“Overutilization in health care is driven by many factors: ‘defensive’ medicine by doctors trying to avoid lawsuits (unnecessary tests add an estimated $150 billion each year to the health care budget); a reluctance on the part of doctors and patients to accept diagnostic uncertainty (thus leading to more tests); lack of consensus about which treatments are most effective; and the pervading belief that newer, more expensive drugs and technology are better. The most important factor, however, may be the perverse financial incentives of our current fee-for-service system."
Quote from “Doctored” by Sandeep Jauhar MD, page 96
Editor's note: The pharmaceutical industry has been making 20-40% profits, but they're not satisfied. At the recently concluded World Economic Conference in Davos, Switzerland 85 drug company CEOs called on governments to pay billions in lump sums "to support innovation", such as the development of new anti microbial medicines. Our proposal: stop spending billions on direct marketing to consumers on products of questionable (if not harmful) value. Also, whenever a drug patent expires, its generic equivalent should become a public good and sold 'at cost' under government supervision.
Making prescription drugs affordable through rational pricing will be one key result of moving to universal, publicly funded health care, the goal of Maine AllCare.
Pharma 'cash call' for new antibiotics
By James Gallagher
January 21, 2016, BBC News
More than 80 pharmaceutical companies have called on governments to develop new ways of paying them to develop antibiotics.
In a joint declaration, at the World Economic Forum, they said the value of antibiotics "does not reflect the benefits they bring to society".
In return, they have promised to invest in research and improve access to antibiotics around the world.
Signatories include GSK, Merck, Pfizer and Johnson & Johnson.
There have been repeated warnings the world is on the cusp of a "post-antibiotic era", raising the prospect of untreatable infections.
It would be a world in which surgery and cancer therapies, reliant on antibiotics, would be under threat.
Drug-resistant microbes are predicted to kill 10 million people a year by 2050 and cost $100 trillion in lost economic output.
Yet there has not been a new class of antibiotic brought to market, against Gram negative bacteria, for more than four decades.
The declaration says the current approach has "largely failed" despite the investment of billions of dollars.
It also sites the "formidable" scientific challenges that have led to many pharmaceutical companies pulling out of antibiotic research.
One of the biggest issues is money - at the moment, a company is paid only for the drugs it sells.
Yet any new antibiotic would probably be used only as a last resort, so companies would not recover the development costs.
Cash up front
A report by economist Jim O'Neill had suggested lump-sum payments should be given to companies that created proven new antibiotics, estimating the cost to governments would be $16-37bn over the next decade.
The declaration, from 85 companies, calls "for governments to commit funding and support the development and implementation of transformational commercial models that enhance conservation of new and existing antibiotics" as well as creating a "sustainable and predictable" market for new drugs.
AstraZeneca chief executive Pascal Soriot said: "The declaration's call for collaborative action on new commercial models is timely.
"Industry is ready to engage with governments to develop alternative market structures to enable the sustainable investment that is necessary if we are to overcome the formidable technical and scientific challenges of antibiotic discovery and development."
Redx Pharma Plc chief executive Neil Murray said: "There is a doomsday clock ticking, with the effectiveness of antibiotics diminishing at an alarming rate.
"New ways must be found to support innovation and drug discovery in this critical area."
World Health Organization director general Dr Margaret Chan said: "Antimicrobial resistance is beyond the capacity of any organisation or country to manage or mitigate alone.
"WHO and its member states have called for the development of new antimicrobial medicines and affordable access to them, in line with the global action plan on antimicrobial resistance.
"This declaration affirms that the challenges of antimicrobial resistance can be addressed only through collaboration and global collective action."
You can read another BBC News report on profiteering on prescription drugs here.
If buying pizza was like paying a hospital bill
A short video on the crazy cost of health care – very funny and very true. Published by Consumer Reports September 24, 2015
Americans are paying more out of pocket for medical care more than ever before—and being socked with surprise charges. Would you stand for that when buying anything else? Say, a pizza?
Maine has 1,329,608* reasons for universal health care.
Please click on our Facebook page for today's personal story.
* Maine population estimate 2014
Maine Doctors Support Single Payer
By Julie Keller Pease, M.D.
Oct. 7, 2015 published in The Times Record (Brunswick, Maine), Letters
I was interested to read the article in Friday’s Times Record about the “Broader health care debate for 2016.” Giving prominence to “single payer” makes sense because only a single-payer plan can cover everyone for all medically necessary care, eliminate financial barriers to care, and allow free choice of doctor and hospital. Single payer healthcare would also control costs. Noted healthcare economist Dr. William Hsiao, when he visited Maine in 2010, estimated that if Maine moved to a single-payer system of health care, the state would save $1 billion during the first year alone.
