KEY PROVISIONS THAT TAKE EFFECT IMMEDIATELY UNDER SENATE BILL AS AMENDED BY RECONCILIATION BILL
Below are some of the key provisions that will take effect immediately, under the legislative package the House will consider later this week (the Senate health bill as amended by the reconciliation bill). The reconciliation bill is based largely on the improvements put forward by the President’s proposal – moving towards the House bill in certain critical areas.
1. SMALL BUSINESS TAX CREDITS—Offers tax credits to small businesses to make employee coverage more affordable. Tax credits of up to 35 percent of premiums will be immediately available to firms that choose to offer coverage. Effective beginning for calendar year 2010. (Beginning in 2014, the small business tax credits will cover 50 percent of premiums.)
2. BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE—Provides a $250 rebate to Medicare beneficiaries who hit the donut hole in 2010. Effective for calendar year 2010. (Beginning in 2011, institutes a 50% discount on brand‐name drugs in the donut hole; also completely closes the donut hole by 2020.)
3. FREE PREVENTIVE CARE UNDER MEDICARE—Eliminates co‐payments for preventive services and exempts preventive services from deductibles under the Medicare program. Effective beginning January 1, 2011.
4. HELP FOR EARLY RETIREES—Creates a temporary re‐insurance program (until the Exchanges are available) to help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55‐64. Effective 90 days after enactment
5. ENDS RESCISSIONS—Bans health plans from dropping people from coverage when they get sick. Effective 6 months after enactment.
6. NO DISCRIMINATON AGAINST CHILDREN WITH PRE‐EXISTING CONDITIONS—Prohibits health plans from denying coverage to children with pre‐existing conditions. Effective 6 months after enactment. (Beginning in 2014, this prohibition would apply to all persons.)
7. BANS LIFETIME LIMITS ON COVERAGE—Prohibits health plans from placing lifetime caps on coverage. Effective 6 months after enactment.
8. BANS RESTRICTIVE ANNUAL LIMITS ON COVERAGE—Tightly restricts new plans’ use of annual limits to ensure access to needed care. These tight restrictions will be defined by HHS. Effective 6 months after enactment. (Beginning in 2014, the use of any annual limits would be prohibited for all plans.)
9. FREE PREVENTIVE CARE UNDER NEW PRIVATE PLANS—Requires new private plans to cover preventive services with no co‐payments and with preventive services being exempt from deductibles. Effective 6 months after enactment. (Beginning in 2018, this requirement applies to all plans.)
10. NEW, INDEPENDENT APPEALS PROCESS—Ensures consumers in new plans have access to an effective internal and external appeals process to appeal decisions by their health insurance plan. Effective 6 months after enactment.
11. ENSURING VALUE FOR PREMIUM PAYMENTS—Requires plans in the individual and small group market to spend 80 percent of premium dollars on medical services, and plans in the large group market to spend 85 percent. Insurers that do not meet these thresholds must provide rebates to policyholders. Effective on January 1, 2011.
12. IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH‐RISK POOL)—Provides immediate access to insurance for Americans who are uninsured because of a pre‐existing condition ‐ through a temporary high‐risk pool. Effective 90 days after enactment.
13. EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 26TH BIRTHDAY THROUGH PARENTS’ INSURANCE – Requires health plans to allow young people up to their 26th birthday to remain on their parents’ insurance policy, at the parents’ choice. Effective 6 months after enactment.
14. COMMUNITY HEALTH CENTERS—Increases funding for Community Health Centers to allow for nearly a doubling of the number of patients seen by the centers over the next 5 years. Effective beginning in fiscal year 2010.
15. INCREASING NUMBER OF PRIMARY CARE DOCTORS—Provides new investment in training programs to increase the number of primary care doctors, nurses, and public health professionals. Effective beginning in fiscal year 2010.
16. PROHIBITING DISCRIMINATION BASED ON SALARY—Prohibits new group health plans from establishing any eligibility rules for health care coverage that have the effect of discriminating in favor of higher wage employees. Effective 6 months after enactment.
