Why Is Health Care In America So Fucked Up?

Rambo

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https://www.insurancejournal.com/news/national/2018/10/08/503575.htm

Employees’ Share of Health Costs Continues Rising Faster Than Wages
October 8, 2018 by John Tozzi
Annual family premiums for employer-sponsored health insurance rose five percent to an average $19,616 this year, extending a seven-year run of moderate increases.The average single deductible now stands at $1,573 for those workers who have one, similar to last year’s $1,505 average. On average, workers this year are contributing $5,547 toward the cost of family coverage, with employers paying the rest.
Those findings are from the 2018 benchmark Kaiser Family Foundation Employer Health Benefits Survey. About 152 million Americans rely on employer-sponsored coverage.

Annual premiums for single coverage increased three percent to $6,896 this year, with workers contributing an average of $1,186 according to the same survey.
This year’s premium increases are comparable to the rise in workers’ wages (2.6%) and inflation (2.5%) during the same period. Over time, the increases continue to outpace wages and inflation. Since 2008, average family premiums have increased 55 percent, twice as fast as workers’ earnings (26%) and three times as fast as inflation (17%).
Deductibles paid by workers continue to climb over time in two ways: a growing share of covered workers face a general annual deductible, and the average deductible is rising for those who face one.
“Health costs don’t rise in a vacuum. As long as out-of-pocket costs for deductibles, drugs, surprise bills and more continue to outpace wage growth, people will be frustrated by their medical bills and see health costs as huge pocketbook and political issues,” KFF President and CEO Drew Altman said.

Currently 85 percent of covered workers have a deductible in their plan, up from 81 percent last year and 59 percent a decade ago. The average single deductible now stands at $1,573 for those workers who have one, similar to last year’s $1,505 average but up sharply from $735 in 2008. These two trends result in a 212 percent total increase in the burden of deductibles across all covered workers.
Looked at another way, a quarter (26%) of all covered workers are now in plans with a deductible of at least $2,000, up from 22 percent last year and 15 percent five years ago. Among covered workers at small firms (fewer than 200 workers), 42 percent face a deductible of at least $2,000.
“Deductibles of $2,000 or more are increasingly common in employer plans, which means the bills can pile up quickly for workers who require significant medical care,” said study lead author Gary Claxton, a KFF vice president and director of the Health Care Marketplace Project.
Employers Offering
The survey finds 57 percent of employers offer health benefits, similar to the share last year (53%) and five years ago (57%). Employers that do not offer health benefits to any workers tend to be small, and nearly half (47%) cite cost as the main reason they do not offer health benefits.
Some employers that offer health benefits provide financial incentives to workers who don’t enroll –either for enrolling in a spouse’s plan (13%) or otherwise opting out of their employer plan (16%).
The survey also probes employers’ expectations about how the 2017 tax law, which eliminated the Affordable Care Act’s tax penalty for people who do not have health insurance, would affect enrollment in employer coverage in future years. Overall 10 percent of all offering firms – and 24 percent of large ones – expect fewer workers and dependents to enroll because of the elimination of the tax penalty.
Among large firms that offer health benefits, one in five (21%) report they collect some information from workers’ mobile apps or wearable devices such as a FitBit or Apple Watch as part of their wellness or health promotion programs. That’s up from 14 percent last year.
Most large offering employers (70%) provide workers with opportunities to complete health risk assessments, which are questionnaires about enrollees’ medical history, health status, and lifestyle, or biometric screenings, which are health examinations conducted by a medical professional, or both. Thirty-eight percent of large offering firms provide incentives for workers to participate in these programs. The maximum financial incentives for these and other wellness programs often total $500 or more.
Other survey findings include:
  • High-deductible health plans with savings option. The survey finds 29 percent of firms that offer health benefits offer a high-deductible health plan with a savings option – a plan that either can work with a Health Savings Account or is linked to an employer-created Health Reimbursement Arrangement. Most (61%) of those firms offer only this type of plan to at least some of their workers. Overall, 29 percent of covered workers are enrolled in such plans.
  • Telemedicine. About three quarters (74%) of large offering firms (at least 200 workers) cover services provided through telemedicine, such as video chat and remote monitoring, which allow a patient to get care from a provider at a remote location. That’s up from 63 percent last year and 27% in 2015. A separate analysis also released today suggests very few workers are using telemedicine services in place of traditional in-person physicians visits, as less than 1 percent of all enrollees in large employer health plans used any telemedicine services in 2016.
  • Retail health clinics. Similarly, three quarters (76%) of large offering firms cover services received in retail clinics, such as those located in pharmacies, supermarkets and other retail stores. A small share also provide financial incentives for workers to use these clinics.
The annual survey was conducted between January and July of 2018 and included 4,070 randomly selected, non-federal public and private firms with three or more employees (including 2,160 that responded to the full survey and 1,910 others that responded to a single question about offering coverage)
Source: Kaiser Family Foundation
 