Currently, the criticism of single payer (mentioned in the article) is that it would require a tax increase. In his fiscal study of H.R. 676, “The Expanded and Improved Medicare for All Act,” economist Dr. Gerald Friedman estimated that 95 percent of all households would actually SAVE money. This is because any increase in taxes would be more than offset by a massive decrease in insurance premiums and out-of-pocket expenses. Further, a streamlined single-payer system would reap about $400 billion annually in savings by slashing wasteful administrative costs, the government would be able to use its negotiating clout to bargain for lower drug and medical supply prices and it would be allowed to take other proven measures to save money.
Maine doctors support single payer. In January 2014, 450 Maine physicians responded to a survey question from the Maine Medical Association: “When considering the topic of health care reform, would you prefer to make improvements to the current public/private system or a single-payer system such as a 'Medicare for all' approach'? Nearly 65 percent of Maine doctors preferred the single-payer option, a jump from about 52 percent in a 2008 MMA survey that asked the identical question.
If you’re interested in learning more about health care for all, I urge you to visit the websites of Physicians for a National Health Program (www.pnhp.org) and Maine AllCare (www.maineallcare.org). Please join us in our advocacy for health care for everyone in Maine.
Dr. Julie Keller Pease resides in Brunswick.
What Can Maine Doctors Do?
Return medicine to its healing roots — help educate and advocate for universal, single-payer health care that covers every Maine resident
- Join Maine AllCare mailing list, and volunteer to help, including supporting financially
- Join PNHP — www.pnhp.org
- Visit our websites regularly — www.maineallcare.org & www.philcaper.net for more information
- Organize and make your voices heard through the Maine Medical Association
- Doctors have lost influence during the past 30 years or so, but we are far from powerless – they don’t have much of a business without us!
- Doctors are still influential – make your views known
- Write op-eds and letters to the Editor of your local paper
- Testify in person and in writing before the relevant legislative committees when legislation affecting health care is being considered. MAC can help organize these efforts
- Organize speaking events directed at professions and lay audiences for Maine AllCare speakers
- Grand rounds
- Local and specialty medical societies
- Community forums, church groups, Rotary Clubs, Lions Clubs, Chambers of Commerce
If you have ideas about how else we might advance the cause of universal health care here in Maine, please write to us at firstname.lastname@example.org and and put "Idea" in the Subject line. Thank you.
Kaiser Health Tracking Poll
Support grows for universal, publicly funded health care
Editor's Note: Two key results jump out from the December 17, 2015 Kaiser Health Tracking Poll.
- Those currently uninsured adults, about 29 million 18-64 year olds, 46 % say that they "tried to get coverage but it was too expensive".
- Regarding universal health care, 58% say they favor Medicare-for-all to cover all Americans.
We at Maine AllCare are encouraged by the steady growth of support for an affordable, comprehensive, publicly funded health care system as the next logical step, post-ACA, the Affordable Care Act.
Opinions of a Medicare-for-All Idea
As the presidential primaries inch closer and candidates begin to debate the intricacies of their platforms, a long-discussed health policy option has reemerged in debate between democratic candidates; the idea of creating a national health plan in which all Americans would get their insurance through an expanded, universal form of health insurance called Medicare-for-all. When asked their opinion, nearly 6 in 10 Americans (58 percent) say they favor the idea of Medicare-for-all, including 34 percent who say they strongly favor it. This is compared to 34 percent who say they oppose it, including 25 percent who strongly oppose it. Opinions vary widely by political party identification, with 8 in 10 Democrats (81 percent) and 6 in 10 independents (60 percent) saying they favor the idea, while 63 percent of Republicans say they oppose it. (read full story)
FIX IT – Healthcare at the Tipping Point a must see documentary for all Americans
This documentary takes an in-depth look into how our dysfunctional health care system is damaging our economy, suffocating our businesses, discouraging physicians and negatively impacting on the nation's health, while remaining un-affordable for a third of our citizens. Produced by Richard Master, owner and CEO of MCS Industries, an Easton PA company.
My company now has to pay $1.5 million a year to provide access to health care for our workers and their dependents. When I investigated where all that money goes, I was shocked. I found that the first three cents of every premium dollar goes to the insurance agent who helps MCS select an insurance plan and negotiate rates with our insurer. The next 20 cents goes to the insurance company to help pay for its sales and marketing and other administrative functions, which includes the work of a huge staff that does nothing more than approve or deny care. Another 10 cents (at least) goes to cover what it costs doctors and hospitals to handle the massive amount of paper work and phone time made necessary by my insurance company’s pre-approval demands, denials and other payment issues. That’s 33 cents of every premium dollar, 33 cents that has nothing to do with the delivery of health care.
Excerpt from a introductory letter by Richard Master
For arranging a FREE screening of this one hour documentary please email us.
