecting the newly transplanted organ as foreign.

According to the government health site MedlinePlus, “all [organ] recipients have some amount of acute rejection,” and if anti-rejection medicines are not used—risky unto themselves—”the body will almost always launch an immune response and destroy the foreign tissue.”

When transplants come from pigs—a preferred animal donor over primates because of size, breeding time, and public acceptance of their use—their intrinsic protein, alpha-gal, leads to rapid human rejection.

In 2020, the FDA approved a pig without alpha-gal, the first intentional genomic alteration. Some researchers and medical scientists want to use pigs that are genetically altered to prevent rejection of their organs in humans.

Issues With Transplantation Research

As the human body becomes more manipulatable by surgeons and scientists, the extent to which transplant research requires “living” human bodies also increases. This can complicate the mourning process for family members or play on the emotions of the organ recipients themselves.

In one example, earlier this year, scientists at NYU Langone Health in New York City announced the plan to study pig kidney behavior in brain-dead individuals for two to four weeks.

After a pig heart was transplanted into Alva Capuano, who was brain dead, as part of a study at Langone medical center, her husband, Richard Capuano, told The Wall Street Journal that the decision “was monumentally hard on the entire family.”

“Even though we realized she had already died and wasn’t coming back, there is still a respirator on and there is still a heartbeat. Psychologically it plays a game with you,” he said.

Many remember the recent saga of 57-year-old David Bennett, the first human recipient of a pig heart, who died weeks after his transplant, apparently from porcine cytomegalovirus (though human herpesvirus 6, which may cross-react with cytomegalovirus, was also found in Bennett).

According to a study published in The New England Journal of Medicine, the pigs used in recent failed human heart transplants at Langone, were significantly altered.

“The genetic modifications of the donor pig (including its heart) fell into two categories: those that inactivated pig genes and those that introduced human genes. In total, 10 different modifications were introduced, most to prevent graft rejection by the human immune system,” noted the journal.

The pig heart recipient, Bennett, had a criminal history and was denied a human heart because he was known to not follow medical guidance, raising other transplantation questions.

Scientific and Ethical Experts Weigh In
While many applaud scientific breakthroughs that allow more organs for human transplants (and these developments can certainly be lucrative), others question the direction in which we are going. In a 2021 statement, the American College of Physicians (ACP) raised serious concerns about NRP-cDCD.

The procedure, it said “is more accurately described as organ retrieval after cardiopulmonary arrest and the induction of brain death. It raises significant ethical concerns and questions regarding the dead donor rule, fundamental ethical obligations of respect, beneficence, and justice, and the imperative to never use one individual merely as a means to serve the ends of another, no matter how noble or good those ends may be.”

ACP is the largest medical-specialty society in the world, with 160,000 members internationally.

‘Humanized’ Animals
In a 2018 paper in the journal Embo Reports, authors worry that human stem cells transplanted into genetically altered pig embryos “will migrate to the animal’s brain and alter its behavior or cognitive state.” While such a brain presence could propel Alzheimer’s and Parkinson’s disease research, “there is no consensus on accurately assessing what it means to possess a human-like cognitive state,” wrote the researchers.

“Should personhood be defined as the percent of human brain cells expressed in a human-animal chimera…?” ask the researchers.

The U.S. National Institutes of Health has refused to support the transplantation of human-animal chimeras for this reason.

Moreover, could the advanced genetic technology we have today be used on “healthy human embryos to create designer babies for behavioral or cosmetic enhancements?” they asked.

Nita Farahany, a professor of law and philosophy at Duke Law School, agrees about the slippery slope that genetic engineering allows, she said in a recent interview with The Wall Street Journal. Scientists still don’t have a grasp on how insertion of human genes through gene editing affects animals’ cognitive capabilities, so “you’re starting to blur the line essentially between humans and non-human animals,” she says.

Disease Transmission

Research in the magazine Philosophy Now raises another ethical question: The possibility of disease transmission and future pandemics occasioned by transplantation.

“Diseases like HIV, Ebola, Hepatitis B, and, most recently, bird flu, originated in animals,” wrote co-author Laura Purdy in the magazine. “Pigs, where current xeno research is now focused, are thought to have been the vector of the devastating 1918 influenza epidemic.”

Known and unknown viruses are embedded in pigs’ DNA as they are in all mammals, says Purdy, and “currently harmless organisms, like the E. coli that lives in our guts, could pick up new, possibly harmful traits from the micro-organisms that came along for the ride on pig organs.”

Whether extreme NRP-cDCD surgery or the creation of pig-human chimeras, the race to harvest new organs has a dark side, according to experts.

“In some ways, the legal determination of death and medical practice are starting to diverge in ways that raise complex ethical and legal challenges we will increasingly face as a society,” Farahany of Duke University told The Epoch Times.

Beyond the moral issues of giving further intelligence to genetically modified pigs, or the health issues of inserting animal organs into people, there are fundamental questions about how we are commodifying the body and what it will mean for the sanctity of the body for future generations.

In a time when people can be fired or censured for not getting injected with a relatively new and unverified mRNA vaccine, which some describe as a gene therapy, these questions take on particular urgency.

And given that many of these organ failures are driven by preventable lifestyle factors, such as stress, diet, and a lack of natural movement, one has to wonder if we are putting scientific and commercial interests ahead of the human beings they are supposed to serve.

DougMacG

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Re: ET: New Transplant Methods Raise Difficult Questions
« Reply #1851 on: November 14, 2022, 11:16:03 AM »
It seems to me medical ethics used to put some kind of limits on what modern medicine could and should do in the manipulation of God's creation.

Now if you oppose genital removal of a minor you are a transphobe and if you oppose chopping the head off a fully developed fetus in the womb, you are a threat to 'women's rights'.

I don't claim to know where the limits should be but there ought to be some kind of limits on what we do with science and 'medicine' as our capabilities keep expanding.

Crafty_Dog

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WSJ $1M a pop for gene therapies?
« Reply #1852 on: December 26, 2022, 09:38:16 AM »
Drug Prices Reach New High—in the Millions
Several new drugs, most of them gene therapies, promise to cure or treat diseases in one course, but their price tags will test the health-insurance system

The most recent gene therapy approved in the U.S. set a price record: $3.5 million for CSL’s Hemgenix, a treatment for hemophilia B.
PHOTO: DARRIAN TRAYNOR/GETTY IMAGES
By Peter Loftus


Dec. 26, 2022 8:00 am ET

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A new era of expensive drugs has arrived: medicines priced in the millions of dollars a patient.

Since August, U.S. or European health regulators have approved four new products intended as one-time treatments for rare genetic diseases that carry list prices of at least $2 million a patient, including two from Bluebird Bio Inc.

The most recent one approved in the U.S. set a price record: $3.5 million for CSL Ltd.’s Hemgenix, a treatment for the blood disorder hemophilia B.

The price tags mark a new high for medicines, which drugmakers were once reluctant to charge more than six figures for but whose prices have been heading upward. The companies say the cost reflects the drugs’ potential to help patients in a single dose, but paying for it could challenge patients and health insurers.

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“It’s an innovation freight train headed toward an inflexible insurance wall,” said Steven Pearson, president of the Institute for Clinical and Economic Review, a nonprofit drug-pricing watchdog group. “The payers are not in a position to say no because there will be no other alternatives” for patients, he added.

