Politics Thread

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Originally Posted by Strange Brew

My guess is because the major companies are based here?

PBMs arose to help negotiate drug prices as a middle org. Not sure it’s a driving cost factor however I don’t care either way if they exist.

Lack of price transparency is due to the use of health insurance m. A third party.

Which party created the cookie jar to feast from? I’ve given you that answer.

Ville, the Dems have owned the Healthcare issue for 30-40 years. It’s been their pet project. The ACA was passed with 0 R votes. And D states have messed around with the system multiple times a failed miserably.

If you want to blame both parties for an issue, this one is not it.

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The reason I can blame both parties is because neither has been instrumental in changing anything for the better. You blame aca and while it hasn’t helped anything, it’s not a main cost driver for why things are the way they are.

You should care about pbms and why they are allowed to do the things that they do, unchecked. They do things that in any other industry is completely illegal. They make a ton of money at every step of the pharmaceutical process from manufacturing, to transportation to dispensing medication. Spread pricing, formulary manipulation, “rebates” from manufacturing etc etc. and why are they allowed to do all this? Because they have powerful lobbyists in Washington that line congress’ pockets. In a lot of cases, pharma is outpacing costs and claims vs medical. It’s one of the biggest drivers in costs in healthcare today.


Lack of price transparency has little to do with Insurance companies. It has mostly to do with hospitals, and clinics. They are the ones that are able to charge whatever they want without any oversight. Ins companies just negotiate those prices or cover a portion of whatever that price is. Not saying ins companies don’t have a hand in rising costs but price transparency isn’t one of them.

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Originally Posted by Xville

The reason I can blame both parties is because neither has been instrumental in changing anything for the better. You blame aca and while it hasn’t helped anything, it’s not a main cost driver for why things are the way they are.

You should care about pbms and why they are allowed to do the things that they do, unchecked. They do things that in any other industry is completely illegal. They make a ton of money at every step of the pharmaceutical process from manufacturing, to transportation to dispensing medication. Spread pricing, formulary manipulation, “rebates” from manufacturing etc etc. and why are they allowed to do all this? Because they have powerful lobbyists in Washington that line congress’ pockets. In a lot of cases, pharma is outpacing costs and claims vs medical. It’s one of the biggest drivers in costs in healthcare today.


Lack of price transparency has little to do with Insurance companies. It has mostly to do with hospitals, and clinics. They are the ones that are able to charge whatever they want without any oversight. Ins companies just negotiate those prices or cover a portion of whatever that price is. Not saying ins companies don’t have a hand in rising costs but price transparency isn’t one of them.

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So, the ACA made things worse?

The Ds have owned the issue and have created the “cookie jar”.

The examples I gave previously are why the health insurance industry is what is is today.

If you want to blame the Rs for a mess, we could talk about military spending. However, it seems the new generation of Rs are sick of funding and fighting endless wars.

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Originally Posted by Xville

Here are some questions to ponder:

Why does the U.S. pay for most of the r&d when it comes to pharma? Which party is responsible for that?

Why do pbms exist? Why are they unregulated by the government? Who is responsible?

Why is there a lack of price transparency for most services in healthcare? (Admittedly there are a few changes happening around this) why has government done little to change this?

The point is that both parties have their hands in the cookie jar, and neither one of them have done much of anything to prevent drug and healthcare costs from skyrocketing.

While some republicans want to blame it all on ACA, it’s much more complex than that, and at least it allowed for coverage of preexisting conditions like Lou’s brain damage.

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This is such a typical post from you!!

You can't explain the situation, so your response is to ask more questions to obfuscate your lack of knowledge on the topic.

You're not fooling anyone!!

You're trying to pass yourself off as some high level executive - by claiming to be an "expert", when it's clearly obvious you're not. Moreover, you're on this damn website throughout the day - everyday. What kind of an employee claiming to be an expert has the time to blow on a website every single day??

I'm calling bullshit!

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Originally Posted by Strange Brew

So, the ACA made things worse?

