What's That All About?

So, I went to the pharmacy to get my prescription filled. It is on the Wal-Mart $10 list and I have been paying out of pocket for it for years. I thought “well, now that I have my new Medicare benefit this will be like $2 or something.” Think again! When the pharmacist rang it up she said proudly, “that will be $155.” I responded with surprise to say the least and asked exactly how it is that my prescription costs more now than when I paid cash? They rechecked it and said that was indeed the case and I had them ring it up as a cash sale. This is not the only time. I had an albuterol inhaler that cost $47 and change without insurance and $46 and change with insurance for a savings of a buck or so and the entire amount going toward reaching my doughnut hole where I pay for everything which would not be much of a change since I have been doing it for years. I can buy 6 of those inhalers from Canada for the same money. Get this! Now I have a Medicare C plan that costs be around $150 per month and my prescriptions are now more than before. But if I don't sign up for the Medicare benefit then I am penalized later. So, what is the deal?

Here is the deal. Our Congress, in their allegiance to the obviously false notion that competition among drug makers brings prices down, made it illegal for Medicare to use its huge purchasing power to negotiate lower prices giving Big Pharma a gift worth billions of dollars of your tax money. Now, if you want to rant about taxes here is a good chance to do just that. Just call your Congressman or Congresswoman and tell them that free enterprise is just great but maybe they ought to consider the free enterprise of your checkbook. Now, I am thrilled to have some medical coverage now because I have not had any for years due to the exorbitant cost. Even with what I now have I am exposed to catastrophic financial burdens and, as far as I can tell, unless I start using a lot more drugs my plan is a net loss to me.

While I am on this topic, you may recall that I have held forth against the new scheduled drug bill that requires me to go pee in a cup every three months for a prescription that I have had for many years. Now, instead of paying $8 for the prescription I now get to pay for a doctor's visit and lab work. Fortunately Medicare picks up most of the extra tab but what that really means is that you are helping pay for my totally unnecessary doctor's visits and lab work. Thank you very much. As I have said before, wouldn't it be enough to just run the prescriptions through KASPER, our drug monitoring agency, until some evidence of misuse pops up? It seems that our legislators, when given a chance to revisit this and do it some justice, decided that some tinkering was better than offending Congressman Rogers and Greg Stumbo. My guess is that you pay for their insurance coverage also.

There are a couple of prescriptions that I get from Canada due to the difference in costs which amounts to hundreds of dollars per prescription. Yes, I am a bit uneasy about not having the FDA keeping track of my drugs but the alternative is to not use them. Using them at $500 per prescription is out of the question. Insurance companies use their buying power to negotiate lower prices from the pharmaceutical industry and then bill the U.S. Government for full price making a handy profit on the drugs along with the handsome premiums they charge you. Think about it. You pay both ways. If that isn't socialized medicine then I don't know what is. If you, the taxpayer, is going to get stuck with the bill you might as well get a good deal for it. But, no. As I previously said, our Congress saw fit to prevent the Federal Government in the form of Medicare, Tricare and whatever else from negotiating lower prices for you, the taxpayer. Why? It is no secret that Big Pharma charges American residents many times more than what is charged in the rest of the world. The reason is simple, they make more money that way. One of the things they tell us is that they must make the exorbitant profits on the American market because they can't on the overseas market. Duh! Why can't they? It is because those countries do what we don't. They regulate their insurance industries and use purchasing power to negotiate lower prices. The fact of the matter is that we transfer billions of your tax dollars to the pharmaceutical industry needlessly, just as a gift. That happens because your legislators have their hands in the pockets of Big Pharma. If you want to see just take a trip to Open Secrets.Org and check it out.

People are scared to death of what is going to happen with Obamacare and socialized medicine. First, medicine is already socialized but to the benefit of Big Pharma and the insurance industry. Secondly, according to the preliminary results from California, the biggest user of Obamacare, insurance rates are lower than expected. Don't expect a program as big as Obamacare to implement without some headaches. Social Security didn't and neither did Medicare. But there are some features of Obamacare that are pretty neat one of which requires the insurance companies to pay out 80% of their premiums in benefits.

Make no mistake, the regulated industries will not hesitate to spend millions, even billions, to influence legislation in their favor. Don't expect your legislator to act with your interests at heart. Very few will do that. Most will act in their own self interest but if their self interest in being reelected is tied to your getting a fair deal then things will be better.

Whenever politicians don't want to talk about something they change the subject to something they do want to talk about. Something they can use to get your attention off the matters that really make a difference to you. Sound familiar? No one is talking about the ridiculous cost of medicine and the delivery of medical care because it is a hard subject and would require some serious thinking. It would also require taking a position on the issues which is exactly what they don't want to do.

So, my take on paying more for prescriptions now that I have insurance coverage? What's that all about anyway?