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Friday, December 5, 2008

Alzheimer's Reading Room: Obama laying the groundwork for U.S. health reform


I'm really looking forward to U.S. Health reform. One of my "pet peeves" is the deal that Congress cut with the pharmaceutical companies on Medicare. Unlike the Veterans Administration and Medicaid, Medicare is not allowed to negotiate the price it pays for prescription drugs--by law (The Medicare Prescription Drug, Improvement, and Modernization Act of 2003).

Here is a good example of what I mean. Each month we purchase Aricept for my mother who suffers from Alzheimer's disease. The price we are charged by our Medicare HMO- Humana - is $166.29. At the beginning of the year, before we hit the Medicare "dough nut" hole, we pay the $25.00 co-pay and Humana covers the additional $144.29 via our Medicare insurance. Once we hit the doughnut hole, $2510 annually, we are on the hook for the entire $166.29 payment.
Here is the problem. If I walked into a drug store with prescription in hand how much do you think I would pay for Aricept? $166.29. So Medicare, the largest single purchaser of Aricept in the world, is paying full retail. The same price I pay as an individual.
Now if I go in the same store as an individual consumer and buy a three pack of Klenex, as opposed to a single box, I receive a 20 percent discount. When you buy in bulk or the larger sized product in this country you pay less. Unless you are Medicare.
Each month we purchase both Aricept and Namenda for a combined price of $243.88. Once we get into the "doughnut hole" we pay that full amount monthly. My mother also takes two blood pressure medications, a thyroid medication, and a cholestrol medication so we hit the "doughtnut hole" early in the year.

Few people understand the "Medicare doughnut hole" or the Medicare practice of paying full retail for prescription drugs. If you are not yet falling into the "doughnut hole" its unlikely that you care. You should care, regardless of age, because if you pay taxes you are paying for these drugs and you are paying an unfair price.

This practice of non-negotiation has to stop. We send our politicians to Washington and we trust them. Instead of representing us in the fashion we expect they put their own self interests before ours. They take special interest money and "perks" from special interest groups; and then, spend 100s of times those amounts in special favors. This by the way is a conflict of interest. Not that anyone seems to care.
I am hoping that President-elect Obama will stop the Medicare rip-off. I think that is the kind of change we could believe in.

Read More: Obama laying the groundwork for U.S. health reform