The Ds have owned the issue and have created the “cookie jar”.

The examples I gave previously are why the health insurance industry is what is is today.

If you want to blame the Rs for a mess, we could talk about military spending. However, it seems the new generation of Rs are sick of funding and fighting endless wars.

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I’m not saying made things worse I’m saying it isn’t any better. It’s not the main cost driver of what is occurring in health care today as I’ve illustrated

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Originally Posted by Xville

I’m not saying made things worse I’m saying it isn’t any better. It’s not the main cost driver of what is occurring in health care today as I’ve illustrated

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So it should be repealed then, correct?

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Originally Posted by bjf123

I’m afraid we might eventually have to go to a one payer government system. Our current system is not sustainable. It’s gotten way too expensive to get medical care, including prescriptions. We’re paying way more than most first world nations, especially when it comes to prescriptions. I think a major part of that is the governments of the other nations negotiate lower prices and the pharmaceutical companies make it up by overcharging in the US. Unfortunately, I think the only way to stop that is for the government to play hardball and negotiate similar prices here for everyone. The only way to do that is with a single payer system, which I’m sure our government would colossally screw up.


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Hmmm. That would be a heck no from me on total government controlled healthcare.

1) just imagine how much more control, power, and financial responsibility we will be giving the federal government.

2) why reward the entity that is partially responsible for the mess we are in.

I obviously don’t have the answers but government control is not. Not to saying you’re advocating, but government is not the answer. And you are correct, they would totally screw it up.

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Originally Posted by Strange Brew

So it should be repealed then, correct?

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I think there are good elements and bad elements. I don’t think it should be repealed but there are certainly elements of it I would personally change.

The good parts of getting rid of preexisting conditions even as something as silly as pregnancy was sorely needed, and I’m for more people having the ability to be covered.

With that said, I’d enhance it by offering things like catastrophic plans which went away when it was enacted. People should be free to choose their own plan design if it’s something like that, especially for younger, healthier single folk. There are other things I’d change to, but I don’t want to write a thesis.

I don’t think it’s all good or all bad, I don’t think overall it did much positively or negatively in terms of cost driving. Other elements of our healthcare system are way more to blame.

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Originally Posted by noteggs

Hmmm. That would be a heck no from me on total government controlled healthcare.

1) just imagine how much more control, power, and financial responsibility we will be giving the federal government.

2) why reward the entity that is partially responsible for the mess we are in.

I obviously don’t have the answers but government control is not. Not to saying you’re advocating, but government is not the answer. And you are correct, they would totally screw it up.

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Agree with these points. Regulation is badly needed, but like with all things government touches, I worry it would just be made worse. Something needs to be done, and it starts with getting pharma way under control. I just don’t think the government gives a crap to fix it properly. Everyone is just making too much money.

Single payer does NOT equal government run health plan (only in Great Britain)
The European and other models that perform so much better than ours at less cost, are non-profits for the most part.
They just remove the overhead of insurance companies, standardize administration, don't need PBM's and cover everybody.

You may not like the ACA, but there are millions of Americans who now have some form of insurance that didn't have it before.

Anyone who thought the ACA was going to reduce premiums doesn’t have a clue how insurance works. In theory, it could have if EVERYONE who didn’t have insurance signed up for it, but that didn’t happen. The penalty for not signing up was small enough, that all the young, healthy, people that the ACA was counting on signing up, paying premiums, and having little to no claims, didn’t. It was cheaper for them to pay the “tax”, which is the only reason it wasn’t overturned by the SCOTUS. Instead, we ended up with a lot of adverse selection, meaning most of the people who signed up were older, needed coverage, and many times had expensive preexisting conditions. The result? Claims a hell of a lot more than expected resulting in skyrocketing premiums for everyone.

As someone else said, the business model of PBMs would be illegal in most industries with the collusion and kickbacks involved. In many cases, prescriptions are cheaper when you pay the cash price without using insurance, or using a service like GoodRX. If PBMs were truly saving all the money they claim, the cash price shouldn’t be less.


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