It's In the Mail

        I love the availability of hard data provided by the Internet. Opinions, not so much. Here are some numbers which should give even the most avid Trump supporter pause.

        Of the 350,000,000 or so of us US citizens,  although estimates vary and real numbers are sparse and changing, by a conservative estimate considering just one  on-line mail order Pharmacy, Express Scripts, close to 1/3 of all of us regularly receive at least one prescription by U.S. Mail (USPS). Moreover, for the majority of those, the drugs are maintenance drugs such as insulin, statins, blood pressure meds, anti-psychotics, allergy meds, anti-virals, etc.  

        This is not an endorsement of Express Scripts, although we (Emily and I and many other retired US Military families) use them. I’m simply using them as an example of the genre. Express Scripts is a wholly owned subsidiary of Cigna, and dispenses medications two ways: The first, through preferred pharmacies, such as CVS, Walgreens, etc. is managed by Express Scripts and generally results is lower than retail costs for “one-off” prescriptions, such as a Z-pack, or other single fill prescriptions. This is primarily because, like all on-line pharmacies they leverage lower prices from manufacturers. Disclaimer: this is not true for Medicare which, by law, pays manufacturers’ asking price.    

       For repeating drug prescriptions, the afore mentioned “maintenance” drugs, the already reduced price is dramatically lowered if the drugs are delivered from Express Scripts or another on-line pharmacy via US mail. As an example, a three-month supply delivered by mail, usually costs the customer the same as a two-month supply bought over the counter at a traditional pharmacy, consequently, most customers use mail delivery. 

       So, how many prescriptions or customers are we talking about? Express Scripts advertises that they interact with “86 million lives.”   Using the best available numbers for the percentage of us who use mail order delivery for maintenance drugs, that works out to about 17 to 20 million customers! Note, that there are other large mail order pharmacy plans, Humana, CVS Caremark, etc. Also, Amazon is about enter the lists, although they are getting “pushback” from the entrenched companies who don’t want the competition. Meanwhile, 85% of polled Amazon Prime customers have indicated they would use PillPack, the company Amazon has bought.  Combined, it is likely that the total number of Americans receiving some or all of their medications by USPS is already somewhere close to 150,000,000!  

       So what? So, if Donald Trump defunds (and essentially destroys) the US Postal Service as he has indicated he might do) an awful lot of Americans are to be hurt and hurt immediately. Consider that in recent polls related to household concerns over lack of funds, the top three worries are, unexpected medical bills, health insurance deductibles, and prescription drug costs. These are more pressing concerns than, as examples, food, rent, or utility bills.

         Bottom line, defunding the USPS and leaving all mail delivery in private hands is a catastrophically bad idea, just like privatization of Social Security. The things which have continued to hurt the USPS income stream aren’t inefficiency or parcel delivery as much as the steep decline in the amount of first- class mail, which has decreased over 40% from 2000 to 2020. This isn’t the fault of USPS. These are not the results of mismanagement, as Trump would have us believe, either. 

        Two of the principal components of first-class mail are classified (By USPS) as “transactional” (bills and payments) and “correspondence” (inter-household) mail. Both have been hammered, and to great degree, supplanted, by electronic correspondence. Like many households who used to mail bill payments, and other financial transactions, ours is now, and has been for years, all electronic. That’s a lot of 50 cent stamps not used! Similarly, e-mail or Facebook have largely supplanted the personal letter.

       Another issue is the slight decrease in parcel delivery as, FedEx, UPS, and Amazon all now do local deliveries in convenient areas seven days a week. This still leaves the USPS with its mandated “universal service” obligation, which requires USPS to deliver anywhere in the United States, including remote locations that are more expensive and resource-intensive to reach and that other carriers are not obligated to service. 

       Again, not the fault of USPS, but the reflection of a change in the game playing field. Doing the math, without any change to current rates, reveals a simple fix. $5 monthly per US household would work. $5 X 12 months X 128,000,000 US households, all but wipes out the current yearly $8.8 billion operating deficit. Add it to the income tax bill. OR add 15 cents to the cost of first-class mail which last year would have almost exactly erased the operating deficit. If that seems excessive, here’s a comparison. The UK Royal mail cost of sending a first-class letter is currently equivalent to  94.2 cents, and their postal service has a far more densely settled populace than many US states.Better yet, increase the cost to mail commercial advertising (catalogs) and other non-essential mail.

        These are just a couple of quick take suggestions, but Trump’s threat to defund, and essentially do away with, the USPS is a world class bad idea on a par with inhaling Lysol.