ACA premiums up as much as 50% as 2016 renewals hit...

[CosmicCowboy]

The reasons for the rising premiums are complex. Part of it, as Levitt noted, is simply that the carriers know a lot more about the health status and health care patterns of their new customers. Part of it’s rising drug prices. And the planned phasing out of certain ACA programs that were designed to reduce risk for insurers who entered the untested Obamacare marketplaces, are also causing carriers to price cautiously.

Read more: http://www.politico.com/story/2015/05/how-affordable-is-the-affordable-care-act-118428#ixzz4HR11gQGp

[ducks]

HE IS A FUCKING LIAR
KEEP YOUR DOCTOR NOT
RATES WILL NOT INCREASE NOT
TELLS MILIARY TO SAY DOING BETTER AGAINST ISIS THEN WHAT THEY ARE
CLINTON HE IS DOING A FUCKING GOOD JOB LIAR

[MultiTroll]

Repugs as usual, bitch but offer nothing in return.
Oh wait, the Repug plan:
http://alterinspire.com/wp-content/uploads/2009/11/da23736e3b5d957faf71f4885c04f246.jpg

[MultiTroll]

http://www.searchindia.net/images/sib/alan-grayson.jpg

[SpursforSix]

Read more: http://www.politico.com/story/2015/05/how-affordable-is-the-affordable-care-act-118428#ixzz4HR11gQGp

Lol. "price cautiously". That's doublespeak.

[CosmicCowboy]

Lol. "price cautiously". That's doublespeak.

Meaning they would have lost their asses without the govt. guarantee to cover losses. Now that the subsidies are phasing out the customer has to pay the actual cost.

[ducks]

Repugs as usual, bitch but offer nothing in return.
Oh wait, the Repug plan:
http://alterinspire.com/wp-content/uploads/2009/11/da23736e3b5d957faf71f4885c04f246.jpg

yes it is the republican fault the president is a liar

[SpursforSix]

Meaning they would have lost their asses without the govt. guarantee to cover losses. Now that the subsidies are phasing out the customer has to pay the actual cost.

I don't know enough about it tbh. But "pricing cautiously" clearly means pricing agressively.

[CosmicCowboy]

I don't know enough about it tbh. But "pricing cautiously" clearly means pricing agressively.

They have the data now to back up the price increases.

Any time you can let people wait until they are really sick and THEN let them buy insurance at "average" rates that is a business model that is doomed to failure.

[boutons_deux]

evidence that people are waiting to get sick before they buy insurance? and show us NUMBER of such cases.

Insurance prices are going up because THEY ALWAYS GO UP, WAY BEYOND INFLATION, and have been going up for 30 years.

Just another way BigCorp fucks Americans into unfuckability.

[CosmicCowboy]

evidence that people are waiting to get sick before they buy insurance? and show us NUMBER of such cases.

Insurance prices are going up because THEY ALWAYS GO UP, WAY BEYOND INFLATION, and have been going up for 30 years.

Just another way BigCorp fucks Americans into unfuckability.

Because most people aren't as stupid as you are.

If you are a healthy 20-30 something you would be an idiot to buy insurance as long as the ACA exists. why pay a shitload of money for something you don't use? Stick your dick where it shouldn't have been and get AIDS? THEN go buy ACA insurance because they can't deny a pre-existing condition.

[boutons_deux]

Because most people aren't as stupid as you are.

If you are a healthy 20-30 something you would be an idiot to buy insurance as long as the ACA exists. why pay a shitload of money for something you don't use? Stick your dick where it shouldn't have been and get AIDS? THEN go buy ACA insurance because they can't deny a pre-existing condition.

Why do you pay auto insurance for something you'll never use?

[Warlord23]

One of my clients is a top-tier global pharma company with their HQ in Europe. Their sales and marketing spend in the US dwarfs that of the rest of the world. Every product line has their own sales teams in every territory and they each bombard the same set of hospitals/physicians to hawk their stuff. And then you have the massive advertising campaigns and brand websites, while Europe and most other advanced nations don't even allow direct consumer ads for prescription drugs. Why do you think they spend so much on selling only in the US? It's because they can sell specialised drugs for a king's ransom, even if the drugs don't actually provide a significant benefit over off-patent alternatives.

The US healthcare industry needs serious reform, and ACA was never going to seriously dent cost rises. All it did was broaden coverage and attempt to create a larger insurance market. As long as drug companies are allowed to charge unreal prices for dodgy new drugs, cost containment is a mirage. And Congress took away Medicare's ability to negotiate prices. It won't matter if you vote R or D - both are in the lobbyists' pockets. If you want to change the status quo, Congress has to be pushed to consider single payer / Medicare expansion for most common disease groups... not easy to do when lawmakers are for sale and the public is more animated by bathroom laws, planned parenthood and guns.

[boutons_deux]

"The US healthcare industry needs serious reform"

well, duh

and double duh, it ain't gonna happen.

BigHealthCare destroyed the ACA's opportunity for reform by WRITING ACA, and pre-empting any talk of Medicare-for-all.

[ducks]

Why do you pay auto insurance for something you'll never use?

to fix your car illegal imigrats run into you and do not have insurance

[clambake]

to fix your car illegal imigrats run into you and do not have insurance

or to fix your car when its just a typical piece of shit that doesn't have insurance.

[CosmicCowboy]

Why do you pay auto insurance for something you'll never use?

If auto insurance worked like the ACA you could go out and buy insurance after your wreck, dunbass.

[boutons_deux]

If auto insurance worked like the ACA you could go out and buy insurance after your wreck, dunbass.

your argument was young people shouldn't be forced to pay health insurance because they don't get sick, don't have accidents, never need medical care

[rmt]

Repugs as usual, bitch but offer nothing in return.
Oh wait, the Repug plan:
http://alterinspire.com/wp-content/uploads/2009/11/da23736e3b5d957faf71f4885c04f246.jpg

Here is the Republican plan:

http://abetterway.speaker.gov/_assets/pdf/ABetterWay-HealthCare-PolicyPaper.pdf

[rmt]

ACA was intended to fail in order to usher in single-payer. Let's see if Obama delays open enrollment till after the election.

[boutons_deux]

Here is the Republican plan:

http://abetterway.speaker.gov/_assets/pdf/ABetterWay-HealthCare-PolicyPaper.pdf

total bullshit, which is all Repugs offer

[TeyshaBlue]

Why do you pay auto insurance for something you'll never use?
You dont buy auto insurance after you've had a wreck. :rolleyes

[ElNono]

Because most people aren't as stupid as you are.

If you are a healthy 20-30 something you would be an idiot to buy insurance as long as the ACA exists. why pay a shitload of money for something you don't use? Stick your dick where it shouldn't have been and get AIDS? THEN go buy ACA insurance because they can't deny a pre-existing condition.

But you can't really enroll whenever you want. You do still have the 'enrollment window'... if you can wait that long, I guess it works out, but if you can't, you're certainly fucked.

That said, since ACA didn't deal with costs, this is all more or less expected. Insurance Cos are in the business of making money, not caring about citizen's health (or at least they only care about the part of how much is going to cost them).

So without actually controlling costs, we're back to profit motive. From drug companies, insurance companies, service providers, etc. This is what we were discussing with rmt a while ago.

Hopefully this does bring a single/mixed system and some cost control sooner rather than later.

[DarrinS]

Sounds like the ACA death spiral has begun.

[Splits]

WTF?

Why is there an 18 month old article on this topic being discussed as if it is news?


Obamacare Premiums Are Lower Than You Think

Loren Adler (http://healthaffairs.org/blog/author/adlerl/) and Paul B. Ginsburg (http://healthaffairs.org/blog/author/ginsburg/)
July 21, 2016
http://healthaffairs.org/blog/wp-content/uploads/Blog_Gaus.jpg


Since the Affordable Care Act’s (ACA) health insurance marketplaces first took effect in 2014, news story after story has focused on premium increases for certain plans, in certain cities, or for certain individuals. Based on preliminary reports (http://kff.org/health-reform/issue-brief/analysis-of-2017-premium-changes-and-insurer-participation-in-the-affordable-care-acts-health-insurance-marketplaces/), premiums now appear set to rise by a substantial amount in 2017.

What these individual data points miss, however, is that average premiums in the individual market actually dropped significantly upon implementation of the ACA, according to our new analysis, even while consumers got better coverage. In other words, people are getting more for less under the ACA.

Covered California, that state’s marketplace, just announced premium increases (http://khn.org/news/covered-california-health-plan-rates-to-jump-13-2-percent-in-2017/?utm_campaign=KHN%3A+Breaking+News&utm_source=hs_email&utm_medium=email&utm_content=31838547&_hsenc=p2ANqtz--qt4SixSX20DyQAf9fQAKputqvVOOu_SOH0iRZBkMLsNtAZdn2h eRD_kNz-kSPJI4qREJiRm1TikwyFovHoPB7sk_f9Q&_hsmi=31838547) averaging 13.2 percent. But even if premiums increase by the 10 or 15 percent overall that some are predicting for 2017, they will still be far lower than premiums otherwise would have been in the absence of the law. Moreover, this analysis does not include the effects of premium and cost-sharing subsidies that serve to make ACA marketplace plans more affordable for many people.

2014 Premiums In The ACA Marketplaces Were 10-21 Percent Lower Than 2013 Individual Market Premiums

While many stories of pronounced increases are simply the natural result of a law that works differently in every region and for people of different health statuses, it appears to be conventional wisdom that the ACA increased premiums in the individual, non-group insurance market, if only because it increased the quality and robustness of coverage. Indeed, many of the ACA’s new rules do have the anticipated effect of increasing premiums, such as:



mandated guaranteed issue regardless of health status;
restrictions on the ability to charge different premiums based on anything besides age and smoking habits;
requirements for plans to offer certain benefits deemed “essential;”
limits on out-of-pocket costs an enrollee can pay for covered services in a given year; and,
the elimination of any lifetime limits on coverage.

However, many features of the ACA push in the opposite direction and save consumers money. The individual mandate and federal subsidies greatly expanded (http://kff.org/health-reform/issue-brief/data-note-how-has-the-individual-insurance-market-grown-under-the-affordable-care-act/) the number of people purchasing coverage in the individual market, pushing premiums down both by increasing the sheer size of the market—the bigger the market, the lower the prices—and including many healthier people who previously went uninsured. In addition, the ACA created relatively transparent marketplaces where insurers must compete on premiums for products standardized by actuarial value, allowing competition to drive down prices.

Together, by creating a much larger and more competitive market, these changes placed strong downward pressure on insurance premiums, outweighing the factors pushing in the opposite direction. Stronger rate review and minimum requirements for how much an insurance plan must spend on actual health care expenses furthered this downward pressure on prices.

According to our analysis, average premiums for the second-lowest cost silver-level (SLS) marketplace plan in 2014, which serves as a benchmark for ACA subsidies, were between 10 and 21 percent lower than average individual market premiums in 2013, before the ACA, even while providing enrollees with significantly richer coverage and a broader set of benefits. Silver-level ACA plans cover roughly 17 percent more (https://www.cbo.gov/sites/default/files/111th-congress-2009-2010/reports/11-30-premiums.pdf) of an enrollee’s health expenses than pre-ACA plans did, on average. In essence, then, consumers received more coverage at a lower price.

