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Stealth Plan to Shift Costs of Certain Widely-Used Drugs to Consumers

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The US healthcare system is wildly overpriced and delivers mediocre outcomes. And while the many of the problems are well known, such as bad incentives for doctors, patients trained to equate over-testing and over-treatment with high quality care, high administration costs, and unrestricted drug pricing (despite lavish public funding of drug research), Obamacare has sided with industry incumbents, namely Big Pharma and health care insurers, at the expense of everyone else.

We predicted that one outcome would be overpriced insurance that didn’t cover much (note for middle class and affluent consumers, it would probably be better to have only catastrophic coverage and self insure for the rest; the worst is pricey insurance that leaves you carrying meaningful costs, particularly for major medical procedures). We seem to be moving in that direction already.

Reader bob alerted me to a news item that also seems to have gone below the radar of most finance and economics bloggers: that of an FDA proposal to have more drugs available on an over-the-counter basis, including ones for diabetes (insulin), high cholesterol, allergies, and migraines.

On the surface, this seems like a great cost saving move. You could get meds with no doctor visit. But most people I know who are treated for these conditions don’t get prescribed them via a separate office visit; they get a scrip in the course of getting an annual checkup. And if you wanted to reduce the doctor cost element, in Australia, a doctor will dispense a scrip to an established patient for a minor administrative charge (when I was there ten years ago, $15).

But the stealth part of this is by making drugs for certain widespread chronic conditions and frequent ailments OTC, the result will be to move the cost onto the consumer. And this is a feature, not a bug. Per the Washington Times:

By removing the prescription requirement from popular drugs, the Obama administration could ease financial pressures on the overburdened Medicare system by paying for fewer doctor visits and possibly opening the door to make seniors pay a larger share of the cost of their medications…

“We would expect that out-of-pocket costs for insured individuals, including those covered by Medicare, would be increased for drugs that are switched from prescription to OTC status,” said Dr. Sandra Adamson Fryhofer, who testified last month on behalf of the American Medical Association in an FDA-held public hearing.

To the extent the media is covering this story, it appears to be focusing on the fight between physicians and pharmacists, with physicians concerned about the loss of effective oversight and revenues while pharmacists are keen for the boost in stature. And no one seems to have discussed the additional risk of drug overconsumption. With drug companies already spending more on marketing than on research, expect a blizzard of ads to boost sales of any drugs that go from prescription to OTC to the worried well.

USA Today has come out in favor of the FDA’s plan, arguing that it promotes consumer choice and that plenty of drugs have gone from prescription to OTC with no mishap. But those almost without exception are drugs that have gone off patent and where the FTC has also approved the switch (there are plenty of old drugs, like tetracycline, that are still prescription only). That means that there was a very long period of use (and thus plenty of experience) before the medication was made freely available to consumers.

Given horrorshows like Vioxx, a mere substitute for aspirin that was marketed aggressively to people who had no reason not to use aspirin, I don’t trust Big Pharma as far as I can throw it. But the more important issue is that this measure, which is presented as enhancing consumer choice, is actually about reducing medical insurance coverage. And this move is unlikely to reduce health care costs; it merely changes the payment scheme.

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94 comments

  1. CaitlinO

    I agree with most of your conclusions about this story, but Vioxx was WAY more than a mere substitute for aspirin. Two severe childhood illnesses left me with arthritis. Vioxx bought me years of pain relief and ambulation that I would otherwise not have had and that no other medicine could provide.

    There just aren’t substitutes for some drugs and they need to be made more widely available at the lower prices that people overseas get to pay. We need to both reduce the time that drugs stay on patent and allow the government to negotiate end user prices.

    1. Yves Smith Post author

      I hate to tell you, but the research was clear that Vioxx provided no more pain relief than OTC painkillers, and the clinical argument for them was for the patients (1-2% of the population) who got gastric bleeding or other digestive upset from daily doses of OTC products.