Most of the multimillion-dollar treatments are gene therapies, a groundbreaking type of treatment that involves injecting a functional gene into a person to correct a faulty, disease-causing one.

Bluebird’s Skysona gene therapy for a rare neurological disease affecting children costs $3 million, while its Zynteglo for an inherited blood disorder is priced at $2.8 million.

Novartis AG’s Zolgensma gene therapy treating a muscle-wasting condition costs $2.1 million.

Drugmakers say gene therapies can make a difference to patients with rare genetic diseases, by either curing them or providing yearslong benefits through delivering a correct copy of a faulty gene, though there have been some safety concerns over the class.

Some of the new therapies could produce long-term savings, the companies say, by sparing patients from having to take older treatments repeatedly for the rest of their lives. Most of the gene therapies approved to date are for diseases with small patient populations, limiting their overall cost to health insurers’ budgets despite high per-patient prices.


A syringe containing Novartis’s genetic treatment Zolgensma, priced at $2.1 million.
PHOTO: PA WIRE/ZUMA PRESS
Yet health insurers say they aren’t set up to handle such big payouts. They are accustomed to paying for older, chronic treatments on a recurring basis over time, rather than paying a high price for a single treatment that could have lasting benefits.

The introduction of more high-price gene therapies could raise healthcare costs, especially once the drugs target bigger patient populations, health insurers say. That could lead to higher insurance premiums, before any long-term savings kick in.

McKinsey & Co. estimates that about 30 new gene therapies could be introduced in 2024 alone.

“When you think about hundreds of gene therapies under development, if we’re fortunate enough that they all work, there’s a concern about the collective budget impact,” said Michael Sherman, chief medical officer of Point32Health, which administers health-insurance plans primarily in New England. “Each time we see a new gene therapy they are at a higher price point.”

One-time therapies are on the horizon for diseases with bigger patient populations, including a more common form of hemophilia, as well as another blood disorder known as sickle-cell disease.

ccp

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Re: The Politics of Health Care
« Reply #1853 on: December 26, 2022, 10:13:33 AM »
to my knowledge there are no new classes of oral antibiotics being researched

occasionally an intravenous one for hospitals that can cost a lot

but nothing for most everyday use

as bacterial increasingly mutate to more resistant forms we are slowly running out of options


Crafty_Dog

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WSJ: The West's Drug-Price Self-Sabotage
« Reply #1854 on: January 23, 2023, 04:55:16 PM »
The West’s Drug-Price Self-Sabotage
A lesson from Europe for America on how price controls reduce access to treatments and cures.
By The Editorial BoardFollow
Jan. 23, 2023 6:35 pm ET

Democrats and even some Republicans want to import Europe’s drug price controls. So it’s worth observing how Europe’s raid on drug makers to bolster its ailing national health systems is reducing pharmaceutical investment and access to treatments.


The latest alarm came last week when AbbVie and Eli Lilly said they’re pulling out of a “voluntary” agreement with the U.K. government aimed at reducing drug spending. An AbbVie executive said the government’s policies are harming “our ability to operate sustainably in the UK.”

The British National Health Service (NHS) imposes price controls on drugs that reduce their cost on average by 60% versus America. U.K. law also requires drug makers to pay a 24.4% rebate on revenue from branded drugs. This levy on top of the NHS price controls discourages drug makers from selling treatments in the U.K.

The government and companies struck a deal in 2019 aimed at increasing access to innovative treatments, but this has turned out to be even more punitive. The agreement capped the government’s annual drug spending growth at 2%. Drug makers must pay the government rebate equal to their revenue above the cap.

Government spending on drugs has nonetheless continued to rise at a faster rate owing to Covid and delayed care for diseases such as cancer. As a result, companies this year must pay the government 26.5% of their brand drug revenue (about $4 billion), up from 15% last year and 5% in 2021. In short, drug companies are dunned more because more Brits are sick.

Eli Lilly and AbbVie last week withdrew from the 2019 agreement, and Bristol Myers Squibb has warned that the U.K. levies might cause it to divert investment. An executive at Germany’s Bayer last week said it is reducing its U.K. footprint and “deprioritising Europe to some degree.”

***
Governments across the continent are making it difficult for drug makers to earn a return on investment. Germany last fall increased mandatory drug discounts to 12% from 7% and extended a 2010 price freeze through 2026 that was supposed to expire in 2022.

Hard to believe, the U.K. and Germany are also still trying to attract pharmaceutical investment. But as Bayer’s pharmaceutical head Stefan Oelrich recently explained, “European governments are trying to create incentives for research investments, but they are making our lives miserable on the commercial side.” While Europe boasts a handful of pharmaceutical powerhouses, venture capital is flowing into biotech startups in the U.S. and China.

The result for Europe will be less investment and access to life-saving treatments. About 85% of new medicines launched between 2012 and 2021 were available in the U.S., compared to 61% in Germany, 59% in the U.K. and 52% in France and Italy. Bluebird bio in 2021 said it was unwinding operations in Europe and withdrawing gene therapies for rare diseases, citing the challenges of “achieving appropriate value recognition and market access.”

Generic drug firms also say Europe’s price controls, onerous regulation and rising energy costs are contributing to shortages of medicines and driving more production to China and India. Germany in December eased price controls on pediatric drugs in short supply because manufacturers were prioritizing countries with higher reimbursements.

According to a European Public Health Alliance survey in 2019, nearly half of patients reported that they or a family member couldn’t get a drug they needed. In France, 2,446 drug shortages were reported in 2020, up from 868 in 2018 and 44 in 2008. Two in three French oncologists say shortages of anti-cancer medicines can reduce survival odds.

But European governments refuse to pay more to ensure their citizens have access to treatments. Bureaucrats in Brussels are therefore now considering legislation that would reduce intellectual property protection for drugs that don’t launch in nearly all European Union markets. Such a deal: Accept price controls, or Europe will hand IP to the Chinese. Dealing with the Italian mob is easier.

***
The U.S. has drawn more pharmaceutical investment amid Europe’s war on drug makers, but this may not continue as progressives pound the industry. Democrats last year limited the price growth for drugs in Medicare to the rate of inflation and required the feds to dictate lower prices for dozens of drugs to finance climate spending.

Democrats also want the Health and Human Services Department to abrogate patents for higher-cost drugs such as prostate cancer treatment Xtandi that benefitted in part from government research. This would discourage cooperation between private industry and government, which helped produce life-saving Covid vaccines and therapies.

Pfizer CEO Albert Bourla warned last week that attacks on drug makers would leave the West more vulnerable to the next pandemic. “What was the big lesson from Covid? It was that thank god there was a thriving life-sciences industry that was predominantly fueled privately, but also supplemented by academia,” he said.

The novel mRNA vaccines didn’t turn out to protect as well against Covid infection as hoped, but they did save lives and helped the world return to normal. It makes no sense for governments to try to kill companies that came to their rescue.

