Tuesday, October 16, 2018

Our Pill Bouncers


Americans are victims. From Doctors that prescribe addictive pain killers like candy, health care is so different from one person to another and also co-payments for prescription plans can be so dramatically different in price  even from one family to another. Who or what is responsible for this mess?  I blame it all in part on mergers of big corporations that happen daily. Recently shareholders voted on if health insurer Cigna should acquire Express Scripts for $67 billion dollars. They did and now together under one roof they are the country’s largest Pharmacy Benefit Manager or PBM. So now this merger, CVS Caremark  and Optima RX are the biggest managers in America that control about 80% of the market. As usual the average American who has to pay a co-payment for their meds are screwed and victimized by just another large corporation.
Image result for cartoon of PBMs as bouncers at a barWhat is a PBM and why would a company want to spend $67 Billion dollars to merge. Why do Americans have so little money for medications but the big medication distributor companies have $67 billion dollars to play with? Americans are victims. A PBM is like the bouncer at the bar. They are the middle man to your meds. They control who gets the meds for free and who has to pay hundreds of dollars for the same exact bottle of medication and they get paid to do it. They are the middle man in almost every transaction. PDMs process prescriptions for insurers and determine which drugs get covered by insurance, how much insurers will pay for them, how big your personal co-payment will be and they even influence which pharmacy you will use.
Like bouncers at the bar, PBMs have lists of which drugs insurance companies will or won’t cover and how much you will pay for your pills. PBMs say these lists help patients get competitive prices. But the drugs on these lists can also be good for drug companies and often leads to more prescriptions. For certain drugs, when you fill your prescription, drug companies   pay the PBM a cut called a rebate. The FDA say that these rebates keep drug prices high. The PBM’s deny that claim. The blame the high prices for our meds is on the drug makers deal because they alone set the cost. Small independent pharmacists are virtually out of business because they just can’t compete with the big guy pharmacies.
If you thought the Mafia was a racket, it is nothing compared to how Americans are being held hostage by everything having to do with our health services. It is like going to a restaurant where the prices for the food isn’t disclosed. We just don’t even know what the hell that bottle of meds really costs. Arkansas became the first state to regulate PBMs. Shouldn’t Congress get involved and pass some National law on the problem? Nope. Our bloated rich Congressmen could care less about the people they represent. They pass laws giving themselves full and completely paid benefits from doctor’s care, hospital care and paid prescriptions paid to them by the taxpayers. They literally are the Kings and we are the poor sick towns folk on the other side of the moat protection their castle life.
We need lawmakers to get rid of the entire co-payment system. We need to get rid of the Old turd richasaureses in our government.


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