      1. dearieme

        “the research was clear”: I should be astonished if the research proved that for every patient Vioxx was no better a painkiller than aspirin. What may be true on average may not be true for every individual. Any patient for whom Vioxx proved inferior to aspirin would doubtless stop using it.

        1. CaitlinO

          Certainly I would have. One by one I tried and abandoned medicines over the years that didn’t help. Two doctors told me that there was a group of patients for whom nothing worked as well as Vioxx and I certainly seemed to be in that group.

        2. Yves Smith Post author

          1. The drug companies would have a huge incentive to show it offered superior pain relief, not simply that it was a pain killer that didn’t cause gastric upset. If they couldn’t cherry pick data to prove that, it’s highly unlikely it was better

          2. Go look at the lawsuits on Vioxx. It was marketed extremely heavily to doctors. If someone is in pain and their doctor says use Vioxx, tell me exactly how many American patients will say no? And insurance covers it too, so they’d be more or less indifferent on the cost front.

      2. Flscott

        Just a clarification here. NSAIDS ( the family of drugs that aspirin, ibuprofen, vioxx and celebrex among others) belongs to have two separate but related functions for relieving arthritis pain.(Tylenol is not an NSAID, it reduces pain and fever but has no effect on inflammation) They do act as pain-killers but a huge part of how effective they are depends on the second function as a inflammation reducer. While it is true that Vioxx was no better at reducing pain, it WAS a more effective anti-inflammatory and that enabled many that took it to report reduced pain and discomfort. That said all the other things you said about it were true. It was wrongly pushed on people who never exhausted the cheaper alternatives that had fewer side effects.

    2. chitown2020

      I tend to believe more and more that what is in the vaccines is the real problem. Vaccines are like a game of Russian roulette IMHO.

      1. binky bear

        Darwin approves. “I didn’t trust the vaccines” will be on the gravestones of potentially thousands of children thanks to a Playboy model and a crooked doctor. Anything to keep the population down, I guess.
        In the meantime, your food has poison genetically engineered into its very cells, was bathed in neurotoxins, and delivered in endocrine disrupting hormone like packaging.

        1. dearieme

          “your food has poison genetically engineered into its very cells”: all fruit and vegetables certainly have – if they didn’t synthesise their own insecticides they’d have become extinct. Blame Darwin or God, according to your views on such matters.

  2. ozajh

    Australia also has a government-run monopsony system to keep down the cost to the consumer of commonly prescribed drugs, and every survey taken shows an enormous bi-partisan majority in favour of maintaining it. When the FTA was being negotiated between the US and Australia, US Big Pharma interests lobbied the US negotiators to try to get it changed. The response from the RIGHT-wind Australian government of the day was a flat-out ‘not a chance’.

    I suspect such a system would be regarded as politically unthinkable in the US.

    1. Yves Smith Post author

      Yes, I liked the Therapeutic Goods Administration. They’d do the research and wouldn’t buy the newest, latest, greatest formulation (usually at a big cost premium) unless there was a clear cut clinical benefit. They’d select one drug in each category and bargain like hell.

      Australia proves you can have smart, well run bureaucracies. Not that all of Australian government is great (don’t get me started on the Australian Tax Office, which is hugely nit-picking, and the stupidity of the GST), but on the whole it is a ton cleaner and much more effective.

      1. Flying Kiwi

        Li’l ol’ New Zealand, with half the population of New York City, does the same through Pharmac.

        1. alex

          Yes, but everybody knows that Trotsky, Che Guevera and Elvis are alive and well and members of the NZ government.

  3. Middle Seaman

    Agreed on the first two comments. Even OTC in Europe are treated differently. While you can buy 10 containers of Tylenol in the US, most European pharmacies keep their OTC behind the counter requiring you to speak to the pharmacist and describe/justify your request before you get the drug.

    1. Tim

      Yeah, good point.

      So maybe our acronym for non-prescription drugs in America should be changed from OTC (Over The Counter) to OTS (On The Shelf).