Appeared in the January 24, 2023, print edition as 'The West’s Drug Self-Sabotage'

ccp

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Re: The Politics of Health Care
« Reply #1855 on: January 31, 2023, 07:15:24 AM »
from previous CD post :

"The West’s Drug-Price Self-Sabotage
A lesson from Europe for America on how price controls reduce access to treatments and cures.
By The Editorial BoardFollow
Jan. 23, 2023 6:35 pm ET"

of course WSJ thinks only of "profits "

but this is the down side of drug companies ripping us off. in the US :

https://www.nytimes.com/2023/01/28/business/humira-abbvie-monopoly.html

I am for price controls that the market itself would take

ie : competition

 2 things bother me:

 price fixing among drug companies - not clear they actually collude per se
but they do not seem to compete on pricing

when a similar drug comes out it seems to be priced like the earlier drug from another company

they see what the competition charges then charge the same but claim their drug is better (usually marginally etc ) and sell on that basis
but do not cut cost for consumers

the other problem is this legal patent scam
they make tiny differences in their drug
 and patent them to prevent competition
or as noted in the article simply pay off the generic manufacturer to not make the drug

THIS IMO needs regulation
folks we are being ripped off 
I am telling everyone


Crafty_Dog

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Re: The Politics of Health Care
« Reply #1856 on: January 31, 2023, 07:52:26 AM »
Some of what you describe is the inherent behavior of oligopolistic markets.

There is also the matter of markets dominated by insurance. 

ccp

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Re: The Politics of Health Care
« Reply #1857 on: January 31, 2023, 07:55:10 AM »
hey CD

CD responded with :

"Some of what you describe is the inherent behavior of oligopolistic markets.

There is also the matter of markets dominated by insurance. "

implying what ?

it is all ok and we should not confuse predatory behavior with free market forces ?

Crafty_Dog

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Re: The Politics of Health Care
« Reply #1858 on: January 31, 2023, 08:02:52 AM »
No, just seeking a good starting point for good diagnosis.

ccp

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Re: The Politics of Health Care
« Reply #1859 on: January 31, 2023, 08:29:28 AM »
"No, just seeking a good starting point for good diagnosis."

I am thinking
diagnosis is human nature

which is  sadly placing profit over morality .

Not inevitable but all too common .

I am not a regulation kind of guy
but sometimes protecting consumers and reducing health costs is legitimate cause for intervention

pros vs cons

IMveryHO

Crafty_Dog

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Re: The Politics of Health Care
« Reply #1860 on: January 31, 2023, 10:07:40 AM »
FWIW my starting orientation:

In the absence of coercion, the Free Market is most harmonious with human nature.

Insurance exists for good and proper reasons but has the consequence of separating the consumer and payor; the consumer is not constrained by price.   Once the insurance modality exceeds a certain portion of the market, the dynamics of a healthy free market are subverted.

IMHO Dr. Ben Carson had a serious proposal when he was running for President that I saw as being a very realistic and plausible way of returning the price mechanism to the health care market while still allowing for insurance for the cases that people could not be reasonably be held to be financially capable.

ccp

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Pharmacy Benefits manager
« Reply #1861 on: February 21, 2023, 09:21:48 AM »
PBM are used as middlemen between companies, insurances , to "negotiate " prices for drugs from the pharmaceutical companies

the top 3 control 80 to 90 % of all drug plans in the nation

and the top 10 control 97%

detailed inspected in recent Jama article recently. I can't post as I am not member of AMA - but I get the magazine free.

Bottom line
 they are more profitible then the pharm companies

while at the same time there is ZERO transparancy to the public

the government allowed them to continue and merge with the health plans and drug stores
United Health Care , Humana, CVS Aetna etc
thinking they this would lower prices .

However, it seems the academics who research this cannot tell if they do this
[certainly does not seem likely with the cost of medicines today ]
or how they and the drug companies seem to be getting fantastically rich while the insurers stock prices at or near at all time highs.

The big pharma are cutting deals with the PBMs to use their drugs as preferred
but paying the BPMs off at the same time

Somehow everyone gets rich - except the consumers who seem to paying more and more for prescriptions

anytime back room wheeling and dealing occurs and is kept from outside inspection and oversight we KNOW it ain't good .

Without a doubt we will be hearing more about people trying to crack this complex maze of  of shenanigans .

We must.
I am near certain US consumers are getting screwed




G M

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Re: Pharmacy Benefits manager
« Reply #1862 on: February 21, 2023, 10:05:02 AM »
anytime back room wheeling and dealing occurs and is kept from outside inspection and oversight we KNOW it ain't good .

PBM are used as middlemen between companies, insurances , to "negotiate " prices for drugs from the pharmaceutical companies

the top 3 control 80 to 90 % of all drug plans in the nation

and the top 10 control 97%

detailed inspected in recent Jama article recently. I can't post as I am not member of AMA - but I get the magazine free.

Bottom line
 they are more profitible then the pharm companies

while at the same time there is ZERO transparancy to the public

the government allowed them to continue and merge with the health plans and drug stores
United Health Care , Humana, CVS Aetna etc
thinking they this would lower prices .

However, it seems the academics who research this cannot tell if they do this
[certainly does not seem likely with the cost of medicines today ]
or how they and the drug companies seem to be getting fantastically rich while the insurers stock prices at or near at all time highs.

The big pharma are cutting deals with the PBMs to use their drugs as preferred
but paying the BPMs off at the same time

Somehow everyone gets rich - except the consumers who seem to paying more and more for prescriptions

anytime back room wheeling and dealing occurs and is kept from outside inspection and oversight we KNOW it ain't good .

Without a doubt we will be hearing more about people trying to crack this complex maze of  of shenanigans .

We must.
I am near certain US consumers are getting screwed

Crafty_Dog

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WSJ: Insulin Prices
« Reply #1863 on: March 02, 2023, 12:20:39 PM »
Joe Biden’s Insulin Fictions
He peddles nonsense about prices that almost no one paid.
By The Editorial BoardFollow
March 1, 2023 6:41 pm ET


The drug maker Eli Lilly said Wednesday that it will cut the sticker price of some insulin products by 70%, and Democrats are taking a victory lap. Well, yes, government coercion can work. But the supposed pricing triumph here is far less than meets the press releases, and the truth is worth noting for the future of drug innovation for Americans with diabetes and other diseases.


“Insulin has been around for 100 years,” President Biden said Tuesday in Virginia Beach, and he says the drug costs $10 to make. “But you’ve been paying three, four, five hundred dollars a month for that. But Big Pharma has been unfairly charging you that—record profits. Not anymore.” The Inflation Reduction Act capped insulin out-of-pocket costs at $35 a month for Medicare, and Mr. Biden wants to extend his price control on insulin into private insurance markets.

This bedtime story also appeared in Mr. Biden’s State of the Union address, and it’s pure fiction. The insulin of a century ago came from animals like pigs and cattle, hardly comparable to today’s products. Long-acting forms can regulate blood sugar for up to 24 hours. Only those who don’t have to inject themselves with needles all day could fail to see the value of an inhaled insulin.

And despite the intoning about profits, net insulin prices have been flat or declining for years. The few patients who struggle to afford the drug are dealing with distortions in insurance and benefit design, not corporate greed. Not everyone benefits from the discounts negotiated by pharmacy-benefit managers.


Mr. Biden said Wednesday that Eli Lilly’s price cut was “a big deal,” but the best industry analysis suggests three in four patients pay less than $30 out of pocket for insulin. Eli Lilly noted in its press release that, same as before, anyone who doesn’t have insurance can “immediately download” an online coupon for $35 a month insulin, and all the major manufacturers offer such help.