Rambo

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https://www.amjmed.com/article/S0002-9343(18)30509-6/fulltext



Results
Across 9.5 million estimated new diagnoses of cancer from 2000–2012, individuals averaged 68.6±9.4 years with slight majorities being married (54.7%), not retired (51.1%), and Medicare beneficiaries (56.6%). At year+2, 42.4% depleted their entire life's assets, with higher adjusted odds associated with worsening cancer, requirement of continued treatment, demographic and socioeconomic factors (ie, female, Medicaid, uninsured, retired, increasing age, income, and household size), and clinical characteristics (ie, current smoker, worse self-reported health, hypertension, diabetes, lung disease) (P<.05); average losses were $92,098. At year+4, financial insolvency extended to 38.2%, with several consistent socioeconomic, cancer-related, and clinical characteristics remaining significant predictors of complete asset depletion.
 

Rambo

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Drug Prices Just Keep Going Up

Happy New Year! Your meds might cost more this year, starting yesterday. According to the Wall Street Journal, pharmaceutical companies are raising the prices of “hundreds” of drugs, with an average increase of 6.3 percent.

While drug companies didn’t raise prices by as much as in previous years—in 2014, drug prices increased by 13 percent—the price of some drugs rose significantly. Allergan, the company that makes Botox, raised the prices of “more than half of its portfolio,” according to the paper, with 27 prices raised by 9.5 percent. That might sound low, but a 2017 Bloomberg piecelaid out how Allergan’s actions work to increase drug prices across the board: Through shady deals and gaming the patent system.


These games are how AbbVie’s Humira, which is used to treat inflammatory conditions such as rheumatoid arthritis and Crohn’s disease and is the world’s best-selling drug, can continue to be sold for $60,000 a year in the U.S. while Britain’s National Health Service gets to strike a deal to pay $384 million less per year for the new biosimilar (generic) version, available in the EU and Britain but not here.

Allergan, meanwhile, transferred the patent for its eye drug Restasis last year to a Native American tribe to protect its exclusivity:

Under the deal, which involves the dry-eye drug Restasis, Allergan will pay the tribe $13.75 million. In exchange, the tribe will claim sovereign immunity as grounds to dismiss a patent challenge through a unit of the United States Patent and Trademark Office. The tribe will lease the patents back to Allergan, and will receive $15 million in annual royalties as long as the patents remain valid.
Yet in 2016, Allergan’s CEO boasted that it would “keep [drug price] increases under 10% as part of a ‘social contract’ with patients,” according to the Journal. Does that social contract include legal trickery to keep an exclusive patent and prevent cheaper generics from reaching the market? Apparently so!

The Journal noted that many of this year’s price increases are “relatively modest this year, amid growing public and political pressure on the industry over prices.” It’s true that the pharmaceutical industry had perhaps its worst year ever in Washington; a major piece by Stat today outlined how PhRMA, the industry’s absurdly well-funded lobbying group, actually lost a major battle for the first time in 2018. (No wonder, then, that PhRMA was so desperate to reach Washington power-players with sponsorships of Politico’s health newsletter.)

But the fact remains that any price increases are evidence that the pharmaceutical industry isn’t being regulated properly; that millions of Americans who are already struggling to pay for drugs will find themselves worse off this year; and that boy, our standards are low. Increasing drug prices by a few percent—when drug prices are already absurd, unaffordable, and the highest in the world—is not good news.


*bolding mine. i had to use restasis once. thank christ i had insurance. at the time it was $3000 out of pocket for a month's supply. i somehow only paid $100 for a month.
 

fxh

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Why are Americans, both as patients and taxpayers, paying billions of dollars for a drug whose efficacy is so questionable that it's not approved in the European Union, Australia or New Zealand? Restasis, a blockbuster drug sold by Allergan to treat chronic dry eye, has done $8.8 billion in U.S. sales between 2009 and 2015, including over $2.9 billion in public monies through Medicare Part D. Restasis and Allergan have been in the news lately due to the company's novel legal strategy of transferring their patents on the drug to the Saint Regis Mohawk Tribe in order to stave off competition posed by generic drugs.
 
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