Exhibit 1

http://healthaffairs.org/blog/wp-content/uploads/Adler_Exhibit1.png (http://healthaffairs.org/blog/wp-content/uploads/Adler_Exhibit1.png)
Moreover, ACA marketplace SLS plan premiums are still lower in 2016 than individual market premiums were in 2013, on average, and a full 20 percent below where the Congressional Budget Office (CBO) originally projected they would be when they first estimated the impacts of the ACA in 2009.

Health insurance was expensive before the ACA and continues to be, but the ACA appears to have had a salutary impact on premiums even while providing more robust coverage. Judging by the low or negative profits for many insurers on their ACA plan offerings and preliminary reports indicating significant marketplace premium increases for 2017 in many areas, premiums to date were likely set lower than they should have been. However, barring increases much larger than foreseen today, premiums are likely to remain notably below expectations, or where they would have been in the absence of the ACA.

For this analysis, we generally focus on average premiums for the second-lowest silver marketplace plan because they determine federal premium subsidies and represent the most common coverage level. CBO also provides good data on such plans, and this metric allows us to compare actual experience to the original predictions. A “silver” plan is one that has an actuarial value of 70 percent, meaning it pays for roughly 70 percent of the average enrollee’s covered health expenses.

While not a pure apples-to-apples comparison, the finding that SLS plans are available for a lower cost than individual market plans before 2014, on average, is significant. This is particularly true given that SLS plans have an actuarial value roughly 10 percentage points higher than the average for individual plans prior to 2014 (and thus pay roughly 17 percent more of an enrollee’s covered health care expenses).

Beating CBO’s Expectations

In 2014, the Congressional Budget Office highlighted (https://www.cbo.gov/publication/45231) that ACA premiums had come in 15 percent lower than expected, but premiums since then have continued to grow slower than projected (the average SLS plan premium grew at 2 percent (https://aspe.hhs.gov/sites/default/files/pdf/108466/rpt_MarketplaceCompetition.pdf) in 2015 and 7.2 percent (https://aspe.hhs.gov/sites/default/files/pdf/198636/MarketplaceRate.pdf) in 2016 in the federally-facilitated exchanges), increasing the difference in 2016 to 20 percent.
Exhibit 2

http://healthaffairs.org/blog/wp-content/uploads/Adler_Exhibit2.png (http://healthaffairs.org/blog/wp-content/uploads/Adler_Exhibit2.png)
Some of this decline is the result of the impressive system-wide health care spending slowdown (http://crfb.org/blogs/900-billion-slowdown-federal-health-care-spending) the nation has experienced in recent years, which is broader than just the ACA and is due in part to the slower than expected economic recovery (though growing evidence (http://kff.org/medicare/issue-brief/how-much-of-the-medicare-spending-slowdown-can-be-explained-insights-and-analysis-from-2014/) suggests that the ACA has played some role).

However, ACA marketplace premiums have beaten projections by significantly more than other areas of health care spending, therefore implying that the marketplaces have been particularly effective in driving low premiums. By comparison, premiums for employer-sponsored health plans (which the ACA only minimally impacts) in 2014 were roughly 12 percent (http://meps.ahrq.gov/mepsweb/data_stats/summ_tables/insr/national/series_1/2014/tic1.pdf) below (https://www.cbo.gov/sites/default/files/111th-congress-2009-2010/reports/12-23-selectedhealthcarepublications.pdf#page=230) CBO projections from the same 2009 report (https://www.cbo.gov/sites/default/files/111th-congress-2009-2010/reports/12-23-selectedhealthcarepublications.pdf#page=230)and total national health spending in 2014 was about 7.5 percent lower than projected back when the ACA was enacted.

The ACA’s Effect On Individual Market Premiums

To address this issue, we draw on Congressional Budget Office estimates (https://www.cbo.gov/sites/default/files/111th-congress-2009-2010/reports/12-23-selectedhealthcarepublications.pdf#page=230) of average individual market premiums in 2009 (the most recent pre-ACA year for which CBO provides an estimate), largely based on data from the Medical Expenditure Panel Survey (MEPS) and adjusted for insights from their Health Insurance Simulation Model (https://www.cbo.gov/sites/default/files/110th-congress-2007-2008/reports/10-31-healthinsurmodel.pdf) and observed data. We then adjust this estimate downward to account for it being based on pre-2009 data, by the ratio of actual 2009 employer-provided plan premiums for single coverage (from MEPS) to CBO’s predictions at the time.

Therefore, we estimate that the average annual premium in the individual market in 2009 was $3,480 (or $290 per month), which was for a plan that on average covered roughly 60 percent of an enrollee’s covered health expenses — an actuarial value of 60 percent.

By comparison, the average premium in 2014 for the SLS plan was $3,800 (https://www.cbo.gov/sites/default/files/113th-congress-2013-2014/reports/45231-ACA_Estimates_OneColumn.pdf#page=6) according to CBO, only 9 percent higher despite the passage of five years. Adjusting for the difference in actuarial value, this premium was actually lower in nominal dollars than that in 2009.

Moreover, by any measure, individual market premiums had grown enough by 2013 such that the $3,800 average SLS plan premium in 2014 represented a sharp drop from the previous year, despite covering a higher percentage of enrollee costs and offering a broader set of health benefits.

Jon Gabel (https://aspe.hhs.gov/report/trends-premiums-small-group-and-individual-insurance-markets-2008-2011) and Stephen Smith (https://aspe.hhs.gov/report/effects-implementing-state-insurance-market-reform-2011-2012) of NORC at the University of Chicago conducted the most thorough analyses of how much premiums in the individual market increased between 2009 and 2013, before the ACA marketplaces took effect. Gabel and Smith analyzed data on rate increase filings for comprehensive health insurance products from a sample of states and found that individual market premiums grew by 11.7 percent in 2010, 7 percent in 2011, and 7.1 percent in 2012. A subsequent Assistant Secretary for Planning and Evaluation (ASPE) analysis (https://aspe.hhs.gov/sites/default/files/pdf/180056/rb.pdf) by Rose Chu and Richard Kronick, also looking at public insurer rate filings to states, found that individual market premiums in 2013 grew by 7.9 percent in their data sample.

These analyses are imperfect and tell us more about increases in base premium rates offered (before underwriting) than average premiums paid. Nevertheless, they imply that ACA marketplace premiums for the SLS plan in 2014 came in a remarkable 21 percent lower than average individual market premiums the year prior, or 32 percent lower when accounting for the new plans’ higher actuarial value, even without incorporating likely utilization increases in response to the additional coverage.

Other data sources indicate that individual market premiums may have grown more slowly from 2009-2013 than the two ASPE studies found, but suffer from other limitations. An analysis by eHealth (http://news.ehealthinsurance.com/_ir/68/201311/eHealth%202013%20Cost%20and%20Benefits%20Report.pd f), a company that sells health insurance policies online, found that premiums for their customers on the individual market grew by 5.2 percent per year, on average, for single plans from 2009 to 2013. It is possible, though, that their customers are unrepresentative of the full market, as people buying insurance online might differ from those buying coverage through other means, differences that might have changed over this period of expanded online purchasing. Nonetheless, premiums for employer-provided health insurance (on which better data exists) also grew by roughly 5 percent annually over that time period, both according to data from the Medical Expenditure Panel Survey (MEPS) and the Kaiser Family Foundation / Health Research & Educational Trust Employer Health Benefits Survey.
Even if average individual market premiums grew at only 5 percent annually from 2009 to 2013, then, ACA marketplace premiums for the SLS plan in 2014 still represented a 10 percent decline from the average individual market premium in 2013, or a 23 percent drop for a plan of the same actuarial value (again before incorporating likely utilization increases in response to additional coverage).

Is it important to note, though, that while average individual market premiums appear to have declined nationwide upon implementation of the ACA, local conditions can vary significantly because premiums are determined separately for each local marketplace. Similarly, due to its community rating provisions, the impacts of the ACA on individuals’ premiums may vary significantly based on health status — the ACA is more likely to increase premiums for healthier enrollees and decrease them for sicker enrollees.

Supporting Evidence

An analysis (http://healthaffairs.org/blog/2014/06/17/cancelled-non-group-plans-what-we-know-now-that-we-did-not-know-in-october/) by Jon Gabel in Health Affairs Blog, examining base premium offerings in the individual market, lends further evidence to our new finding. He utilizes data from America’s Health Insurance Plans (AHIP) that show base individual market premiums averaging $2,985 in 2009.

Suppose that base premiums subsequently grew annually by somewhere between 5 percent and the higher ASPE estimates detailed earlier from 2009-2013. That would then imply that average base premium offerings in the individual market in 2013 were similar to the $3,800 (https://www.cbo.gov/sites/default/files/113th-congress-2013-2014/reports/45231-ACA_Estimates_OneColumn.pdf#page=6) average premium for the SLS plan on ACA marketplaces in 2014 (anywhere from 8 percent lower to 5 percent higher).

Base health insurance premium rates before the ACA, though, are by definition lower than the actual premiums paid by many enrollees, given the ability to charge higher premiums based on a myriad of factors, including poor health status or gender, in the pre-ACA individual market. It is no surprise, then, that our estimate (based on CBO analysis) of average premiums paid in 2009 is 17 percent higher than AHIP’s finding of base premium rates that year.

How Did The ACA Lower Individual Market Premiums?

That the ACA might have caused premiums to drop so precipitously when its marketplaces took effect may seem surprising at first — it was to us. After all, the ACA prohibited insurers from denying coverage or charging higher rates to sicker individuals, required them to cover a broader set of benefits, and imposed new taxes and regulations. However, the premium reductions make more sense upon deeper analysis.

First, even though sicker people were charged higher premiums in the pre-ACA world (and some were denied coverage altogether), many still purchased insurance, but likely at significantly higher rates; as noted above, this made average premiums in the pre-ACA individual market notably higher than the base rates available to the healthy. Moreover, by creating large premium subsidies and imposing the individual mandate, the ACA may have caused a greater influx of relatively healthy enrollees into the individual market in 2014 and beyond, which was the hope all along. CBO, in fact, originally predicted (https://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/107xx/doc10781/11-30-premiums.pdf#page=18) that the ACA would create a healthier risk pool in the individual market by 2016, on average, than existed before 2014 (although we have not seen evidence in either direction as to whether this prediction came to fruition).

Second, the ACA creates a price-competitive and transparent market structure, where consumers can compare similar health insurance products. ACA marketplace consumers, to date, appear (http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-february-2014/) to be (http://healthcare.mckinsey.com/sites/default/files/Intel%20Brief%20-%20Individual%20Market%20Performance%20and%20Outlo ok%20(public)_vF.pdf) very cost-conscious and drawn to lower-cost, narrower-network offerings. As a result, many health plans have been very aggressive in negotiating lower provider payment rates and utilizing narrow networks to help do so; a McKinsey Center for U.S. Health System Reform analysis (http://healthcare.mckinsey.com/sites/default/files/Intel%20Brief%20-%20Individual%20Market%20Performance%20and%20Outlo ok%20(public)_vF.pdf) finds that narrow-network silver plans offered median premiums 22 percent lower than broad-network plans in 2016.