17. HEALTH INSURANCE CONSUMER INFORMATION—Provides aid to states in establishing offices of health insurance consumer assistance in order to help individuals with the filing of complaints and appeals. Effective beginning in FY 2010.
18. CREATES NEW, VOLUNTARY, PUBLIC LONG‐TERM CARE INSURANCE PROGRAM—Creates a long‐term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled. Effective on January 1, 2011.
OFFICE OF SPEAKER NANCY PELOSI MARCH 18, 2010
Showing posts with label Health care. Show all posts
Showing posts with label Health care. Show all posts
Monday, March 22, 2010
Sunday, March 21, 2010
Just the Beginning
Teabaggers have ridiculed a man with Parkinson's, compared Obama to Hilter, threatened violence with guns, used racial slurs, and said health care is a privilege and not a right. Health care is a privilege? Are the Teabaggers so out of touch that they believe all working people can afford health care? I couldn't afford an extra $180 a month for insurance and that's with a $2500 deductible! Even with a good job I pay almost $100 a month but that includes dental and optical and a much lower deductible.
Here are several reasons why health care should be a right and not a privilege:
How about just the first point? For every infection that goes untreated and festers or for every patience that does not follow their medication regimen we are setting the stage for super bugs. TB now comes in a bright, new, shiny drug resistant strain, childhood illnesses once thought to be eradicated are making a comeback.
When I was in school we had immunization day. We were given Polio vaccines right in school. There have been cries, on the right, of socialized medicine invading our country and we are on a slippery slope to becoming a European style state but many of the people so violently opposed to the public option also received Polio Vaccines in Public schools, as well as other vaccines, TB tests, and fluoride treatments. There was a time when we as Americans all worked together to achieve great things and I was hoping we were about to experience a Renaissance but I was wrong. I was not so naive as to believe that Obama would be able to cure everything but he came with a message of hard work and pulling together and personal responsibility that I liked.
The reason I think this health care reform is a good start (but only a start) is that I hope it will put us on track for a single payer system. Or, if not a single payer system then establish a system of private NON-PROFIT insurers. We always hear about the English, Canadian, or French system but what about the German system?
excerpted from Germany’s Health Care System: It’s Not The American Way
by Uwe E. Reinhardt
First, Germany’s system is almost elegant in its simplicity. That is probably
no historical accident. Germans appear to understand the trade-off
between the operational simplicity of a system and its fairness and efficiency
in each particular instance...
Second, the ethical precepts driving German health policy differ substantially
from those driving American policy. Germans, along with other
Europeans and Canadians, view health care as part of the cement that binds
a people sharing the same geography into a genuine nation. All social
classes in Germany thus are made to share the same health care system.
About 90 percent of the population gains access to that system through one
social insurance scheme that is administered by some 1,000 fiscally independent,
semiprivate sickness funds operating under the constraints of a
federal statute. Only about 10 percent of the German population has
private commercial insurance, but they share the same health care delivery
system and merely enjoy more amenities.
Under Germany’s statutory insurance scheme, premiums are based on
ability to pay. With the financial burden of illness fully socialized in this
way, the system inevitably would be subjected to top-down global budgeting,
including controls on price and volume. Germany’s clear social ethic,
to which all political parties still pledge explicit allegiance, makes the
global budgeting described by these authors politically acceptable.
The United States never has had a one-tier health care system, and, as
the recent debate on health reform in Congress has demonstrated, the
United States never will have a one-tier health care system. A working
majority of the politicians representing Americans in the policy arena
evidently view health care as essentially a private consumption good of
which low-income families might be accorded a basic ration, but whose
availability and quality should be allowed to vary with family income. This
view lends official sanction to the following three-tier system: Tier I for
the low-income uninsured: a system of public hospitals and clinics that
rations health care severely through constraints on capacity. Tier II for
the insured, broad middle class: a system of competitive, integrated private
health plans budgeted on a per capita basis, with limited choice of providers
and with varying degrees of tacit rationing. Tier III for the Medicare
population and the moneyed elite: the traditional, open-ended, free-choice
fee-for-service health care system with little or no rationing of care.
