We are talking around each other. You keep showing examples of negotiating the actual price the government pays for drugs. And yes before yesterday, the government couldn’t do that directly with Medicare.
However, I’m referring to how much money the Medicare patient is saving now based off their negotiations with pharma. If these negotiations didn’t take place today, the patient would still be on the hook for over $11,000 out of pocket costs annually. That is how the Medicare PDP was designed. Now, that burden has decreased by 50%. I’m sorry, but this sounds like “real” negotiations to me.
Why do you think Congress put a cap on out of pocket pocket costs with this new bill (gee, wonder where they got this idea)? They knew just lowering what they pay would not guarantee to be a cost saver for the patient. Nothing like telling the patient I got mine but you are out of luck.
You have an uncanny ability to have me defend industries and people that I don’t necessary like to.
Results 14,361 to 14,370 of 26805
Thread: Politics Thread
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08-17-2022, 12:34 PM #14361
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08-17-2022, 12:58 PM #14362
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08-17-2022, 01:20 PM #14363
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08-17-2022, 01:25 PM #14364
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08-17-2022, 01:29 PM #14365
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08-17-2022, 04:39 PM #14366
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08-17-2022, 06:03 PM #14367
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08-18-2022, 02:32 PM #14368
Well if you take in consideration 43 million people are enrolled in a plan d program and $5,250 per patient is a pretty big chunk of change. If you do the math, that’s $215 billion in potential savings to the patient in out of pocket costs.
Also, any comparison to VA benefits is apples to oranges. Ask any healthcare professional. Yes I know, in your mind there shouldn’t be.
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08-18-2022, 02:55 PM #14369
Very few ever reach the max out of pocket on Part D. 1.5 million in 2019.
Last edited by bobbiemcgee; 08-18-2022 at 02:59 PM.
2023 Sweet 16
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08-18-2022, 05:24 PM #14370
Well if ask any physician, they will tell you all their seniors are in the donut hole lol. On a serious note, there is a reason because your number leaves out one important number, those who became dual eligible or low income subsidy patients. Those people are not included in the number you presented.
That number fluctuates yearly, but is roughly between 29-30% of the plan d patients. The percentage should drop because of number of patients entering Medicare age.
If you become dual eligible by hitting the donut hole, your benefits moves over to the State and they will cover your drug costs. As you can imagine, drugs become extremely inexpensive because now they will be using Medicaid out of pocket costs. Each State each year negotiates directly with the manufacturer on price (Paul would be proud - real negotiating).
The only problem with the States is they normally only include one drug per class to be on their formulary. So a patient may be switched from a drug that is currently working.
As you can see from my last post, I used the word potential because there no way to know and so many moving parts. Is it only 8 billion, 100 billion, or more? No one really knows. Only the government could come up with a plan so complicated.
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