Third, selling costs are likely to be lower in the ACA marketplaces because of the prohibition on medical underwriting and limited variation in the policies and policy riders that can be offered. Higher enrollment also provides insurers more enrollees over which to split their fixed costs. The structure of the marketplaces, by presenting all insurance options to consumers on a single platform, should also somewhat reduce the need for marketing expenses and commissions paid to brokers.

Evidence (https://aspe.hhs.gov/sites/default/files/pdf/77041/rpt_RateReview.pdf) additionally suggests that the impositions of medical loss ratio minimums (the percentage of revenue insurers must spend on enrollee health expenses) and more prevalent rate review have had a small impact in lowering premiums. Programs that limit insurers’ risk, such as reinsurance and risk corridors, also have the effect of keeping premiums down, although both are expiring after this year and Congress has restricted risk corridor payouts.

Outlook For 2017: Premiums Below What They Would Have Been Without The ACA

This analysis finds that ACA marketplace premiums have been quite low to date. Indeed, it is likely that premiums through 2016 have been too low to be sustainable in many cases given the financial difficulties (http://healthcare.mckinsey.com/sites/default/files/Intel%20Brief%20-%20Individual%20Market%20Performance%20and%20Outlo ok%20(public)_vF.pdf)many insurers are having, whether the result of underestimating the cost of serving new populations, loss leader strategies to build a customer base, or other reasons. It is not surprising, then, that we are seeing higher (http://acasignups.net/16/06/02/remember-2017-rate-hikes-are-requests-so-far-not-approved) premium (http://avalere.com/expertise/managed-care/insights/early-analysis-finds-2017-proposed-exchange-rates-exceed-2016-increases-but) increase requests for 2017.

Large premium increases for 2017, if they do occur, would certainly be jarring to existing enrollees (although federal premium subsidies would soften the impact for low- and middle-income consumers). However, even if ACA marketplace premiums grow significantly in 2017, they will still be much lower than individual market premiums would have been in the absence of the ACA, on average, according to our analysis. This finding holds true under any reasonable set of assumptions about premium growth in the individual market in the counterfactual scenario that the ACA was never enacted.

Exhibit 3
http://healthaffairs.org/blog/wp-content/uploads/Adler_Exhibit3.png (http://healthaffairs.org/blog/wp-content/uploads/Adler_Exhibit3.png)


http://healthaffairs.org/blog/2016/07/21/obamacare-premiums-are-lower-than-you-think/

[DarrinS]

^ctrl-v

[boutons_deux]

BigInsurance will fuck us all, and most state regulators will let them.

[rmt]

That article fails to factor in deductibles, co-pays and the drastic narrowing of networks. Before ACA, I had a PPO plan with low deductible and could go to any doctor/hospital in the country. Now, the crappy second lowest silver plan costs more than that plan, the deductibles and copays are sky-high and I'm restricted to doctors/hospitals in my area.

Average rate request of 24 percent this year. That's according to findings from independent analyst Charles Gaba, who has crunched the numbers for insurers participating in the ACA exchanges in all 50 states, including a handful of recent updates.
Story Continued Below
For instance, Cigna and Humana recently revised their rate requests in Tennessee, and the new filings are dramatically higher. Cigna is now asking for a 46 percent average increase, up from 23 percent, and Humana is requesting a 44 percent increase, up from 29 percent, The Tennessean reported on Friday.
Average approved rate increase so far: 17 percent. That's according to weighted averages across just five states — Mississippi, New York, Oregon, Rhode Island and Vermont — Gaba reports, so there's bound to be fluctuation.

http://www.politico.com/tipsheets/politico-pulse/2016/08/obamacare-hikes-average-rate-request-of-24-percent-215881

[rmt]

BigInsurance will fuck us all, and most state regulators will let them.

I'll remind you of the 85-15 rule - 85% must be spent on healthcare - blame Obama and the democrats for the mandated essential benefits on all policies (regardless of whether you can even use them). Insurance companies now have the data to back up their increase requests. Admit it, boutons, unless one gets a subsidy, this is one crappy law.

[boutons_deux]

this is one crappy law.

tell that to people who can now get health care they couldn't afford without the law.

ACA is "crappy" because it's trying co-exist with the butt-fucking BigInsurance that WROTE THE LAW.

[TeyshaBlue]

WTF?

Why is there an 18 month old article on this topic being discussed as if it is news?

Try again, splits. :rolleyes

Destroyed in the comments section.

This blog post contains several material methodological errors, omissions, and distortions, such that it presents a misleading picture of the insurance marketplace.
First, the authors completely ignore multiple prior studies — including one published by one of their Brookings colleagues — all showing a significant increase in premiums when PPACA’s major insurance provisions took effect in January 2014. A paper published by Brookings non-resident fellow Amanda Kowalski in the Fall 2014 issue of Brookings Papers on Economic Activity concluded that “Across all states, from before the reform to the first half of 2014, enrollment-weighted premiums in the individual health insurance market increased by 24.4 percent beyond what they would have had they simply followed state-level seasonally adjusted trends.” This conclusion, as part of a paper studying the broader welfare effects of PPACA, utilized actual National Association of Insurance Commissioners data for 2013 and 2014 — unlike the post above, which compared 2009 data (extrapolated to 2013) with 2014 premiums. (Also unlike the blog post above, Dr. Kowalski’s paper was peer-reviewed by colleagues prior to publication.)
https://www.brookings.edu/wp-content/uploads/2016/07/Fall2014BPEA_Kowalski.pdf
Likewise, a recent Mercatus Center study (also peer-reviewed, unlike the above post) found that premiums for PPACA-compliant qualified health plans (QHPs) were significantly higher than non-PPACA compliant non-QHPs in 2014 — again suggesting a significant spike in premiums due to the law. Despite the higher premiums for the new PPACA plans, however, insurers also suffered losses in 2014 — a point not acknowledged by the Brookings researchers. Again, this Mercatus Center study utilized actual insurer data from 2013 and 2014, not the extrapolation method used by the above post.
http://mercatus.org/publication/affordable-care-act-turmoil-large-losses-individual-market-portend-uncertain-future
The post above also conflicts with data from Standard and Poor’s showing significant increases in individual market costs in 2014 — a trend which continued in 2015. The data show a nearly 38% increase in total health care costs for the individual market in 2014, and an aggregate 69% increase in total health care costs for the individual market from 2013 to 2015. As with the Kowalski and Mercatus studies, the S&P report uses actual pre-post data, as opposed to an extrapolation of premium costs for the 2013 pre-PPACA period.
http://media.mhfi.com/documents/SP_Global-Healthcare-Claims-Index-Monthly-Report-May-2016.pdf
Second, as noted above, the authors make their estimates based on CBO’s estimate (using MEPS data) of premiums for 2009, extrapolated forward based on inflation measures to 2013, rather than actual 2013 premiums. They provide insufficient support and justification for doing so. While PPACA was enacted in March 2010, its largest regulations did not take effect until January 2014. Moreover, as the authors themselves admit, by utilizing 2009 rather than 2013 data, they omit much of the effects of the slowdown in health spending that occurred following the 2008-2009 recession. Given that the studies using ACTUAL (as opposed to extrapolated) pre-post data all show significant increases beginning in 2014, it is reasonable to question whether their conclusion is primarily, if not solely, the result of the use of a favorable inflation measure for the years 2009 through 2013. Utilizing more recent MEPS premium data could have functioned as a sensitivity test — to determine whether their findings were solely a result of missing the effects of the health spending slowdown — but the authors chose not to undertake such analysis.
In a similar vein, the authors provide no explanation why they used 2009 CBO/MEPS data as the starting point, but then used a different inflation measure to adjust premiums upward from 2009-2013. If the MEPS premium data (as utilized by CBO) were sufficient to provide the
point, but then used a different inflation measure to adjust premiums upward from 2009-2013. If the MEPS premium data (as utilized by CBO) were sufficient to provide the starting point, then why not use MEPS data going forward, to provide the inflation measure for years 2010 and following? The authors neither acknowledge nor answer this question.
Third, the authors acknowledge — but failed to make any attempt to quantify — the effects of reinsurance on plan premiums in 2014 through 2016. A recent Mercatus Center study using actual data from insurer filings found that in 2014, reinsurance payments to insurers amounted to approximately 20.4% of gross premiums — yet still suffered over $2 billion in losses. Reinsurance payments alone account for all — if not more than all — of the supposed 10-21 percent premium “reduction” in premiums form 2013 to 2014. It undermines entirely the authors’ argument that PPACA “lowered premiums” if said premium “reduction” came solely based on redistribution of reinsurance funds from employer-based plans (via the Treasury) — particularly when the reinsurance program will end following this calendar year.
http://mercatus.org/publication/affordable-care-act-2014-significant-insurer-losses-despite-substantial-subsidies
Fourth, the statements about PPACA plans providing “more” and “better” coverage because the law “increased the quality and robustness of coverage” were made in the absence of evidence. http://www.chrisjacobshc.com/2016/07/22/does-brookings-have-a-wonk-gap/ The law included new requirements regarding minimum actuarial values, but it also — as the authors admit — has resulted in narrower physician and hospital networks, as studies by Avalere Health and McKinsey have demonstrated.
http://mercatus.org/publication/affordable-care-act-2014-significant-insurer-losses-despite-substantial-subsidies
http://healthcare.mckinsey.com/hospital-networks-perspective-three-years-exchanges
The talking point that “people are getting more for less” under PPACA remains key to press coverage of this post — despite the lack of research or analysis to support it. A Los Angeles Times article last week highlighted that talking point, as have prior pieces elsewhere:
http://www.latimes.com/business/hiltzik/la-fi-hiltzik-obamacare-premiums-20160726-snap-story.html
http://www.arktimes.com/ArkansasBlog/archives/2016/07/21/obamacare-has-led-to-lower-health-insurance-premiums-and-better-coverage-study-finds
http://www.politico.com/tipsheets/politico-pulse/2016/07/after-doj-brings-case-against-insurers-whats-next-215479
In sum, with respect to the assertion that PPACA lowered premiums, the authors 1) did not explain why they used CBO/MEPS data from 2009 rather than more recent data, 2) did not explain why they used the inflation measures they did, rather than MEPS data, 3) did not attempt to quantify the effects of reinsurance on premiums, and 4) ignored the multiple studies — including one from a Brookings colleague — using actual pre-post data (as opposed to an extrapolation based on a 2009 estimate) that have all found PPACA raised premiums, and 5) undertook no research to prove that PPACA coverage is “better” or of higher quality than prior plans — in other words, the first half of the “people are getting more for less” equation has no evidence to support it.
While not mentioned on Brookings’ site, Mr. Adler previously worked as a data analyst for then-Senator Obama’s campaign for the presidency in 2008. This “analysis” properly belongs in that arena — as a political talking point for a campaign, not a scholarly study undertaken by a heretofore reputable organization like Brookings, or published (even in blog form) in a forum such as Health Affairs. The authors should respond to the legitimate criticisms I (and others) have raised about their methodology — and if they cannot, or will not, the post should be taken down in its entirety.