The interesting thing is that this article was written in 1994 and things have not changed. Well what has changed is that we spend a great percentage of our GDP, 14% in '94 and over 16% now, Germany still only spends about 10%.
The Netherlands, Germany and Switzerland do not use a government-run, Medicare-like health insurance plan. They all rely on purely private, nonprofit or for-profit insurers that are goaded by tight regulation to work toward socially desired ends. And they do so at average per-capita health-care costs far below those of the United States — costs in Germany and the Netherlands are less than half of those here.
So really the Teabaggers are willing to risk another 1918 flu pandemic, or the rampant infection from the next superbug because they don't want to give any handouts... I am truly saddened at the level of hate this country has come to. Just wait for the immigration reform. If you thought health care was a fight you ain't seen nothin' yet
Here are several reasons why health care should be a right and not a privilege:
Drug resistant infections
out of control emergency rooms
new pandemics on the horizon
lost productivity
spiralling costs for everyone...
How about just the first point? For every infection that goes untreated and festers or for every patience that does not follow their medication regimen we are setting the stage for super bugs. TB now comes in a bright, new, shiny drug resistant strain, childhood illnesses once thought to be eradicated are making a comeback.
When I was in school we had immunization day. We were given Polio vaccines right in school. There have been cries, on the right, of socialized medicine invading our country and we are on a slippery slope to becoming a European style state but many of the people so violently opposed to the public option also received Polio Vaccines in Public schools, as well as other vaccines, TB tests, and fluoride treatments. There was a time when we as Americans all worked together to achieve great things and I was hoping we were about to experience a Renaissance but I was wrong. I was not so naive as to believe that Obama would be able to cure everything but he came with a message of hard work and pulling together and personal responsibility that I liked.
The reason I think this health care reform is a good start (but only a start) is that I hope it will put us on track for a single payer system. Or, if not a single payer system then establish a system of private NON-PROFIT insurers. We always hear about the English, Canadian, or French system but what about the German system?
excerpted from Germany’s Health Care System: It’s Not The American Way
by Uwe E. Reinhardt
First, Germany’s system is almost elegant in its simplicity. That is probably
no historical accident. Germans appear to understand the trade-off
between the operational simplicity of a system and its fairness and efficiency
in each particular instance...
Second, the ethical precepts driving German health policy differ substantially
from those driving American policy. Germans, along with other
Europeans and Canadians, view health care as part of the cement that binds
a people sharing the same geography into a genuine nation. All social
classes in Germany thus are made to share the same health care system.
About 90 percent of the population gains access to that system through one
social insurance scheme that is administered by some 1,000 fiscally independent,
semiprivate sickness funds operating under the constraints of a
federal statute. Only about 10 percent of the German population has
private commercial insurance, but they share the same health care delivery
system and merely enjoy more amenities.
Under Germany’s statutory insurance scheme, premiums are based on
ability to pay. With the financial burden of illness fully socialized in this
way, the system inevitably would be subjected to top-down global budgeting,
including controls on price and volume. Germany’s clear social ethic,
to which all political parties still pledge explicit allegiance, makes the
global budgeting described by these authors politically acceptable.
The United States never has had a one-tier health care system, and, as
the recent debate on health reform in Congress has demonstrated, the
United States never will have a one-tier health care system. A working
majority of the politicians representing Americans in the policy arena
evidently view health care as essentially a private consumption good of
which low-income families might be accorded a basic ration, but whose
availability and quality should be allowed to vary with family income. This
view lends official sanction to the following three-tier system: Tier I for
the low-income uninsured: a system of public hospitals and clinics that
rations health care severely through constraints on capacity. Tier II for
the insured, broad middle class: a system of competitive, integrated private
health plans budgeted on a per capita basis, with limited choice of providers
and with varying degrees of tacit rationing. Tier III for the Medicare
population and the moneyed elite: the traditional, open-ended, free-choice
fee-for-service health care system with little or no rationing of care.