Drug makers know they’re on the political menu and are responding to the pressure. Drug makers will probably spread the costs of cheaper insulin in other products they sell. The Biden Administration sees insulin as a convenient political wedge to sell controls on all drugs, and the politics of lower prices now beats the promise of therapies that may never be discovered because of price controls.

Republicans have been under deep cover on healthcare since they failed to repeal the Affordable Care Act, but there is an opening for a politician willing to make the case that the U.S. is the world’s premiere medicine cabinet. A dynamic economy can make drugs more available now without crushing the capital and ingenuity that eventually produce cures to brutal diseases like diabetes.
« Last Edit: March 02, 2023, 01:49:21 PM by Crafty_Dog »

ccp

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Re: The Politics of Health Care
« Reply #1864 on: March 02, 2023, 01:27:48 PM »
"Mr. Biden said Wednesday that Eli Lilly’s price cut was “a big deal,” but the best industry analysis suggests three in four patients pay less than $30 out of pocket for insulin. Eli Lilly noted in its press release that, same as before, anyone who doesn’t have insurance can “immediately download” an online coupon for $35 a month insulin, and all the major manufacturers offer such help."

75 % pay $30 or less
but not clear to me how much the insurance foots the bill
which we all pay for

and the newer insulins are far more expensive usually
 



ccp

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Fauci belongs behind bars/don't know how he got away with it
« Reply #1865 on: March 08, 2023, 10:29:47 AM »
https://www.ncbi.nlm.nih.gov/books/NBK22944/

*The federal Anti-Kickback Statute (AKS) (See 42 U.S.C. § 1320a-7b.) is a criminal statute that prohibits the exchange (or offer to exchange), of anything of value, in an effort to induce (or reward) the referral of business reimbursable by federal health care programs.*

https://www.nationalreview.com/corner/did-fauci-and-collins-receive-royalty-payments-from-drug-companies/


G M

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Re: Fauci belongs behind bars/don't know how he got away with it
« Reply #1866 on: March 08, 2023, 10:42:04 AM »
https://www.ncbi.nlm.nih.gov/books/NBK22944/

*The federal Anti-Kickback Statute (AKS) (See 42 U.S.C. § 1320a-7b.) is a criminal statute that prohibits the exchange (or offer to exchange), of anything of value, in an effort to induce (or reward) the referral of business reimbursable by federal health care programs.*

https://www.nationalreview.com/corner/did-fauci-and-collins-receive-royalty-payments-from-drug-companies/

https://www.revolver.news/2023/03/video-the-hidden-real-reason-why-fauci-lied-to-you-about-hcq-ivermectin/

G M

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ccp

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the religion of tony fauci
« Reply #1868 on: March 13, 2023, 07:08:05 AM »
"Dr Anthony Fauci, the Biden COVID advisor who retired from the government last year, has said he still believes it was likely a natural occurrence"

but he included unnatural cause as being natural cause

if a scientist is out in the woods and brings an animal to the lab and gets corona from that animal  that is in the mind of tony a "natural occurrence "

 :roll:

what a BS artist this guy is .
 

G M

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Re: the religion of tony fauci
« Reply #1869 on: March 13, 2023, 07:10:32 AM »
There is nothing more natural than a PLA Biowarfare lab!


"Dr Anthony Fauci, the Biden COVID advisor who retired from the government last year, has said he still believes it was likely a natural occurrence"

but he included unnatural cause as being natural cause

if a scientist is out in the woods and brings an animal to the lab and gets corona from that animal  that is in the mind of tony a "natural occurrence "

 :roll:

what a BS artist this guy is .

G M

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Re: the religion of tony fauci
« Reply #1870 on: March 13, 2023, 09:43:42 AM »
https://acecomments.mu.nu/?post=403547

There is nothing more natural than a PLA Biowarfare lab!


"Dr Anthony Fauci, the Biden COVID advisor who retired from the government last year, has said he still believes it was likely a natural occurrence"

but he included unnatural cause as being natural cause

if a scientist is out in the woods and brings an animal to the lab and gets corona from that animal  that is in the mind of tony a "natural occurrence "

 :roll:

what a BS artist this guy is .


ccp

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Brit Health care collapsing
« Reply #1872 on: March 16, 2023, 06:41:00 AM »
I didn't know it was that bad there

my nephews first wife was a brit

her father was discussing US vs Brit health care with me
explaining why theirs is better and why don't we want it here.

my short answer was called "freedom" to choose .

I think I caught him off guard.

G M

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Re: Brit Health care collapsing
« Reply #1873 on: March 16, 2023, 06:44:47 AM »
I didn't know it was that bad there

my nephews first wife was a brit

her father was discussing US vs Brit health care with me
explaining why theirs is better and why don't we want it here.

my short answer was called "freedom" to choose .

I think I caught him off guard.

We are the last place where freedom matters, and we are losing ground.

Crafty_Dog

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Re: The Politics of Health Care
« Reply #1874 on: March 16, 2023, 06:47:42 AM »
Which is why we fight by speaking and searching for Truth here.


Crafty_Dog

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NRO: If healthcare is so expensie, why are hospitals closing?
« Reply #1876 on: April 28, 2023, 09:04:58 PM »
If Health Care Is So Expensive, Why Are Hospitals Closing Their Doors?

On the menu today: It’s time to take a look at one of those looming national problems that is not sexy and unlikely to get a lot of attention in the presidential race but that is a problem nonetheless: We’re used to seeing hospitals claim they’re running out of money and need more government assistance. What we’re not used to seeing is hospitals actually going ahead and closing their doors, and not necessarily those in the most rural, far-out places. Somehow the U.S. government went on an unprecedented spending binge during the pandemic, with much of that spending focused on health care, and yet hospitals, particularly rural hospitals, contend they’re just scraping by. Meanwhile on Capitol Hill, lawmakers have noticed that Medicaid reimburses hospitals at a much higher rate than private practices for the same procedures and care, and they are taking a serious look at “site-neutral payments” — perhaps the only proposal to reduce Medicaid spending that is plausible and that won’t automatically get demagogued to death.

The High Costs of Health Care and the Falling Fortunes of Hospitals

How can it be that health care in the U.S. is so expensive — hey, remember when Obamacare and moving to electronic health records were supposed to fix all that? — while at the same time many hospitals claim they are in dire straits?

Some of these claims clearly were not exaggerated: Hospitals have closed or are in the process of closing. In San Antonio, Texas Vista Medical Center permanently closed this week. The hospital’s parent company, Steward Health Care Network, issued a statement to local news reporters blaming the closure on a combination of insufficient support from local government and an unsustainable rate of patients who could not afford to pay their bills:

Twenty-five percent of the patients treated at TVMC do not pay for their care. Without Steward’s commitment, TVMC would have closed years ago. As a physician-led company, Steward has been very reluctant to close TVMC and stayed the course throughout the pandemic. Steward sought partners and many avenues to avoid closing TVMC. However, in the absence of much needed and denied assistance from Bexar County, Steward can no longer keep it open. Very few companies can give away 25 percent of its product and remain viable.

(For anyone preparing their “this is because of tight-fisted Republicans who won’t pay for health care” arguments, note that Bexar County is a heavily blue county where the Democrats swept almost all of the local and county offices last year, Beto O’Rourke carried 57 percent of the vote in last year’s governor’s election, and in 2020, Biden carried 58 percent of the vote.)

