Let me start by asking you:
Can we trust incumbent
Clay Shaw’s to have impartiality on behalf of elders?
Can Congressman Shaw support the best prescription-drug plan for seniors?
We know he has voted for
pharmaceutical-industry backed drug plans, and has benefited handsomely from GOP
fundraisings often sponsored by the PhRMA (Pharmaceutical Research and Manufacturers of
are among the major donors in the GOP's fundraising events!
ponder about: Why is that the case?
Clay Shaw is the most
senior Republican in the House Ways and Means Committee (which devised the
Republican version of the prescription-drug plan, although the main
architect was not Shaw, but Chairman Bill Thomas, a Republican from
Republican, nor the Democratic “prescription drug plan” goes far
enough to make it affordable to all seniors.
In my view both plans are not adequate . Although seniors might be
the group with the most voting clout, and there are 10.3
million seniors who do not have any drug plan- let’s
not forget that in America we also have working poor, and a financially
stretched out middle class!. There are 70
million Americans today not covered by any prescription drug plans!
Medicare protects only seniors (about 40 million
people). Medicaid covers the medical needs of those under the
poverty line, as well as the disabled, (about 36 million in total).
Federal and States share the Medicaid expense in a 50/50 basis.
should be in America a UNIVERSAL coverage of “needed” prescription drugs for ALL people,
including middle class, the poor, and the legal immigrants. And we should have more compassion for those illegal aliens
who are –tacitly- allowed to work in our land, without much Government
effort on expelling them; yet their health care –as well as their
children medical needs- is in limbo.
The previous paragraph (2) could imply a raising of the cost of the
drug plan to an exorbitant level that might not be affordable.
To palliate that real possibility from happening, we
need to put some limits on coverage of drugs.
Especially those that are too expensive and yet that have
been proven wasteful, or not effective. This is quite similar to what PBMs (Pharmacy
Benefit Managers, such as AdvancePCS, Merck-Medco and others) do these
days with the administration of drug co-payments.
They do this “co-payment management” to make drugs
cost-effective the the benefit plans of many corporations.
Fancy, non-proven drugs, have high co-pay.
Needed, effective drugs, have lower co-pay.
These PBMs manage drug benefits for 170 million people, and process
70% of all prescriptions filled in the USA.
A leukemia drug can cost $28,000 per year per patient (Gleevec).
A colon-cancer treatment can cost more than $60,000 per year per
patient (Camptosar). A
coronary bypass may cost $45,000 to Medicare.
Sometimes for that price you get to extend -for a year or
two- the life of an octogenarian who is going through a miserable time
anyway, and who -if legally possible in the US- would opt to end his/hers
life’s penuries (ask Dr. Kevorkian, he met quite a few of the
unfortunate individuals until he was stopped by the religious right).
At the same time, millions of children -with many years of
productive life ahead of them- do not receive proper medical care.
And mothers are discouraged from having children, because they can hardly
afford the proper preventive care during their pregnancies and follow ups. Or are
unable to finance the cost of giving birth in a good hospital, plus the
expenses that might follow delivery's complications. I ask, is our public policy sensible
to the needs of working Americans, young mothers, and their children who
go without basic medicines, or without preventive medical care that costs
only a few hundred dollars a year? I
hope there will be enough funds in our national budget to take care of every
need, real and unreal. But,
if the time comes to make hard choices, I just
hope we stop playing politics and we put our civil and democratic
priorities in the proper order. We also need to put an extra effort
in separating Church and State, these bodies are too much
new mission for the FDA (Federal Drug Administration), and for the NIH (National Institutes of
CONTROL. This is not
too different to the limits placed on the coverage of “health flex”
plans, that the Florida Congress would like to see implemented, so as to
cover many more thousands of those currently uninsured Floridians. Or to the price controls that have been always the trademark
of European healthcare systems.
I do not like “premiums” ($35 proposed by the
Republicans, $25 by the Democrats).