[ElNono]

I'll remind you of the 85-15 rule - 85% must be spent on healthcare - blame Obama and the democrats for the mandated essential benefits on all policies (regardless of whether you can even use them). Insurance companies now have the data to back up their increase requests. Admit it, boutons, unless one gets a subsidy, this is one crappy law.

Actually, under that rule insurance companies have an incentive to ask providers to charge more, as that grows the 15% share they get to keep. Since cost was never a discussion with this law, providers are free to charge whatever the market will bear, and a lot of what the market will bear in this case is what the insurance company wants to pay. See the conflict of interest there?

I mean, I have zero intentions of defending the law because I also agree it's crappy (although it's certainly debatable it's worse than what was there before).

[ElNono]

Now that I'm reading this article (http://www.politico.com/story/2016/08/aetna-obamacare-state-exchanges-227040) on Aetna leaving a bunch of markets, it's also a good reminder of what this is all about.

We used to have a system that only cared about healthy people. People with pre-exisiting conditions were basically either priced out or shunned completely, and that's people that needs care the most. That was nice gig for insurance companies while it lasted.

Now we have this monstrosity that tried to bring those in (and at this point even republicans coincide that people with pre-exisiting conditions should not be denied coverage), by basically partially subsidizing it through the government, but without actual control on cost and prices, you're basically back to the profit motive vs access competing interests.

This is why, IMO, you're never going to find a "free-market" solution to this. The state will always have a compelling interest in access, but it won't be able to achieve it until it can at least severely tame the profit-motive aspect of it, and then you're not in a free market anymore. If you let profit-motive reign supreme (compounded with monopolistic instruments like patents and copyrights), then you're going to price people out, or severely restrict access (businesses are not in it to lose money).

Now we're full circle again to where we were before Barrycare passed. Access vs profit-motive.

[SnakeBoy]

We need VA for all

[ElNono]

We need VA for all

I sense sarcasm, but actually isn't the VA the only one allowed to negotiate prices with drug companies?

[boutons_deux]

what this is all about. ... Access vs profit-motive.

Health care is all about maximizing profits for mgmt and investors, aka, wealth transfer. shittiest possible product for highest possible price (and under no or minimized competition)

Estimates say that Americans pay about $1T/year too much for health care, transferred to the capitalists.

Health care is just another way America is fucked and unfuckable.

BigHealthcare owns enough politicians at all levels that it will NEVER allow its profits to be reduced by a Medicare-for-all. Even Medicare has been corrupted by the Repugs and their Medicare Advantage scam of taxpayers.

[CosmicCowboy]

your argument was young people shouldn't be forced to pay health insurance because they don't get sick, don't have accidents, never need medical care

Learn how to read, dumbass.

[boutons_deux]

Learn how to read, dumbass.

your argument was young people shouldn't be forced to pay health insurance because they don't get sick, don't have accidents, never need medical care

[CosmicCowboy]

your argument was young people shouldn't be forced to pay health insurance because they don't get sick, don't have accidents, never need medical care




Got damn you are stupid.

In your auto insurance analogy, if auto insurance was run like the ACA you could drive without insurance until you had a wreck, Then under ACA-AUTO you could go to a health insurance company and pay a new monthly car insurance premium and have your wreck covered as a pre-existing condition.

[boutons_deux]

Got damn you are stupid.

In your auto insurance analogy, if auto insurance was run like the ACA you could drive without insurance until you had a wreck, Then under ACA-AUTO you could go to a health insurance company and pay a new monthly car insurance premium and have your wreck covered as a pre-existing condition.

Your argument was that young people shouldn't be forced to pay health insurance because they don't get sick, don't have accidents, never need medical care.

People (sick or healthy) who don't buy health insurance get penalized on their income tax, so not buying health insurance until one gets sick isn't "free".

People pay one way or the other. (The penalties for not buying are too low but have ramped up nicely.)

And you seem to be really concerned about (mostly poor) people trying to game ACA, but don't give a flying fuck about BigHealthCare gaming the system to rip all of us off for profit (from which you yourself profit nicely, IIRC), and getting their whores in Congress to criminalize citizens for buying BigPharma's drugs MUCH cheaper in Canada, etc.

[CosmicCowboy]

Your argument was that young people shouldn't be forced to pay health insurance because they don't get sick, don't have accidents, never need medical care.

People (sick or healthy) who don't buy health insurance get penalized on their income tax, so not buying health insurance until one gets sick isn't "free".

People pay one way or the other. (The penalties for not buying are too low but have ramped up nicely.)

And you seem to be really concerned about (mostly poor) people trying to game ACA, but don't give a flying fuck about BigHealthCare gaming the system to rip all of us off for profit (from which you yourself profit nicely, IIRC), and getting their whores in Congress to criminalize citizens for buying BigPharma's drugs MUCH cheaper in Canada, etc.

The "penalty" is a joke. It's not even close to the cost of health insurance premiums.

I'm not making this shit up, dumbass. ACA isn't working because they can't get enough healthy people to buy into it.

[Pelicans78]

The "penalty" is a joke. It's not even close to the cost of health insurance premiums.

I'm not making this shit up, dumbass. ACA isn't working because they can't get enough healthy people to buy into it.

It's a tremendous joke, yet people will always defend it no matter what because it fits their agenda.

[rmt]

Your argument was that young people shouldn't be forced to pay health insurance because they don't get sick, don't have accidents, never need medical care.

People (sick or healthy) who don't buy health insurance get penalized on their income tax, so not buying health insurance until one gets sick isn't "free".

People pay one way or the other. (The penalties for not buying are too low but have ramped up nicely.)

And you seem to be really concerned about (mostly poor) people trying to game ACA, but don't give a flying fuck about BigHealthCare gaming the system to rip all of us off for profit (from which you yourself profit nicely, IIRC), and getting their whores in Congress to criminalize citizens for buying BigPharma's drugs MUCH cheaper in Canada, etc.

You don't have to pay the penalty - just adjust your withholding so you don't get a refund - IRS cannot get it any other way. There are other ways of not paying the penalty like turning off your utilities (shut-off notice from utility company is a hardship exemption). Besides the penalty is small - it doesn't offset those who enroll, get checkups/labs/procedures done and then cancel after.

[ElNono]

Health care is all about maximizing profits for mgmt and investors, aka, wealth transfer.

Also known as running a business... there's nothing inherently wrong with that. But, there's (or should be) an obvious competing state interest in guaranteeing access. This is a riddle the rest of the world figured out a long time ago.

The only positive about ACA, IMO, is that it shook the status quo. It's a terrible law, but it did put us into a road to change a deeply flawed system.

[boutons_deux]

Also known as running a business... there's nothing inherently wrong with that. But, there's (or should be) an obvious competing state interest in guaranteeing access. This is a riddle the rest of the world figured out a long time ago.

The only positive about ACA, IMO, is that it shook the status quo. It's a terrible law, but it did put us into a road to change a deeply flawed system.

running a business to maximize profit by minimizing health care delivery is inhumane.

It's the fucking idea that BigCorp/capitalists profits MUST BE SERVED, at all costs, which includes letting diseased people suffer and die for want of health care.

It's the horribly inhumane idea that health care is privilege not a right, because EVERYTHING in America must make a profit.

[CosmicCowboy]

Greedy, bloodsucking health care company pulls out of ACA after losing almost half a billion dollars...


When Aetna Inc. announced that it would withdraw from three-quarters of the states where it offers Affordable Care Act exchange plans, the move wasn’t entirely unexpected: The company had signaled its woes early this month.

But the decision by one of the nation’s largest health insurers AET, -0.20% to withdraw from 11 of 15 state exchanges follows similar moves by UnitedHealth Group Inc. UNH, -0.38% , the largest U.S. health insurer, and Humana Inc. HUM, +0.00% , another large health insurer.

The string of bad news marks a tidal shift for the ACA. Where insurers, including Aetna, had once planned on exchange expansions next year, many are instead curtailing their coverage.

Aetna’s pared-down 2017 exchange participation “raises further questions about the long-term viability of the ACA marketplaces,” said Susquehanna analyst Chris Rigg.

Read: Aetna to retreat from most of its Affordable Care Act markets

Aetna explained the decision as a way to “limit our financial exposure moving forward,” after pretax losses of $200 million in the second quarter and losses totaling $430 million on individual products since January 2014. The company did not specify what portion of the losses was attributable to individual public plan offerings.

The company criticized the ACA’s “inadequate” risk-adjustment mechanism, which is meant to limit insurers’ losses as they start covering sicker individuals. It’s a common criticism from health insurers, which have long said that the risk-pool program isn’t working the way it’s supposed to, though others say big insurance companies should instead change their model to keep costs down.

See: Aetna just became the fifth big health insurer with Obamacare exchange issues

Of Aetna’s exchange membership this year, more than half is new, with those needing expensive care making up “an even larger share” in the second quarter, the company said.

Coupled with the risk pool, this makes premiums costlier and “creates significant sustainability concerns,” the company said.

http://www.marketwatch.com/story/why-aetnas-exchange-withdrawal-could-mark-a-turning-point-for-obamacare-2016-08-16

[TheSanityAnnex]

running a business to maximize profit by minimizing health care delivery is inhumane.

It's the fucking idea that BigCorp/capitalists profits MUST BE SERVED, at all costs, which includes letting diseased people suffer and die for want of health care.

It's the horribly inhumane idea that health care is privilege not a right, because EVERYTHING in America must make a profit.
Off topic

Do you do any volunteer work? And donating money does not count, like actual, physical volunteer work, for anybody.

[Fabbs]

yes it is the republican fault the president is a liar
yes Hillarys telling lies makes it okay for the repugnatin to wish death on any

[Fabbs]

Does anyone think Hillary really will follow thru on Berns designs for free heathcare and college?

[Pelicans78]

running a business to maximize profit by minimizing health care delivery is inhumane.

It's the fucking idea that BigCorp/capitalists profits MUST BE SERVED, at all costs, which includes letting diseased people suffer and die for want of health care.

It's the horribly inhumane idea that health care is privilege not a right, because EVERYTHING in America must make a profit.

Nothing is a right in this country. Everything is privileged. Housing, clothes, food, etc. Health care is included.

[Pelicans78]

Does anyone think Hillary really will follow thru on Berns designs for free heathcare and college?

If she's smart, she's not gonna follow thru with her stance on Obamacare.

[Splits]

Does anyone think Hillary really will follow thru on Berns designs for free heathcare and college?

:lol is this a serious question?

Of course not, she's a lying cunt who will do anything to get elected.

[CosmicCowboy]

It will be interesting to see what she really does. Her proposed tax increases on corporations and individuals are an economy killer. Corporations will either leave of keep their profits overseas for good. Tim Cook explained it pretty well...


What do you say in response to Nobel economist Joseph Stiglitz’s comments on Bloomberg [television], where he called Apple’s profit reporting in Ireland a “fraud”?

