Mines going down to 0
*Extension of dependent child(ren) limiting age to 26.
*Removal of pre-existing condition exclusions for enrollees under the age of 19.
*Information revisions to the appeals process.
*Explanation of how your coverage is safe from non-permissible rescissions.
I Hear and I Forget...I See and I Remember...I Do and I Understand
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I believe that some of the O-care provisions have taken effect ... like the state exchanges and the requirement there not to reject pre-existing conditions. It is unclear to me whether those state exchanges are totally funded by govt $ or whether the insurance is ultimately provided by existing private insurors that are then subsidized by govt $ to some degree. Whatever the case, the fact that is emerging is that the cost of insurance for those entering state exchanges with pre-existing conditions is quite high ... thus the cost is resulting in low participation.
With regard to the increase in health care costs, the U.S. is not unique. From organ transplants to stem cell therapies, why do we find it so hard to acknowledge that these medical advances have a price tag? Whether the cost of health insurance has risen faster than the cost of care, would be a separate issue.
We also fail to acknowledge, for the most part, how much medical care is given at no cost to the patient. Any effort to provide health insurance to everyone will undoubtedly miss the mark ... short of a system like the UK or Canada (etc.) ... which, it is becoming evident, also has some flaws.
But, Pat is correct ... that it appears nobody bothered to read the bill in its finer details (which most of us long suspected). In today's NY Times
WASHINGTON — In an unintended consequence of the new health care law, drug companies have begun notifying children’s hospitals around the country that they no longer qualify for large discounts on drugs used to treat rare medical conditions.
As a result, prices are going up for these specialized “orphan drugs,” some of which are also used to treat more common conditions.
Over the last 18 years, Congress has required drug manufacturers to provide discounts to a variety of health care providers, including community health centers, AIDS clinics and hospitals that care for large numbers of low-income people.
Several years ago, Congress broadened the program to include children’s hospitals.
But this year Congress, in revising the drug discount program as part of the new health care law, blocked these hospitals from continuing to receive price cuts on orphan drugs intended for treatment of diseases affecting fewer than 200,000 people in the United States.
The reason behind the change is murky, though some drug makers had opposed expansion of the drug discount program. The discounts typically range from 30 percent to 50 percent, and children’s hospitals say the change is costing them hundreds of millions of dollars.
Under the new law, hundreds of rural hospitals became eligible for discounts for the first time, but the discounts are not available on orphan drugs, which account for a surprisingly large share of their outpatient pharmacy costs. At the same time, children’s hospitals lost access to discounts on the drugs.
In a typical letter to a children’s hospital, one company, Genentech, said that, because of the new law, it would not offer discounts on certain cancer medicines like Avastin, Herceptin, Rituxan and Tarceva, or on Activase, which is used to dissolve blood clots in heart attack and stroke patients.
Another drug maker, Allergan, cited the new law as a reason for denying discounts on Botox, which, besides removing wrinkles from the face, is used to reduce spasticity in patients with cerebral palsy and other neurological disorders.
Joshua D. Greenberg, vice president of Children’s Hospital Boston, said that loss of the discounts “jeopardizes our ability to care for some of the sickest children with the most complex health care needs.”Christina M. Barnes, the pharmacy director at Galion Community Hospital in rural Galion, Ohio, said she was excited when her hospital qualified for the discount program earlier his year. But, she said, she was dismayed to learn that many drugs would be excluded.
“We were given an advantage with one hand, and it was taken away with the other hand,” Ms. Barnes said.Ah, yes, I seem to remember that pharma companies came on board for O-care during the process.In a last-minute change sought by some drug manufacturers, Congress stipulated in the new health care law that rural hospitals, children’s hospitals and certain free-standing cancer centers could not get discounts on orphan drugs through the 340B program. Ms. Barnes, at Galion Hospital in Ohio, said: “The list of orphan drugs is small, but it involves big dollars. Many, perhaps most, of our cancer patients receive at least one orphan drug during their treatment.”
I'm wondering about another "unintended consequence" that is brewing. Compel business to provide health insurance ... but do not allow them to deduct that cost as a business expense for tax purposes. Does that make any sense at all? sounds like a great way to get more businesses to ship more jobs to other countries.Drug companies said that the discount program was intended to help hospitals care for the uninsured, and that this need would diminish as millions of the uninsured gained coverage under Mr. Obama’s health care overhaul. [Many might become insured, but I seriously doubt that ALL will be insured. For the "working poor", the cost of health insurance may still be out of reach, as is the case with the state exchanges. And the "penalty" for not having insurance may not be of much help ... you can't get blood out of a rock.]
But Ted Slafsky, the executive director of Safety Net Hospitals for Pharmaceutical Access, a nonprofit group, said, “The exemption for orphan drugs undermines the mission and purpose of the drug discount program.”
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