How High Is America’s Health Care Cost Burden? Findings from the Commonwealth Fund Health Care Affordability Tracking Survey
July–August 2015, The Commonwealth Fund
- Health care costs are unaffordable for 25% of privately insured working-age people
- 53% of privately insured people with low incomes have unaffordable health care costs
One-quarter of privately insured working-age adults have high health care cost burdens relative to their incomes in 2015, according to the Commonwealth Fund Health Care Affordability Index, a comprehensive measure of consumer health care costs. This figure, which is based on a nationally representative sample of people with private insurance who are mainly covered by employer plans, is statistically unchanged from 2014. When looking specifically at adults with low incomes, more than half have high cost burdens. In addition, when privately insured adults were asked how they rated their affordability, greater shares reported their premiums and deductible costs were difficult or impossible to afford than the Index would suggest. Health plan deductibles and copayments had negative effects on many people’s willingness to get needed health care or fill prescriptions. In addition, many consumers are confused about which services are free to them and which count toward their deductible.
More Americans than ever before have private health insurance, in large part because of the coverage expansions of the Affordable Care Act (ACA), now in their third year.1 At the same time, as more people than ever are gaining coverage, many of those enrolled in private plans, including employer-based and ACA marketplace plans, have high deductibles and other forms of cost-sharing. These elements can place a great financial burden on individuals and families, especially those with low or moderate incomes.2
This issue brief draws from the second installment of the Commonwealth Fund Health Care Affordability Tracking Survey to measure the extent to which U.S. adults have high health care cost burdens.3 We created what we call the Commonwealth Fund Health Care Affordability Index, a composite measure that assesses the share of U.S. adults who have high premium costs, high deductibles, and/or high out-of-pocket health care costs relative to their incomes (see graphic below). In addition, we asked adults about how they perceive the affordability of their premiums, deductibles, and copayments or coinsurance. Adults also told us how their deductibles and copayments affected their health care decisions in the past year.
US pays three times more for drugs than Britain, study reveals
By Ben Hirschler/REUTERS
Published October 13, 2015 in Bangor Daily News
LONDON — U.S. prices for the world’s 20 top-selling medicines are, on average, three times higher than in Britain, according to an analysis carried out for Reuters.
The finding underscores a transatlantic gulf between the price of treatments for a range of diseases and follows demands for lower drug costs in America from industry critics such as Democratic presidential candidate Hillary Clinton.
The 20 medicines, which together accounted for 15 percent of global pharmaceuticals spending in 2014, are a major source of profits for companies including AbbVie, AstraZeneca, Merck, Pfizer and Roche.
Researchers from Britain’s University of Liverpool also found U.S. prices were consistently higher than in other European markets. Elsewhere, U.S. prices were six times higher than in Brazil and 16 times higher than the average in the lowest-price country, which was usually India.
The United States, which leaves pricing to market competition, has higher drug prices than other countries where governments directly or indirectly control medicine costs.
That makes it by far the most profitable market for pharmaceutical companies, leading to complaints that Americans are effectively subsidizing health systems elsewhere.
Manufacturers say decent returns are needed to reward high-risk research and prices reflect the economic value provided by medicines. They also point to higher U.S. survival rates for diseases such as cancer and the availability of industry-backed access schemes for poorer citizens.
In recent years, the price differential has been exacerbated by above-inflation annual increases in U.S. drug prices at a time when governments in Europe have capped costs or even pushed prices down.
In fact, U.S. prices for top brand-name drugs jumped 127 percent between 2008 and 2014, compared with an 11 percent rise in a basket of common household goods, according to Express Scripts, the largest U.S. manager of drug plans.
In Europe, meanwhile, the impact of austerity on health budgets since the financial crisis has led industry executives to complain of single-digit percentage annual price declines.
The U.S. Pharmaceutical Research and Manufacturers of America says international comparisons are misleading because list prices do not take into account discounts available as a result of “aggressive negotiation” by U.S. insurers.
These discounts can drive down the actual price paid by U.S. insurance companies substantially. However, similar confidential discounts are also offered to big European buyers such as Britain’s National Health Service.
“The U.S. has a competitive marketplace that works to control costs while encouraging the development of new treatments and cures,” Holly Campbell, PhRMA’s director of communications, said in a statement.
PhRMA also argues that while Americans may pay more for drugs when they first come out, they pay less as drugs get older, since nearly 90 percent of all medicines prescribed to U.S. patients are now cheap generics.
In Britain, generics account for just over three-quarters of prescriptions and that level is lower in other parts of Europe.
Still, the United States is slower to see the arrival of generic competition to some top-selling drugs, which explains some of the differences in pricing for certain medicines on the top-20 list.
Overall, the analysis found that price differentials were slightly smaller for complex antibody-based drugs, which are used to treat conditions like cancer and rheumatoid arthritis.
Many of the biggest differences were evident for older drugs, reflecting the fact that prices are typically hiked each year in the United States, said University of Liverpool drug pricing expert Andrew Hill.
“It shows the U.S. drug pricing situation isn’t just a matter of isolated cases like Turing Pharmaceuticals,” he said.
The latest furor over U.S. drug costs was prompted by the decision by unlisted Turing to hike the cost of an old drug against a parasitic infection to $750 a pill from $13.50. It has since promised to roll back the increase.
The same medicine is sold in Britain by GlaxoSmithKline for 66 cents.