Valeant Pharmaceuticals is the flashpoint for a conversation that quite frankly should have been addressed by the self-proclaimed “reformers” when it came to smug self-congratulations on passing Obamacare. Like many other problems that have emerged with Obamacare, the philosophy and practices outlined in the Act ENABLED rather than prevented bankrupting American people who have the misfortune to become sick in our country.
The PPACA incentivized two OLD-TIME GAMES played by health insurers and providers that puts us in peril, first allowing for increasingly narrow networks of providers, especially specialists which essentially limits access to needed medical services for the sick and secondly by omitting any requirement that prescription drugs, ALL prescription drugs be counted towards a patient’s out of pocket maximum.
Instead, our rights under the PPACA merely codified the old-time, inadequate concept of leaving patients without access to needed medical services and medications in the face of insurance company denials with their only recourse being to appeal decisions of denial of coverage and seeking exceptions to denial of coverage of specific prescriptions.
Sure, if you’ve got the money then paying for those needed services in cash remains AS IT’S ALWAYS BEEN an option. But if not then the PPACA is merely business as usual—and worse—you’re up a creek, Death by Denial.
I LIKE what Valeant did, because instead of the death-by-1,000-cuts approach of other drug prices which even according to the, “Go business,” view of the Wall Street Journal have increased 76 PERCENT over the last five years (http://www.wsj.com/articles/for-prescription-drug-makers-price-increases-drive-revenue-1444096750, Joseph Walker, 10/5/2015), Valeant simply and LEGALLY raised the price of Daraprim from $13.50 a tablet to $750 a tablet overnight.
It was that enormous and overnight increase in price that finally got our silly politicians to notice that WE, the consumer had finally noticed yet another bad outcome of Obamacare that they SHOULD HAVE disclosed and fought against before the ridiculous plan became law in 2010.
Instead we’ve got the government class wagging their fingers at Valeant, with more money about to be wasted as we pay these lame ducks to hold yet another “investigation” off taxpayer backs (this time the Senate’s Special Committee on Aging) into Valeant’s conduct.
Because Obamacare incentivized this sort of endless increase by omitting any requirement that prescription drugs be covered by health insurance plans AND that such expenses for prescription drugs that are covered MUST contribute to out-of-pocket maximum, neither of which is true under Obamacare, those who need prescriptions omitted from insurance company formularies are essentially sh*t out of luck (see HealthCare.gov, Getting prescription medications, advising patients denied prescription drug coverage to try and APPEAL).
As for the ever-predictable Republicans with their allegiance to “free market,” the secret’s out: They APPROVE of the Obamacare provision that will end the lives of people unable to get their prescriptions covered by insurance or afford the out-of-pocket costs for those prescriptions as part of their idiotic capitalism argument of whatever the market will bear in terms of prices charged.
So what is the sudden politician uproar about Valeant about, the public finger-wagging and attempts to shame the company into better behavior?
FIRST, Valeant is being targeted by politicians as a distraction away from what the situation really proves which is that the criticisms of Republicans by Democrats and Democrats by Republicans were both true when it comes to Obamacare.
It proves that Democrats are right, the Republican inaccurate reliance on the “free market” and whatever that market will bear results in THIS.
The Valeant situation also validates Republican criticisms of Obamacare that Obamacare’s primary goal to save government money by forcing insurance companies to cover certain things that not all subscribers need while leaving subscribers vulnerable to bankruptcy or no access to needed medical services and medications when they’re sick by raising coinsurance, copayments, and deductibles, and in the case of drugs increasing the number of medications that are NOT COVERED results in THIS.
SECOND, Valeant has gained attention because of the sheer AMOUNT OF THE INCREASE in its prices. This argument is silly—There is no limit on what they’re allowed to charge that’s why we’re hearing the word “immoral” rather than “illegal” around the story.
Increasing drug prices have been addressed before, with even the Go Business! Wall Street Journal reporting on 10/5/2015 in an article by Joseph Walker, “For Prescription Drug Makers, Price Increases Drive Revenue,” noting that “…the 30 drugs analyzed by the Journal averaged 76% over the five-year stretch from 2010 through 2014. That was more than eight times general inflation.”
So what increases are moral? Obviously it must be somewhere between the seemingly perfectly acceptable 76 percent increase in prices overall and Valeant’s price increase on Daraprim of 5,000 percent.
In between we know that Gilead came under fire for its $1,000 pill for Hepatitis C (http://www.wsj.com/articles/gileads-1-000-hep-c-pill-is-hard-for-states-to-swallow-1428525426) with public outcry prompting an attempt to get rid of Gilead’s patent which here in the US continues though China rejected it.
We also know from a 10/20/2015 report by CNN (http://money.cnn.com/2015/10/20/investing/drug-price-hikes-martin-shkreli-valeant/), “Sticker Shock: Drug Prices with Price Hikes of Up to 1,200%,” by Matt Egan, that Horizon raised the price of its drug Vimovo 1,170 percent from 2013 to 2015.
THIRD, desperate to do “something,” the federal government is running around trying to wipe the egg off its face as citizens live through this next revelation of what Obamacare really IS for citizens and what Republican’s pro-business stance really IS for citizens by acting as if they’re “outraged” and seeking to find SOME LAW, ANY LAW or any REGULATION that they can use to “stick it” to Valeant.
VALEANT’s business conduct is the hook that our politicians are using to try to clear themselves and their anti-consumer policies. Whether the allegations and examination lead to some or any finding of wrongdoing is NOT relevant for consumers because it won’t be based on the price hike but instead on some business practice that politicians hope to find Valeant violated. Unless they’re stockholders in the company (the stock has dropped precipitously).
This leaves us where we started…NO LIMIT on what can be charged for prescription drugs, because ultimately VALEANT isn’t the problem, it’s the result of Obamacare and its failure to require that prescription pharmaceuticals be covered by health insurance plans AND that any out-of-pocket expenses for those prescriptions must be included in consumers reaching their out-of-pocket maximum under their health insurance plan.