The interesting thing is that this article was written in 1994 and things have not changed. Well what has changed is that we spend a great percentage of our GDP, 14% in '94 and over 16% now, Germany still only spends about 10%.
The Netherlands, Germany and Switzerland do not use a government-run, Medicare-like health insurance plan. They all rely on purely private, nonprofit or for-profit insurers that are goaded by tight regulation to work toward socially desired ends. And they do so at average per-capita health-care costs far below those of the United States — costs in Germany and the Netherlands are less than half of those here.
So really the Teabaggers are willing to risk another 1918 flu pandemic, or the rampant infection from the next superbug because they don't want to give any handouts... I am truly saddened at the level of hate this country has come to. Just wait for the immigration reform. If you thought health care was a fight you ain't seen nothin' yet
Tuesday, March 16, 2010
Word Clouds
I was experimenting with Wordle last night. Nate Silver at fivethirtyeight created two word clouds based on Gallup's health care survey. Gallup provided the verbatim responses and Silver snagged those to create his Wordle clouds so I thought I would too. It's very addicting and I soon found that several hours had passed. The top one is the against reform responses and the bottom one is the for reform responses. Each image definitely tells a different story...
I thought I could do another based on Constitution. What evolved shows a document that is heavily weighted for the States. If you have not played with Wordle it creates a graphic illustration of text by giving weight to words that appear most often. Articles and common words are deleted like A, The, An, And... It's a pretty interesting tool to play with and explore.
I thought I could do another based on Constitution. What evolved shows a document that is heavily weighted for the States. If you have not played with Wordle it creates a graphic illustration of text by giving weight to words that appear most often. Articles and common words are deleted like A, The, An, And... It's a pretty interesting tool to play with and explore.
Wednesday, March 10, 2010
Why is Medicine So Expensive?
If you are one of the 255 million Americans WITH health insurance you probably have seen an EOB or Explanation of Benefits. What is shocking about and EOB is the difference between what a doctor charges and what insurance actually pays. For example, I recently had an allergic reaction to an antibiotic prescribed by my doc, actually he's a Physician Assistant. To treat my hives the EOB show the doc billed, my copay and the plan allowance:
the strange thing about the charges is that I was never given IV Therapy. The PA mis-coded a procedure. As a health care consumer, with insurance, I have little knowledge of the true cost of health care. Does an injection of steroids to treat an allergic reaction really cost $75.60? Why is the plan allowance only $6.36 and I only have to pay .64¢? What happens to the other $68.60? And, what about the mis-coded treatment. The receptionist asked why I care... She said I only have to pay $2.37 for it and my insurance picks up the rest so what's the big deal...
Doctors are paid by a scheme called Fee For Service The idea of a government-run health-insurance plan made doctors nervous, and Lyndon Johnson's administration was worried that doctors wouldn't take Medicare patients. So Joseph Califano, Johnson's adviser for domestic affairs, made what seemed like a small concession: Medicare would pay doctors whatever they thought was reasonable. This concession cause health care costs to spiral out of control. By 1967 the Johnson Administration knew Fee for Service would soon bankrupt the country with spirally health care costs But doctors, who had a lot of sway with Congress, found they liked the payment system. So the system stayed in place for decades, as medicine got more expensive.
By the mid-1970's health care costs were growing faster then anticipated. By capping what doctors would be paid it was thought costs could be contained. Unfortunately Docs found a loop hole by ordering more tests and more procedures. Many time Docs pit patients against insurance companies knowing that we intrinsically trust our doctors and not the faceless insurance giants. Instead of thinking of our doctors as finance managers on car dealer lots trying to talk us into buying extended warranties; we blindly follow their advice even if it involves treatments and test that have no value.
