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Obama Targets Medicare Advantage, Again
Townhall.com ^ | February 9, 2015 | Neil McCabe

Posted on 02/10/2015 5:21:02 AM PST by Kaslin

In his march towards total government control of American lives, President Barack Obama strikes at Medicare Advantage, or Medicare Part D, in his new budget released Feb. 2 for fiscal year 2016.

“The Budget proposes to give the Secretary of HHS the authority to negotiate drug prices for biologics and high-cost drugs in Medicare Part D to help ensure access to and affordability of these treatments,” according to “Investing in America's Future,” the White House's FY 2016 budget narrative. “This proposal is one of a range of potential solutions to address these growing costs, and the administration looks forward to working with the Congress on this challenge.”

This is not the first swipe the president has taken at Medicare Advantage, but this year the White House is pushing harder compared to its previous attempts.

Of the reforms and tinkering, the two significant changes proposed by Obama are giving the Health and Human Services secretary authority to dictate drug prices and the shortening of the brand-name drug use window from 12 years to eight years before the program is allowed to use generics.

As soon as HHS starts setting prices, the drug companies will start to take their drugs off the manifest—if the price is set too low. The other side is that once the HHS starts setting prices, the price could be set too high, out of ignorance or corruption. Either way, some federal hack is picking winners and losers, rather than the competitive market.

Nobody on first glance has a problem with the expanded use of generic drugs. For existing brand-name drugs, taking the 12-window down to eight years will not have a major effect, since the drugs are already developed and on the market.

The rub comes when a company is deciding to invest $50-$75 or $100 million in a new drug. Drugs are like blockbuster movies. You invest $100 million and you expect to take in $750 million. Then, what looks like $650 million in profit actually goes to cover the $300 million blown on box office bombs and the $300 million next films in production.

The generic drug companies have no development risk and no research and development cost, so it is their lucky break to be the first winner in the president's proposed reforms.

Regardless of the proper and focus-grouped phrasing, the target is the Medicare Advantage program itself and the real result will be a more control over access to the pharmaceuticals senior citizens depend on to live healthy and independent lives.

The program is a voluntary add-on to a senior's Medicare coverage, where seniors pay a premium and deductibles for one of the more than 1,500 private sector drug insurance plans. There are something like 30 million senior Americans participating in the program that is relentlessly popular and under-budget.

Medicare Part D, established in 2003, was not a conservative program or conservative goal. In fact, back when the Republican Study Committee was a conservative bloc inside the House GOP, members of the RSC proposed delaying its launched as a budget pay-for in exchange for federal funds to relieve the victims of Hurricane Katrina.

Theplan was first proposed by President William J. Clintonas a pure give-away that polled off the charts, but could not get through the GOP-controlled Congress. In the star-crossed 2000 presidential election campaign, Democrats made access to drugs one of its central themes.

Although Republicans understood the problems with government intervention into another part of the health care market, they were not profiles of courage when faced withWinifred Skinner, the elderly woman Al Gore's campaign drove around the country in a luxury Winnebago with a five-person entourage, so she could tell reporters that she ate dog food because of the cost of her medicine.

The Republican response was to acknowledge the political reality that people wanted the elderly to have a government drug benefit and thus came Medicare Advantage, a government program that subsidizes the premiums, but otherwise steps aside.

In the hands of the Republicans, the Clinton-conceived program was raised as a first step towards privatizing the government's role in health care—and this is the reason why Obama and the Democrats need to destroy it—before it spreads.

For what it is worth, if Obamacare was converted to a similar straight-out subsidized premium scheme with plans that crossed state borders, instead of having the infected horse blanket known as the Patient Protection and Affordable Care Act, most folks, even conservatives would take that deal and move on.


TOPICS: Culture/Society; Editorial; Government
KEYWORDS: 0bama; hhs; medicare
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1 posted on 02/10/2015 5:21:02 AM PST by Kaslin
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To: Kaslin
I'm a senior with Medicare Part A and disagree with most of my peers. Medicare Part A should be the only part there is. It's the insurance we paid into the system for. It was designed so seniors would not be impoverished by a hospital visit.

Medicare Part B and Part D, the pharmaceutical program, should not be part of the federal program. They should be private sector insurance.

It was GWB who force-fed us Medicare Part D. What's happened? Increased pharmaceutical expenses, copays many recipients can hardly afford, over-prescribing of drugs, and many seniors walking around in a drug-induced zombie state.

2 posted on 02/10/2015 5:25:51 AM PST by grania
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To: Kaslin

Medicare advantage is not Part D. Part D is only for drugs. Advantage is hospitals, doctors, and can include drugs.


3 posted on 02/10/2015 5:30:01 AM PST by TAP ONLINE ( Democrats are Scorpions, you get the ride you deserve)
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To: Kaslin

The rub comes when a company is deciding to invest $50-$75 or $100 million in a new drug.

Those numbers are light by a factor of ten.


4 posted on 02/10/2015 5:31:53 AM PST by Attention Surplus Disorder (At no time was the Obama administration aware of what the Obama administration was doing)
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To: grania

I agree with your point and I am on medicare.


