The healthcare – or shall I call it “sickness care” – industries in the United States and, perhaps globally, apparently operate under several misleading practices of being there to help consumers get well.
Although that sounds altruistic, nothing probably is further from factual and monetary truths, according to many concerned individuals who recognize what amounts to “rip-offs” and are calling it out for what it is.
In view of the exorbitantly annual increases in healthcare insurance premiums and prescription drug plans, consumers and regulatory agencies must step back to reassess “what the hell is going on” with price increases that prevent those folks who take prescription drugs from either cutting back on them or not being able to afford them in the first place.
One of the prime areas of apparent deceitful healthcare practices to investigate is found in prescription pharmaceuticals where ‘mammoth monetizing’ goes on at various levels along the distribution/sales channels. One of the identified ‘culprits’ is “Pharmacy Benefit Managers” (PBMs), which basically amounts to what some call “abusive middlemen.”
This video is a short explanation of PBMs.
Pharmacy Benefit Managers (PBMs): Abusive Middlemen
1:29 minutes
https://youtu.be/nNyXSnT3rJQ?t=7
The CDC’s National Center for Health Statistics “Therapeutic Drug Use” website lists statistics for the period 2011 to 2014. According to their data, 3.7 billion Rx drugs were ordered or provided with the most-frequently prescribed drugs being: Analgesics, Antihyperlipidemic agents [cholesterol lowering drugs?] and Antidepressants. Those Rx listings apparently will have to change when the stats are updated for 2015 to 2018 when opioids ought to be included as one of the top three. That drug probably was monetized further after the PBMs’ cuts by physicians who ‘bartered’ for those scripts.
If you are taking Rx drugs, the information in this reporting ought to be of vital concern to you, especially if you feel you cannot afford to pay for your prescriptions. The apparent emerging reasons ought to make you angry enough to contact your members of Congress to do something about that, especially senior citizens on Medicare and who use Medicare Part D.
PBMs make drugs more expensive
“How ‘price-cutting’ middlemen are making crucial drugs vastly more expensive”
http://www.latimes.com/business/hiltzik/la-fi-hiltzik-pbm-drugs-20170611-story.html
“Complaints about PBMs driving up drug prices have become increasingly common.”
One of the examples given in the above Los Angeles Times article is what happened to the pricing for the EpiPen in which most of “the list price went to middlemen, including PBMs.”
According to a distribution chart in the above article, here’s the route how the EpiPen was monetized until the consumer bought and paid for it: Mylan, the manufacturer >> insurers >> wholesalers >> pharmacy retailers >> patients. All those from Mylan to patients were “middlemen,” each making a profit from ‘handling’ the product!
CBS News reported “The Problem With Prescription Drug Prices”
https://www.cbsnews.com/news/the-problem-with-prescription-drug-prices/
Now, here’s something most consumers probably will not consider in the prescription sales mix, “Desperate Families Driven to Black Market Insulin,” an NBC News exposé.
https://www.nbcnews.com/business/consumer/desperate-families-driven-black-market-insulin-n730026
The ten-year-old little girl’s family cannot afford to pay for the insulin she needs to keep her alive because of what amounts to apparent PBM regulations! Hey, HHS and Congress, why aren’t you doing something about such outrageous treatment to correct the ‘monetizing politics’ of prescription drugs and healthcare services in general?
Black Americans and Native Americans have the highest percentage rates of diabetes.
12.7% of non-Hispanic blacks
15.1% of American Indians/Alaskan Natives
Source: American Diabetes Association
How do they make out under the PBM rip-offs? Didn’t ObamaCare, aka Affordable Care Act, make things even more problematic?
Obamacare Premiums Will Be Officially Unaffordable for Many in 2018. An analysis of health insurance costs conducted by eHealth finds that projected rate increases for 2018 health insurance plans would make coverage unaffordable for many, according to the rules of the Affordable Care Act (the ACA or Obamacare)
(Source)Resource:
Race/Ethnic Difference in Diabetes and Diabetic Complications
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3830901/
Then there’s another ‘factor’ that must be included: alleged FRAUD! The American Council on Science and Health published “Department Of Justice, CVS Caremark, Fraud And Whistleblowers,” which acts like a ‘map’ for identifying the Players, the Game, the Context, the Alleged Fraud, Blowing the Whistle, and Points to Ponder. It involves Medicare D, the senior citizens’ drug plan, that’s administered by insurance companies like Aetna and SilverScript.
In this writer’s opinion, Medicare D was a ‘betrayal of senior citizens’, which became a gift for the pharmaceutical and healthcare industries that just keeps on giving!
Finally, there’s this to consider: “The So-Called ‘Safe Harbor’ Law” published at Physicians for Reform at NoMiddlemen.org where the following video explains their position.
Government-sanctioned Kickbacks
4:15 minutes
https://youtu.be/aQhsPLcFwN8?t=4
“A pay to play scheme.”
“Government-approved kickbacks.”
As a healthcare information/data researcher there’s an area within the healthcare information dispensing system that amounts to a rip-off, in my opinion. It’s scientific papers publishing! In many instances, the research is taxpayer funded through government research grants. Therefore, accessing that information online should be free and not monetized as is the case employed by many journals.
The British online website The Guardian published “Scientific publishing is a rip-off. We fund the research – it should be free,” which basically defines the differences between “behind a paywall” and “open-access” journals and publishing.
George Monbiot, the journalist who wrote the article, coined the phrase “demand the democratisation of knowledge,” something that is needed now more than ever, especially during the current era of online search engines and operating systems censorship and deplatforming, a form of online boycotting individuals who have opposing points of view, which control freaks want to eliminate.
Image credit: AlterNet
The good news is you don’t need any of these drugs to get better and stay alive. The bad news is too many people already already know this. That’s why mandatory participation in health insurance was recently required.