In March, Madera Community Hospital and its three rural clinics in Madera, Calif., closed. Madera is not a terribly small town; its population is about 66,000, and it’s smack in the middle of the San Joaquin Valley, just up the road from Fresno. The county is home to 160,000 people.

Last year, Mississippi’s only burn center closed, and the Delta region’s only neonatal-intensive-care unit closed. Things don’t look better next door in Alabama, the sixth-poorest state in the country:

Over the last three years, hospitals in the state have lost $1.5 billion compared to pre-pandemic levels. The reason? Everything costs more—from contract labor which grew by 450 percent, to the cost of medical supplies which has risen by $82 million across the state. Drug expenses are also up 14 percent.

At the beginning of the year, the Center for Healthcare Quality and Payment Reform identified “631 rural hospitals — more than 29 percent nationwide — [that] are either at immediate or high risk of closure. Those at high risk either have low financial reserves or high dependence on nonpatient service revenues such as local taxes or state subsidies.”

And yet, it is unlikely that anybody who has been to a hospital lately will tell you that the experience was cheap. Yes, the pandemic imposed all kinds of new and unexpected costs on hospitals, and the burnout rate among staff was high. Runaway inflation after the pandemic clearly raised operating costs as well. But the U.S. government also spent utterly unprecedented sums on health care during the pandemic, in all kinds of ways — the Provider Relief Fund, American Rescue Plan rural funds, delayed reductions in Medicare payments, and a 20 percent increase in Medicare payments for inpatient Covid-19 admissions during the declared emergency — with much of that funding going to hospitals. Medicare paid $40 to administer each dose of a Covid-19 vaccine. The U.S. government was throwing money at hospitals across the country; how can so many hospitals be going broke?

In that article about Alabama above, a pediatrician argues that the hospitals would be in better shape if the state expanded Medicaid; Alabama is one of eleven states that hasn’t expanded eligibility for the program since the passage of the Affordable Care Act.

A quick refresher: Medicaid covers pregnant women, individuals with disabilities, children in low-income households, some of the poorest elderly, and parents meeting specific income thresholds, generally those at or below the federal poverty level — $14,580 per year for an individual, or $30,000 per year for a family of four. (Children above the threshold for Medicaid can qualify for a separate program, the Children’s Health Insurance Program; North Dakota’s CHIP program covers children up to 175 percent of the poverty level, and New York’s goes up to 405 percent of the poverty level.) States are allowed to impose a usually small copayment on Medicaid recipients for nonemergency care, also determined by income level. In Virginia, “most adults in Medicaid have small copayments for some services. The copayments are usually $1 to $3 for each service. There copayment for inpatient hospitalization is $100.”

Most hospitals insist they lose money — a lot of money — on Medicaid patients. Last year, the American Hospital Association pointed to data from the Medicare Payment Advisory Commission, finding that “hospitals experienced a –8.5 percent margin on Medicare services in 2020, and it projects that margin will fall to –9 percent in 2022. Combined underpayments from Medicare and Medicaid to hospitals were $100 billion in 2020.”

Some studies argue the opposite, and you can find Republicans who argue that the transparency, accountability, and oversight of Medicaid spending are so minimal that hospitals are making money and then telling the world that they’re covering Medicaid patients at a terrible financial loss.

Getting the remaining eleven states to expand Medicaid would mean they’d be switching from one program that loses money to a different program that loses money, hopefully at a slower rate. If expanding Medicaid were a magic wand to help hospitals, we wouldn’t see hospitals closing in places like California.

One of the ideas on the table to control costs moving forward is “site-neutral payments.” Under Medicaid, medical care administered at a hospital-owned outpatient department is reimbursed at a higher rate than care administered at sites that are independent or owned by clinicians. In the anecdote of one doctor, the reimbursement rates are wildly and unjustifiably different:

Hospitals convinced Medicare to pay hospital-owned physicians in outpatient settings at nearly twice the rate that they pay independent physicians. I know of two internists who practiced internal medicine in the same office. Both were trained at the same institution. Both were board certified. One was owned by a hospital, and one practiced independently. Medicare paid the hospital-owned physician nearly double the rate of the independent physician for both an office visit and complete physical exam. There is no valid reason for this. It’s a classic example of corporate welfare.

The Blue Cross Blue Shield Association argues that moving to site-neutral policies would save Medicaid $471 billion over ten years. Because so few members of Congress are willing to touch entitlements in any serious way, enacting site-neutral policies might be one of the very few realistic ways of reducing spending on Medicaid. Congress could credibly argue that it isn’t cutting aid for anyone, just insisting on the same lower payment rate for all care providers.

Unsurprisingly, hospitals hate this proposal. The American Hospital Association contends that hospitals get reimbursed at a higher rate under the law because they do so much more than private practices do:

Americans rely heavily on hospitals to provide 24/7 access to care for all types of patients, to serve as a safety net provider for vulnerable populations, and to have the resources needed to respond to disasters.

However, these roles are not explicitly funded; instead, they are built into the overall hospital cost structure and supported by revenues received from providing direct patient care. Hospitals are also subject to more comprehensive licensing, accreditation and regulatory requirements than other settings.

The Federation of American Hospitals argues, “Blunt site-neutral payment policies, such as the current reduction for clinic services performed in hospital provider-based departments, ignore fundamental functional and cost structure differences between hospitals and physician offices, among other settings, and the unique, mission-critical services communities rely on hospitals to provide.”

But there’s a surprisingly broad coalition endorsing site-neutral payments. On the left, there’s the Progressive Policy Institute; in the middle-ish, there are the Brookings Institution and Committee for a Responsible Federal Budget; and on the right, there are the American Legislative Exchange Council, Americans for Prosperity, and Americans for Tax Reform.

If Congress were to pass legislation requiring site-neutral payment polices and Biden signed it into law, it would represent one of the most unlikely of policy victories — an entitlement reform that saved money, had minimal if any impact on care, and got Republicans and Democrats to agree. The House Energy and Commerce Committee is taking a hard look at this idea. Will it get off the drawing board?

ccp

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Biden NIH nominee
« Reply #1877 on: May 16, 2023, 07:46:30 AM »
Believes Fauci should win Nobel Peace Prize

https://redstate.com/bonchie/2023/05/15/biden-nominates-an-absolute-nightmare-to-lead-the-nih-n746103

 this, and thus she is a woman assures her the nod

ccp

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American Medical Association
« Reply #1878 on: May 20, 2023, 08:39:19 AM »
from the Journal of the American Medical Association

(JAMA)

May 9,2023 pg 1549-50
volumE 329 #18
ABSTRACT:

A fundamental shift in the Supreme Court was set in motion in 2020 with the death of Ruth Bader Ginsburg. President Trump appointed Amy Coney Barrett as his third appointee, forming a conservative 6-3 supermajority. The Supreme Court’s jurisprudence is having a profound effect on public health, safety, and environmental policy. This Viewpoint looks back at the Supreme Court’s 2021 and 2022 terms and forward to the 2023 term and beyond.

Rather than deferring to scientific decisions during the COVID-19 pandemic, the Supreme Court often struck them down. The justices invalidated New York and California’s restrictions on religious gatherings (eTable in the Supplement) despite considerable evidence that congregate settings pose a high transmission risk. The Supreme Court similarly overturned the Centers for Disease Control and Prevention eviction moratorium despite findings that evictions contribute to the spread of SARS-CoV-2.

