Tuesday, November 24, 2020

Opuscula

Ripping off
Medicare

BOTH PRESIDENTIAL CANDIDATES talk about lowering the cost of pharmaceuticals, but neither is talking about Over The Counter (OTC) meds.

I buy a small bottle of 81 mg coated aspirin at a “dollar store” for $1.

My Medicare Advantage plan claims the same bottle of aspirin costs SIX TIMES AS MUCH; $6.

My plan providers “gives” me $n/month for OTC products. Assume for a minute that the provider pays $1 for a bottle of 81 mg coated aspirin bought in bulk. Does the provider bill Medicare $1 or does it bill Medicare $6 when a client orders from the provider?

More than “just” over-priced OTC products, my Advantage plan provider sends multiple copies of the same information via the USPS.

Why?

Because the federal government generously reimburses the plan provider for every cent (America doesn’t have “pennies”) the Medicare providers claim to have spent on their clients.

 

I DID NOT identify the Advantage plan provider since most are alike.

While each plan may offer slightly different benefits, but when it comes to ripping off the taxpayer, they are all about the same.

Who cares?

Apparently not the Centers for Medicare & Medicaid Services (a/k/a, CMS; no, I don't know why there only is one "M" — a cost saving measure?)

Medicare Advantage plans are a wonderful thing for their clients; geezers such as this scrivener.

If the geezer — OK, “senior citizen” by another issue — lives in an area with a lot of others of the same status, plan prices usually are fully covered by the geezer’s monthly Medicare payment. Competition keeps a lid on some plan charges; e.g., in some areas, visits to a Primary Care Practitioner (PCP) are $0; in less geezer-populated areas, the charge can be $10 or greater. Likewise specialists. In areas with lots of seniors, the charge typically is $5 to $15; elsewhere, the charge may be $20 or more.

    The idea that undocumented immigrants, a/k/a illegals (and, therefore, criminals) should receive Social Security and Medicare benefits — benefits for which they have paid not a sous1 — galls this scrivener, more so since I have been paying into Social Security since 1957 and into Medicare since Lyndon Johnson introduced it in 1965.

If a person is seen by a doctor or a nurse, Medicare is billed the same.

It does no good to complain to CMS that the patient was seen by a nurse rather than a licensed physician; Medicare foots the bill — to my mind, that encourages less-trained nurses to diagnose and treat patients rather than a physician.

    Caveat: I know some nurses who are far better diagnosticians than some doctors.

Bottom line: Medicare doesn’t care; it’s taxpayer money, after all.

A taste of “socialized” medicine?

Medicare is socialized medicine for practitioners (and insurers) profits.

Granted, the providers — physicians, hospitals, etc. — don’t get what they want from the insurance companies or Medicare; but they often don’t get what they bill private, uninsured patients. (No worry, local taxes will make up the difference — again, the taxpayer pays; the indigent — and those claiming to be indigent — and illegals get a free ride.)

    It is a pity that the medical and hospital bills for the illegals can’t be placed on the people who HIRE the illegals; if there were no employers (exploiters) and the jobs they provide, there would be fewer illegals for the taxpayers to support. I have no problem funding services for people who simply lack the resources and the capability to acquire resources; e.g., people unable to work.

Two sides to the ℞ coin

Presidential hopefuls an a few other politicians repeatedly tell Americans “when I’m elected, your drug prices will go down.” These politicians will allow U.S. insurers, hospitals, etc., to buy medicines from across the border or overseas.

    Americans already are taking medicines all or part of which come from China.2 The safety, potency and efficacy of the imports has repeatedly be challenged.

While it sounds nice, but U.S. ethical pharmaceutical companies pour millions of dollars into the development of new medicines.

If the U.S. stops developing new remedies, will foreign manufacturers pick up the slack? If they DO “pick up the slack,” will the medicines be tested as thoroughly as in the U.S. (anyone remember Thalidomide?3).

While there are arguments that the U.S. takes too long to get a medicine to market, this has to be balanced against the risks of another harmful medicine.

How can a foreign government sell the same medicine for a drastically lower price is beyond my ken unless the government is somehow cheating the pharmaceutical company that developed the medicine.


Sources

1. Sous: https://tinyurl.com/y3e3s2wm

2. Chinese Medicines: https://tinyurl.com/wqulbka

3. Thalidomide: https://tinyurl.com/y28msfra

PLAGIARISM is the act of appropriating the literary composition of another, or parts or passages of his writings, or the ideas or language of the same, and passing them off as the product of one’s own mind.

Truth is an absolute defense to defamation. Defamation is a false statement of fact. If the statement was accurate, then by definition it wasn’t defamatory.

Web sites (URLs) beginning https://tinyurl.com/ are generated by the free Tiny URL utility and reduce lengthy URLs to manageable size.

 

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