Under my plan, which is sketched on this page, there are no premiums
to be paid by anybody.
Therefore, regardless of income, no family will pay drug-plan
premiums. Again, it
sounds good, but is this sensible? My
reason against premiums, is based on:
Low-income families who are enjoying good health may be
pressed to use their limited family budgets for other “urgent”
necessities, instead of making the monthly payment due to the drug plan
(premium). That will make them ineligible when the real need comes.
Waiving the premium for low-income families, and still require the
middle-class to make payments would be unfair.
Because, although they earn higher wages, they might be as cash
poor as the low-income class.
High income earners would be free to complement the basic
coverage with a premium of their own with private insurers, to have more
adequate coverage for their needs. Even
to the point of receiving a voucher for the cost of
“basic generic-brand drugs” that the Government would normally cover,
so they can use it to buy more expensive “designer” drugs, if they
would like to do so.
major difference between the plan –I am suggesting- with the Republican
and Democratic plans are not just the extension of coverage beyond the
senior group (it is truly Universal), and the lack of monthly premiums
(which can be a trap that could make many families ineligible), but the amount that is deductible.
True, there is no deductible in the Democratic Plan. And the deductible
is only $250 in the Republican plan. But they leave many Americans
In my plan the deductibles are a lot higher, but -remember- drugs will
cost a lot less because the Government will buy them in volume, and then
there is a subsidy of 50%, 75%, or even 100% (depending on income level
-see below) and it would cover ALL of us. To be affordable we must
have a higher deductible.
Under the Republican plan there is a $250 deductible.
After having covered the deductible at full cost of drugs (no
subsidy), the cost of the drugs to the
seniors is 20% from the deductible amount up to $1,000 of disbursements; then 50% up to
$2,000; and (no help form uncle Sam) full 100% beyond $2,000.
If their drug expenses for that year reach $3,800, then Medicare
will take over and cover 100% over $3,800.
CONFUSING AND TERRIBLY INADEQUATE!
Under the Democratic plan -proposed by Florida Senator Bob Graham-
there is no deductible.
But there is a co-payment of $10 in generic drugs, and
$40 in brand name ones. Only
after they have spent more than $4,000 is that the co-payment is
eliminated. MUCH BETTER
THAN THE REPUBLICAN PLAN, BUT ONLY COVERS SENIORS, NOT THE GENERAL
POPULATION. Furthermore, chronically sick people may end up paying
near the $4,000 a year out of their pockets (based on 8 brand-name
medicines bought per month). Yet, I salute the talent of the
Democratic Senator, and his humane intentions.
My plan -I believe- is more sensible, and it should be
affordable. It is:
all, citizens and legal U.S. residents.
also means that it would save $154 billion per year to Corporations.
They would not need to cover their employees prescription-drug needs, whom would be
under the Government's Universal plan umbrella.
would not be able to deduct the cost of drug insurance, as they do
now, which means the Government will receive $14 billion more in
tax revenues per year.
It requires no
deductible is relative to the "poverty level" of the family
(please see below table with the HHS Poverty Level Guidelines).
drugs are subsidized by the Government until the deductible is met.
the deductible is met a $10 co-payment kicks in
(regardless of generic or brand name).
Government will stockpile the drugs. They would only
provide generics, unless that there is no alternative drug
available for that ailment, in which case the brand name drug will be
offered for just the same $10 co-payment. The Government may
not carry in stock, nor make available some ludicrously priced drugs.
The co-payment will never
be eliminated, That would also help control costs, yet
it is only $10.
Families below the poverty line:
To prevent abuse, they still have to
provide the co-payment.
Families between poverty level
the poverty level: (Note- For
the typical American family with 3 or 4 members, the poverty line is about
$15,000 of yearly income. The
term “Twice the poverty line”- would be $30,000 for that same
per individual ($2,000 for family)
only ¼ (25%) until the deductible is satisfied.
