While Medicare is a valuable resource for seniors and some individuals with disabilities, it’s crucial to dispel the illusion that it covers all health expenses. Medicare is a lifeline for millions of Americans, providing essential healthcare coverage to those aged 65 and older and some younger individuals with specific disabilities. It’s often seen as a safety net, a promise of comprehensive healthcare coverage later in life. However, there’s a common misconception that Medicare covers all health expenses.
Medicare
Lowering the price of prescription drugs is a complex issue. Still, there are several strategies that Medicare can consider to address this challenge, especially with a new Alzheimer’s drug that could cost taxpayers $5 billion. Here are some ways to lower Medicare costs.
“We are hearing about it more and more,” said Jacqueline Reid, a government research analyst at the Office of Inspector General who has analyzed Medicare Advantage overbilling. It’s costing us billions and continues unchecked because Medicare has become too big. This is a summary of an article from the NY Times.
Nationwide, prescription drug spending last year is estimated to be $328 billion among all payers, including private insurance, Medicare Part D, and patients’ out-of-pocket expenses. Reforms to let Medicare negotiate prices, cap out-of-pocket costs for prescription drugs, and limit insulin cost-sharing would make lifesaving drugs more affordable. Still, the pharma industry is fighting hard to keep it off the table.
SUMMARY: Three House Democrats on a key committee voted against the measure to lower drug prices as PhRMA ramped up its lobbying dollars to buy politicians. “I understand that the pharmaceutical industry owns the Republican Party and that no Republican voted for this bill, but there is no excuse for every Democrat not supporting it,” Sen. Bernie Sanders wrote in a scathing statement.
SKIMMERS SUMMARY:
- According to a GAO Report “Medicare Parts B and D and beneficiaries spent $560 billion on drugs from 2016 through 2018, $324 billion of which was spent on advertised drug”.
- GAO’s review of four advertised drugs found that drug manufacturers changed their DTCA spending during key events, such as increasing spending when a drug was approved to treat additional conditions or decreasing spending following the approval of generic versions.
- The report fails to acknowledge the role of HCPs in prescribing medications and empowered patients who may have been educated by DTC ads.
- This report is going to lead to more calls to limit DTC advertising.