Rational Government Health Care Negotiating

[Phil1111 911]

Finally the US is moving out of the stone age. The place where GOP free market competition is the answer to high health care costs. Its using the Inflation Reduction Act to start government to direct pharma price negotiations over patented drugs. In other words its going to do what every other western government does. Not pay full retail for new drugs but instead negotiate prices with the manufacturer.

Obviously republicans will fight this. Big pharma will go all out in its lobbying. U.S. Announces First Drugs Picked for Medicare Price Negotiations Imagine hundreds of billions in savings in the next couple decades. Credit to President Biden and dems.

FOX spin on the story: "This is the first time the federal government will control prices directly with manufacturers for lower prices on selected covered high-expenditure drugs. Those controls wouldn't take effect until 2026. While the Inflation Reduction Act refers to "negotiation," the text of the legislation allows the CMS to set a "maximum fair price" for a drug. The pharmacuetical company then must "enter into agreement" for the price. If they do not, the government will assess a daily excise tax on every drug sold over the "maximum fair price."

Edited August 29, 2023 by Phil1111

[riggerrob 558]

Not specific to drug prices ... just a general comparison.

The other week I got bitten by a dog, so a (pharmacist) friend suggested a tetanus shot, so I went to the emergency room at the Royal Columbian Hospital, Coquitlam, British Columbia, Canada.

At the ER check-in desk they had a sign: "ER visit costs $1300 for foreigners. $300 for non-insured residents of B.C." ER visits are free for B.C. residents with a provincial health care card. The last thing I wanted to do was compare the risk of rabes, distemper, infection, etc. with the cost of a simple visit to a hospital or clinic.  Since my family doctor does not work on Sundays, I went to the nearest hospital.

Yes, service was slow because ER staff took care of me after all those patients who were bleeding or puking or yelling all over the ER. I just sat quietly reading my book until an ER doctor took a quick look at my leg and the nurse gave me an injection. Ten days later, the bite is healing fine with no additional side effects.

[ryoder 1,384]

On 8/29/2023 at 7:39 AM, Phil1111 said:

FOX spin on the story: "This is the first time the federal government will control prices directly with manufacturers for lower prices on selected covered high-expenditure...

Show me any other product/service purchased by the federal government, for which it does NOT negotiate price.

[JerryBaumchen 1,048]

39 minutes ago, ryoder said:

Show me any other product/service purchased by the federal government, for which it does NOT negotiate price.

Hi Robert.

Having worked in contract management for the federal gov't for 30 yrs, IMO approx 85% of all purchases are NOT negotiated.  They are a simple low-bid system.

Jerry Baumchen

[ryoder 1,384]

4 minutes ago, JerryBaumchen said:

Hi Robert.

Having worked in contract management for the federal gov't for 30 yrs, IMO approx 85% of all purchases are NOT negotiated.  They are a simple low-bid system.

Jerry Baumchen

Well, I would argue a low-bid system is a form of negotiation.

It certainly isn't the govt going to a vendor and saying: "I'll take it. What is the price?"

[gowlerk 1,913]

33 minutes ago, ryoder said:

Well, I would argue a low-bid system is a form of negotiation.

It certainly isn't the govt going to a vendor and saying: "I'll take it. What is the price?"

If you are talking about a drug with only one manufacturer it is pretty much the same thing.

[wolfriverjoe 1,340]

1 hour ago, gowlerk said:

If you are talking about a drug with only one manufacturer it is pretty much the same thing.

Right. Until the patent expires, and generics become available, it's a legal monopoly.

For bidding on government contracts, lots of vendors have the opportunity to participate.

Not so with the patent protected drugs.

[JerryBaumchen 1,048]

3 hours ago, ryoder said:

Well, I would argue a low-bid system is a form of negotiation.

It certainly isn't the govt going to a vendor and saying: "I'll take it. What is the price?"

Hi Robert,

And, at my age, I usually say:  'Do you have a senior discount?'

Works sometimes.

