Stanley Feld MD,FACP,MACE
https://www.cbsnews.com/news/trumps-medicare-rx-blueprint-has-a-tricky-wrinkle/
President Trump’s proposal for lowering drug prices to an affordable range is on target.
I have received a several requests asking me to explain the administrations plan. The “media is the message.” The traditional media has once again missed President Trump’s message completely. I suspect the traditional media has missed President Trump’s message on purpose because of their bias against the president.
The traditional media jumped on Trump’s plan as a non-plan aimed to penalize the middle class for the benefit of the pharmaceutical industry.
Either the traditional media hates Trump and his administration so much that they are against everything he does or they have not read his plan with an open mind because it has too many words in it.
It is pretty clear that Nancy Pelosi did not read President Trump’s drug plan or if she did she did not understand it. She said:
“This weak plan abandons the millions of hard-working families struggling with the crisis of surging drug prices.”
Nancy Pelosi’s statement is otter nonsense.
Her statement is reminiscent of the statement she made about Obamacare;
“You have to pass the plan in order to see what is in it.”
Any thoughtful Democrat should be ashamed that Nancy Pelosi is their leader.
I picked the coverage of only a few of the traditional media, CBS news, The New York Times and the Washington Post’s. All the progressive leaning media are really echo chambers of each other.
Each media outlet missed the Trump administrations’ point. They all are looking through their progressive lens. They believe the only plan that would work is a single party payer system controlled by the government.
They also see a tired public looking forward for the government to take over the complicated issue of healthcare. They have not interest is looking at the unintended consequences of a government takeover of the healthcare system.
A single party payer system will not work because public dependence on bureaucrats and politicians has never worked.
Simple examples are the VA Healthcare System and Medicaid. Government controlled health plans such as the VA system became too inefficient, costly, corrupt and unsustainable. The quality of care decreased and consumer choice and input has been eliminated.
People would never know what President Trump’s drug plan is all about it if they just read about it in the traditional media. If they made it easier for themselves and just read the headlines, as some of my friends have, they would know nothing about Trump’s drug plan.
One must listen carefully and read the source material.
This is the official outline document of the steps that need to be taken to fix the broken drug plan system.
CBS new got it wrong right off the bat.
http://www.cbsnews.com/trumps-medicine-rx-bluprint-has-a-trickly-wrinkle/
"The Trump administration's "Blueprint" to lower drug prices and reduce patient costs made one thing clear: The government will not directly negotiate with drug companies to secure lower prescription prices. But that doesn't mean it isn't proposing changes that would dramatically alter the way Medicare pays for some of the most expensive drugs, and in the process, potentially raise out-of-pocket costs for some of the country's sickest patients."
CBS News then brings up an issue that part of President Trump’s solution. The news agency criticizes the administration before it knows the administration’s solution.
A cornerstone of the Trump plan calls for all Medicare drug payments to be consolidated under Medicare Part D, the prescription drug plan for Medicare enrollees administered by private insurers. Under Part D, insurers and middlemen known as pharmacy benefit managers (PBMs) negotiate with drug companies for discounted prices in exchange for the drug companies' products being included in the PBMs' list of covered drugs.
But drugs intravenously administered in physicians' offices, such as chemotherapy and vaccines, are usually covered as a medical treatment under Medicare Part B. Physicians buy these drugs directly from manufacturers, and Medicare reimburses doctors for the drugs' average sales price plus 6 percent.
A perfect example is the yearly flu shot. Most flu shots are given at local pharmacies and supermarkets for Medicare patients’ convenience.
Medicare Part B pays $120 for a $15 injection dose. How is that for a colossal waste of Medicare dollars?
Pharmaceutical companies are against the idea, partly because they generally are paid more under Part B than Part D.
Alex Azar, Health and Human Services secretary and former president of the U.S. division of pharmaceutical giant Eli Lilly (LLY), has been touting the move to consolidate Medicare drug payments.
