Keeping health-saving life-saving drugs from people who can't afford them is not the hallmark of a civilized society. Beyond any double-talk or justification or whining, making potentially health-saving, life-saving drugs available to people who need them should be a non-negotiable bare-minimum of a civilized society.
Just like making sure everyone has enough to eat. These were the beginnings of programs like Food Stamps and SNAP and Medicaid. For consumers no amount of government "explanation" or "excuses" or other claims of government money shortage should sacrifice these basic humane hallmarks of a society.
President Obama created additional barriers to both obtaining health-saving, life-saving drugs and to food, with Obamacare and then separately slashing the budget for Food Stamps and Snap even as his wife bragged that her gardening was growing food for some DC shelter or whatever.
Sadly, President Trump shows signs of making the same mistake. While lavishly bestowing money on the military, President Trump has seemingly forgotten the citizens of the country those military public employees are paid to protect and whom he was voted in to represent. It boils down to the same thing President Obama did as he funneled money into the government class at the expense of the citizens of this country.
The news this week confirmed what we already knew, that big pharma was part of an Obama government deal that left big pharma untouched by the alleged "consumer protections" offered by Obamacare in a tradeoff where big pharma would support Obamacare.
From 2012 to 2017 drug prices both generic and specifically name-brand drugs have risen to obscene levels in excess of 10X the rate of inflation (see Democrat Claire McCaskill's report). It will be curious to see whether the tattered relics of Obamacare fans like the stragglers after a concert populating an abandoned venue amidst the rubble and debris of everyone else who has moved on will finally take up a new cause: The shameful UNAVAILABLITY OF DRUGS TO AMERICANS BECAUSE OF THEIR COST.
Like other exploitive and brutal aspects of Obamacare, Democrats are full of excuses, but even they have reluctantly admitted that leaving big pharma alone helped garner support for Obamacare. Another deal. And like all the really tough issues that necessitated health insurance reform to begin with and that were ignored by Obama's motivations, the Obamacare deal was designed to save the partnership of government and insurance companies money, not and NEVER consumers.
Obamacare is a stain. A con game sold to the American people by an untruthful President who promised health insurance reform that would save Americans money, that would give Americans options like his family had for health insurance (right before our government representatives weaseled out of having to comply with Obamacare, as do most public employees whose benefits remain far superior to the citizens paying up to 72 percent of those public employee premiums).
Oh yes, we should have been suspicious when Democratic leadership led the way as lawmakers announced they were not part of the Obamacare scheme and could opt out through a loophole, instead retaining their rich public employee benefits for which the public pays up to 72 percent of those public employees' premiums.
Oh yes, we should have been suspicious as Obama shamelessly reassured us that insurance companies would have to buckle under the citizen oriented Obama, even as the law passed with temporary federal money handouts to insurance companies to lure them into participation in "exchanges" and that when those payoffs to insurers expired as per the law in 2017 left the exchanges abandoned by these same insurance companies.
Oh yes, we should have been suspicious as we listened to the federal government proudly announce the decrease in the number of uninsured even when that drop, in spite of a new tax penalty against those without insurance never amounted to covering the number of uninsured anticipated and whose number even the federal government confessed had been overestimated.
Oh yes, we should have been more suspicious when we learned that Obama's government didn't count the number of people who enrolled in Obamacare because their former insurance was no longer available, in other words they weren't "Newly" insured reducing the number of "uninsured" they were just "differently" insured because of another Obama lie, they could not keep their plan if they wanted it.
Oh yes, we should have been suspicious of the (still existing) family glitch, which Obama dismissed with a wave of his hand as "only" five million responsible working adults unable to provide dependent coverage for their families because there was no limit on how much insurers could charge for such dependent coverage.
Oh yes, we should have been suspicious when the federal government boasted it was saving on how much it paid out on behalf of people (per capita spending) while announcing that the government would not calculate the costs of administering Obamacare and that our tax dollar expense for the federal administrative, infrastructure and salary costs of Obamacare would be omitted from calculations because it was too hard to do.
Oh yes, we should have been suspicious when the federal government went to court and won the right to force people to TAKE government money in the form paid premium assistance and enroll in Obamacare rather than opt out because otherwise the fragile enrollment numbers would have dropped again.
Oh yes, we should have been suspicious at the blurring together of the underperformance of Obamacare enrollment for the years 2014 through 2017 with the swelling of Medicaid enrollment by people eligible for newly expanded virtually free health insurance and health care. After all, Medicaid expansion was part of Obamacare, but the core of Obamacare was its non-Medicaid provisions and the insurance company-federal government partnership and deal-making designed to save both insurance companies and the federal government money on how much they spend on people using insurance.