I cannot post the whole article now without subscription but it is written by 2 Georgetown lawyers  Lawrence O. Gostin, JD  and Sarah Wetter, JD, MPH

https://en.wikipedia.org/wiki/Larry_Gostin
https://www.linkedin.com/in/sarah-wetter-a81b74107?original_referer=https%3A%2F%2Fwww.google.com%2F

IT BASHES THE SUPREME COURT AND CONSERVATIVE JUSTICES  on all woke issues claiming it is harming health (specifically mentioning "with the death of PBG and Trump appointing Barrett").

1) that challenges to the Medical establishment powers CDC moratorium , OSHA edicts and overturning powers by SCOTUS

2) Free speech - "false and misleading scientific information " 

3) Environmental "health" SCOTUS putting more guardrails on EPA tyrannical edits
     and rules

4) Firearm "safety

5) Abortion "rights" ; like I said babies never count in the Universities etc

6) LBGTQ + "rights"

7) and of course Health "equity"

This is the very most blatant partisan publication since I started reading journal somewhere ~ 1982 or 1984.

AMA
JAMA

now the DemocraticSocialistMedicalJournal

or maybe JAMSNBC

disgusting
I would think more than half of doctors are outraged yet will not either say or be allowed to say anything

perhaps there will be letters to the editor but I doubt they will express the necessary outrage or counter points well enough.

even though I get for free I am thinking of still cancelling
but once in a while they do have some article and very rarely a study that concerns
my area of practicing medicine so I feel it best to keep getting .  OTOH I have closer insight into what is going on .

I can only imagine the medical schools or training programs with DEI LBGTQ*+*
classes and brainwashing now.
« Last Edit: May 20, 2023, 08:42:32 AM by ccp »


ccp

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Congress has finally, after reading my posts here, plan to take on PBMs
« Reply #1880 on: May 24, 2023, 02:02:53 PM »
https://www.yahoo.com/news/congress-trying-tackle-rising-prescription-182927024.html

I doubt this :

"he trade association representing PBM’s is called the Pharmaceutical Care Management Association. The group’s President and CEO, JC Scott, said they weren’t invited to share their perspective for this hearing.

In a statement, Scott said the committee risks “fundamentally misconstruing the role of pharmacy benefit companies and playing right into the hands of Big Pharma, which wants nothing more than to weaken this one check on big drug companies’ otherwise unlimited pricing power and avoid accountability for their egregious abuse of the patent system that blocks competition and keeps prices high.”

IF THIS WERE SO TRUE THEN WHY ARE ALL THE PBMs BUSINESS DEALINGS TOTALLY NON TRANSPARENT.

Hard to believe they too mild the system beyond what big pharma does


Crafty_Dog

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Re: The Politics of Health Care
« Reply #1881 on: May 24, 2023, 02:12:58 PM »
mild= milk?

DougMacG

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pharma price, medicare
« Reply #1882 on: August 30, 2023, 07:30:37 PM »
« Last Edit: August 31, 2023, 07:49:53 AM by Crafty_Dog »

ccp

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Re: The Politics of Health Care
« Reply #1883 on: August 31, 2023, 05:25:53 AM »
as expected Ben Shapiro does what the pharma wants:

reduced innovation

kill profits

opening pandora's box

of endless price limits

the end of the pharma industry

I don't buy it

sell more drugs at lower prices and thus profits are preserved.

maybe change the patent time to being longer though drug companies already have schemes to extend it.



ccp

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doctor lenny glass
« Reply #1884 on: November 22, 2023, 07:48:23 AM »
**** harvard psychiatrist ****

on Trump , of course:

https://www.msn.com/en-us/news/politics/harvard-psychiatrist-fears-trump-s-mental-state-has-crossed-into-dangerous-new-terrain/ar-AA1klDIz

and this from the leftist charlatan:

https://www.psychiatrictimes.com/view/dealing-american-psychiatrys-gag-rule

gag rule for doctors diagnosing people they have never interviewed should be lifted for Trump.

how about psyhoanalysis of Obama or Biden or yourself.

Crafty_Dog

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Re: The Politics of Health Care
« Reply #1885 on: November 30, 2023, 02:35:38 PM »
Biden, Trump and ObamaCare
Democrats distort the issue, but the GOP offers no alternative.
By
The Editorial Board
Follow
Nov. 29, 2023 6:49 pm ET


Donald Trump handed his opponents another gift over the weekend by vowing to “terminate” ObamaCare—or at least that’s how Democrats are translating his blunderbuss comments. Democrats are distorting the issue as ever, but they know Mr. Trump has no plan of his own.

“The cost of Obamacare is out of control, plus, it’s not good Healthcare,” Mr. Trump wrote Saturday on Truth Social. “I’m seriously looking at alternatives. We had a couple of Republican Senators who campaigned for 6 years against it, and then raised their hands not to terminate it. It was a low point for the Republican Party, but we should never give up!”


His comments were responding to our editorial (“Elizabeth Warren Has an ObamaCare Epiphany”) about complaints from the Massachusetts Senator that insurers are exploiting the law’s profit cap and driving healthcare costs higher. Thanks for reading, sir, but it would help if there were an idea behind your impulse.

Democrats seized on his post, warning that 40 million Americans could lose health coverage if Mr. Trump wins again. In 2024 “the Affordable Care Act and all its transformational benefits will be on the ballot,” Nancy Pelosi declared. “The American people will need to know that if Donald Trump wins next year, he’s coming for your health care.”

On Tuesday President Biden told donors that “if Trump gets his way, it’s all gone.” Democrats successfully ran on protecting ObamaCare in 2018 and 2020, and they are trying to make it a three-peat. Bidenomics isn’t selling with voters, so why not run on the tried-and-true strategy of scare-mongering about losing health coverage?

Recall that Republicans failed to repeal and replace ObamaCare in 2017 despite controlling both houses of Congress. John McCain’s opposition ultimately killed the GOP’s last reform bill, but Mr. Trump’s unwillingness to understand the policy arguments was the bigger problem. His inability to marshal a case to rally public opinion contributed to its failure and the GOP’s losses in the midterms.

Democrats are again making false claims about ObamaCare that Mr. Trump and Republicans seem incapable of refuting. Mr. Trump later attempted to clarify that he merely wants to “replace” ObamaCare with “MUCH BETTER HEALTHCARE,” though he again missed the mark by suggesting that other countries’ socialized health systems are superior to America’s private care.

The reality is that ObamaCare has increased healthcare costs while producing few tangible benefits for patients. As we recently pointed out, the law’s de facto profit cap has driven industry consolidation, resulting in higher costs for patients and taxpayers. Insurers have pocketed subsidies while increasing premiums and deductibles.

The share of Americans with insurance increased by about five percentage-points in the six years after the law’s Medicaid expansion and health exchanges took effect. This resulted in about 17 million Americans gaining health coverage. But most newly insured are young, healthy adults on Medicaid. They could have afforded “skinny” plans more appropriate for their age and health risks, but the Biden Administration is restricting those plans.

Medicaid spending was growing at an unsustainable 9% a year even before its pandemic expansion. Taxpayers are shelling out $90 billion this year for ObamaCare subsidies—$6,324 per household—which Democrats sweetened in 2021 to offset surging premiums for middle- and upper middle-income Americans.