I didn’t hear it. But if anybody said that, they don’t know what they’re talking about. Let me explain what goes on with our international taxes. The money that’s in Ireland that he’s probably referring to is money that is subject to U.S. taxes. The tax law right now says we can keep that in Ireland or we can bring it back. And when we bring it back, we will pay 35 percent federal tax and then a weighted average across the states that we’re in, which is about 5 percent, so think of it as 40 percent. We’ve said at 40 percent, we’re not going to bring it back until there’s a fair rate. There’s no debate about it. Is that legal to do or not legal to do? It is legal to do. It is the current tax law. It’s not a matter of being patriotic or not patriotic. It doesn’t go that the more you pay, the more patriotic you are.

[Fabbs]

:lol is this a serious question?
I cannot picture Bern with his amount of backers caving in without some kind of solid agreement.
And I say that knowing Shillary will make stuff up.
Just that Bern has been around the political block so I can't see him endorsing her without some kind of assurance.

[CosmicCowboy]

I cannot picture Bern with his amount of backers caving in without some kind of solid agreement.
And I say that knowing Shillary will make stuff up.
Just that Bern has been around the political block so I can't see him endorsing her without some kind of assurance.

:lmao

she will just say "she tried" and blame it on the Republicans.

[TeyshaBlue]

I sense sarcasm, but actually isn't the VA the only one allowed to negotiate prices with drug companies?

Yeah....and they're damn good at it.

[ElNono]

running a business to maximize profit by minimizing health care delivery is inhumane.

It's the fucking idea that BigCorp/capitalists profits MUST BE SERVED, at all costs, which includes letting diseased people suffer and die for want of health care.

It's the horribly inhumane idea that health care is privilege not a right, because EVERYTHING in America must make a profit.

It's a business, they're not in it for moral reasons, but to make a buck. The state is the one that should have the competing interest in the well being of citizens, affordable access to healthcare, etc.

That's exactly the dilemma I'm talking about. Until you actually deal with profit-motive (and thus cost), nothing is going to change.

[boutons_deux]

Rising cost of potentially life-saving EpiPen puts pinch on families

In 2009, pharmacies paid slightly more than $100 for a 2-pack of EpiPens. The price has since skyrocketed to more than $600.

http://www.cbsnews.com/news/allergy-medication-epipen-epinephrine-rising-costs-impact-on-families/

"Don't wanna die? Then pay up."

[SnakeBoy]

Yeah....and they're damn good at it.

http://www.heritage.org/research/reports/2007/04/the-va-drug-pricing-model-what-senators-should-know

[Warlord23]

http://www.heritage.org/research/reports/2007/04/the-va-drug-pricing-model-what-senators-should-know

More BS from the Heritage Foundation, which incidentally devised the Individual Mandate that became part of the ACA. Single-payer systems in Europe restrict access when they assess that the price of a new drug isn't commensurate with the increase in effectiveness over existing drugs. Guess what drug companies do when threatened with restricting access? In most cases, they give in and cut prices so that their drug is picked up by the country.

And that is the most important thing the US misses out on. If a drug company can prove a very minor increase in efficacy with a new drug and get a patent, they set high prices when the drug hits the market. There is no "drug review board" in the US which examines whether the price is worth the efficacy benefit. If I tried to sell you a product that's 5% better than what's on the market, but at a 50% higher price, you would tell me to take a hike unless I cut the price. The US healthcare system doesn't have a way of doing that. If the drug is FDA approved, healthcare payers will cover it because they don't want to impinge on individual choice.

Is the drug review board system perfect? Not always. Sometimes they deny access wrongly. But they publish the rationale for everyone to see, and are open to criticism from anyone. Sometimes public opinion has led them to reverse their decisions. No system is perfect, but the US system doesn't even attempt to correlate drug price and effectiveness.

[boutons_deux]

Heritage Stink tank, one of the oldest, most corrupt outfits in the VRWC strategy. Of course Heritage would be against regulating drug prices, keeping America to be the only industrial country which doesn't.

5 ways drug makers and the health care industry are shaping campaigns

WASHINGTON — Vilifying drug companies has been de riguer among this year’s political candidates.

But for the pharmaceutical industry, today’s critic is tomorrow’s committee chair, or perhaps even president. And in Washington, tradition holds that early generosity, or even one small pre-election check, will be remembered by candidates once they are in office.

And so drug makers and others in the health care industry have responded in force during the 2016 election — contributing heavily to both parties, including to the very politicians who are criticizing them.

“Money is absolutely key for access, that’s the harsh reality,” said Wright H. Andrews Jr., a longtime lobbyist and former head of the American League of Lobbyists. “They are still going to make donations — directly, indirectly — or they will hire people who have.”

With that in mind, here are five things you may not have known about how the health care industry is spending its political money this year:

Drug makers and others are giving heavily to super PACs favoring Hillary Clinton

There’s big action in the states

Health care providers can rally to support their own

Forget what you’ve read. There really are no limits.

In some cases, the health care industry is withholding support

https://www.statnews.com/2016/08/16/political-money-health-care/

aka, The Domestic Corrupt Practices Action.

Hilariously hypocritical that the Foreign Corrupt Practices Act even exists.

FCPA is just another LIE that America tells its vainglorious self

American politics is total bribery at all levels.

Politicians run for office to get (more) wealthy.

[SnakeBoy]

More BS from the Heritage Foundation, which incidentally devised the Individual Mandate that became part of the ACA. Single-payer systems in Europe restrict access when they assess that the price of a new drug isn't commensurate with the increase in effectiveness over existing drugs. Guess what drug companies do when threatened with restricting access? In most cases, they give in and cut prices so that their drug is picked up by the country.

And that is the most important thing the US misses out on. If a drug company can prove a very minor increase in efficacy with a new drug and get a patent, they set high prices when the drug hits the market. There is no "drug review board" in the US which examines whether the price is worth the efficacy benefit. If I tried to sell you a product that's 5% better than what's on the market, but at a 50% higher price, you would tell me to take a hike unless I cut the price. The US healthcare system doesn't have a way of doing that. If the drug is FDA approved, healthcare payers will cover it because they don't want to impinge on individual choice.

Is the drug review board system perfect? Not always. Sometimes they deny access wrongly. But they publish the rationale for everyone to see, and are open to criticism from anyone. Sometimes public opinion has led them to reverse their decisions. No system is perfect, but the US system doesn't even attempt to correlate drug price and effectiveness.

The article isn't about single payer healthcare and that's not why I provided the link.

[boutons_deux]

The article isn't about single payer healthcare and that's not why I provided the link.

no, it's propaganda about HOW BAD are VA's drug regulations and typically boring Heritage stink tank transparent bullshit about why regulating drug prices is just another horrible overreach by hated big govt.

Contributors to Heritage:

"drug and medical companies Johnson & Johnson (http://www.sourcewatch.org/index.php/Johnson_%26_Johnson), GlaxoSmithKline (http://www.sourcewatch.org/index.php/GlaxoSmithKline), Novartis (http://www.sourcewatch.org/index.php/Novartis), and Bristol-Myers Squibb (http://www.sourcewatch.org/index.php/Bristol-Myers_Squibb) Foundation"

http://www.sourcewatch.org/index.php/Heritage_Foundation#Campaign_Contributions

[Warlord23]

The article isn't about single payer healthcare and that's not why I provided the link.

I know ... I was refuting the central argument in the article that price capping / negotiation will damage consumer choice and access

[rmt]

Rising cost of potentially life-saving EpiPen puts pinch on families

In 2009, pharmacies paid slightly more than $100 for a 2-pack of EpiPens. The price has since skyrocketed to more than $600.

http://www.cbsnews.com/news/allergy-medication-epipen-epinephrine-rising-costs-impact-on-families/

"Don't wanna die? Then pay up."




With the My EpiPen Savings CardTM, you could be eligible to save on up to three EpiPen 2-Pak® or EpiPen Jr 2-Pak® cartons every time you fill your prescription, now through December 31, 2016. You’ll even be able to reuse your $0 co-pay card for multiple purchases.

https://www.epipen.com/copay-offer/

[ElNono]

http://www.heritage.org/research/reports/2007/04/the-va-drug-pricing-model-what-senators-should-know

That's a terrible read. He undermines his own argument from the get go: He first says drug companies can skip the VA price controls because they're a small market, then moves on to explain how Medicare is 40% of the pharmaceutical market in the US. With such a huge market, it's the drug companies that won't have a choice, as seen in countries like Canada and pretty much the rest of the world. Eventually you have to sell you product, and the only place on earth where they can do so with unrestricted prices is the US. You take 40% of that market from them, and they can't just sit it out. That's the whole point, and there's plenty of evidence worldwide that actually does work to reduce costs for beneficiaries. That's why importing drugs from Canada has been made illegal in the US. We're subsidizing those low prices everywhere else.

Thanks for sharing it though.

[angrydude]

Because as we all know, if the government doesn't mandate something it doesn't happen.

[ElNono]

Because as we all know, if the government doesn't mandate something it doesn't happen.

When you're looking at regulation, that's pretty much how it works. Would you pay taxes if the government didn't mandate you to? How about getting a driver's license if you weren't mandated to get one in order to drive? Plenty of examples, tbh...

[SnakeBoy]

That's a terrible read. He undermines his own argument from the get go: He first says drug companies can skip the VA price controls because they're a small market, then moves on to explain how Medicare is 40% of the pharmaceutical market in the US. With such a huge market, it's the drug companies that won't have a choice, as seen in countries like Canada and pretty much the rest of the world. Eventually you have to sell you product, and the only place on earth where they can do so with unrestricted prices is the US. You take 40% of that market from them, and they can't just sit it out. That's the whole point, and there's plenty of evidence worldwide that actually does work to reduce costs for beneficiaries. That's why importing drugs from Canada has been made illegal in the US. We're subsidizing those low prices everywhere else.

Thanks for sharing it though.

So you think medicare can negotiate the same prices as the VA if they also go to a single formulary that excludes 35% of the most common drugs prescribed to seniors?

[ElNono]

So you think medicare can negotiate the same prices as the VA if they also go to a single formulary that excludes 35% of the most common drugs prescribed to seniors?

If Medicare does get to negotiate the prices, it would actually make manufacturers of those 35% of drugs have to think very long and hard about pricing or they risk missing over 50% of the US market. It might work for them when it's just the VA, which is a small market, relatively speaking, but when you're talking half of their market, then that's a completely different story. And there's no other market they can go to, everywhere else outside the US already set prices.

At the end of the day the question is the same: do you want to control costs or not? If anybody holding a patent can charge whatever they want, then you're not going to bring costs down. There's zero incentive for them not to charge what the market will bear, so the only solution you have (considering the patent precludes actual competition), is to control the market and set the value. The alternative is what you have today, under the guise of "choice", which it really isn't if you can't afford insurance, the insurer won't cover it or you just can't afford the medicine. "choice" and "access" are two completely different things.

[boutons_deux]

There are way too many "me too" drugs that have almost no advantage.

and old generic, cheapo, very well known metformin works just as well for blood sugar control as the hyper-expensive new drugs with all their side effects, at least the side effects known so far.

BigPharma is as a big a scam as the $700B MIC.

[SnakeBoy]

do you want to control costs or not?

