12 Responses

  1. I remember back when I started pharmacy (1987) not only were computers coming into play but insurance companies started using PCS and Key Health was huge in Indiana+another local HMO. Copays ran anywhere from zero-5.00. Our script counts jumped to over 400/day. Suddenly we had customers we never saw before getting on ave of 5-6 scripts apiece and at quantities of 100or more each cause it was only 5.00 or less. I see very simliar things happening when this whole ridiculous plan goes into full gear. Suddenly the less the script costs the more their going want the doc to write for, the more they’ll want to go to the doc for something as a simple cold. I see a tremendous drop in new drug research due to lack of incentives. I have a famliy member with bipolar who now has type 2 diabetes from his psych meds. Mental health is one area that there still so much to research. Right now im greatful for being in long term care though I know rationing will be the word of the day

  2. Ah the lets raise sales tax argument. Cause that’s just what America needs, more unfair taxes on the poor. The rich in America have it so bad they need more breaks.

    • Give it a break… SAVE THE POOR… SHAFT THE RICH.. in reality the ones that get the biggest shaft is the MIDDLE CLASS.. A sales tax is very progressive.. the more you make.. the more you spend.. the more you spend .. the more you support the system. The IRS admits that they fail to collect some 300 -400 billion in taxes.. that means that somewhere in excess of a TRILLION dollars in income is not reported … a sales tax makes it much harder for that income to escape some taxation.
      By today’s standard of what “poor” is… my family and my wife’s family when we were kids was destitute… I guess our parents were too busy making ends meet to realize that we were living in poverty !

      • Part of the reason the middle class has gotten the shaft is corporations outsourcing or otherwise shifting jobs either out of the country or not reinvesting profits in order to help the workers.

        There’s a disloyalty issue in corporate America, compared to when people were valued as people not just labor.


  3. Steve, what legislation did that video refer to? Seems more like a local congressmen’s issue as to anything likely to happen with the ACA.

    Anyway, the ACA is not a new program akin to Medicare or Medicaid. It’s tackling the evil insurance companies, and as pharmacists, we know they’re cost-cutting devils. The law is designed to increase the pool to lower costs. It expands medicaid coverage to more people. It may work. If the number of uninsured goes from 48 million to 24 million (“half”), then isn’t that pretty good? Think of how much will be saved from costs of emergency room primary healthcare visits.

    Then you’ve got the provisions that help people to stay insured, like not preventing people with preexisting conditions and who become sick. All this is available on Wikipedia.

    As for a sales tax to fund things, the problem is that sales taxes are notoriously regressive, percentagewise punishing the poor more than the rich. If the sales tax exempted necessary items like food and diapers and rent, etc., then the regressiveness would be mitigated a bit.

    I think the ACA is an okay place to start. If it works poorly, at least it’s a step toward getting employers from being so firmly entrenched in the insurance business. They have made it worse and costs have been going up for years.

    As for the website issues, it’s no different than Med D confusion at the beginning. Growing pains. Now it works pretty seamlessly.

    • That was back in 1989 +/-.. I don’t remember the law exactly.. but I remember that Congressman being “assaulted ” when he was back in his district – Chicago I think – He was chairman of the committee that was behind it… a Democrat – if I remember correctly.. I think that he failed to get re-elected when his term was up.
      A Federal sales tax should exempt the “necessities of life”.. BUT.. our country has went from basically ZERO entitlements to close to half the population on some sort of entitlement in abt 75 yrs.

      IMO.. Medicare D – or the lack of it.. when Medicare was implemented in 1965.. was a mistake.. Part A.. was basically catastrophic and it was free and Part B.. a pt could get all the diagnosing they wanted.. but.. they were on their own for medication to manage their disease state… how many extra untold dollars spent on healthcare for that mistakes .. no one knows.

      All we have to do is look at the compliance rate of mandatory vehicle insurance… reportedly some areas have only 50% compliance. Can this be indicative of what we can expect out of Obamacare ?

      We also know how all too many pts on Medicaid, that use the ER for their primary care ..

      The larger issue is how to we get pts to take more responsibility for their health and use our health care system more responsibly …

      A Federal sales tax would eliminate anyone having to sign up and or paying premiums.. If you are a citizen.. you are covered … they could use a FSA to fund the deductible and/or purchased a supplement… like Medicare B supplements are available.

