Re: The PPACA Thread Part III - Let's have a healthy debate!
FreshFish: Interest post of yours pointing out the changes in prescription drug coverages. The insurers (and the government) hasmade some major changes in the past couple years and it appears will be doing even much more of it in the coming year. In addition to simply raising the cost of the insurance (most seniors have not seen the increase in Part D Medicare premiums yet for 2016). By having a tier structure for copayments for drugs that they can change at any time, there are lots of ways to alter costs. This coming year for example, across the board or Medicare part D coverage is raising the copays for almost each tier. Although the numbers in some case seem small (from $8 to $11) the percentage increase is massive when viewed against the backdrop of the government claim of inflation being so tame that no one will receive a COLA on the Social Security for only the third time in recent history. However there are other more massive increases hidden in this. Tier 4 drugs (which are most of the more expensive Brand name or newer drugs) will no longer have a dollar amount copay but have been moved to a 50% of cost copay. And the list of drugs in Tier 1 (inexpensive generics) has been shortened to the point of making it ludicrous.
A second interesting development has been in the generic drug industry. When brand name drugs lose their patent protection status, often multiple companies jump in with much cheaper (but questionably truly equivalent) medications. That has been some help for the past years. But we are now seeing a very interesting development as after a while, most of the competing generics stop or the companies merge or they simple decide not to make them. This leaves a market in which only one remaining company makes the so called generic pharmaceutical. They then have the ability to charge almost whatever they please . I am sure most have seen the headlines recently in which some drugs (generically produced) have increased by 500% to 7000% virtually over night. It has made part of the practice of medicine like working through a maze in trying to find medications to treat a disease for a patient without putting them in financial jeopardy or in many cases, made them simply unaffordable. Trying times to be sure. Physicians are put into a position of being unable to prescribe appropriate medications that have been used for decades, simply based upon outrageous costs.
FreshFish: Interest post of yours pointing out the changes in prescription drug coverages. The insurers (and the government) hasmade some major changes in the past couple years and it appears will be doing even much more of it in the coming year. In addition to simply raising the cost of the insurance (most seniors have not seen the increase in Part D Medicare premiums yet for 2016). By having a tier structure for copayments for drugs that they can change at any time, there are lots of ways to alter costs. This coming year for example, across the board or Medicare part D coverage is raising the copays for almost each tier. Although the numbers in some case seem small (from $8 to $11) the percentage increase is massive when viewed against the backdrop of the government claim of inflation being so tame that no one will receive a COLA on the Social Security for only the third time in recent history. However there are other more massive increases hidden in this. Tier 4 drugs (which are most of the more expensive Brand name or newer drugs) will no longer have a dollar amount copay but have been moved to a 50% of cost copay. And the list of drugs in Tier 1 (inexpensive generics) has been shortened to the point of making it ludicrous.
A second interesting development has been in the generic drug industry. When brand name drugs lose their patent protection status, often multiple companies jump in with much cheaper (but questionably truly equivalent) medications. That has been some help for the past years. But we are now seeing a very interesting development as after a while, most of the competing generics stop or the companies merge or they simple decide not to make them. This leaves a market in which only one remaining company makes the so called generic pharmaceutical. They then have the ability to charge almost whatever they please . I am sure most have seen the headlines recently in which some drugs (generically produced) have increased by 500% to 7000% virtually over night. It has made part of the practice of medicine like working through a maze in trying to find medications to treat a disease for a patient without putting them in financial jeopardy or in many cases, made them simply unaffordable. Trying times to be sure. Physicians are put into a position of being unable to prescribe appropriate medications that have been used for decades, simply based upon outrageous costs.
