Discussion for article #227820
just one more argument for Universal Health coverage.
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Hey, that’s Fletcher-Allen in Burlington, VT!
Go pick on another state! 
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Extortion— the insurance industry 's reason to exist.
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The slow unraveling of the Ocare duct tape.
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Caremark started doing this with HIV and cancer patients last January. The move was unannounced and not described in the November 2013 reenrollment for 2014.
Gannett, the employer using Caremark in this case, claimed in midsummer that they were unaware of Caremark’s actions until May of 2014.
Caremark’s behavior with patients in January, February and March was inexcusable…intentionally rude and unhelpful they demanded all patient info including signing privacy waivers again claiming a new computer system for "preferred’ that could not communicate with the previous and still existing Caremark system. This demand for the same information wasn’t requested. Caremark allowed patients to attempt to refill existing meds then failed to deliver them until the same patient info was proffered again to the “preferred” system without regard for the medical chaos caused. When med prices were requoted the prices skyrocketed…a 3 month supply of one HIV med in one case was Caremark “preferred” priced at $3,200!
I wrote the White House but this story is only the 2nd I’ve seen since January of 2014.
Caremark should be fined or punished for the agony and fear they needlessly caused.
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This is why Obamacare has always been a con game. In return for forcing everyone to sign up, the insurance companies make promises that they won’t keep. And then Eric Holder comes down on them as hard as he did on all those Wall Street crooks.
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I would be surprised if the insurance companies aren’t doing the same thing with their provider networks by excluding certain types of specialists.
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Well it is the massively over-budget new medical center where the boss actually went went to jail for lying about cost overruns. (Hmm, jail for lying bosses, what a novel idea). But still a nice building.
It’s really unlikely that this is going to work to exclude particular patients, at least in the short run. Even assuming that there are a lot of plans out there that have different treatment for different drugs, not a lot of people are going to get that far down into the weeds when choosing a plan. And even if they do, as the article notes, insurance companies can change things up on them from month to month.
I tend to blame the pharma industry, which has for some years been manipulating supply to set prices wherever seems more profitable. Last year one of my son’s standard medications (off patent for decades) went from $5 a month to $50 because of “supply shortages”. And in other medications the generic costs almost exactly the same as the name-brand version…
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While this is a serious problem, what does it have to do with “Obamacare”? This is not limited to policies purchased through the exchanges, but is being done in many cases for all policies, including employer plans. It’s time to stop blaming everything that happens in healthcare on Obamacare, as though it was perfect before.
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Yes, I was just going to post that the insurance companies seem determined to push us into a single payer system.
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TBH, this doesn’t make sense for the reasons proposed. Insurers don’t really make money off of copays, and if every medication for a condition has the same copay, as the article claims, then it doesn’t do anything to change which drug people use - they’re just going to use whichever one they get from their doctor (who is actually usually the one picking it anyway, not the patient).
Also, a $20 copay has been standard for a long time. Except for people taking a lot of medications or at the bottom of the pay scale, lots of people just pay that even for brand meds. Epilepsy medications, for example, are notorious for generics not working as well as brand name ones (very frustrating given that the brand ones cost 10x as much, even after the patents have expired).
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It’s better than what we had before, and given the current situation in Washington, it’s the best we were going to get. One can only hope that in time, we’ll improve it.
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This is what you get when you implement a republican health care plan (that no republicans voted for, of course) that uses “market-based solutions”.
It always comes down to: “Do you want to pay or do you want to die?”
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“Your money or your life!” used to be the watchword of muggers. Now it is the pharma/insurance motto.
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Universal healthcare and get rid of the vultures…
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You just don’t get it. Capitalism wins out in the end. It’s what America does best. It’s one or the other, a government program or a profit driven private industry investment. Only a fool would think America could have it both ways. And that fool sits in the Oval Office.
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Narrowing provider Networks is already in the works. Plenty of articles on this out there. Here’s one.
This was always a completely predictable result of the ACA. Insurers have to pump up the bill so that the smaller percentage of earnings they are allowed to keep as profit will still be the same or larger amount of money. Limit them to 15% of what they pay for medical services, and they have an interest in letting the cost of medical services rise.
Of course this dynamic wouldn’t work if we had an actual free market in medical insurance and medical services. Insurers who pumped up the bill would lose beneficiaries to ones that didn’t, and therefore could afford to charge less in premiums.
But we don’t have a free market in health insurance of medical services. What we have are geographic monopolies and massive vertical and horizontal integration, within and between the entities providing both the insurance and providing the medical services. What we have are cartels and monopolies.
The ACA was not at all designed to deal with the actual problem, the monopolies and cartels, but merely with a downstream effect – that monopoly pricing was pushing more and more people out of coverage. The ACA left the monopolies and cartels controlling the commanding heights, it left them capable of responding to the ACA in ways that would allow them to continue to garner monopoly prices.
Market forces are very powerful. If you could organize the market for medical services as a free market, with robust competition, those market forces would act powerfully to bring down costs. But, leave the market dominated by monopolies and cartels, and those same forces will ct just as powerfully to maintain monopoly prices. That doesn’t just mean non-specifically higher prices, it means that prices will continue to rise until they price many people out of the market. That is the logic of monopoly pricing, that the price point of maximum profitability is only reached when many buyers are priced out of the market. Subsidies to these people are only a temporary fix, because they encourage the price spiral.
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Because clearly it’s not possible for new regulations to be written to fix loopholes found in existing regulations as happens with every other regulated industry. No, clearly they’ll just let insurers find and exploit loopholes in the existing regulations until the entire regulatory scheme has been so thoroughly circumvented that the whole thing fails.
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