After deductible, the $10 co-pay kicks
Higher level income:
per individual ($5,000 for family)
until the deductible is satisfied.
After deductible, $10 co-pay kicks in.
Another interesting aspect of my plan is that the
US Government is the “insurer”, and no the private insurance
does not mean that I believe that federal employees can do the buying of
drugs more effectively than private companies.
What it means is that the Government could buy and stockpile
huge orders of drugs, making it possible for drug companies to reduce
manufacturing costs, and consequently they could offer such a
“mammoth wholesaler” incredibly low prices. No other organization would be
able to do this in the same order of magnitude.
I would not mind having private organizations –working under good
Government standards and controls- doing the transactions with the drug
companies and deciding the “out sourcing” when analyzing the
availability of drugs.
You could also order the drugs online, or go to your usual drugstore (Walgreen's
and Eckert would have delivery arrangements with the federal agencies
controlling the stocks. Because we would need an Agency
within the FDA (Federal Drug Administration) or the NIH (National
Institutes of Health) to be
the final approvers or drugs, especially when acquired in massive
than anybody else the efficacy of drugs (so we do not pay with tax dollars
for brand name “hype”). In
2001 we spent more than $170 billion in medicines (17% more than in 2000).
Just 10 brand-name drugs accounted for $32 billion.
The cost of brand name drugs average $70, while generics
Can estimate the amount that should be stockpiled for the
current year needs, and for future needs.
They are doing a good job with vaccines, after the 9/11 events.
Large orders mean less cost. Remember,
Bayer used to price Cipro (anti-Anthrax drug) at $5
per tablet. The Government was able to get the drugs from them for
just $0.95 per tablet (an 81% discount).
A final thought.-
THE REAL PROBLEM WITH PRESCRIPTION DRUGS.
Prescription drugs have always side effects.
You do not even have to exceed the recommended drug dosages to
develop some unforeseen problems in other parts of your organism, years
down the road. No matter
what the guarantees are, and who gives them, I have always been one of
those skeptics who only would take a prescription drug when a “real”
need exists. And I mean REAL
... like almost NEVER!
I have never taken pills
foolishly, not even vitamin supplements.
My medicine cabinet is empty.
Moreover, I do not think that I have taken more than 30 aspirins in
my whole life. Maybe that
explains why I have not been in a Doctor’s office in three decades
(other than Dental). And the
last time I went to the Doctor (1982) it was because of a compulsory
medical exam required by an employer-to-be.
Pressured by my wife, one of these days I am going to start with
prudent yearly medical checkups, to prevent the malign onset of
potentially serious health problems.
Colon rectal checkups though, are out of the question, only on my dead
Bio-Chemistry, Biology and
Genetics have been my preferred elective courses while in College, and my
Engineering academic transcripts would show I am not an uneducated in
these fields of knowledge. For
ten years I developed software for farmers, and tried to learn as much as
I could in animal sciences. Having worked for two decades developing
complex software, I truly believe that “code patches” -as we call
them- can often be more damaging than beneficial to the performance of a
computer program. This despite the fact that at first look the patch would seem
to “optimize” the code.
To understand my analogy, please look at the human body as a
complex biochemical mechanism, which controls thousands and thousand of
proteins in a delicate metabolic balance.
Not too different in concept to a tricky computer code with
thousands of executable statements.
It is truly lucky –in my view- to be able to synthesize a drug
that only has positive effects in our overall metabolism.
Aspirin might be one such wonder drug, time will tell!
Yet, time and time again, experience has shown that most drugs
always have pernicious effects in our body -at
least to some degree.
Sometimes that realization comes a few months after having
“fixed” the original problem that caused the prescription drug to be
written, sometimes it is years or decades later that we find out.
Moreover, there is that huge "gray area", where we do not
know until we discover any correlation -if ever- on how pernicious the effects
of some drugs might be.