Meantime, insurance provider networks have become narrower while out-of-pocket costs increase for patients. Democrats have no plan to deal with these problems or soaring government healthcare spending other than drug price controls or rationed care. But neither do most Republicans, who more or less stopped thinking about healthcare after their 2017 failure. The policy chops of former Reps. Paul Ryan or Tom Price are nowhere to be seen in the current House majority.

Republicans could start by educating voters about ObamaCare’s regulatory distortions, such as the de facto cap on insurer profits, rigid plan designs, and benefit mandates that increase costs while limiting choice. They could also propose giving states more flexibility to manage Medicaid in a way that offers better patient care while imposing work requirements for the young and healthy, among other ideas.

There are other ideas, but they require doing some homework and honing a message. If Republicans have nothing more to say than Mr. Trump does, they’re better off ducking the subject lest they lead with their chin.

ccp

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Mark Cuban drug plan model being picked up by CVS
« Reply #1886 on: December 06, 2023, 11:00:56 AM »
https://www.yahoo.com/finance/news/cvs-shaking-drug-pricing-thank-110038889.html

Not clear how this will affect the prices we pay for drugs

I do not like behind the scenes wheeling and dealing by the PBMs.

Do they save or cost us money? I have no idea.

Crafty_Dog

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Re: The Politics of Health Care
« Reply #1887 on: December 06, 2023, 02:09:38 PM »
This bears watching!

ccp

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Biden wants to seize drug patents
« Reply #1888 on: December 06, 2023, 09:06:53 PM »
This I can't agree with:

https://www.politico.com/news/2023/12/06/biden-admin-authority-seize-certain-drug-patents-00130452

However I do wonder if it is right for Drug companies to shyster the duration of patents by changing the drug a tad with slightly different version to keep out generics or they buy out the generic company
and make it themselves.   Something odd all around going on.

Note Biden will emphasize health care, and of course keep reminding us all how Trump will end Obamacare and everyone will die.

we will see if Trump can truly come up with any kind of replacement. Not holding my breath.  Better be better then we can pump more oil and sell to the world to reverse 33 trillion in debt and at the same save Medicare and Social Security

as though money will flow from the heavens into our treasure chest like manna.



Crafty_Dog

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WSJ: DeSanti is right about Medicaid
« Reply #1889 on: December 18, 2023, 05:09:53 PM »
DeSantis Is Right About Medicaid
North Carolina becomes the 40th state to join the expansion, which harms taxpayers and existing beneficiaries alike.
By Brian Blase
Dec. 17, 2023 4:08 pm ET

North Carolina has become the 40th state to succumb to federal cash and adopt ObamaCare’s Medicaid expansion for able-bodied working-age adults. A new study from the Paragon Health Institute shows there is little to celebrate. Overall health is unlikely to improve despite this massive increase in public welfare.

We now have 10 years of data on ObamaCare’s Medicaid expansion. The evidence against the policy is overwhelming: Expansion leads to a surge in spending but reduces healthcare access for traditional Medicaid enrollees such as low-income children and people with disabilities. And it doesn’t improve health.

The Paragon study contains specific estimates for Florida, one of the most populous states that have resisted the policy. If Florida expands Medicaid, some 2.5 million people would newly enroll in the program. Three in 10 Floridians would be on Medicaid, and there would be only 1.5 workers for every Medicaid enrollee. Among people who join Medicaid, 65% would replace private coverage.

The cost of expansion to Florida’s state taxpayers would reach $2 billion by the end of the decade. To pay for that, the state would need to raise its sales tax from 6% to 6.4% or significantly cut other public priorities such as education.

Expanding Medicaid also leads to much higher federal deficits. Florida’s decision to reject ObamaCare’s Medicaid expansion has already saved American taxpayers nearly $50 billion.

After ObamaCare’s Medicaid spending surge, federal officials found that more than 20% of payments nationwide were improper—mainly payments to health insurers for ineligible recipients. A much bigger Medicaid program hasn’t improved health. In the first four years of Medicaid expansion, mortality trends were worse in expansion states.

Medicaid expansion reduces healthcare access for traditional program enrollees. After expansion, Medicaid enrollees were one-third less likely to secure doctor appointments, driving more people into emergency rooms. A Mercatus Center study found that Medicaid spending stagnated for children and people with disabilities and significantly increased for able-bodied working-age adults in expansion states.

Part of a state’s calculus should be how vulnerable it would be to a change in federal Medicaid financing that lowers the ObamaCare reimbursement rate to the traditional enrollee rate, which is 30 percentage points lower for Florida. This policy change passed the House in 2017 and will undoubtedly be on the table when Washington next pursues deficit reduction. If Florida decides to expand and the enhanced match rate ends, the state’s extra costs will exceed $40 billion over the next decade, according to my estimates. North Carolina’s decision to expand creates fiscal risk for the state exceeding $10 billion over the next decade.

Leaders in 10 states have kept Medicaid a priority for those who most need it, and saved Americans from higher taxes that don’t improve health. That is the correct approach—and a courageous one, given enormous pressure from the healthcare industry and the left to expand the program.

Mr. Blase, who served as a special assistant to President Trump at the National Economic Council, is president of Paragon Health Institute and a co-author of “Resisting the Wave of Medicaid Expansion: Why Florida is Right.”


ccp

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Francis Collins restrospective by Rich Lowry
« Reply #1891 on: January 01, 2024, 08:22:10 AM »
https://patriotpost.us/opinion/103221-confession-of-a-public-health-expert-2024-01-01

we all questioned at some point early on was the prescription written by the Medical experts worse then the disease itself.

answer in retrospect - yes.

I don't know if there is any good way to handle such a respiratory viral epidemic that has relatively high death rates - once it is out.


Body-by-Guinness

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Healthcare Spending Up, Payments to MDs & Hospitals Down
« Reply #1892 on: January 24, 2024, 09:14:39 PM »

Body-by-Guinness

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Biden Admin Seek to End Affordable Short Term Health Plans
« Reply #1893 on: March 14, 2024, 04:33:44 PM »
Currently enduring far fewer regulations imposed on the health industry by Obamacare, Biden seeks to eliminate this workaround, impacting a half million Americans along the way:

https://www.cato.org/policy-analysis/biden-short-term-health-plans-rule-creates-gaps-coverage#introduction

ccp

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'The Doctor Will Ask About Your Gun Now'
« Reply #1894 on: April 02, 2024, 06:36:11 AM »
https://www.msn.com/en-us/news/us/the-doctor-will-ask-about-your-gun-now/ar-BB1kTixP

The only time I would/have ask(ed) a patient if they own a gun is when they are contemplating suicide.

Otherwise in my opinion it is not anyone's damn business.

DougMacG

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Re: 'The Doctor Will Ask About Your Gun Now'
« Reply #1895 on: April 02, 2024, 08:29:50 AM »
Let's see, we have a right of privacy, sort of, and we have a right to bear arms, sort of, but we don't have a right of privacy as it relates to our exercise of the (first or) second amendment.

Informing the government of all the privately owned guns would defeat the purpose of having those guns in the event they are needed to stand up against a rogue, tyrannical government.

Or does someone think the government won't get your "health" records if they want them?  And whose idea was it to merge government and healthcare?

The second amendment wasn't about hunters' rights.