We were so enamored with the plan that it took another two years to remind voters that Medicaid was not a government gift and that states had and have the option to grab the estate of anyone reaping these benefits and in fact MUST go after the estate of anyone over 55 using Medicaid, according to the 1993 law.
And don't forget that now that people with means were now eligible under Obamacare for Medicaid. This means that states, which formerly did not go after people to recover Medicaid costs which they would have to split with the federal government because it wasn't worth it because Medicaid recipients didn't have much, now under Obamacare were incentivized to do just that. States like New York already started expanding the term estate for just such purpose.
So, here we are. It wasn't complicated. From the beginning it was a thousand pages of expanding the powers of the federal government, especially the IRS and CMS, part of the Department of Health and Human Services in a partnership with insurance companies to save both the federal government as payer and insurance company as payer money that after the lies began becoming evident became a law with the vague feeble goal of merely "getting more people insured."
Like the demise of a cult after the departure of a cult leader, gone are the bellowing voices and long-winded second-hand liars re-mouthing the lies delivered to us by President Obama. Instead, since Obama's departure more of us are shamefacedly acknowledging that we were played, just like Obamacare architect Jonathan Gruber said because of the "stupidity of the American voter."
And then there are the Republicans.
The promised departure of Paul Ryan is a big yea for sensible, moderate voters. His recycled austerity plans for citizens while he has been sucking off the public teat has been an embarrassing display of self-interest for years. But it is President Donald Trump himself who needs to catch up on the insurance industry or risk the stain of Obamacare that will jeopardize his presidential legacy.
Giving up on reforming the health industrial complex is but should not be part of President Trump's approach. Doing other things will not distract Americans from our everyday living with Obamacare. As more and more baby boomers become eligible for Medicare, further slashing the program and allowing the Obamacare loophole for big pharma where seniors and those with chronic illness cannot get medications that are in existence is a national disgrace.
As for formularies and asking people to anticipate the drugs they need and seek out plans that cover them, it's another side effect of Obamacare's hyperfocus on protecting insurance companies by allowing them to cover the cheap finite costs of things like checkups while charging consumers more with higher deductibles, higher copayments, higher coinsurance or non-coverage. After all, if we KNEW what healthcare we would need in a year, we would NOT need health insurance plans covering more than that need. Insurance is about CONTINGENCY, not about prescience.
As for out-of-pocket maximums, in addition to being raised every year by CMS, now requiring thousands upon thousands of dollars, the needed prescription drug problem is exacerbated by the increasing list of drugs NOT COVERD AT ALL. NOT COVERED means there is NO protection for people using available drugs that are NOT covered at all, because as we should all know, if it's not covered, it's not subject to the limit of out of pocket maximum.
OK President Trump, time to do something. Public employees must live with what the rest of us are living with, the higher costs, less coverage, narrower networks and excluded drugs of insurance plans. For Republicans who tired all of us with their hypocritical "skin in the game," and for Democrats who have engaged in a political beatification of President Obama while engorging themselves off the backs of citizens, time for some reality, you get the same choices as the same prices we do.
Then, incentivize insurers and government actively pursuing FRAUD. Instead of outcomes based being the statistical tool for denying people or limiting people's access to health solutions and whether a treatment is "worth" trying on an individual, let's bring some outcomes based money to insurers for going after fraud.
Under Obamacare, such pursuits were deincentivized by the 80/20 rule under which insurers' 20 percent profit is where the pursuit of fraud would fall and therefore insurers will not pursue fraud which eats into their 20 percent, after all they make that up fraud losses by charging more to consumers.
Further incentivize insurers through rating them in terms of their coverage, with the public employee formulary becoming the bare minimum of what any insurance plan must cover at the same premium rate of public employees rather than public employees getting great coverage that we pay for and citizens getting inadequate coverage.
Institute fines for those non-compliant plans or lower ratings for those plans that offer sub-standard formulary lists based on this public employee insurance formulary standard and that would help consumers know what they're getting and more importantly not getting.
Expand out of pocket maximums to include the expenses for all potentially health-saving, life-saving drugs regardless of whether they are included in a formulary. Right now, if consumers fail to anticipate a drug they might need that might not be covered, all the cheap checkups in the world won't save lives when they can't afford to get treated. Insurers are always looking to NOT COVER, that's the insurance game, but an out of pocket maximum that includes ALL prescription drug costs, whether or not included by insurer formularies as contributing towards reaching an out of pocket maximum will correct this situation.
It's time for President Trump to step up. We are not distracted…DO SOMETHING to protect American lives from the denial of potentially health-saving, life saving medications or join your predecessor by perpetuating the shameless exploitation of the American people.
