An Intelligent friend of mine, who is now on Medicare, just found out inadvertently about yet another deal between Congress and the drug companies. In this deal, Medicare Part D (prescription drug benefit) was passed with a right of the pharmaceutical companies to raise drug prices during the open enrollment period. For the person choosing a plan during the Open Enrollment that occurs every year from November to the end of the year, this means it's a bait and switch.
He wrote a letter to his Congressman about it, the text of which can be found here.
Like me, he was under the impression for the last five years that during Part D open enrollment the plans were not allowed to change prices. He was shocked during this last open enrollment to discover that two of the plans he was reviewing changed the full price of some of their drugs AFTER November 15. When he reported this to Medicare he was told that because my complaint was against CMS he had to complain to his Congressman.
Congressman Ed Pastor (D-AZ) confirmed that Congress did write into the MMA law of 2003 that CMS could not interfere with the pricing of drugs and companies could update their prices as often as every 14 days, including during open enrollment and thus Congress either deliberately or unwittingly stacked the deck in favor of the plans and drug companies. My friend, who was saving search results on his computer, discovered this by accident.
He says this is a bait and switch tactic that was resolved by an act of Congress as far back as 1946. How can a consumer properly evaluate and compare plans if the prices unbeknownst to him or her are changing during the process and they have no awareness that prices are changing?
This is either an outrageous hoax that Congress played on the American people who are on Medicare, or a frank admission that no members of Congress read the legislation they pass.
It makes no difference if you have a standalone Part D plan or you are a member of a Medicare Advantage plan. For the last five (5) years the insurance companies and the drug companies have been getting away with robbing the pocketbooks of senior.
Only Congress can correct this. You might want to write a letter to your Congressperson, reminding them that it's an election year and that seniors vote. And that this isn't much different than what the banks and credit card companies do with the small print in their mailers.
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For instance, I can buy one prescription medicine for $325 without insurance, but the part D insurance says they have to pay $525 total cost for the drug.
They are doing this so you will hit the doughnut hole faster. The total cost of a drug counts toward the doughnut hole, not just what you pay. If you had to buy this same medicine, you would hit the doughnut hole in 4 months. Then, if you buy from the prescription D plan during the doughnut hole period, they will make huge profits off their drugs by charging $525 for a drug they probably pay $200 or less for.
Then when you have spent your way out of the doughnut hole at the cost of $4300, then you only pay 5 percent of the cost of the medicine. That will run about $150 a month when you include your premium. It averages out to cost more by having prescription D.
This is just on one drug. It is no savings for the elderly. The doughnut hole is silly and prescription D is a piece of junk insurance created to help ruin Medicare. Many plans are subsidized by the government at Medicare's expense. This is blatant theivery.
Simple as that.
US citizens are being reduced from participants in a vibrant democracy to victims of ruthless corporate capitalists. It's like we're being held hostage by kidnappers, and to add insult to injury, we're having to pay our own ransom. I'm beginning to feel like an abused wife, or just something dirty. I feel sad and ashamed to be an American. I predict the incidents of planes being flown into buildings will escalate in America in the coming years. We're definitely in a steep decline, the end of which is no where in sight..
The program signed by Bush in 2004 paid $177 billion in government subsidies to insurance companies. This wasn't Health Insurance Reform this was Corporate Welfare.
Even Bush and the Republicans were for single payer when it lined their pockets.
Example – just drugs- nothing else. Some 25% of out-of-pocket spending by individuals is for prescription drugs
Currently, the U.S.negotiates some drug prices but is forbidden by law from negotiating drug prices for the Medicare program due to a Medicare bill passed by the Republican-controlled 109th Congress and signed into law by President George W. Bush in 2005. This allows the pharmaceutical industry to profiteer off of the Medicare program.
Patented drug prices in Canada average between 35% and 45% lower than in the United States. The price differential for brand-name drugs has led Americans to purchase upward of $1 billion US in drugs per year from Canadian pharmacies. (So because of republicans billions of US dollars goes into Canada’s coffers to help pay for their health care)
Bushes Medicare program is single payer – but in no way paid for. It entirely went on the debt. It also has a donut hole that penalizes the very people it is supposed to benefit but instead benefits the drug companies and insurers.
Back in 1993, all our Veterans Administration hospitals got together and agreed to buy prescription drugs as a group. The next week, the costs of those drugs went down by 50 percent.
the PBMs (middle men between the plans and the pharmacies) are reimbursing at cost, charging the plans at least 10x more.. and keeping the spread as "profit"-
For example, my dad's atenolol 50mg #30 - I was reimbursed $1.50, when I checked his plan it said they had paid the pharmacy $23- they use the higher number to get you to the donut whole faster- The PBMs rip everyone off and hide their business from any transparency.- I am not allowed to tell anyone what pharmacies are being reimbursed by what plans because they consider that info "proprietary" -
ENOUGH!!! I would pick socialized medicine or ANY other system vs this corporate tyranny.
How about a little transparency?
You know it is obvious that they are having their pharmacy to buy it from the other pharmacy for $200 and paying their pharmacy $500 and making themselves a high profit off of the elderly in this country.
We need single payer in this country with cost controls on drugs. Unfortunately, no one in Washington cares about the American people.