Another reason health care costs are so expensive might be due to the fact that most new doctors start their profession $150,000 or more in debt. The cost of medical school is so expensive that doctors will take 50 years to pay off student loans.
I think the system is so broken that it will take a total overhaul to fix it. Single payer will end the bureaucratic nightmare that is currently health care billing. Student Loan forgiveness programs for Docs will change the mindset and encourage more medical student to consider Primary Care instead of Specialties. The end of the Fee for Service model and adoption of a salary system will trim cost too. Finally. reigning in big Pharma and controlling costs of prescription drugs needs to happen. But it will never happen. It's too much. There would have to be a populist revolt.
the strange thing about the charges is that I was never given IV Therapy. The PA mis-coded a procedure. As a health care consumer, with insurance, I have little knowledge of the true cost of health care. Does an injection of steroids to treat an allergic reaction really cost $75.60? Why is the plan allowance only $6.36 and I only have to pay .64¢? What happens to the other $68.60? And, what about the mis-coded treatment. The receptionist asked why I care... She said I only have to pay $2.37 for it and my insurance picks up the rest so what's the big deal...
Doctors are paid by a scheme called Fee For Service The idea of a government-run health-insurance plan made doctors nervous, and Lyndon Johnson's administration was worried that doctors wouldn't take Medicare patients. So Joseph Califano, Johnson's adviser for domestic affairs, made what seemed like a small concession: Medicare would pay doctors whatever they thought was reasonable. This concession cause health care costs to spiral out of control. By 1967 the Johnson Administration knew Fee for Service would soon bankrupt the country with spirally health care costs But doctors, who had a lot of sway with Congress, found they liked the payment system. So the system stayed in place for decades, as medicine got more expensive.
By the mid-1970's health care costs were growing faster then anticipated. By capping what doctors would be paid it was thought costs could be contained. Unfortunately Docs found a loop hole by ordering more tests and more procedures. Many time Docs pit patients against insurance companies knowing that we intrinsically trust our doctors and not the faceless insurance giants. Instead of thinking of our doctors as finance managers on car dealer lots trying to talk us into buying extended warranties; we blindly follow their advice even if it involves treatments and test that have no value.
Another reason health care costs are so expensive might be due to the fact that most new doctors start their profession $150,000 or more in debt. The cost of medical school is so expensive that doctors will take 50 years to pay off student loans.
I think the system is so broken that it will take a total overhaul to fix it. Single payer will end the bureaucratic nightmare that is currently health care billing. Student Loan forgiveness programs for Docs will change the mindset and encourage more medical student to consider Primary Care instead of Specialties. The end of the Fee for Service model and adoption of a salary system will trim cost too. Finally. reigning in big Pharma and controlling costs of prescription drugs needs to happen. But it will never happen. It's too much. There would have to be a populist revolt.
Sunday, March 7, 2010
Failure to Lead
I remember the argument like it was yesterday. I was searching through the bins at Ace Hardware trying to find the right screws for the bathroom project. I was picking up boxes and discarding them with one hand and holding my phone with the other. It was late September 2008 and I was trying to convince my mom that Barack Obama was different, that voting for McCain was a mistake and that we needed to change direction. She was dismissive. She said she didn't trust any of them and that nothing would change. That's when she told me about her "wasted" vote. My mom, a life long Republican, voted for Jimmy Carter in 1976.
1976 was the Bicentennial year. The country was trying to forget it's economic troubles and trying to put the Nixon scandal behind us. The only thing I remember about the Presidential election was that a peanut farmer from Georgia was running and that he looked at Playboy. That night at dinner, my brothers and I asked mom and dad who they voted for and my mom was actually swooning over Carter. She kept saying that he's so smart and that he will take this country in a new direction and that he's so smart and he will change Washington and that he's so smart... For those too young to remember the late 70's stagflation (a period of slow economic growth and high unemployment with rising prices) was gripping the country, fuel prices were through the roof and Chrysler was heading for bankruptcy.