"Bringing negotiation to Part B drugs is such a potent way to bring down prices that PhRMA is already protesting the idea," Azar said in a recent speech at the American Enterprise Institute in which he referred to the drug industry trade group called Pharmacuetical Research and Manufacturers.
Nonetheless, CBS points out a potential paper tiger to leave the message that the plan is no good. The “media is the message” even if it is a lie.
“But Azar and others have shed little light on exactly how this change would take place, leaving patients worried about the potential for astronomically higher out-of-pocket costs”.
The plan is there. CBS news has not read the plan.
"Medicare Part B presently creates incentives for doctors to purchase more expensive drugs to get a higher dollar profit"
This is a negative incentive that the President promised to eliminate. Physicians to not profit from higher drug prices. In the case of the flu shots pharmacies and supermarket pharmacies administering the flu shots profit.
“Azar said; it will create incentive for insurance companies and PBMs in Medicare Part D to negotiate discounts and lower prices and pass them on to patients.”
President Trump said he promises to eliminate the extreme profit the pharmacy benefit managers take from the system.
The New York Times took a different negative slant in order to criticize Present Trump.
“President Trump has the power to sink pharmaceutical stocks with a single jab about high drug prices.”
“But in a much-anticipated speech on the topic on Friday, Mr. Trump largely avoided the issues the industry fears the most, such as allowing Medicare to directly negotiate drug prices, or allowing Americans to import drugs.”
President Trump’s plan is to force pharmacy benefit managers to negotiate the best price for Medicare and patients with private insurance in a free market system and not in a government controlled system.
The government negotiates much lower drug prices for itself in the military and VA systems. The drug companies just cost shift and charge the rest of us a higher price
“Investors noticed: Stocks of major drug companies rose after his speech, as did those of pharmacy benefit managers, or the “middlemen” that Mr. Trump said were getting “very, very rich.”
Last weekend I asked a retired friend what he thought of the Trump plan. He said President Trump is going to make the drug companies and the pharmacy benefit managers very, very, rich.
This is regurgitation of the NY Times coverage from a well-educated man. The media is the message!
Time Magazine coverage was no better. It, too, was anti-Trump. Time Magazine did not bother to understand that the Trump drug program is a free market system without cronyism.
“ President Donald Trump’s long-promised plan to bring down drug prices would mostly spare the pharmaceutical industry he previously accused of “getting away with murder.” Instead he focuses on private competition and more openness to reduce America’s prescription pain.”
Why can’t the media discuss the facts and let us decide what will work or not work? What is wrong with competition? It works. Government control doesn’t seem to work.
“The administration will pursue a raft of old and new measures intended to improve competition and transparency in the notoriously complex drug pricing system.”
“But most of the measures could take months or years to implement, and none would stop drug makers from setting sky-high initial prices.”
I believe the public is starting to see how the traditional media does not want to understand President Trump’s proposal or how President Trump is going to execute on his promises.
“Trump called his plan the “most sweeping action in history to lower the price of prescription drugs for the American people.”
“But it does not include his campaign pledge to use the massive buying power of the government’s Medicare program to directly negotiate lower prices for seniors.”
Actually President Trump’s drug plan does use the massive buying power of the Medicare program to negotiate lower prices for seniors. He is doing it indirectly but through a free market system.
The traditional media’s prime focus is to criticize President Trump’s programs regardless of the facts.
In fact, with his drug plan, President Trump has published a blueprint that is going to change the metrics of how drugs are priced. His plan will make prices transparent to patients and physicians.
Patients will be given the choice to pick the best price. Physicians will be given the choice to decide if the price charged for new medication is worth the increase in price.
President Trump is going to eliminate the present failed system of pricing medication. It has not worked for consumers.
His blueprint cannot be evaluated in the context of the present pricing system.
I will describe the potential for improving the system with his blueprint in my next article.
All I can say at this point is let us see what is going to happen.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.
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