My Rant; Your Precious Obamacare - Page 5

LF, I have to say I do agree your scenario is a bit of a scare tactic. Even with the link to the site you provided. I wasn't sure where to go from there, but I am sure it helps you plan for many scenarios; you have to try to anticipate with the coming changes. There will be plenty to complain about with the change, that is unavoidable. LOL Look what happens with a dog website when they change things around... lol you'd think it was the End Of The World!  

But....think about it. Why would a normal person with insurance and a headache even go to the ER?  Who goes to the ER now for a headache?  The answer: it is usually someone with no regular physician, someone who goes to clinics, but the clinic was closed! So, what if only emergencies where seen at the ER? What would that mean to the bottom line, moral even, personnel numbers? You'll have to tell us after it is all in place, a review of the Rant, lol... see how it pans out.

Lady Frost, if what you posted above is, in fact, an accurate recounting of the example given to you and your co-workers as to the effect of "Meaningful Use" implementation, then whoever was giving the presentation has little grasp of the initiative, and has no business speaking on the subject from an expert's lecturn.  I suggest you request your employer finds someone better educacted educated on what Meaningful Use brings with it, because someone giving what you've described as an example of such is woefully misinformed at the very least.

Will someone who shows up at an ER complaining of severe head pain likely have, at the very least, some form of imaging done before they leave the facility?  Probably, but it's NOT going to occur automatically based upon a single question by a nurse regarding the severity of the patient's pain. The patient will also be asked the sort of things you suggest are appropriate--did you fall or otherwise hit your head?  Have you taken anything to try and relieve the pain? What? When?, and so on.  If for some reason you think that ONLY a doctor is qualified to ask and record the answers to such questions, then you do a great disservice to registered nurses, nurse practitioners and physician's assistants. 

IMO, the healthcare legislation commonly referred to as Obamacare is an appalling piece of legislation. The goal of the legislation was laudable but it went about it completely the wrong way.

I have worked in the healthcare industry most of my working life - several members of my family also worked or are currently working in the healthcare industry. I am not referring to some of the scare tactics referred to above because gaming the system has gone on for years. There is a fine line between gaming the system and breaking the law and healthcare providers use sophisticated techniques to accomplish this without breaking the law. Sometimes they go over the line and, if caught, they are prosecuted but the number of such prosecutions is still fairly infintesmal.

The real problem with the legislation is that there is not the "infra-structure" to take care of the millions of patients who will come into the system as they get coverage. We already have a shortage of primary care physicians especially in  rural areas and some urban areas and little or no consideration was given to how these millions of additional patients will get primary care. 

The constant reductions in reimbursement have had the effect of the better physicians refusing to take new Medicare patients. I don't blame these doctors for declining Medicare patients - the cost of medical school is substantial and most doctors are in their thirties by the time they finish their internship and residency.

There are no real incentives to reduce drug costs: attempts to allow competition through the importation of medications from countries like Canada were stymied. The reality is that the very same medications cost a fraction of the cost they do in the US. Pharmaceutical companies are literally ripping off the consumer. There is a medication that I take which used to cost less than $300 for a 90 day supply but today (five years later) it costs over $800. Fortunately, most of the cost is paid by insurance but for those who don't have coverage or adequate coverage,  I don't know how they would manage.

I was opposed to a single-payer system but I felt that there was a compelling need for a public option to provide competition to insurance companies. Frankly, all that Obamacare did was to give insurance companies a pool of tens of millions of patients who are currently uninsured or underinsured. 

With increasing signs that there will be some form of amnesty for the 12-20 million illegals, they will also become eligible down the line for medical coverage including millions who will have paid little or nothing toward Medicare but will be entitled to full coverage under the program. And we all know that the Medicare program as is already in financial trouble - just imagine the impact of even more beneficiaries who are currently illegal.

I have lived in several countries and the medical care in the US is outstanding. I dread to think what the next few years will bring given the financial and health care delivery stresses that are in the offing.

Does anyone really know why US prescription brandname drugs are so high? How the patent driven system that depends on super performing billion dollar profit makers works, how it depends on discovering truly remarkable scientific breakthroughs?

I guess I'd rather be called funny than assinine. I don't think I'm the only poster here who writes and defends what she believes to be the truth. Ninja is gone?

Blitzen....

