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The Doctor Will See You Now!

By Arthur Piccolo

News Americas, NEW YORK, NY, Fri. Nov. 6, 2015:  No, No don’t worry; President Obama is fit as can be.

Probably fitter than you and me. We Americans give him the best that money can buy as our President. He and his family want for nothing the best shelter, food, transportation, medical care you name it he and his family get better than even the riches Americans.

What’s that? He deserves it as President?

It is all the good stuff that comes with the Highest Office in the land. OK. The problem for the rest of us in this episode is about the medical problems for the rest of us.

Better means worse – let’s call it the medical and drug problem. In this episode it is all part of one mega-business that is out of control in America.

What’s that? what about Obamacare?  Obamacare is indeed for the health care mega industry not so much for you and me.

Let’s take a look at drug prices in America. By far they are the highest in the world. Virtually any medicine that exists costs an individual less in Europe. Often far less! And the drug companies still makes a profit;  just not the megs-profits they make on the same drugs in the United States.

But how can that be? It is very, very simple. All the countries in Western Europe as well as Canada sensibly regulate what drug companies can charge for their products but no such controls in America either before Obama or during the Obama years.

Let me turn to one of my frequent partners The New York Times for some detail. This article titled: “Drug Makers Sidestep Barriers On Pricing.”

Let’s take a look at the article from October 30, 2015 ……

“The pain reliever Duexis is a combination of two old drugs, the generic equivalents of Motrin and Pepcid. If prescribed separately, the two drugs together would cost no more than $20 or $40 a month. By contrast, Duexis, which contains both in a single pill, costs about $1,500 a month.”

Did you get that?
Two simple drugs that would cost just $20-$40 a month for a user now are being effectively sold together under another name for $1,500 a month.

So you say well who is possibly going to pay $1,500 for Duexis????

Read this …

“Needless to say, many insurers do not want to pay for Duexis. Yet sales of the drug are growing rapidly, in large part because its manufacturer, Horizon Pharma, has figured out a way to circumvent efforts of insurers and pharmacists to switch patients to the generic components, or even to the over-the-counter versions.”

That’s right … The system is set up in the U.S. so this drug company can get away with it. As the Times explains …

“Instead of sending their patients to the drugstore with a prescription, doctors are urged by Horizon to submit prescriptions directly to a mail-order specialty pharmacy affiliated with the drug company. The pharmacy mails the drug to the patient and deals with the insurance companies, relieving the doctor of the reimbursement hassle that might otherwise discourage them from prescribing such an expensive drug.”

That’s right, this drug company and willing doctors their co-conspirators, are screwing all the rest of us legally. I say legally because there is no mechanism in the U.S. to prevent or stop this kind of blatant fraud. Please don’t be naive and think this is some kind of very unusual abuse by the medical and drug industries in the United States. Far from it.

“Horizon is not alone. Use of specialty pharmacies seems to have become a new way of trying to keep the health system paying for high-priced drugs. Valeant Pharmaceuticals Int’l, which has attracted government and media scrutiny for its huge price increases, does much the same thing for its dermatology products with a pharmacy called Philidor Rx Services,” continues The Times.

Again …

“Use of specialty pharmacies seems to have become a new way of trying to keep the health system paying for high-priced drugs.” In other words this is a very profitable marketing strategy that is just going to grow and grow as a very popular way  to screw the rest of us.

In return for some supposed convenience for doctors and patients, these companies are charging exorbitant prices for drugs and since insured Americans don’t pay the $1,500 for the drug directly they don’t care. The doctors don’t care obviously and insurance companies don’t complain loudly because they just raise their rates. Then there is the fact many of the patients are enrolled in Medicare or Medicaid and so the government pays the outrageous cost. Everyone wins. Free money!

Here is the real deal – in a normal system this kind of abuse would not be tolerated. Instead in the U.S. it is for all practical purposes encouraged.

The bigger problem is that this is only one small example of what is going on here in the U.S. that is far worse than elsewhere. Yet President Obama tells us medical care is one of his great achievements.

Where is the outrage President Obama? Instead we get silence.
Now here is a different take on the same situation and here Obama is not silent but rather he is taking action to make the problems of abuse worse in the medical system which wastes hundreds of billions $$ each year ..

President Obama is making the system worse by reducing audits!

This time I will turn to The Wall Street Journal …

Their article titled “Medicare Cuts Back Work of Auditors Probing Improper Payments to Hospitals”

Believe it or not! Thanks President Obama.

The subtitle of the article … “Federal program reduces work of auditors that seek to recoup money for the government.”

The article from October 30, 2015 begins …

“The federal Medicare agency is sharply cutting back the work of auditors that review hospital claims and seek to recoup improper payments for the government, according to a letter reviewed by The Wall Street Journal.”

“Starting in January, the auditors will be able to review only 0.5% of the claims the agency pays to each hospital or provider every 45 days, according to an Oct. 28 letter to the contractors. That is a quarter of the prior threshold: 2% of claims.”

That right the measly 2% of claims submitted by hospitals and other providers is now being reduced to ½ of 1% by Obama. What does auditing just 1 out of every 200 claims for hundreds of billions of dollars in claims every year mean it is an INVITATION to steal …….

…… some hospitals and providers by simply inflating their claims “innocently” and for others the opportunity to STEAL millions upon millions of $$ with virtually no change of ever being caught. In fact if you are NOT one of 200 claims that gets audited by the overworked and underfunding audit department you will never get caught.  Take your big check!

Sorry I did not have time to get to all the flaws surfacing in Obamacare as the rates everyone is paying are experiencing large increases. More later!

For now thank you President Obama for “fixing” our medical system.

About The Writer: Arthur Piccolo is a professional writer and commentator and often writes about Latin America for New Americas.

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