  4. Conscience of a Conservative

    Or, switching medecines for high cholesterol , migraines and allergies may have nothing to do with shifting the cost of health care but more to line the pockets of big pharma who could sell a great deal more of this stuff. It’s not an accident that medecines to treat these conditions are already heavily advertised on TV ads with the caveat, go see your doctor(one of the clinton’s lowest moments was approving this practice). I suspect this move has nothing to do with health care costs but the result of a lobbying move by Pfizer, Merck, etc to get permssion to sell these drugs more widely. Now everyone can pop a Lipitor after gorging on sausages and Big Macs.

    1. propertius

      I suspect this move has nothing to do with health care costs

      Don’t view it as “lowering health care costs”, view it as “increasing insurance company profitability”. There damned sure aren’t going to be any premium cuts as a result of this.

  5. F. Beard

    By removing the prescription requirement from popular drugs, the Obama administration could ease financial pressures on the overburdened Medicare system by paying for fewer doctor visits … Yves Smith

    That’s fine with me! I get sick every two years or so with a hacking cough. It can linger for a month or two untreated. Yet, with a generous amount of hydrocodeine I can be over it in 2 weeks comfortably. I DO NOT appreciate having to go to a doctor to beg for a drug and usually get far less than I need (and a big bill) because some busybody thinks I might abuse it. What if I do? Who’s business is that? Is it my body or what?

    Or course, “they” are not likely to make opiates OTC anyway because heaven forbid that a adult get genuine pain relief. The sky would fall, no doubt.

    1. Noni Mausa

      Hey, brother Beard, I used to suffer from the same cough, a hacking, gagging cough that lasted weeks. We never did find out what precipitated these attacks, but it wasn’t till I moved to Canada in the late 70s that I found a way to treat them.

      Here, we can get codeine cough syrup from any pharmacy, though you do have to ask the pharmacist. It’s not an addiction problem because from the point of view of an established addict, it’s as weak as near-beer. They would need a gallon to get a giggle. But for me, using the stuff before bed allows me to sleep and my throat to rest and heal overnight, cutting the attack to a few days. It’s also handy for those Friday night toothaches (why do they always hit on the weekend? a great mystery.)

      For about $8 I can buy a bottle that lasts me a couple of years and gives me peace of mind. The only time I EVER asked that it be prescribed was in order to obtain an official bottle I could carry in my luggage when traveling to the US.

      1. F. Beard

        Thanks for that.

        I’m tempted to move to Canada or Mexico. Between the Right and the Left in the US all this “freedom” is killing me!

      2. Walter Wit Man

        So it’s basically a sleep aid?

        Could you also take up running or do some serious exercising so you are nice and tired at night?

        I notice a huge difference when I’m training for a marathon and when I’m not.

        Cutting my caffeine down and shutting the t.v./computer off well before bed helps a lot too.

      3. chitown2020

        The hydrocodone cough syrup works great as well but you need a prescript and it is pricey. Around 70 dollars for a small bottle. Lots of people coughing everywhere that you go. Before Michael Savage got booted from Chicago radio, not long after Rahm became Mayor, he was talking about allergies. Michael was saying how strange it is that people seem to have allergies all year round now and the truth is that they shouldn’t have allergies all year round. Things that make you go hmmmmm….

    2. pws

      Extremely unlikely they’d make these over the counter. If they do, you’ll get a lot of “this pharmacy doesn’t carry that” and “this is locked up behind the prescription counter along with the benedril and sold only in small amounts.”

      1. F. Beard

        Dexedrine (Mother’s little helper) was widely used before the Bureau of Narcotics and Dangerous Drugs restricted their use in the 1970s to fight the hippy plague, I guess.

        Now meth has taken its place. Chalk it up to pious busybodies.

        I’m tempted to vote for gold-bug Ron Paul just to get both the Left and the Right out of my medicine cabinet!

        1. Frank Drebbin

          Fat Bread c’mon, there was a bit more to it that this. “to fight the hippy plague, I guess.” The Drug War is a war on the poor and then some! Talk about debts to society,sheesh

          1. F. Beard

            The Drug War is a war on the poor and then some! Frank Drebbin

            Amen,amen,amen!