I never said I didn't. I provided the link to TB's comment that the VA was "damn good" at negotiating drug prices which is true but there is a reason why. If you think that medicare can simply copy the VA model and achieve the same results then I guess we'll have to agree to disagree. I also don't agree with your argument that if medicare did implement price controls then drug manufacturers would simply have no other options to make up the lost revenue.

[TeyshaBlue]

So you think medicare can negotiate the same prices as the VA if they also go to a single formulary that excludes 35% of the most common drugs prescribed to seniors?

They won't....different clientele.

[boutons_deux]

They won't....different clientele.

Repugs' hated REGULATIONS that forbid Medicare from negotiating drug, device prices have to overturned first.

[TeyshaBlue]

Herp Derp.

No shit. :rolleyes

[ElNono]

I never said I didn't. I provided the link to TB's comment that the VA was "damn good" at negotiating drug prices which is true but there is a reason why. If you think that medicare can simply copy the VA model and achieve the same results then I guess we'll have to agree to disagree. I also don't agree with your argument that if medicare did implement price controls then drug manufacturers would simply have no other options to make up the lost revenue.

well, I suppose they can always "lobby" (wink, wink) politicos for a sweeter deal. I mean, the US is basically the last place on earth where they can actually charge whatever they want. They're not stupid, and it's a business after all. When a country like India threatened to simply ignore their patents and produce generic versions of their prized meds, they sat down, and licensed the drug so at least they would get a cut, even if the drug would sell at 1% of the original price they had in mind.

It's certainly debatable whether the US should prioritize the health of their citizens over the profit motive of certain companies. I think that's where the debate needs to be, or if there's some middle-ground somewhere there.

[SnakeBoy]

well, I suppose they can always "lobby" (wink, wink) politicos for a sweeter deal. I mean, the US is basically the last place on earth where they can actually charge whatever they want. They're not stupid, and it's a business after all. When a country like India threatened to simply ignore their patents and produce generic versions of their prized meds, they sat down, and licensed the drug so at least they would get a cut, even if the drug would sell at 1% of the original price they had in mind.

It's certainly debatable whether the US should prioritize the health of their citizens over the profit motive of certain companies. I think that's where the debate needs to be, or if there's some middle-ground somewhere there.

Like I said, I'm not against all price controls. Something needs to be done to prevent the type of price gouging you see in cases like the epipen for example where the company ends up with a monopoly and decides to make an inexpensive product a cash cow because of it. Or like that Shkreli dick did when he obtain the rights to a life saving drug and then tried to use that single drug to fund his entire startup.

At the same time I don't think it is as simple as you seem to believe. Take away the most profitable market for drugs and publicly traded pharmaceutical companies will just say "ok fine we never really needed these profits" and there won't be any negative consequences just doesn't seem believable to me.

Same way I don't think single payer is the panacea so many seem to think it is without any details of how it would actually work in this country. That doesn't mean I think our system isn't fucked up but I don't see the problem as "We don't have a single payer model" or "We don't have a nationalized model" or "We don't have a mixed model". I see the problem as we don't have a model, just a hodge podge collection of reactionary ideas put on top of each other every 4-8 years.

[boutons_deux]

"I don't think single payer is the panacea"

no worry, medicare-for-all will never happen in USA. BigHealthCare will always block it.

[ElNono]

Like I said, I'm not against all price controls. Something needs to be done to prevent the type of price gouging you see in cases like the epipen for example where the company ends up with a monopoly and decides to make an inexpensive product a cash cow because of it. Or like that Shkreli dick did when he obtain the rights to a life saving drug and then tried to use that single drug to fund his entire startup.

At the same time I don't think it is as simple as you seem to believe. Take away the most profitable market for drugs and publicly traded pharmaceutical companies will just say "ok fine we never really needed these profits" and there won't be any negative consequences just doesn't seem believable to me.

Same way I don't think single payer is the panacea so many seem to think it is without any details of how it would actually work in this country. That doesn't mean I think our system isn't fucked up but I don't see the problem as "We don't have a single payer model" or "We don't have a nationalized model" or "We don't have a mixed model". I see the problem as we don't have a model, just a hodge podge collection of reactionary ideas put on top of each other every 4-8 years.

I don't know if they "needed" those profits, but we certainly know they spend about half of that in marketing alone, which makes it hard for me that have much sympathy for them. The R&D is more tilted towards what sells instead of what might be needed. They're businesses, they have every right to do all that, though.

But I rather have this conversation, about what role, if any, the state (which does have a compelling interest towards it's citizens) should have about reining in costs, and in which ways, than keep insisting with magical stuff like HSAs, etc, which don't really tackle the actual problem (pricing). Maybe the solution is not price-fixing, maybe it's severely limiting the availability or duration of patents for certain pharmaceutical products. Maybe it's allowing imports of medication, and then we get an across-the-board price alignment, instead of the US citizen subsidizing the world.

There's many ways to skin a cat, but I feel sometimes we reduce the argument to silly stuff and we lose sight of what the actual dilemma really is.

[Th'Pusher]

At the same time I don't think it is as simple as you seem to believe. Take away the most profitable market for drugs and publicly traded pharmaceutical companies will just say "ok fine we never really needed these profits" and there won't be any negative consequences just doesn't seem believable to me.



Well you're right in that they will attempt to replace those revenue streams or reduce costs to maintain their bottom line. The question is how? Scale back R&D? Scale back their marketing campaigns? What are the effects of these?

[boutons_deux]

"Scale back R&D? Scale back their marketing campaigns?"

years ago, I read that BigPharma spent $30B on R&D, and $30B on marketing. probably no different now, maybe even worse.

It has been shown that BigPharma/BigDevice "marketing" corrupts 1000 of docs.

Some countries block all marketing to consumers, and still provide drugs as needed.

And of course, BigPharma's "testing" is hidden, where good results are published, hyped, and bad results are hidden.

So many death and injuries from BigPharma's poison that BigPharma has paid many $10Bs to victims and govt (and still have one of the highest profit margins of any Fortune 500 sector).

[ElNono]

Also, I don't know if single-payer is a panacea... it just needs to be better than what we have. I'm actually in favor of a mixed system, where you do get baseline care from single-payor, and if you can afford and want more of a concierge type of service from a private entity, you can certainly pay for that. I feel removing a bunch of intermediaries in the US system would go a long ways to reducing cost also.

[TeyshaBlue]

Also, I don't know if single-payer is a panacea... it just needs to be better than what we have. I'm actually in favor of a mixed system, where you do get baseline care from single-payor, and if you can afford and want more of a concierge type of service from a private entity, you can certainly pay for that. I feel removing a bunch of intermediaries in the US system would go a long ways to reducing cost also.

This is the approach I've always favored. However, you set the stage for Elysium in the next century.

[boutons_deux]

PHARMA CEO GAVE HERSELF AN $18 MILLION RAISE AFTER HIKING EPIPEN PRICES

Bresch went from making $2.453,456 in 2007 to$18,931,068 in 2015 (http://www.mylan.com/-/media/mylancom/files/company/corporate%20governance/184592_10ka_bmk.pdf), amounting to a 671 percent raise over eight years.

But Bresch wasn’t alone in the windfall resulting from the rising price of the EpiPen. Mylan’s president, Rajiv Malik, saw his base pay increase by 11 percent to $1 million annually as of 2015 (http://www.nbcnews.com/business/consumer/mylan-execs-gave-themselves-raises-they-hiked-epipen-prices-n636591),

while Mylan Chief Commercial Officer Anthony Mauro got a 13.6 percent raise, amounting to $625,000 per year.

http://usuncut.com/class-war/pharma-ceo-epipen/

yep, ACA FORCES BigPharma to pay its execs and investors extremely well.

[Chucho]

I can't believe people question if the Government can regulate big pharma and actually do something to help people with actual healthcare...of course they can. They flat out don't want to because big pharma has big lobbyists in DC spreading around that sweet, sweet bribe cash.

[boutons_deux]

I can't believe people question if the Government can regulate big pharma and actually do something to help people with actual healthcare...of course they can. They flat out don't want to because big pharma has big lobbyists in DC spreading around that sweet, sweet bribe cash.

That's why it's hilarious to see "serious people" think that Trash's glorious crash and burn in November will cause the GOP to disappear or even reform.

GOP's strategy is, has been to sucker voters with social issues, while fully implementing/defending/extending (laws, policies, regs, obstruction) the corporatocracy that their big donors pay them for.

The corporatocracy will be untouched by Trash's electoral disaster (and BigFinance's whore/establishment Hillary won't do anything serious about corporatocracy, either)

btw, unwinnable wars are unending profits for BigCorp. Military people don't "serve", they are "used" as cannon fodder, for profit.

[Chucho]

GOP's strategy is, has been to sucker voters with social issues, while fully implementing/defending/extending (laws, policies, regs, obstruction) the corporatocracy that their big donors pay them for.



Wait, it's the Right that is pushing and fostering the racial divide? Pushing agendas that pander to the extreme, extreme minorites such as transgender-.003% of the population and pushing an absurd $15 dollar minimum wage that 90% of the companies that employ 95% of the workforce simply can't afford after payroll and FICA taxes?

I didn't know it was the Right that was continuing wars while ruining entire nations, nor did I know that it was the Right that made Obama's Administration the largest foreign arms dealer in history.

I didn't know that it was the Right that voted to bail out the big banks instead of letting them burn to the ground, like the other Scandinavian countries did. The SAME Scandinavian countries that socialist-Leftists admire so much and claim a country of 350 million people can have the same benefits as a country of 5-10 million people.

I didn't know ANY of that.:sleep

[Warlord23]

Wait, it's the Right that is pushing and fostering the racial divide? Pushing agendas that pander to the extreme, extreme minorites such as transgender-.003% of the population and pushing an absurd $15 dollar minimum wage that 90% of the companies that employ 95% of the workforce simply can't afford after payroll and FICA taxes?

I didn't know it was the Right that was continuing wars while ruining entire nations, nor did I know that it was the Right that made Obama's Administration the largest foreign arms dealer in history.

I didn't know that it was the Right that voted to bail out the big banks instead of letting them burn to the ground, like the other Scandinavian countries did. The SAME Scandinavian countries that socialist-Leftists admire so much and claim a country of 350 million people can have the same benefits as a country of 5-10 million people.

I didn't know ANY of that.:sleep

Social issues have always been used by both parties to rev up their base. However, the GOP is way more cynical at using them. You said it yourself: why should the Democrats talk about transgender bathrooms for 0.03% of the population? It doesn't win them a single new vote - they could just stay a little more moderate than the GOP and scoop up that tiny minority. The GOP's history on this is much longer: Nixon's Southern Strategy and drug war, Reagan's "states rights" speech in Mississippi, Atwater's Willie Horton attacks, Rove planting stories about McCain's illegitimate black child, making the 2004 election about gay marriage bans, questioning Obama's religion/birthplace - all these were deliberate attempts to get social conservatives to look beyond the GOP's economic and foreign policy record.

Yes, both parties are equally in the pockets of the banks and arms manufacturers. That's a feature, not a bug, of money in politics. Neither side comes out looking good in that conversation.

