It does bear actually listening to this because words can not possibly convey how much this man wanted to die during this questioning.
I know it’s impossible to believe that America could be less than #1 in anything, but it bears comparing with “how they do this in other countries”. In the UK, the entire cost of health care is subsidized and costs less on a per capita basis than the US spends just on Medicare and Medicaid
How can this be? One might reasonably ask. It’s because the entire thing is heavily regulated at every step of the process. Health care companies have to negotiate for the best price at every step. Drugs actually have to provide tangible benefits over cheaper alternatives. Prices are set by non profit actors.
In the US, the same company is allowed to own the doctors, the insurance, the pharmacy cost controls, and the pharmacies themselves. If one were to say go for a high blood pressure a doctor could say “CVS is really pushing this new drug I better prescribe and I’ll get a kickback” and then Caremark decides it costs 100 million billion dollars per pill specifically for Medicaid patients, and then cvs can decide to carry it instead of generics because it will bump stockholder price up.
This wasn’t theater or a “gotcha” moment, it was someone calmly walking an executive through his own org chart until the math couldn’t hide anymore. When one company owns the insurer, the PBM, the clinic, the pharmacy, and the manufacturer, that’s not efficiency, it’s a toll booth on sickness. Watching him try to call that “good for consumers” while staring at his own investor slide was the whole story. You don’t need ideology to see the problem, just basic arithmetic and a functioning conscience.
"I think the Federal Trade Commission has also found that health care conglomerates like CVS Health charge more for medications filled at their pharmacies.
We’re talking about thousand percent markups on medications for cancer and HIV."
* The US has the highest costs to fill prescriptions of any country in the world:
> "Why are prescription drug prices so high in the U.S. compared to other countries? In 2019, the U.S. spent $1,615 per capita (per person) on prescription drugs. Take a look at Harvoni, a medication for hepatitis C. People in the U.S. paid $30,808 on average for a 28-day supply. The same prescription costs $4,944 in Chile, and $14,720 in Switzerland, according to a 2019 survey.
The U.S. does not set similar rules. Therefore pharmaceutical companies set the prices for medications at their will. This leads to high prices, especially for innovative or unique drugs.
[...]
◾ 5. Drug patents and exclusivity
Higher drug prices are often the result of drug patents that pharmaceutical companies hold. Strategic drug patenting prevents companies that make generic drugs from competing. This is because their generic products could be subject to court action." ibid
* Yeah, but the Fulvous Fuckwad has promised to reduce costs by 400%, 500%, or more!
-----
“I do want to ask one simple question,” he said. “Wouldn’t it make a lot more sense to subsidize low-income patients — which is the point of the ACA, right? — subsidize low-income patients directly through a health savings account that it, that they own, instead of subsidizing you, the insurance companies. You can answer that one. Anybody? Does anybody agree with that that concept? Subsidize patients through an, through a health savings account instead of subsidizing insurance companies?”
No, what would make considerably more sense to lower healthcare/Rx costs through a Single Payer healthcare system.
Here's the thing about that 85% ACA requirement to spend on actual healthcare (that's for large groups, it's actually only 80% for individuals and small groups). That 80-85% is simply pass-thru money, the administrative service they are providing shouldn't require 15-20% of every healthcare dollar, that's inexcusable waste, given that Medicare administrative costs are around 3% for traditional Medicare (don't get me started about Medicare Advantage privatized plans).
AOC brought up 1 thing I forgot about - the ACA requires insurers to spend no less than 85% of premium income on health care. No doubt you love seeing all the Medicare Advantage advertising on TV which must not have that requirement. Well when the ACA ends for good, insurers can spend 15% on care and 85% on advertising so you'll not only get worse insurance, you'll get 10 minutes of each hour of TV programming and 50 minutes of insurance ads.
Welp, I didn't expect Rethuglians to understand how insurance works. So that Rep. Cliff Bentz doesn't understand what a non-Cadillac health insurance works isn't surprising. The insurance that he and the other congress critters get probably is so superior, they don't have to worry about having an HSA to use for a health care matter.
Members of Congress are employees of the Federal Government, so they get the same benefits (insurance, retirement, etc) as any other Federal employee.
That means that part of their compensation is the employer (the government) pays a large fraction of their health insurance premiums, and they pay the rest. This is pretty much standard for large corporations, and even small ones.
The only difference is that the Members and their main staffers have to buy an insurance plan at the Gold level on the ACA marketplace. So while the Gold plans are pretty good (similar to the top plans offered by big corporations), they are also expensive (similar to the top plans offered by big corporations), so that employee part of the premium is not inexpensive.
Since this is insurance offered by private companies, it comes with all of the caprices and exclusions and suchlike that you get from the policy you might get from Blue Cross or whatever.
And let us not forget that the majority of the Members are very wealthy (AOC is one of the few non-wealthy), so they can cover the premiums without a problem.
I cannot help but think that "Fully Engaged Member" would be an excellent name for a punk rock band.
"Say, you put $200,000 a year into an HSA, doesn't the interest on that cover most allergy medication costs?"
They extract our health and hold it hostage
AOC is one of the few democrats who is bucking the system. We need more like her.
AOC is a national treasure and our current greatest natural resource, fo sho!🥰🧐🤩
It does bear actually listening to this because words can not possibly convey how much this man wanted to die during this questioning.
I know it’s impossible to believe that America could be less than #1 in anything, but it bears comparing with “how they do this in other countries”. In the UK, the entire cost of health care is subsidized and costs less on a per capita basis than the US spends just on Medicare and Medicaid
How can this be? One might reasonably ask. It’s because the entire thing is heavily regulated at every step of the process. Health care companies have to negotiate for the best price at every step. Drugs actually have to provide tangible benefits over cheaper alternatives. Prices are set by non profit actors.
