Runaway Drug Prices

New York Times, May 5, 2015

A drug to treat abnormal heart rhythms can cost about $200 on one day and more than $1,300 the next. A diagnosis of multiple sclerosis can lead to a drug bill of at least $50,000 a year. How companies set prices of specialty drugs for these and other complex diseases, like cancer and AIDS, has been a mystery to the patients who need them. Now the Obama administration and some states are tackling that lack of transparency and the rising costs.

Mr. Obama has asked Congress to let Medicare officials negotiate prices with drug manufacturers, a practice forbidden by current law that may be hard to change with the antiregulatory mood among Republicans. And several states are considering bills that would require drug companies to justify their prices to public agencies. It is the least the states can do to bring costs to levels that patients, hospitals and government programs can afford.

Spending on all prescription drugs, including commonly used medicines like antibiotics, accounts for a tenth of the nation’s total health spending. Prices have been rising slowly in recent years mainly because many brand-name drugs lost protection and lower-cost generics were prescribed. But there are fewer patent expirations ahead. Specialized medicines already on the market carry huge price tags, as The Times reported recently, and strain the budgets of Medicare, Medicaid and consumers. The list price for a one-year’s supply of Kalydeco to treat cystic fibrosis is $311,000. A standard course of treatment with Blincyto, a leukemia drug, is about $178,000.


Fed war on health care spending abuse needs to include Medicare Advantage

Commentary: Obama administration bragging about anti-fraud efforts, but Center report showed bigger dollars are being lost elsewhere

by Wendell Potter
The Center for Public Integrity, March 23, 2015

The Obama administration went to great lengths last week to inform us that it recovered $3.3 billion in fraudulent payments to Medicare health care providers in fiscal year 2014. Officials even went so far as to give an advance copy of their report to The Wall Street Journal, which, like the Center for Public Integrity, has been investigating Medicare fraud and abuse.

In a story that appeared in the Journal before the official release of the report, WSJ reporter Stephanie Armour wrote that the recovery “was part of an effort by the Obama administration to improve enforcement and prevent abusive billing practices.” That effort is run jointly by the Department of Health and Human Services the Justice Department.

HHS secretary Sylvia Burwell was quoted in the story as saying that “we’ve cracked down on tens of thousands of health care providers suspected of Medicare fraud,” an effort she said is helping to extend the life of the Medicare Trust Fund.

That’s good news, of course. Taxpayers benefit when doctors and other health care providers get caught trying to rip off the government.

But when it comes taking on big and well-connected insurance companies that have been ripping off the Medicare program for years, the administration has been far less aggressive in catching, much less punishing, the abusers.


Overwhelming Evidence that Half of America is In or Near Poverty

Photo Credit: ChameleonsEye / Shutterstock.com

Photo Credit: ChameleonsEye / Shutterstock.com

And it's much worse for black families.

The original poverty measures were (and still are) based largely on the food costs of the 1950s. But while food costs have doubled since 1978, housing has more than tripled, medical expenses are six times higher, and college tuition is eleven times higher. The Bureau of Labor Statistics and the Census Bureau have calculated that food, housing, health care, child care, transportation, taxes, and other household expenditures consume nearly the entire median household income.

by Paul Buchheit / AlterNet  March 23, 2014

The Charles Koch Foundation recently released a commercial that ranked a near-poverty-level $34,000 family among the Top 1% of poor people in the world. Bud Konheim, CEO and co-founder of fashion company Nicole Miller, concurred: "The guy that's making, oh my God, he's making $35,000 a year, why don't we try that out in India or some countries we can't even name. China, anyplace, the guy is wealthy."

Comments like these are condescending and self-righteous. They display an ignorance of the needs of lower-income and middle-income families in America. The costs of food and housing and education and health care and transportation and child care and taxes have been well-defined by organizations such as the Economic Policy Institute, which calculated that a U.S. family of three would require an average of about $48,000 a year to meet basic needs; and by the Working Poor Families Project, which estimates the income required for basic needs for a family of four at about $45,000. The median household income is $51,000.

The following discussion pertains to the half of America that is in or near poverty, the people rarely seen by Congress.


Herb Rothschild Jr.: Support single-payer

Posted Jan. 24, 2015 
Ashland Daily Tidings, Opinion

This year marks the 50th anniversary of the Voting Rights Act of 1965 and of the enactment of Medicare. Not long ago, a U.S. Supreme Court dominated by Republican appointees gutted the Voting Rights Act, and a Democratic president who never could have been elected without it took Medicare for Everyone off the table when he proposed his much ballyhooed health reform.

The American Medical Association tried to defeat Medicare. It cleverly labeled all such proposals “socialized medicine.” Medicare isn’t socialized medicine. The VA health care system is socialized medicine. Its hospitals are publicly owned, and VA staff are salaried employees paid with tax dollars. Medicare is only an insurance program.

So Medicare didn’t threaten the livelihood of physicians. Instead, it added huge numbers of paying clients to their patient base. The AMA had identified the wrong threat. The real threat emerged in the 1980s. It was the private insurance industry, not public insurance, that drastically interfered with the practice of medicine.

Private insurance plans forced most physicians to join groups like health maintenance organizations, hospital systems, and other large groupings — some of them corporations interested in profits, not health care. Often physicians couldn’t treat their patients without approval for payment from the patients’ insurance carriers, whose on-staff medical personnel could second-guess the attending physician. In more subtle but ever-present ways, the imposition of a corporate model has distorted the practice of medicine and diminished the satisfaction of practitioners.