I do not want to be an
alarmist. But the point is, I am concerned with the abuse and the high level of
drugs being prescribed these days -for little reason or for no
reason. Doctors might do it just to get rid of an obstinate
psychosomatic patient, or to justify the expensive visit the client did to
his/her office. Just imagine my preoccupation if these drugs were
to become totally free. Unquestionably,
Doctors will be in a lot of pressure to write more prescriptions.
need to -urgently- establish listings of medical drugs: the ones REALLY
NEEDED, and those other ones that are only needed in the minds of some
Changing now the subject a
little bit. Have
you notice that any pharmacy in Mexico or Latin America can sell drugs
made in America, cheaper than Walgreen's or Eckerd?
You can even buy on the
internet Canadian drugs at about half the U.S. price ( www.TheCanadianDrugstore.com
Telephone company Verizon
spends $500 million a year in prescription drugs (used by they 380,000
workers and retirees). Interestingly,
about $50 million of those millions are spent on cholesterol-lowering
drugs (such as Zocor or Lipitor, both made by Pfizer).
I wonder how much goes in Viagra and other “lifestyle
also becoming a nation of overweight people.
individuals represent today a whopping 27% of the American population.
Obesity is the root of many physical problems, such as high-blood
pressure, diabetes, arthritis in the heaps, and many other ailments.
It causes low self-esteem and depression, and it is also the "secret
reason" (or not so secret) for many divorces. No wonder we
have the highest rate of divorce in the western world. This
brings more problems, broken families have a higher probability of going
under the poverty level, and kids from broken homes often need
Of course, there are many other reasons for the
breaking of a marriage, but studies indicate that most spouses perceive a
companion as "less attractive" when this person is overweight,
and consequently their bonding and the quality of their love life suffers.
Are these drugs really needed, or could we change eating
habits, working habits, and exercise more instead?
Trade magazines indicate
that tens of millions of people in America are taking psychiatric drugs
and painkillers, I am sure that a large portion of those needed drugs is
just psychosomatic. What a
waste of money!
REMEMBER: “For every dollar the country spends on prescription
drugs, it spends another dollar correcting the medical problems caused by
those same drugs” (Business Week, 12/10/2001, page 110).
The article continues, “Doctors
at hospitals are prescribing the wrong drugs to many, and too many drugs
to others. Harmful side
effects and drug interactions cost $150 billion each year to cure, enough
to pay for a Medicare drug benefit”.
We should substitute
pill gobbling with exercise and good eating habits.
That will reduce the number of cases of diabetes, heart disease,
anxiety and other ludicrous pains.
My final statement:
watchful on those people who make a living lobbying physicians, so the
doctors would prescribe “highly profitable” drugs to patients.
Because, despite the high-price of those drugs, the FDA
has shown time and time again that these pills are as good to the body as
HHS Poverty Guidelines
States and D.C.
When clicking a button takes you to my other political
website ("progress of campaign" at www.Xuna.com
, please remember to come back to www.Gr8St8.com
by clicking the "page back" button of your browser. Thanks!
In another web page, I already mentioned that technology
can be a sward of two edges, in particular "information"
technology. With a few clicks of your mouse or keyboard you
can obtain from the Internet a wealth of information on about anything.
That brings us tremendous benefits, and yet it will bring misery to many
others, unless effective federal action is taken.
Health care providers and insurers -currently- are able
to obtain lists with the prescription medicines you have been buying.
Some employers -who might have been already discriminating people by age
(supposedly to mitigate the high cost of their employee's benefits, such
as health insurance, which tends to go up with employee's age)- now they
have another tool to scrutinize candidates to jobs.
For a small fee they can get health reports from
companies such as Equifax and Experian. Yeap! the credit agencies.
According to Business Week (11/19/2001), they can provide lists of
ailments, anything from Alzheimer's to yeast infections. On April
14, 2003, new federal legislation will be in place to protect further your
medical privacy, but that might not be enough.
Make sure the
person you vote for has the courage to be a watchdog!