No, Ninja has been scarce in posting is about all. Dare I say it, but at the same time, the PhD is on sabbatical writing the next great veterinarian novel.  No doubt I am a muse in the endeavor. I so loved, "All Creatures Great and Small". The Lunar-Dude is waxing and waning, right on time. So, just like a cork? Look what pops up! 

LOL Just wait .... I know what they'll be saying about me....that  Ass-N-mine sure looks funny!  

I'm guessing Ninja will be back?

I'd bet on it.  
LOL

The standard spiel from pharmaceutical companies is that they need the funds/profits for R&D to produce all the wonder drugs that we have seen to this point and those that are in the pipeline. The argument is valid to a point but the flaw is that the American consumer is subsidizing much of the world when it comes to the R&D. Most countries buy the same drugs from the same companies at a fraction of the cost because these countries will not pay the rapacious prices that the US does . This is apart from the fact that the actual dollars expended towards R&D is only 12% of their revenue and the profitability of the pharmaceutical sector is among the top compared to other sectors. 
 

The specific medication I referred to that I am using was developed a while ago and so the increase in the cost from when I started taking it to more recently has nothing to do with R&D as it pertains to that drug since it was already developed and the increase has no bearing to the rate of inflation.

Frankly, the American consumer is being ripped off and nothing is being done because of ideological positions and lobbying by the industry. Both parties are to blame ...... and Obamacare did nothing to deal with this and neither did the prescription drug program for seniors under Bush.

Check out the article below.....here is an excerpt:

"Unlike in other countries, sellers of health-care services in America have considerable power to set prices, and so they set them quite high. Two of the five most profitable industries in the United States — the pharmaceuticals industry and the medical device industry — sell health care. With margins of almost 20 percent, they beat out even the financial sector for sheer profitability.
 

The players sitting across the table from them — the health insurers — are not so profitable. In 2009, their profit margins were a mere 2.2 percent. That’s a signal that the sellers have the upper hand over the buyers.

This is a good deal for residents of other countries, as our high spending makes medical innovations more profitable. “We end up with the benefits of your investment,” Sackville says (Sackville served in Margaret Thatcher's government) . “You’re subsidizing the rest of the world by doing the front-end research.”

But many researchers are skeptical that this is an effective way to fund medical innovation. “We pay twice as much for brand-name drugs as most other industrialized countries,” Anderson (a health researcher) says. “But the drug companies spend only 12 percent of their revenues on innovation. So yes, some of that money goes to innovation, but only 12 percent of it.”

But as simple an explanation as “the prices are higher” is, it is a devilishly difficult problem to fix. Those prices, for one thing, mean profits for a large number of powerful — and popular — industries. For another, centralized bargaining cuts across the grain of America’s skepticism of government solutions. In the Medicare Prescription Drug Benefit, for instance, Congress expressly barred Medicare from negotiating the prices of drugs that it was paying for.

From the article: "Why an MRI costs $1,080 in America and $280 in France"

http://www.washingtonpost.com/blogs/wonkblog/post/why-an-mri-costs-1080-in-america-and-280-in-france/2011/08/25/gIQAVHztoR_blog.html

The standard spiel from pharmaceutical companies is that they need the funds/profits for R&D to produce all the wonder drugs that we have seen to this point and those that are in the pipeline. The argument is valid to a point but the flaw is that the American consumer is subsidizing much of the world when it comes to the R&D. Most countries buy the same drugs from the same companies at a fraction of the cost because these countries will not pay the rapacious prices that the US does . This is apart from the fact that the actual dollars expended towards R&D is only 12% of their revenue and the profitability of the pharmaceutical sector is among the top compared to other sectors. 
 

I don't think the above paragraph shows a true relationship between the Drug Industry's profits and R&D Investment. I found this study to make a better case as to what is most concerning, as to how the higher pricing US customers pay for the same drug, has evolved. IMHO. 

http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/76xx/doc7615/10-02-drugr-d.pdf

I downright disagree with this statement as uninformed and really, only an opinion: Most countries buy the same drugs from the same companies at a fraction of the cost because these countries will not pay the rapacious prices that the US does .

I agree the pharmaceutical ingredients most certainly do come from the same suppliers. I disagree as to your suggested pricing and the reason's for it.

The other thing, that people never consider is the stringent quality of the FDA that makes for a better consumer confidence in their product.  Indeed, that the USA product is made to a certain standard, and you are getting what you are paying (top dollar) for. A cheaper drug from another country will be difficult to tell without a lab test, if it has been altered or cut, and who would ever know that you are not getting what your Dr. ordered in a prescription strength?