[baseline bum]

Wait, it's the Right that is pushing and fostering the racial divide? Pushing agendas that pander to the extreme, extreme minorites such as transgender-.003% of the population and pushing an absurd $15 dollar minimum wage that 90% of the companies that employ 95% of the workforce simply can't afford after payroll and FICA taxes?

I didn't know it was the Right that was continuing wars while ruining entire nations, nor did I know that it was the Right that made Obama's Administration the largest foreign arms dealer in history.

I didn't know that it was the Right that voted to bail out the big banks instead of letting them burn to the ground, like the other Scandinavian countries did. The SAME Scandinavian countries that socialist-Leftists admire so much and claim a country of 350 million people can have the same benefits as a country of 5-10 million people.

I didn't know ANY of that.:sleep

You didn't know it was Bush who bailed out the banks and invaded Iraq?

[boutons_deux]

Wait, it's the Right that is pushing and fostering the racial divide? Pushing agendas that pander to the extreme, extreme minorites such as transgender-.003% of the population and pushing an absurd $15 dollar minimum wage that 90% of the companies that employ 95% of the workforce simply can't afford after payroll and FICA taxes?

I didn't know it was the Right that was continuing wars while ruining entire nations, nor did I know that it was the Right that made Obama's Administration the largest foreign arms dealer in history.

I didn't know that it was the Right that voted to bail out the big banks instead of letting them burn to the ground, like the other Scandinavian countries did. The SAME Scandinavian countries that socialist-Leftists admire so much and claim a country of 350 million people can have the same benefits as a country of 5-10 million people.

I didn't know ANY of that.:sleep

because you're a garden-variety stupid, ignorant, confused rightwingnut fuckoff

[Chucho]

because you're a garden-variety stupid, ignorant, confused rightwingnut fuckoff

LOL, said the by-product of the best propaganda this side of Joe Goerbels. Don't take your aggressions out on me, pal. You're part of a racist, oppressive party that is every bit as awful as history has shown you ancestors of Slave owners to be. Good for you, you can insult people. You're a garden-variety, stupid, ignorant, confused, easily mislead, Oppressive Left fuck off with no handle of decency.

[Chucho]

You didn't know it was Bush who bailed out the banks and invaded Iraq?

But it was Obama who handed them the check. And it's Obama who hasn't reinvested or reimbursed the tax payers one penny of that $64 billion they made in interest off that. But Obama's bitch has racked up a personal spending account of $44 million? Not saying their is a correlation, just saying there is fuckery going on on the Left that the LOLeftists refuse to acknowledge.

[baseline bum]

But it was Obama who handed them the check. And it's Obama who hasn't reinvested or reimbursed the tax payers one penny of that $64 billion they made in interest off that. But Obama's bitch has racked up a personal spending account of $44 million? Not saying their is a correlation, just saying there is fuckery going on on the Left that the LOLeftists refuse to acknowledge.

LOL Republicans running away from the bailout their boy Paulson engineered and Bush signed.

[boutons_deux]

LOL Republicans running away from the bailout their boy Paulson engineered and Bush signed.

Even when Barry implemented it, they disowned it, saying it was all Barry's deal (so they could lie to their suckered base that they were anti-BigFinance)

[ElNono]

You didn't know it was Bush who bailed out the banks and invaded Iraq?

:lol exactly what I was thinking when I read that

Still waiting for Medicare part D being an invention of Barrycare...

[boutons_deux]

:lol exactly what I was thinking when I read that

Still waiting for Medicare part D being an invention of Barrycare...

Then there's the Repugs denying bankruptcy to student borrowers whose debt can carry on after death to other family members.

Then there's Medicare Advantage that costs taxpayers 12% more than Medicare, right into bank accounts of BigInsurance.

Repugs fuck Americans every which way they can at every possible chance.

[boutons_deux]

so Mylan cuts murderous price hike in half, what a big heart

Mylan to Offer a Generic EpiPen at Half the Pricehttp://www.nytimes.com/2016/08/30/business/mylan-to-offer-a-generic-epipen-at-half-the-price.html?partner=rss&emc=rss

Cost of materials? a couple bucks.

Cost of paying investors and Mylan mgmt? $100Ms

For-profit health care, the worst disease afflicting Americans.

[boutons_deux]

"The adult EpiPen has 0.3mg of epinephrine (https://en.wikipedia.org/wiki/Epinephrine).

The cost of 1.0mg of epinephrine is around $2 dollars retail."

https://medium.com/@zachshallbetter/life-and-death-by-the-epipen-9af31ad6f9d7#.wj4vtk9qh

[Winehole23]

Aetna awash in profits:

https://www.healthinsurance.org/blog/2016/08/25/cry-me-a-river-aetna/

[pgardn]

No sarcasm intended.
Could someone help me make sense of this:

https://www.texastribune.org/2016/09/07/north-texas-hospitals-face-27-million-cut-medicaid/

[boutons_deux]

Gov. Greg Abbott (http://www.texastribune.org/directory/greg-abbott/) and other Republican leaders have vehemently opposed offering Medicaid to roughly 800,000 additional Texans on the grounds that

Medicaid is an inefficient government program. :lol

... but the TX Repugs still want those Federal $$$. :lol fucking hypocritical cheaters.

[pgardn]

No sarcasm intended.
Could someone help me make sense of this:

https://www.texastribune.org/2016/09/07/north-texas-hospitals-face-27-million-cut-medicaid/

[boutons_deux]

No sarcasm intended.
Could someone help me make sense of this:

https://www.texastribune.org/2016/09/07/north-texas-hospitals-face-27-million-cut-medicaid/

sense? it's super complicated, and it's a he said/he said, so who knows?

[boutons_deux]

Feds' goal, ACA, was to get poor people covered, insured, and get them health care. Sure sounds like TX gamed the system. but who really knows?

[rmt]

Obamacare Reduced Employment and Shrank the Economy - http://www.cnsnews.com/commentary/hans-bader/obamacare-reduced-employment-and-shrank-economy Below is the study:

The effect of Medicaid expansion on labor force participation of childless adults - a significant negative relationship between Medicaid expansion and labor force participation, in which expanding Medicaid is associated with 1.5 to 3 percentage point drop in labor force participation - http://gradworks.umi.com/10/10/10106085.html

[boutons_deux]

"associated with"

is not proof, not causality. CNS, right wing nut bullshit.

[rmt]

"associated with"

is not proof, not causality. CNS, right wing nut bullshit.




The study is from Georgetown University.

[boutons_deux]

ACA doesn't have or make premiums, it's all on BigInsurance, has been for 30+ years.

[pgardn]

No sarcasm intended.
Could someone help me make sense of this:

https://www.texastribune.org/2016/09/07/north-texas-hospitals-face-27-million-cut-medicaid/

[boutons_deux]

The study is from Georgetown University.

if ACA provably CAUSED something, then why do they say "associated with"?

the "economy" is extremely complex with Ms of factors, health care employment has gone UP, not down, since ACA started, and I'm not saying ACA provably caused the increase.

Georgetown U is Catholic Jesuit and Catholic orgs mostly, officially hate Obama for his ACA, contraception, abortion, and other policies.

[SnakeBoy]

No sarcasm intended.
Could someone help me make sense of this:

https://www.texastribune.org/2016/09/07/north-texas-hospitals-face-27-million-cut-medicaid/

Texas didn't want to expand medicaid because eventually the Federal $'s would run out and they'd be on the hook for the bill but Texas is still trying to get it's hands on as much of that Federal $ as they can. Uncle Sam doesn't like that...so they're having a fight.

[Winehole23]

No sarcasm intended.
Could someone help me make sense of this:

https://www.texastribune.org/2016/09/07/north-texas-hospitals-face-27-million-cut-medicaid/Texas wants Medicaid money they say was promised; the Feds want a refund for funds disbursed.

I thought Medicaid was an evil, inefficient government program -- why would Texas want to participate in that?

[Winehole23]

oh, yeah, because Texas is too stingy to pay for it's own healthcare, so the Feds -- meaning you, me and everyone else in the US -- should pick up the tab.

[Winehole23]

Texas preaches water but drinks wine

[Winehole23]

gubmint wine

[Winehole23]

if we didn't, we'd have to raise taxes

[Winehole23]

why does Texas think the USG should pay for its private hospitals?

[CosmicCowboy]

why does Texas think the USG should pay for its private hospitals?

Do you want to require Medicaid recipients to only go to county/non-profit hospitals?

[Winehole23]

Not at all. Just pointing out how Texas talks from both sides of its mouth when it comes to federal money and socialized healthcare.

[Winehole23]

Texas bad mouths both with its hat out.

[boutons_deux]

EpiPen Maker Dispenses Outsize Pay

Mylan, lambasted for raising prices, ranks No. 2 in U.S. drug industry in executive compensation

The drugmaker buffeted by the furor over hefty price increases on its lifesaving

EpiPen (http://www.wsj.com/articles/mylan-faces-scrutiny-over-epipen-price-increases-1472074823) had the second-highest executive compensation among all U.S. drug and biotech firms over the past five years,

paying its top five managers a total of nearly $300 million,

http://www.wsj.com/articles/epipen-maker-dispenses-outsize-pay-1473786288?utm_source=huffingtonpost.com&utm_medium=referral&utm_campaign=pubexchange

Just another example of BigCorp LOOTING Amreica and American's wealth.

iow, this is what you get from the VRWC's "free market capitalism", and

the Repugs "leaving everything to the private sector under NO regulation"

[CosmicCowboy]

EpiPen Maker Dispenses Outsize Pay

Mylan, lambasted for raising prices, ranks No. 2 in U.S. drug industry in executive compensation

The drugmaker buffeted by the furor over hefty price increases on its lifesaving

EpiPen (http://www.wsj.com/articles/mylan-faces-scrutiny-over-epipen-price-increases-1472074823) had the second-highest executive compensation among all U.S. drug and biotech firms over the past five years,

paying its top five managers a total of nearly $300 million,

http://www.wsj.com/articles/epipen-maker-dispenses-outsize-pay-1473786288?utm_source=huffingtonpost.com&utm_medium=referral&utm_campaign=pubexchange

Just another example of BigCorp LOOTING Amreica and American's wealth.

iow, this is what you get from the VRWC's "free market capitalism", and

the Repugs "leaving everything to the private sector under NO regulation"




Are you advocating that the government decide what people are allowed to pay their employees?

[boutons_deux]

Are you advocating that the government decide what people are allowed to pay their employees?

no, I'm advocating that govt should regulate drug prices, like all other industrial countries.

Mylan and Pharma Bro typify the BigCorp shit bags profiteering off diseases, death, and damn near everything else Americans have or need.

[boutons_deux]

Are you advocating that the government decide what people are allowed to pay their employees?

in the case of Federal minimum wage, yes. Should be $15 immediately, indexed to inflation, and increasing the $25 in 10 years.