Jerry Baumchen

PS)  About 20 yrs ago, I was in a bookstore in Naples, FL.  As I was buying a book, I asked about a senior discount.  She said that they did not do that.  Well, duh, it was Florida, no wonder.

 

Edited September 5, 2023 by JerryBaumchen

[Phil1111 911]

3 hours ago, JerryBaumchen said:

Hi Robert,

And, at my age, I usually say:  'Do you have a senior discount?'

Works sometimes.

Jerry Baumchen

PS)  About 20 yrs ago, I was in a bookstore in Naples, FL.  As I was buying a book, I asked about a senior discount.  She said that they did not do that.  Well, duh, it was Florida, no wonder.

 

Someday I'll be qualified to ask for a seniors discount..."sigh". Perhaps by then given shifting demographics of ageing populations and government debts. It will instead be a seniors premium!

Bookstores in Florida, how quaint. Haven't republicans in Florida closed all the libraries, burned all the books and stopped reading books? With FOX and Truth Social as the new sources of education.

[riggerrob 558]

Hint" grow a white beard because a white beard makes it much easier to negotiate a seniors' discount.

[jimjumper 25]

Just have the right cards and get all the discounts. Retired Military ID, AARP, and AAA.

[Phil1111 911]

6 minutes ago, jimjumper said:

Just have the right cards and get all the discounts. Retired Military ID, AARP, and AAA.

Or live in the EU, Canada, Australia, NZ, etc. where the government negotiates the cheapest drug prices and medical care with insurers in advance.

At least President Biden is making a start.

[JoeWeber 2,299]

2 hours ago, Phil1111 said:

Or live in the EU, Canada, Australia, NZ, etc. where the government negotiates the cheapest drug prices and medical care with insurers in advance.

At least President Biden is making a start.

Screw all of those discounts and those who beg for them; and beg for them they do. One of my brothers is a veteran who fixed radios in Fresno, the other was a veteran who served in the Coast Guard marching band. They don't deserve any discounts, or thanks for their service, nor does anyone lucky enough to get old deserve a Senior discount. It's all a complete a crock of shit no less than the tip jar seeded with a few ones and fives at the coffee shop cash register. Resist!

[jakee 1,255]

34 minutes ago, JoeWeber said:

nor does anyone lucky enough to get old deserve a Senior discount. It's all a complete a crock of shit no less than the tip jar seeded with a few ones and fives at the coffee shop cash register. Resist!

I mean...

 

[Phil1111 911]

7 hours ago, JoeWeber said:

Screw all of those discounts and those who beg for them; and beg for them they do.... nor does anyone lucky enough to get old deserve a Senior discount. It's all a complete a crock of shit no less than the tip jar seeded with a few ones and fives at the coffee shop cash register. Resist!

WTF!... I mistook your DZ website for another one with discounts! So all the brown-nosing I've done here is for naught?

[CygnusX-1 42]

9 hours ago, jakee said:

That just looks like a proper lifestyle to me. Although it really highlights the difference between average and median and really should be shown to those that do not comprehend the concept between those two terms.

But overall, it makes sense. Younger than 35 you are just starting out in this world. You should have very little net worth. 35-44 is where you are starting to accumulate assets and make something of yourself. 45-54 is where you have gained some experience and you income reflecting that. This is where the biggest jump should be happening. 55-64 you are preparing for retirement. If you don't have that nest egg for retirement, you still have some time to invest (although it is really getting a little too late). 65-74 if you are a democrat you are thinking of retirement. If you are a republican and not of the elite, BACK TO THE MINES - otherwise let's party. 75 and older you are living off your retirement so yes your net worth is decreasing. That way you can end your life where you started it back at $76k.

[wmw999 2,122]

Back to the topic of rational health care negotiating by the government. I was talking with my SIL last night; she's a retired CDC doc, still practicing elsewhere. She made it clear that there is no ideal system, they all have to ration health care, because health care costs, and health issues are mounting as health care develops the ability to deal with them. We ration with money, single-payer ones ration by availability, generally a function of time. Single-payer is not the same as Medicare for all, because Medicare is really just a government support system for fee-for-service -- but because it negotiates pay, there is less availability in some markets. 

