08-30-2016, 06:54 AM
Quote: We're still primarily private insured, and HMOs strongly encourage generics.
It's not quite a clear cut as that, a few different elements-
http://www.cnsnews.com/news/article/medi...or-workers
http://www.nbcnews.com/storyline/va-hosp...it-n101771
Combine Medicare, Medicaid, federal payroll and VA and we are looking at ~140 Million people who get their health care from the government.
So what we end up with is roughly half of the US populace is getting their health care under one set of criteria, where as those of us in the private sector have thousands of different sets. You and I could both have say, Blue Cross/Blue Shield and even pay the same premiums and have wildly different coverage. Maybe your plan is better than mine on say prescriptions, while mine may be better than yours on say ambulance services. Totally arbitrary but you get the point I am making. Looking at it from a straight business perspective, roughly half of all possible purchases are going to be one particular item while the other half are a hodge podge of various alternatives- if you own a pharmacy, which one are you going to keep on hand? These things have a shelf life, and inventory is sunk capital.
Another factor we have to look at is, in a general sense, mutual funds. If you have a fund that holds say $700 million in BlueCross/BlueShield, and they own $200 million in Mylan- from on overall bottom line perspective it is best to put pressure on them to only pay for the name brand, take that in conjunction with the US only paying for the same and you, in essence, dictate what everyone else must buy. This isn't precisely or necessarily an evil scheme hatched by mutual fund managers, just trying to illustrate how these things happen and to be fair, the fund managers *are* looking out for their customers best interests in such practices.
That brings us to another factor. Quick anecdote- my company swapped plans at the beginning of this year. We went to pick up a prescription for my kid and it was a $450 copay. It got interesting when I asked how much it was *without* insurance- $250. That isn't a joke(ended up being an error on the insurance companies part, I was refunded all but $10, my normal copay). So, I had to research this practice- turns out that large insurance companies buy into quantities of products not unlike the commodities market. They will negotiate and settle on a price for long term which gives them some level of financial stability, at a potential cost of reduced costs with market fluctuations. Mylan pulling a stunt like they are with Epipen could simply be them trying to leverage people into these sorts of long term commitments giving them a reasonable floor for revenue they can plan on.
Quote:So Ben, will you be joining me in Switzerland when the people here decide we're evil incarnate for wanting a good lifestyle?
Heh, you joke but where I live they have the 'Free State Project', pretty much a militia in the thousands that aren't far off from what Dave is talking about. Honestly, for the most part they seem to like me, they know exactly where I stand, they are a different branch of Libertarian thought than I am, but we are a *lot* closer then the mainstream for sure. Will anything ever come of them? Profoundly unlikely, at least in a revolutionary sense. These are people that have packed up from all over the country to move here and basically try to make sure that the voting block for traditional US values remains somewhere.
Quote:I did mention corporate greed and I did point out the undue influence of the Senatorial father....
Yes, but this 'attack' on the populace was done by the left wing for left wing purposes- this wasn't right wing nut job capitalists.
Quote:I appreciate generics–what I'm saying is that generics are going to be targeted for elimination by corporatism, and that this is a bad thing.
Their lawyers will try, but ultimately clearer heads will prevail. Push the pricing too far out of line for too long of a period of time and the regulatory powers that be will offer them up as a sacrificial lamb in a heartbeat to protect their positions.