Wednesday, April 30, 2014

Should Doctors Care About Cost?

Excellent perspectives here: Link
Dr. Shapiro in the third letter  down points out that Congress has allowed Drug Companies exorbitant pricing on their products. While Medicare and Ins. companies try to "nickel and dime" doctors, who are operating at very low profit margins as it is, drug companies can charge 2000$ a month for medications injected into patient's eyes, and medicare wants to totally eliminate paying ophthalmologists for exams when pt's get injections. If medicare decides to cut out doctor payments for 12 exams a year per patient, it still will not equal what medicare pays for one dose of an injected medicine per month, such as Lucentis. If a patient is getting one of these expensive drugs in both eyes monthly, it costs medicare 48, 000$/year. The payment to the physician is a small fraction of that amount.

In an excellent segment on 60 minutes (link here), which one congressman pointed out was the "ugliest night he had ever seen (in Congress),  it is pointed out that pharmaceutical companies paid 100 million dollars a year to lobbyists (and that was in 2007). Their lobby is bigger than defense and oil according to a recent meeting I attended last week. It is the biggest lobby in the world. 

The whole video is a definite must watch, but at ~5:20 into the video it clearly states that the Bill prohibited the Government, with its massive purchasing power, from negotiating the price of drugs with pharmaceutical companie!. It is thus  no surprise that this bill was written by the pharmaceutical industry

It is no surprise that Tom Scully, Medicare's lead negotiator on the drug bill told the chief actuary to withhold  at the congressional hearings,his revised estimates that it would cost you the tax payer, 500 billion dollars for the first ten years. At the same time he prohibited this revised estimate from being announced, he was negotiating to be a lobbyist for the pharmaceutical companies. It is no surprise that 15 of the key congressman who got the drug bill based shortly thereafter got lucrative jobs working for pharmaceutical companies, either.

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