In the US, the same company is allowed to own the doctors, the insurance, the pharmacy cost controls, and the pharmacies themselves. If one were to say go for a high blood pressure a doctor could say “CVS is really pushing this new drug I better prescribe and I’ll get a kickback” and then Caremark decides it costs 100 million billion dollars per pill specifically for Medicaid patients, and then cvs can decide to carry it instead of generics because it will bump stockholder price up.
The perfect system
I don’t agree with letting the consumer decide and choose.
Healthcare is complicated, and many people are not too bright. And giving people choices doesn’t get rid of the monsters.
This is health insurance, not healthcare.
Diseasecare
This wasn’t theater or a “gotcha” moment, it was someone calmly walking an executive through his own org chart until the math couldn’t hide anymore. When one company owns the insurer, the PBM, the clinic, the pharmacy, and the manufacturer, that’s not efficiency, it’s a toll booth on sickness. Watching him try to call that “good for consumers” while staring at his own investor slide was the whole story. You don’t need ideology to see the problem, just basic arithmetic and a functioning conscience.
I do love how Ms Ocasio-Cortez smiles as she pushes the shiv further in
"I think the Federal Trade Commission has also found that health care conglomerates like CVS Health charge more for medications filled at their pharmacies.
We’re talking about thousand percent markups on medications for cancer and HIV."
* The US has the highest costs to fill prescriptions of any country in the world:
> "Why are prescription drug prices so high in the U.S. compared to other countries? In 2019, the U.S. spent $1,615 per capita (per person) on prescription drugs. Take a look at Harvoni, a medication for hepatitis C. People in the U.S. paid $30,808 on average for a 28-day supply. The same prescription costs $4,944 in Chile, and $14,720 in Switzerland, according to a 2019 survey.
Lantus is used to control blood sugar in people with diabetes. Five syringes cost $419 in the U.S., but people in Chile paid $68. Those in South Africa paid just $55." https://www.goodrx.com/drugs/savings/why-are-prescription-drugs-more-expensive-in-the-us-than-in-other-countries
GoodRx goes on to cite some possible reasons:
◾ "2. Lack of government regulation
[...]
The U.S. does not set similar rules. Therefore pharmaceutical companies set the prices for medications at their will. This leads to high prices, especially for innovative or unique drugs.
[...]
◾ 5. Drug patents and exclusivity
Higher drug prices are often the result of drug patents that pharmaceutical companies hold. Strategic drug patenting prevents companies that make generic drugs from competing. This is because their generic products could be subject to court action." ibid
(also see: https://www.youtube.com/watch?v=min3cUK7CNg&t=44s)
* Yeah, but the Fulvous Fuckwad has promised to reduce costs by 400%, 500%, or more!
-----
“I do want to ask one simple question,” he said. “Wouldn’t it make a lot more sense to subsidize low-income patients — which is the point of the ACA, right? — subsidize low-income patients directly through a health savings account that it, that they own, instead of subsidizing you, the insurance companies. You can answer that one. Anybody? Does anybody agree with that that concept? Subsidize patients through an, through a health savings account instead of subsidizing insurance companies?”
No, what would make considerably more sense to lower healthcare/Rx costs through a Single Payer healthcare system.
fnord
Here's the thing about that 85% ACA requirement to spend on actual healthcare (that's for large groups, it's actually only 80% for individuals and small groups). That 80-85% is simply pass-thru money, the administrative service they are providing shouldn't require 15-20% of every healthcare dollar, that's inexcusable waste, given that Medicare administrative costs are around 3% for traditional Medicare (don't get me started about Medicare Advantage privatized plans).
Wtf y'all act like vertical integration is a BAD thing.
/s
It's fantastic... if you're building a barn! One absolutely wants the parts to finish as one, cohesive thing.
AOC brought up 1 thing I forgot about - the ACA requires insurers to spend no less than 85% of premium income on health care. No doubt you love seeing all the Medicare Advantage advertising on TV which must not have that requirement. Well when the ACA ends for good, insurers can spend 15% on care and 85% on advertising so you'll not only get worse insurance, you'll get 10 minutes of each hour of TV programming and 50 minutes of insurance ads.
and Medicare spends around 97% on actual care (for traditional Medicare), that's a lot of wasted money by the insurers
"Unlock value"... gawd, unlock the consumers and lock up these CEOs.
Welp, I didn't expect Rethuglians to understand how insurance works. So that Rep. Cliff Bentz doesn't understand what a non-Cadillac health insurance works isn't surprising. The insurance that he and the other congress critters get probably is so superior, they don't have to worry about having an HSA to use for a health care matter.
For the eleventy-billionth time:
Members of Congress are employees of the Federal Government, so they get the same benefits (insurance, retirement, etc) as any other Federal employee.
That means that part of their compensation is the employer (the government) pays a large fraction of their health insurance premiums, and they pay the rest. This is pretty much standard for large corporations, and even small ones.
The only difference is that the Members and their main staffers have to buy an insurance plan at the Gold level on the ACA marketplace. So while the Gold plans are pretty good (similar to the top plans offered by big corporations), they are also expensive (similar to the top plans offered by big corporations), so that employee part of the premium is not inexpensive.
Since this is insurance offered by private companies, it comes with all of the caprices and exclusions and suchlike that you get from the policy you might get from Blue Cross or whatever.
And let us not forget that the majority of the Members are very wealthy (AOC is one of the few non-wealthy), so they can cover the premiums without a problem.
Thanks for listening to my TED talk.
... ever again in their lives.
Gosh, who would benefit the MOST from healthy competition? Oh, yeah, business people who actually work hard for a living.
No wonder Republicans are against competition in their sacred "marketplace."