The savior from the south lasted one term, the Iran Hostage crisis did him in and Ronald Reagan was elected overwhelmingly in 1980. My mom was anti union and anti tax; my dad was an old school Democrat and pro-union his dad was in the union and they took care of him. Reagan was the cowboy riding in from the west to bust up the unions and clean up America. Even though I was just a teenager I knew Reagan was trouble but the country loved him and eventually we recovered from the malaise of the 70's and launched into the self-centered, coke-snorting, economic boom of the 80's...
Is Obama really that different? Will he become this generation's Carter? How can candidate Obama, a man so clear and articulate, so utterly fail to lead? His push for Health Care reconciliation isn't even an 11th hour push. It's 2:00am, last call and the lights are on. Frank Rich, in his op-ed column for 3/6/2010 so eloquently put it:
But once again the Republicans are the master of the message and have cornered the conversation into talking points that start with ramming the legislation down the throats of the American voters and end with cries of socialism. What is lost in the battle are the costs. Today's Prime Number in the Times is 197: The amount, in thousands of dollars, that the typical married couple at age 65 should expect to spend on uninsured health care costs over the rest of their lives...
My parents lost their health care this fall. My Dad's pension went belly-up and they searched in earnest for a new prescription drug benefit but ended up with a band aid fix from Walgreens. Thankfully they are healthy but what happens if that changes. Will Medicare step in or will my brothers and I be saddled with the costs? I still find it amazing that Obama, with all his political capital and moral high ground has lost the argument to a few talking points and a few talking heads.
1976 was the Bicentennial year. The country was trying to forget it's economic troubles and trying to put the Nixon scandal behind us. The only thing I remember about the Presidential election was that a peanut farmer from Georgia was running and that he looked at Playboy. That night at dinner, my brothers and I asked mom and dad who they voted for and my mom was actually swooning over Carter. She kept saying that he's so smart and that he will take this country in a new direction and that he's so smart and he will change Washington and that he's so smart... For those too young to remember the late 70's stagflation (a period of slow economic growth and high unemployment with rising prices) was gripping the country, fuel prices were through the roof and Chrysler was heading for bankruptcy.
The savior from the south lasted one term, the Iran Hostage crisis did him in and Ronald Reagan was elected overwhelmingly in 1980. My mom was anti union and anti tax; my dad was an old school Democrat and pro-union his dad was in the union and they took care of him. Reagan was the cowboy riding in from the west to bust up the unions and clean up America. Even though I was just a teenager I knew Reagan was trouble but the country loved him and eventually we recovered from the malaise of the 70's and launched into the self-centered, coke-snorting, economic boom of the 80's...
Is Obama really that different? Will he become this generation's Carter? How can candidate Obama, a man so clear and articulate, so utterly fail to lead? His push for Health Care reconciliation isn't even an 11th hour push. It's 2:00am, last call and the lights are on. Frank Rich, in his op-ed column for 3/6/2010 so eloquently put it:
At last he pushed for a majority-rule, up-or-down vote in Congress. At last he conceded that bipartisan agreement between two parties with “honest and substantial differences” on fundamental principles wasn’t happening. At last he mobilized his rhetoric against a villain everyone could hiss — insurance companies. In a brief address, he mentioned these malefactors of great greed 13 times.
There was only one problem. This finest hour arrived hastily and tardily. At 1:45 p.m. Eastern time, who was watching? Of those who did watch or caught up later, how many bought the president’s vow to finish the job “in the next few weeks”?
But once again the Republicans are the master of the message and have cornered the conversation into talking points that start with ramming the legislation down the throats of the American voters and end with cries of socialism. What is lost in the battle are the costs. Today's Prime Number in the Times is 197: The amount, in thousands of dollars, that the typical married couple at age 65 should expect to spend on uninsured health care costs over the rest of their lives...