So choose your poison, or better, live in a manner that you'll have to use the medical system as little as possible. 

Wendy P.

[JerryBaumchen 1,048]

1 hour ago, wmw999 said:

Back to the topic of rational health care negotiating by the government. I was talking with my SIL last night; she's a retired CDC doc, still practicing elsewhere. She made it clear that there is no ideal system, they all have to ration health care, because health care costs, and health issues are mounting as health care develops the ability to deal with them. We ration with money, single-payer ones ration by availability, generally a function of time. Single-payer is not the same as Medicare for all, because Medicare is really just a government support system for fee-for-service -- but because it negotiates pay, there is less availability in some markets. 

So choose your poison, or better, live in a manner that you'll have to use the medical system as little as possible. 

Wendy P.

Hi Wendy,

For more longer than I can remember, I have been saying that the secret to the success of the US health care system is Do Not Get Sick.

Jerry Baumchen

[kallend 1,623]

22 hours ago, JerryBaumchen said:

Hi Wendy,

For more longer than I can remember, I have been saying that the secret to the success of the US health care system is Do Not Get Sick.

Jerry Baumchen

Marrying an MD helps, too.

[airdvr 197]

Election year theatrics.  Just about every POTUS has tried this one during an election cycle in the last 20 years.

[gowlerk 1,913]

53 minutes ago, airdvr said:

Election year theatrics.  Just about every POTUS has tried this one during an election cycle in the last 20 years.

But this is the first time there has been legislation already passed to back it up and make it happen.

Edited September 13, 2023 by gowlerk

[wolfriverjoe 1,340]

21 hours ago, gowlerk said:

But this is the first time there has been legislation already passed to back it up and make it happen.

Also by the President who's had the most legislative success in recent memory.

[Phil1111 911]

1 hour ago, wolfriverjoe said:

Also by the President who's had the most legislative success in recent memory.

trump had excellent legislative success in protecting the personal assets of the wealthy. About $1.5 trillion worth.

"They were billed as a “middle-class miracle” but according to a new book Donald Trump’s $1.5tn tax cuts have helped billionaires pay a lower rate than the working class for the first time in history.

In 2018 the richest 400 families in the US paid an average effective tax rate of 23% while the bottom half of American households paid a rate of 24.2%, University of California at Berkeley economists Emmanuel Saez and Gabriel Zucman calculate in their new book, The Triumph of Injustice.

Taxes on the rich have been falling for decades. In 1960 the 400 richest families paid as much as 56% in taxes, by 1980 the rate had fallen to 40%. But Trump’s tax cuts – his most significant legislative victory – proved a tipping point."

They’re Giddy in the Private-Jet Industry at Dawn of Trump Era

[JerryBaumchen 1,048]

5 hours ago, Phil1111 said:

trump had excellent legislative success in protecting the personal assets of the wealthy. About $1.5 trillion worth.

"They were billed as a “middle-class miracle” but according to a new book Donald Trump’s $1.5tn tax cuts have helped billionaires pay a lower rate than the working class for the first time in history.

In 2018 the richest 400 families in the US paid an average effective tax rate of 23% while the bottom half of American households paid a rate of 24.2%, University of California at Berkeley economists Emmanuel Saez and Gabriel Zucman calculate in their new book, The Triumph of Injustice.

 

Taxes on the rich have been falling for decades. In 1960 the 400 richest families paid as much as 56% in taxes, by 1980 the rate had fallen to 40%. But Trump’s tax cuts – his most significant legislative victory – proved a tipping point."

They’re Giddy in the Private-Jet Industry at Dawn of Trump Era

Hi Phil,

I have to disagree.  Trump merely signed the documents that they put in front of him.  I seriously doubt he understood even one piece of legislation that he signed.

As one of his instructors at Wharton said, 'He was the dumbest student I ever had.'

It's always amazing what money can buy.

Jerry Baumchen