[Same might apply to the right or privacy relating to bitcoin purchases (or gold).  The right to wealth.  The purchase of bitcoin is not a taxable event.  The sale of it is.  Why do you have to disclose your purchases? They don't have a constitutional right to tax wealth, why do they have the right to track it. Doesn't a right of privacy apply up to the point where it becomes any of their business?]


Body-by-Guinness

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Re: 'The Doctor Will Ask About Your Gun Now'
« Reply #1896 on: April 02, 2024, 04:43:59 PM »
Let's see, we have a right of privacy, sort of, and we have a right to bear arms, sort of, but we don't have a right of privacy as it relates to our exercise of the (first or) second amendment.

Informing the government of all the privately owned guns would defeat the purpose of having those guns in the event they are needed to stand up against a rogue, tyrannical government.

Or does someone think the government won't get your "health" records if they want them?  And whose idea was it to merge government and healthcare?

The second amendment wasn't about hunters' rights.

[Same might apply to the right or privacy relating to bitcoin purchases (or gold).  The right to wealth.  The purchase of bitcoin is not a taxable event.  The sale of it is.  Why do you have to disclose your purchases? They don't have a constitutional right to tax wealth, why do they have the right to track it. Doesn't a right of privacy apply up to the point where it becomes any of their business?]

More than one doctor—particularly pediatricians when my kids were younger—got an earful when they started reading from the gun script. Likely would have stained their britches were they aware of what all was on my person at the time.

DougMacG

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Hospital Costs Up More Than Twice the Rate of Inflation, WSJ
« Reply #1897 on: May 19, 2024, 07:41:24 AM »
https://www.wsj.com/health/healthcare/surging-hospital-prices-are-helping-keep-inflation-high-a146258b

How can that be?  Aren't the buildings paid for yet?  Where I live, all hospitals are "non-profit".  Are the nurses striking because they make too much?  Where does the money go?

Profit is such a waste (if you don't understand our economic system).  Remove the profit and you remove the greed.  Why should anyone profit over someone else's misfortune?

Of course the answer is that all the alternatives to a 'profit' based investment system are worse.  Everything under government subsidy and government control costs more, performs worse.

"Public employees in California saw premiums increase 11% this year, largely because of rising prices"

Total government control and this is what they do with it??

Meanwhile, what have all these government-owned, government-run entities done to innovate lately?

"Surging Hospital Prices Are Helping Keep Inflation High
A 7.7% increase in prices at hospitals last month was the highest in 13 years"


Did care get 20% better under Biden?  Are outcomes better?  Or are costs just higher?

Don't we have lower cost doctors and nurses surging across our southern border, or are we importing the wrong kind of workers, uh, welfare recipients?
« Last Edit: May 19, 2024, 07:49:30 AM by DougMacG »

ccp

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Re: The Politics of Health Care
« Reply #1898 on: May 19, 2024, 11:14:22 AM »
Good questions.
Hospitals have been merging and making regional, state wide , beyond state wide corporate empires all over the US for decades now.

I had one patient tell me a son was CEO of multiple hospitals and he makes millions.

Rick Scott was head of Humana if I recall

https://www.floridabulldog.org/2021/07/rick-scott-nations-richest-senator-gets-millions-richer/

One can also think of a Presidential candidate whose first name begins with V.

Think the Wall Street side of things for one.
But not the only one.

But also think about patients
if everything is totally covered and they have NO skin the game then health care usage goes up.



Body-by-Guinness

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Deficit Spending’s Impact on Health Care
« Reply #1899 on: May 31, 2024, 04:44:14 PM »
Keep spending money you don’t have and soon you have to use money you do have to pay the interest on the money you didn’t have and hence borrowed. Keep on borrowing and eventually the money you do have services interest, elbowing aside other needs, like the health care you’ve promised to provide retirees et al:

The National Debt Is Becoming a Public Health Threat
The Beacon / by Craig Eyermann / May 31, 2024 at 5:23 PM
Over the past three years, the amount of interest the U.S. government has to pay on the national debt has become the fastest-growing category of government spending. It was already the second-largest government expenditure in 2024 and will soon become the largest.

The Committee for a Responsible Federal Budget (CRFB) estimates that the growing burden of the interest paid on the national debt will account for 21% of the total expected growth in government spending over the next ten years.

The cost of paying interest on the national debt is not the only contributor to the growth of future government spending. The CFRB also projects that Medicare and other healthcare spending will account for 35% of the increase in the U.S. government’s spending growth. Social Security will account for another 28% of the anticipated increase. “Everything else” accounts for 16% of the projected government spending growth.

A public health problem

The very rapid growth of how much the U.S. government pays to borrow money to support its spending imposes more than a fiscal burden on Americans. It threatens their health.

In a recent article, the American Council on Science and Health’s Alex Berezow makes that argument, calling the U.S. national debt a “public health threat.” Here’s the crux of how he arrived at that position:

Though the national debt feels like an abstract academic concept, it isn’t. The debt itself can wreak economic havoc, a phenomenon known as “crowding out.” When the government needs to borrow money, it often gets that money from investors (in the form of government bonds like 10-year Treasury notes). But investor money is not unlimited. Other entities, like established businesses and startups, also need investor money. Competition for this money drives up the cost of borrowing that money—the interest rate. So, the more the government borrows, the higher the interest rate for everyone.

Simultaneously, every dollar invested in government debt is a dollar that cannot be invested elsewhere. That means businesses that need to borrow substantial amounts of money to finance major projects like expansion or research cannot do so because the borrowing costs are too high.

And that is precisely why the national debt is a public health threat. Biotech companies and the venture capitalists who invest in them are having difficulty raising money, and layoffs are plaguing the industry. Even large pharmaceutical companies, which many assume are swimming in cash, are cutting back. Bristol Myers Squibb is set to lay off about 6% of its workforce, some 2200 people.

To be sure, the national debt affects all industries, and the troubles facing the biotech and pharma industries cannot solely or even largely be blamed on the national debt. It is simply one factor among many. But it is a factor that the government can control—but chooses not to.

Over the next decade, 84% of the growth in federal government spending will be due to healthcare, Social Security, and interest payments. Without serious reform, the government will need to borrow yet more money to pay for these increased costs, exacerbating the aforementioned issues. Combined, this threatens to underfund basic services like Medicare as well as health innovation in America. Money problems inevitably lead to health problems.

A more direct way that burden will be imposed is through cuts to big government health care programs, like Medicare Advantage. The Biden administration is pushing through cuts to the popular program’s benefits that half of American seniors use for their health care. Those Americans will now face higher out-of-pocket costs because the government can’t afford to pay both public health benefits and the interest it owes to its creditors.

It’s important to recognize that politicians and bureaucrats have absolute control over how much money the U.S. government spends. Politicians are responsible for approving excessive spending that adds to the national debt. Bureaucrats are responsible for managing that spending, and their failure to do so prudently adds to the burden of the national debt.

Since the government can’t skip paying its creditors without defaulting on the national debt, more cuts to public health programs can be expected. What the Biden administration is doing with its cuts to Medicare is just the beginning.

The post The National Debt Is Becoming a Public Health Threat appeared first on The Beacon.

https://blog.independent.org/2024/05/31/national-debt-public-health-threat/?utm_source=rss&utm_medium=rss&utm_campaign=national-debt-public-health-threat