5 posted on 02/10/2015 5:32:15 AM PST by Mouton (The insurrection laws perpetuate what we have for a government now.)
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To: grania
Medicare Part A should be the only part there is.
As long as illegal aliens and the rest of the Takers of Society get free healthcare, Medicare recipients shouldn't be paying a dime.
Most of us have paid in for 40+ years and still get charged every month.
6 posted on 02/10/2015 6:07:16 AM PST by oh8eleven (RVN '67-'68)
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To: oh8eleven
Most of us still get charges every month

You get charged on Part B and Part D....Part A is free. What I'm saying is the parts you're charged for are not part of the original Medicare program and should be totally private sector. Having parts B and/or D is your choice; it's not what you paid for all those years.

7 posted on 02/10/2015 6:13:15 AM PST by grania
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To: grania

Most people can buy drugs cheaper than you can pay for the Part D prescription drug charges, unless they are extremely ill and taking horribly expensive drugs. The average charge for the Part D plan is about $250-400 per quarter, over $1000 per year.

With Walmart’s $4 drugs, and the coupons you can get online...it’s stupid to pay for Part D unless you take drugs without use of coupons or aren’t covered by $4 list of most drug store lists.


8 posted on 02/10/2015 6:17:54 AM PST by Kackikat
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To: Kaslin

What???

You can’t bring a new drug to market for less than $1 billion. It typically costs over $2 billion. Government price-fixing is why companies are unloading their drug operations.


9 posted on 02/10/2015 6:24:42 AM PST by <1/1,000,000th%
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To: Kackikat
With Walmart’s $4 drugs, and the coupons you can get online...it’s stupid to pay for Part D
Stupid? What happens when in February or March - all of a sudden - you need very expensive drugs that aren't on Walmart's list or covered by coupons ... and you can't sign up for Part D coverage until the end of the year?
10 posted on 02/10/2015 6:27:17 AM PST by oh8eleven (RVN '67-'68)
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To: grania
What I'm saying is the parts you're charged for are not part of the original Medicare program ...
And what I'm saying is - I don't give a damn. The Takers of Society have done nothing most of their lives (including not even living in this country), and yet they get treated like they deserve everything for free.
As Øbama keeps defunding the Medicare Advantage program, where do you think that money is going? Yeah, ØbamaCare, Medicaid and any other program set up to help the "poooooooor."
11 posted on 02/10/2015 6:34:51 AM PST by oh8eleven (RVN '67-'68)
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To: Attention Surplus Disorder

Irony alert. Big Pharma backed OC expecting their payoff. Now they will get it. Right up the rear end.

If you give the devil a ride he’s gonna end up driving.


12 posted on 02/10/2015 6:44:24 AM PST by ChildOfThe60s (If you can remember the 60s, you weren't really there....)
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To: oh8eleven

All by design. How else are they going to “death panel” the baby boomers? You wait, the boomers will be the scorge of this nation, using far more government resources than we can afford, $100,000 on a hip transplant on a 90 year old?


13 posted on 02/10/2015 7:38:23 AM PST by thirst4truth (Life without God is like an unsharpened pencil - it has no point.)
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To: Kaslin
This statement is somewhat confusing:

Is "The program" referring to Part D? If so, it is not voluntary. It is mandatory. Anyone not signing up for an approved drug plan is fined. The fine increases each year of non-compliance. When one does enrol in a prescription drug plan later, the cumulative fine is assessed and added monthly to the cost of the drug plan.

If the statement means that drug plans are voluntary with some Medicare Advantage plans, that is technically true, but not signing up for a drug plan -- whether part of an approved Medicare plan or a separate standalone plan -- still result in an accumulating fine.
14 posted on 02/10/2015 8:07:19 AM PST by TomGuy
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To: thirst4truth
the boomers will be the scorge of this nation, using far more government resources than we can afford
Say, don't people like you belong over on DU?
But not to worry, these boomers won't cost you another penny, forever ...
15 posted on 02/10/2015 8:45:46 AM PST by oh8eleven (RVN '67-'68)
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To: oh8eleven

I get my husbands very expensive drugs by using coupons, when Walmart $4 list doesn’t supply them. Now I am not talking about cancer drugs or very expensive inhalers etc.

HoWever the AVERAGE (NOT EVERYONE) person does not use over $1000 of drugs yearly.


16 posted on 02/10/2015 1:52:50 PM PST by Kackikat
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To: Kackikat

I agree with your basic premise.

But FReepers should also realize you pay a penalty if you sign up for part D AFTER your initial eligibility date. And the penalty increases for each month of non-coverage.


17 posted on 02/10/2015 2:00:42 PM PST by nascarnation (Impeach, convict, deport)
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To: nascarnation

You can get a drug discount card from many sources for free and there is no penalty, that is what I did for myself.


18 posted on 02/10/2015 2:05:35 PM PST by Kackikat
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To: Kackikat

It’s a financial judgement call. Having been in cancer treatment for several years, for me Part D was a no-brainer.


19 posted on 02/10/2015 2:08:25 PM PST by nascarnation (Impeach, convict, deport)
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To: Kaslin

Obama has a death wish


20 posted on 02/10/2015 2:09:03 PM PST by bert ((K.E.; N.P.; GOPc.;+12, 73, ..... Obama is public enemy #1)
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