Taxpayers footing the bill
I watched this on my local news the other night: Runaway drug price hikes squeeze Washington’s budget.
Our state is one that expanded Medicaid under the Affordable Care Act (ACA), so I knew we were spending a lot. But I had no idea now much. Through the first 9 months of 2016, my state has spent $1.1 billion on prescription drugs.
Not total medical care. Just prescription drugs.
And Washington is not the only state facing a fiscal nightmare because of skyrocketing drug costs.
Almost half of that spending is for the really high-priced specialty … Continue reading
My goal for 2017? Use as little healthcare as possible
How will healthcare change under a new president and political party?
That’s a question I can’t answer. As I wrote in my last post, both candidates had multiple-point plans to tweak/improve/repeal/replace the Affordable Care Act, aka the ACA or Obamacare.
But I don’t know what will change or when.
What I know for sure is that for 2017 my premiums will be 20% more expensive, my co-insurance and co-pays will be higher, and my current primary care doctor will no longer be in-network.
I can and will shop around … Continue reading
The shrinking drug formulary
Insurance companies have several ways to cut their costs.
We are all familiar with higher premiums, higher co-pays, increased deductibles, and narrower provider networks. These will all be apparent when we look at our policies for 2017.
A lesser-known strategy is to remove high-cost drugs from the drug formulary—the list of medications that insurance will cover.
Insurance companies typically work with a pharmacy benefits manager, or PBM, which acts as the middleman to negotiate drug prices with drugmakers.
Exploding drug costs
The Affordable Care Act made it mandatory that health insurance plans offer prescription drug … Continue reading
Prevnar 13: As seen on TV
I was watching TV the other evening and, as usual, was forced to sit through multiple back-to-back prescription drug commercials.
One that caught my attention was for Prevnar 13, which is one of the pneumonia vaccines. (13 because it protects against 13 strains of streptococcus pneumonia.)
The commercial stated Prevnar 13 was for adults aged 50 and older.
That statement’s true, but needs some clarification.
Yes, Pfizer did get FDA approval a few years ago to market Prevnar 13 to adults over the age of 50. Previously, the vaccine was only used for … Continue reading
Many years ago I had a primary care doctor who used to perform a total body skin examination (TBSE) on me every year as part of my annual exam.
Of course, those all-inclusive physicals are a thing of the past. I haven’t had a physician perform a TBSE for a long time.
I often wondered about that. A TBSE seems like a relatively easy and harmless way to quickly screen for skin cancer. The goal, of course, is to find a melanoma, the deadly skin cancer, when it’s small and possibly curable.
But the go-to source for screening … Continue reading
They say a picture is worth a thousand words, and the online news site Vox recently sought to open Americans’ eyes as to how much more we pay for healthcare compared to other countries.
America’s healthcare prices are out of control. These 11 charts prove it.
I can’t copy their charts, but basically they are bar graphs. The bar that shows how much patients in the US pay for similar drugs and services towers over the others like a skyscraper over a neighborhood of single-family homes. Like this:
Vox got its information from the International Federation of Health Plans (IFHP)… Continue reading
EpiPens – lifesaving but costly
I’m allergic to bee stings, so I keep an EpiPen handy when I’m working out in my garden this time of year.
But my EpiPens are more than 3 years old now, and it’s time to invest in a new set.
Why do I say invest? Because EpiPens are incredibly expensive!
Related post: First aid for bee stings
I didn’t know that three years ago when I bought them. At that time, my health insurance did not include coverage for prescription medications (all ACA-compliant plans must now), so I paid the full price out of … Continue reading
Up, up and away!
Does anyone’s income go up as fast as their health insurance premium? I wish.
11.6%. That’s how much more my current health insurance provider wants to charge for my bronze high-deductible health plan in 2017.
And although 11.6% seems like a lot to me, another company in my state is requesting a 19.9% average increase on all its plans, with a 28% increase on its gold plan!
So far, the rate increases that have been made public in other states are all pretty high, averaging well into the double digits. So at least I’m not … Continue reading
Time is money
Maybe you have affordable health insurance and a doctor you like.
But have you ever had the experience of calling for an appointment for a sore throat, a bladder infection, back pain, or some other minor ailment and being told that the doctor’s next available appointment is in six weeks?
Or you get a same-day appointment, but then have to take time off work, drive to the clinic, perhaps pay for parking, and then wait to be seen by the doctor. For a five-minute appointment.
It’s frustrating, sure, but it’s also costly when you consider the time … Continue reading
I just read about health insurance giant UnitedHealth’s bold but risky new insurance plan, Harken Health:
UnitedHealthcare is betting $65 million that it can profit by making primary care more attractive.
With little fanfare, the nation’s largest health insurer launched an independent subsidiary in January that offers unlimited free doctor visits and 24/7 access by phone. Every member gets a personal health coach to nudge them toward their goals, such as losing weight or exercising more. Mental health counseling is also provided, as are yoga, cooking and acupuncture classes.
At this time, Harken Health is only available in Chicago … Continue reading