      • We also must ask what has caused this boom in so-called entitlements… Maybe loss of millions of jobs here at home, and a failing educational system. Some percentage of people are mooches, but most are hard working if they could find work. Now with so much part time work to exclusion of full time benefited jobs, it’s no wonder entitlements have spiked.

        • While the last 4-5 yrs economy has caused a spike.. the growth in entitlements has been rather a constant. I can remember back in the late 80’s – early 90’s that it was reported that around one million people a year were becoming uninsured. Of course the whole SS system is a ponzi scheme … when implemented in 1938.. >50% of the population died before they reached 65. But Congress did not have the cojones to index the retirement age for SS.. just like they didn’t index the income level at which SS income was taxed.. in the mid-80’s it was pegged at 30 + K and has remained there ever since. So they give Seniors a 1%-3% annual increase in their SS and inflation and taxes take most of it back.

  4. Sorry. I hit the submit button accidentally before I could fill out all the fields. I post semi anonymously because unlike you I work for a chain that would take any opportunity to can my ass for someone cheaper. I read your blog posts all the time.

    I just don’t get the hate of the law. Do I want something better? Sure. My idea was just straight up Medicare E. Under 65 you have to pay premiums in the form of taxes. Over 65 same system. I however do remember the republicans shitting their pants when health care reform was even mentioned. I am not naive enough to think they would ever allow a federal sales tax to fund healthcare. Plus I haven’t seen any convincing evidence that it’s disrupting health care costs for the rest of the people who have health care. My health care premiums went up year after year before the law and they are still going up now.

    By the way if you are basically going to call someone a coward for posting anonymously then on other blogs (JPs blog) post that people never respond to your blog posts don’t have your blog set up to accept anonymous posts.

  5. No I don’t hate more people having access to healthcare.. but.. the numbers now coming forward… MAYBE .. half of the people that currently don’t have health insurance will still not have health insurance.. so .. basically.. we are disrupting the cost of health care for about 85% of the population that does have health insurance.. to see that abt 7.5 % more of the population has health insurance.
    According to what stat you believe.. the IRS failed to collect some 300 -400 billion in taxes last year.. and this is the agency that is going to be put in charge or our healthcare !

    We already have two established government healthcare systems – Medicare and Medicaid and we have to create a third one .. for what reason ?

    Why not fund a catastrophic health care system.. with a $1000 deductible /person and the person then goes to Medicare or Medicaid and the cost would be funded with a Federal sales tax.

    The tax could be adjusted annually.. like Medicare Part B premiums.. based on what was the cost of providing the service in the prior year.. up or down.. that way EVERYONE has some skin in the game.

    The vast majority of the state have figured out that the best way to get revenue is with sales tax.. so that you nickel & dime it out of the population.. somewhat painlessly.

    It doesn’t matter if you make your money as a prostitute, drug deal or baby sitting.. if you spend money.. you contribute to paying for the universal health care system.

    At least … I am willing to put my name on my beliefs !

    • Sorry, Steve. Disagree with the idea that what was available before ACA to the general public was acceptable.

      The previous system was a travesty of justice and the whole shebang should’ve been bombed and started over with a wider federal government option, instead of taking the intellectual approach to avoid dumping all the PBMs, pharmaceutical companies, MBAs, drug delivery truck drivers on the dole.

      Just because I had a pre-existing health condition was no reason that society could get away with charging me full price even though my brain tumor had long been removed and caused no lasting damage in finishing high school, being accepted to pharmacy school and obtaining a doctorate (eventually).

      There was simply NO reason that I should saddle my family with debt and unfair burden of extra costs, and that PBMs, pharmaceutical companies, non-profit hospitals, etc. should make money to fund their own businesses based on the fact that I had no health insurance, nor that I force my family to go into debt or apply for bankruptcy protections. There are some of us that still consider bankruptcy a form of failure, and why should my brain tumor for which I had absolutely NO control, force others into an untenable situation in which I was dependent on society.

      That’s the way I look at it. Not everyone does. It was wayyyy past time for someone to step in and stop the runaway horse, so to speak.

  6. Do you really hate more people having access to healthcare ? What other options would you suggest? How is it catastrophic?

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