My parents lost their health care this fall. My Dad's pension went belly-up and they searched in earnest for a new prescription drug benefit but ended up with a band aid fix from Walgreens. Thankfully they are healthy but what happens if that changes. Will Medicare step in or will my brothers and I be saddled with the costs? I still find it amazing that Obama, with all his political capital and moral high ground has lost the argument to a few talking points and a few talking heads.
Monday, February 1, 2010
Jefferson and Washington
There is a great, probably apocryphal, story about Jefferson and Washington discussing politic of the new republic and at some point Jefferson asks Washington why we even need a Senate. Washington noticing that Jefferson poured his steaming hot coffee into a saucer asked Jefferson why he did so and Jefferson answered "to cool it." Washington said that is why we need the Senate to cool the legislation. Whether it is true or not the story does a nice job illustrating why we sometimes become so angry at the ineffectiveness of the upper house. Much of what comes out of the House of Representatives is a knew jerk reaction and the Senate does tend to temper it.
Over the past 2 weeks I've written some inflammatory posts about the Democrats being pussies and ineffective even with majorities and maybe that's a good thing. I really want to see change in the health care and it would be nice if it was boiled down to a few key ideas:
1. get rid of pre-existing conditions clauses
2. allow price negotiations on prescription drug costs
3. make health insurance companies non-profit
4. change the fee for service structure
The last 2 will never happen but they are at the heart of what is wrong with health care in the U.S. Physicians and insurance companies blame each other for the spiraling costs and the physicians are winning. Doctors love to create a scenario that they are fighting for your health care rights against the mighty dragon of insurance. I just had a battle like this and felt all warm and fuzzy about my doc. He wanted me to get a prescription that my plan would not pay for and tried to fight 'em. What I didn't think about were the kick backs my doc was getting from the pharmaceutical company. There was a little noticed settlement in September: Pfizer did not admit guilt to kickback charges, but instead paid $1 billion to settle the civil case. Pfizer just happens to make the drug my doc was fighting my insurance company over. I guess it's unfair to assume that my doc was getting a kickback but the Pharmacist told me there are other, safer, generic versions and thought it was "silly" to push for one drug in particular... I ended up with a generic and it works fine and cost me $10 instead of the $289 I would have had to pay out of pocket.
Well, that's a long way from Washington and Jefferson but it illustrates the point that we have a long way to go and there will be a lot of coffee cooling in saucers.
Please comment with what you would like to see your representatives do with health care.
Over the past 2 weeks I've written some inflammatory posts about the Democrats being pussies and ineffective even with majorities and maybe that's a good thing. I really want to see change in the health care and it would be nice if it was boiled down to a few key ideas:
1. get rid of pre-existing conditions clauses
2. allow price negotiations on prescription drug costs
3. make health insurance companies non-profit
4. change the fee for service structure
The last 2 will never happen but they are at the heart of what is wrong with health care in the U.S. Physicians and insurance companies blame each other for the spiraling costs and the physicians are winning. Doctors love to create a scenario that they are fighting for your health care rights against the mighty dragon of insurance. I just had a battle like this and felt all warm and fuzzy about my doc. He wanted me to get a prescription that my plan would not pay for and tried to fight 'em. What I didn't think about were the kick backs my doc was getting from the pharmaceutical company. There was a little noticed settlement in September: Pfizer did not admit guilt to kickback charges, but instead paid $1 billion to settle the civil case. Pfizer just happens to make the drug my doc was fighting my insurance company over. I guess it's unfair to assume that my doc was getting a kickback but the Pharmacist told me there are other, safer, generic versions and thought it was "silly" to push for one drug in particular... I ended up with a generic and it works fine and cost me $10 instead of the $289 I would have had to pay out of pocket.
Well, that's a long way from Washington and Jefferson but it illustrates the point that we have a long way to go and there will be a lot of coffee cooling in saucers.
Please comment with what you would like to see your representatives do with health care.
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