Saturday, March 9, 2019

Marco Lite?



Is health care the top reason for bankruptcies, as a Florida GOP leader said?


This may well be the most mendacious, ass backwards, leap of illogic any politician has ideated recently (this excludes almost every single Trump lie, of course). First off, Jose Oliva, Miami Lakes scumbaggery expert, ignores the fact that essentially all insurance in the US which isn't Medicare or Medicaid is private insurance. He comes across as a sort of "Marco Rubio Lite."  Oliva has made reducing Education and Health Care spending his two principal legislative goals in the upcoming Florida Legislative session. Does anyone really think this is out of genuine concern for any interests other than Pharma and Insurance?

       Fact: We have the highest per capita costs of all OECD (developed, generally European) nations and close to the lowest consumer satisfaction. Simply put, we pay far more and get far less than nations with Single payer systems. This is perhaps the most thinly veiled shill for the insurance industry ever. The only truth here is that many Americans find themselves in dire financial straits when major health issues arise. There are many reasons but leading the way is the prohibitively high cost, for many, if not most, working class households, of truly comprehensive coverage. Add to that, the abusive drug pricing not only allowed, but forced upon consumers by a pharmaceutical industry whose annual NET profits, routinely top 25%. That's about 3 to 4 times the average for other US economic sectors. Cap the whole mess with the fact that Medicare/Medicaid cannot negotiate drug prices lower because of the provisions in the Medicare Part D legislation, Bush 43's Valentine to Big Pharma.
    
        Want to cut healthcare spending on a national level?  Allow Medicare/Medicaid to negotiate drug prices. If the Government paid what most insurers pay for Drugs across the entire spectrum (significantly lower prices) Medicare costs would decrease by about 10%. This alone would go a long way towards making the economic side of things much better.

        Let me be clear and simple here: None of the bitching and moaning from Congress or State level legislators about high Medicare costs takes the highly inflated Medicare/ Medicaid drug prices involved into account.

        If you have healthcare insurance and need, just as an example, an Epi-pen 2 pack, your insurer and you, (what you spend depends on the copay) pay somewhere in the area of $175, minus further reduction for any coupons you might have which further defray the cost, for the product. This is still, for this product (I’ve done the research), about 1166% profit on every Epi-pen 2 pack! Understand this. For a $25,000 automobile, the actual percentage that is profit is about 5%, or about $1250. If auto manufacturers enjoyed the same ability to punish consumers as drug manufacturers do, that car would cost you about $277,000!   

       If you are a Medicare or Medicaid patient, the manufacturer lists the 2 pack at about $600, and that's what they get, either from Medicare, your co-pay, or both.  Medicare’s cost, on the other hand, yields a 4000% profit on the same product. God forbid that, as a Medicare patient you find yourself in the “Doughnut Hole” and get stuck with the entire cost. Now you know why the Big Pharma companies list lobbying as their third or fourth largest budget line item, with advertising the first.

        Finally, and I repeat this because you’re going to hear a lot of misleading babble re: single-payer health care over the next year and a half, so far, all negative comparisons re: the cost of single- payer (in some cases labelled “Medicare for all”) healthcare concepts have similar data driven gross inaccuracies:

·       They compare private insurance costs to Medicare without factoring in Medicare’s inflated drug costs. In 2018, drug costs were about 25% of all Medicare spending. Even with a very conservative estimate that Medicare is paying just twice as much for the same drugs, on average, as private insurance, eliminating that inequity would decrease the cost of Medicare by more than 10%. In round numbers for 2018, that savings, alone, would come to well over $70 billion!

·       The high costs cited by opponents of single-payer equate the cost of Medicare for all to the costs of Medicare for those who are currently on it. This is grossly inaccurate for several reasons: 

a.     The average Medicare patient is over 65, ergo has generally higher medical bills that a 35-year-old. Having all citizens on Medicare would result in a lower average cost per-capita due to simple demographics.

b.   Medicare patients over 65 contribute relatively little to the cost of their healthcare under Medicare. At $137 monthly, which is Part b coverage, that is (minus deductibles and copays) the contribution for a healthy senior over 65. Adding part D drug coverage adds a bit more, but as discussed, the drug prices are hugely inflated. Equating Medicare for all to this figure ignores the fact that most working persons under 65 (And, for many if not most, their employers) spend far more for all services) for healthcare insurance, at present. In fact: Premiums for individual coverage in 2016 (higher now!) averaged $440 per month while premiums for family plans averaged $1,168 per month. This is in addition to paycheck deductions for Medicare, which, for a wage earner making $50,000 annually, comes to another $60 monthly.
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S            Single payer is inherently more cost effective from an administrative standpoint. Canada administers a truly far flung system with about the same administrative staffing as Blue Cross uses to handle just Massachusetts.

·                Summarizing: The average working age American currently pays somewhere in the area of $500 monthly for themselves, and the average American family of four now spends an almost unbelievable amount for all healthcare related expenses. The total (2018) annual costs for a typical family of four, insured by the most common health plan offered by employers, will average $28,166, according to the annual Milliman Medical Index. This number alone exceeds the current federal “poverty level” for a family of four! ... But every month, a family of four's health care costs are going up another $100!

        This current expenditure of private funds is usually also conveniently ignored when comparing Single payer, usually Medicare for all, to private insurance. If the current input from retirees over 65 is the only monetary input, as it is now (plus the minimal paycheck deductions for those working and under 65) yes, Medicare for all would be prohibitively expensive. But…. even at current prices, considering all Americans from 1 to 65, the average health care spending per month is now $587 monthly (kids included). So, 65% of the population (Medicare accounts for 15%, Medicaid for 20%) represent an additional spending which greatly exceeds that of current Medicare recipients but goes to private interests. This is also conveniently ignored when comparing what is now obviously apples to oranges.

       So, what to do? Initially, dispel the concept that the government can’t do things efficiently. Medicare is efficient, by comparison to any and all private insurers. Most doctors I know agree that single payer is better. Billing specialists are even more avid fans of single payer.

        Then, negate Medicare part D’s ban on the government negotiating drug prices. Have most, or all, (it could probably actually be less!) of what is currently spent by employers on employee health insurance go to Medicare.

        Retain reasonable (but lower) copays on way would be lower drug prices.

        Enroll citizens in Medicare at birth just like Social Security.       

        “Bump up” the Medicare payroll deduction to, say, 5%, which is still far, far less than the current cost of family insurance plans through employers or private plans.

         Finally, allow private supplemental insurance to be purchased, as about 11% of those in the UK do. Because basic services are free under Single payer programs, supplemental insurance would be (is in the UK) relatively cheap.  

        Also: increasing the Medicare deduct would also somewhat increase the contribution of those now on Medicaid to the overall national healthcare expenditure. Most Americans on Medicare are either disabled or simply don’t have sufficient income to afford regular/preventive medical care. Consequently, many are in far worse shape when they finally seek medical attention, than if they had Medicare for all with the attendant free routine visits. Without any research I would state with confidence that single payer would have the beneficial unintended consequence of reducing the numbers of Medicaid patients.

       What is he likelihood of seeing this information from most legislators? Slim at best, because most take huge campaign contributions from the Pharma industry and it takes a bit of real analysis to grasp the facts and apply critical thinking when the talking heads ae so loud and ubiquitous.  

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