[Winehole23]

Aetna awash in profits:

https://www.healthinsurance.org/blog/2016/08/25/cry-me-a-river-aetna/


On Monday, a federal judge blocked (https://apnews.com/0a7ce7513b794416a0fbcd61f7de2b99/Federal-judge-swats-Aetna-Humana-insurer-combo) Aetna’s $34-billion acquisition of Humana. Combined they would have formed the second largest health insurer, behind the also under-attack Anthem-Cigna merger. The court cited antitrust grounds related to Medicare Advantage insurance plans, where their combined pricing power would ultimately raise the costs that consumers pay for coverage.http://wolfstreet.com/2017/01/24/judge-reveals-shady-side-of-collapsed-aetna-humana-merger-investment-bank-fees-breakup-fee/

[Winehole23]

Aetna threatened the government last summer with pulling out of 11 of the 15 states where it participated in the Obamacare individual insurance markets, claiming it was a “business decision.” The threat was made while the Department of Justice was investigating the merger but before it filed its antitrust lawsuit. It was a shot before the bow. After the lawsuit was filed, Aetna followed through on its threat.


And Judge Bates put his finger on it: It wasn’t just a “business decision,” he wrote. There was more to it. “Aetna tried to leverage its participation in the exchanges for favorable treatment from DOJ regarding the proposed merger.”

[Winehole23]

Aetna cried wolf for wolfish reasons:


Aetna then tried to cover up that connection between the threat to pull out of those markets and the antitrust investigation to the point where the “repeated efforts to conceal a paper trail about the decision-making process” bordered on “malfeasance,” he wrote.


Judge Bates determined that there was “persuasive evidence that when Aetna later withdrew from the 17 counties, it did not do so for business reasons, but instead to follow through on the threat that it made earlier.”

[Wild Cobra]

Look like I'm lucky.

Just this month, my healthcare went up by only 9%. My increase last year this time was 13.5%.

Wish my wages went up that fast...

[Winehole23]

death spiral!

[boutons_deux]

Look like I'm lucky.

Just this month, my healthcare went up by only 9%. My increase last year this time was 13.5%.

Wish my wages went up that fast...

Trumpcare will reduce your insurance costs! :lol

[Wild Cobra]

Trumpcare will reduce your insurance costs! :lol

Not likely.

Since I had a top of the line plan to begin with, after my initial jump following the passage of Obamacare, mine have been below the other increases.

It's the lesser plans that were highly affected by Obamacare.

[baseline bum]

in the case of Federal minimum wage, yes. Should be $15 immediately, indexed to inflation, and increasing the $25 in 10 years.

$25 an hour? Wow, so people would make $50,000 a year for frying chicken at Bill Miller's? What's the point of going to college or learning a trade? We'd have a generation of fry cooks and no doctors, engineers, truck drivers, plumbers, etc. :lol

[Thread]

$25 an hour? Wow, so people would make $50,000 a year for frying chicken at Bill Miller's? What's the point of going to college or learning a trade? We'd have a generation of fry cooks and no doctors, engineers, truck drivers, plumbers, etc. :lol

The point is:::it will be up to you & I to patronize these establishments to their end, be it a success, or, a failure. See how that works, cement head?

[baseline bum]

The point is:::it will be up to you & I to patronize these establishments to their end, be it a success, or, a failure. See how that works, cement head?

I don't see how it works. Are you arguing in favor of boutons' communist utopia? :lol

[Thread]

I don't see how it works. Are you arguing in favor of boutons' communist utopia? :lol

That's because you have the aforementioned head chock full of cement.

[baseline bum]

That's because you have the aforementioned head chock full of cement.

So you're a right wing nationalist commie son?

[Thread]

So you're a right wing nationalist commie son?

They were selling your shit.

[boutons_deux]

$25 an hour? Wow, so people would make $50,000 a year for frying chicken at Bill Miller's? What's the point of going to college or learning a trade? We'd have a generation of fry cooks and no doctors, engineers, truck drivers, plumbers, etc. :lol

Sure, why not? give employers until 2025 to get there, but that $25 will be indexed to inflation from now, so more in 2025.

Taxpayers are already topping up the salaries of Bill Miller, Pudzer, Walmart, etc by many $100Ms if not $Bs per year, so why not have the employers pay living wages and give the taxpayers a break?

Why should taxpayers subsidize employers paying shitty wages?

If employers can't run a business paying decent wages, and without taxpayer subsidies, then the businesses are dead.

The jobs would be in high demand, instead of mostly throway jobs people churned through everyday, resulting in higher quality, more reliable employees, less churn, less training.

[Thread]

Sure, why not? give employers until 2025 to get there, but that $25 will be indexed to inflation from now, so more in 2025.

Taxpayers are already topping up the salaries of Bill Miller, Pudzer, Walmart, etc by many $100Ms if not $Bs per year, so why not have the employers pay living wages and give the taxpayers a break?

Why should taxpayers subsidize employers paying shitty wages?

[[[If employers can't run a business paying decent wages, and without taxpayer subsidies, then the businesses are dead.]]]

The jobs would be in high demand, instead of mostly throway jobs people churned through everyday, resulting in higher quality, more reliable employees, less churn, less training.

Then let them be dead.

[Wild Cobra]

I don't see how it works. Are you arguing in favor of boutons' communist utopia? :lol

Can you say utopia with a Russian accent?

[SnakeBoy]

Not likely.

Since I had a top of the line plan to begin with, after my initial jump following the passage of Obamacare, mine have been below the other increases.

It's the lesser plans that were highly affected by Obamacare.

Are you even on the individual market?

[SnakeBoy]

death spiral!

The individual market is in a death spiral. Do you not believe it?

[Wild Cobra]

Are you even on the individual market?

No, I'm covered through a very large employer. I have what they would call a golden or platinum plan.

Rather expensive already before Obamacare.

[SnakeBoy]

No, I'm covered through a very large employer. I have what they would call a golden or platinum plan.

Rather expensive already before Obamacare.

Well the big increases you hear about are the rates on the individual market. My grandfathered plan went up 26% this year. Don't have much choice since the only individual insurance available in Texas now is a crappy Blue Cross Blue Shield HMO plan which is almost twice the price for the bronze plan.

[Wild Cobra]

Well the big increases you hear about are the rates on the individual market. My grandfathered plan went up 26% this year. Don't have much choice since the only individual insurance available in Texas now is a crappy Blue Cross Blue Shield HMO plan which is almost twice the price for the bronze plan.

Yes, I know they go up more than mine. The facts are fuzzy in my mind, but I believe they have imposed an ever increasing tax of insurance plans, and a way to partially offset subsidized insurance. I forget what the last year is that these taxes stop increasing.

[rmt]

Yes, I know they go up more than mine. The facts are fuzzy in my mind, but I believe they have imposed an ever increasing tax of insurance plans, and a way to partially offset subsidized insurance. I forget what the last year is that these taxes stop increasing.

They've postponed the Cadillac tax on expensive plans like yours until 2020.

The so-called Cadillac tax is an excise tax on high cost health plans offered by employers. Beginning in 2020, health plans that cost more than $10,200 for an individual or $27,500 for a family plan will be subject to the tax, which is 40% of the amount that exceeds those thresholds

[Winehole23]

The individual market is in a death spiral. Do you not believe it?I believe premiums are getting more expensive and that it was foreseeable that they would and that they will continue to. It's undeniably true that insurers have left the market -- some for purely political reasons. Aetna is awash in profits.

does the term "death spiral" have a precise technical meaning?

[SnakeBoy]

I believe premiums are getting more expensive and that it was foreseeable that they would and that they will continue to. It's undeniably true that insurers have left the market -- some for purely political reasons. Aetna is awash in profits.


Aetna wasn't awash in profits on the individual market. Nationally they were losing money every year. The politics in their case was that they pulled out of a few markets where they were making money because they wanted the merger.



does the term "death spiral" have a precise technical meaning?

Yeah it meant that when the ACA put a bunch of people who were previously uninsurable onto the individual market it would cause premiums to rise which would cause healthy people to leave the market which would cause premiums to rise which would cause healthy people to leave the market which would etc. etc.

The public option was supposed to be the counter to that by allowing us to be part of larger national risk pool but Obama quickly abandoned that idea to get insurers on board with the ACA.

[Spurminator]

Looking more and more like the ACA is going to be a 2018 (and potentially 2020) wedge issue.

http://thehill.com/policy/healthcare/319363-freedom-caucus-vows-to-oppose-weakening-obamacare-repeal


The conservative House Freedom Caucus voted Monday night to oppose an ObamaCare repeal bill if it does not go as far as the repeal measure that passed in 2015, drawing a line in the sand that could complicate Republican repeal efforts.

Conservatives have been pushing for the 2015 repeal bill, which kills the core elements of the law including its subsidies, taxes, mandates and Medicaid expansion, to be brought up again. But the move Monday night to oppose an effort if it falls short of that bill is a significant new development.

Some more moderate Republicans are uneasy with repealing all of ObamaCare's taxes, and especially with repealing the Medicaid expansion. But if repeal of those areas is weakened, the Freedom Caucus now says it would oppose the bill.

"If it's less than 2015, we will oppose it," Rep. Mark Meadows (R-N.C.), the chairman of the Freedom Caucus, said after exiting the meeting.

[Winehole23]

Trump promised cheaper, better healthcare coverage for all. One wonders how he'll deliver.

The US Congress may not be on his side.

[boutons_deux]

Shkreli was not an outlier

BigPharma buying protection, immunity for their criminal scamming.

Follow the Money: Drugmakers Deploy Political Cash as Prices and Anger Mount

a multiple sclerosis (http://health.nytimes.com/health/guides/disease/multiple-sclerosis/overview.html?inline=nyt-classifier) drug whose price had soared to $34,000 a vial

This year, a critical and risky one for drug companies, the industry as a whole is ratcheting up campaign donations and its presence on Capitol Hill, a new database compiled by Kaiser Health News shows.

"The stakes are really high right now," said David Maris, who follows pharmaceutical stocks for Wells Fargo, given that President Donald Trump has joined Democrats to demand action on drug costs.

Congressional donations from pharmaceutical PACs rose 11 percent in this year's first quarter,

compared with the first three months of 2015 (the comparable point in the previous election cycle), according to a Kaiser Health News analysis. The increase accompanied a spike in pharma lobbying for the period.

Contributions to powerful committee members who handle health policy matters also increased

in the face of public anger over the opioid crisis as well as anticipated renewal of legislation that determines the "user fees" companies pay for regulatory drug approval.

A dozen Republican committee heads and ranking Democrats on health-related panels collected $281,600 from pharma-related PACs in the first quarter, up 80 percent

from what people in the same positions collected in the first quarter of 2015, the data show. Such initial donations often set the pace for a two-year election cycle, and suggest whom corporate interests are trying to cultivate in a new Congress, with implied promises of more to come, analysts say.

For pharma companies, "now would be the time to give out the money, ahead of a piece of legislation that may come down the road,"

said Kent Cooper, a former Federal Election Commission official who has tracked political money for decades.

"You want to get your name out there and make a connection with these members' legislative assistants -- so you are known to them and you can get in their door."

http://www.truth-out.org/news/item/41421-follow-the-money-drugmakers-deploy-political-cash-as-prices-and-anger-mount

Jus the usual corrupt oligarchy corrupting govt, and making public policy, laws, regulations, if not actually writing the fucking regs and rules to be passed, implemented verbatim.