            And not Biblical either btw:

            Give strong drink to him who is perishing,
            And wine to him whose life is bitter.
            Let him drink and forget his poverty
            And remember his trouble no more.

            Open your mouth for the mute,
            For the rights of all the unfortunate.
            Open your mouth, judge righteously,
            And defend the rights of the afflicted and needy.
            Proverbs 31:6-9 [emphasis added]

          2. F. Beard

            “Until the rich give up usury
            they shouldn’t expect the poor to give up drugs.”

          3. chitown2020

            Beard….there are some good home remedies for coughs like a teaspoon of organic honey. You can go on the net and find more. The natural cures website is a good one. It might not be a bad idea if the American people got off the prescription meds. I personally don’t ever want to be looking to the Fed Gov for help. 330 ppms of colloidal silver is great to clear up lung infections and sinus problems. You gargle down one third of the bottle in a 24 hour period. You can get almost anything at GNC. If they don’t have it on the shelf, they will order it.

          4. F. Beard

            It might not be a bad idea if the American people got off the prescription meds. chitown2020

            It would not be a bad idea if ALL natural drugs like the opiates, marijuana, cocaine, etc were NOT restricted substances. Some might have to answer to the Lord for that.

            The US is run by pious hypocrites, imo.

          5. chitown2020

            How do they get away with outlawing things that grow out of the ground and come from nature? We allow it.

          6. jonboinAR

            Dude! You make prescription narcs otc, you’ll have a nation of junkies in just a few years, even more-so than we have already. Opiates are one of those things that have to be controlled. We can’t deregulate hydrocodone! You just want to satisfy your jones more easily, it sounds like. More likely, you’re just misguided on this. We can’t do that. Sorry.

          7. F. Beard

            You make prescription narcs otc, you’ll have a nation of junkies in just a few years, even more-so than we have already.

            And that’s your business, precisely how?

            You do know that heroin, cocaine and codeine were freely available in the US till 1907? That addicts held down jobs and raised families?

            Being a busybody is a sin!

            Just what good are liberals for anyway besides trying to run other people’s lives?

          8. cwaltz

            F Beard,

            The papers are littered with stories of junkies that burgle and rob in order to pay for their next fix. When people have to take from others to satisfy their addiction it becomes my business. That’s why drugs like hydrocodone will not become OTC, nor should they be.

            Furthermore I don’t know what Bible you got the impression from that being a “busybody” is a sin. According to the New Testament we are all our brother’s keeper(not that I’m advocating this, just pointing out your interpretation is not accurate from a Christian standpoint.)

          9. F. Beard

            When people have to take from others to satisfy their addiction it becomes my business.

            Legalized drugs are inexpensive.

            As for “brother’s keeper” that expression occurs only one time and it might have been used sarcastically. Plus it implies an owner/cattle relationship, at least to me.

          10. propertius

            You make prescription narcs otc, you’ll have a nation of junkies in just a few years, even more-so than we have already.

            Opium is the opiate of the people!

          11. chitown2020

            It’s called freedom of choice.. people can simulate the effects of drugs out of many things like inhalants. The Nanny Government cant stop people from making bad choices. Like the excuses for gun control are lame. Didn’t the 9/11 hijackers use box cutters and kill 2000 innocent americans without guns? People can make weapons out of anything if the want to commit crimes.

          12. jonboinAR

            Uh, that’s a bad argument. Many fewer people commit crimes when you make it more difficult. On one of these sites (I donno if it was a blog or Internet magazine like salon, or even NYTimes online) a few months ago was an article about the decrease in street crime over the past 20 years. One of the conditions attributed to that decrease was a change in tactics by police whereby they tried proactively to make crime committing more inconvenient just by stuff like shadowing gangster-types, hanging around shooting galleries, etc. Gradually, it seems, that fairly mild but consistent pressure made crime committing less “popular” amongst the cohort that had been prone to that activity.

          13. chitown2020

            Sorry Frank..not buying that argument… Esp. After seeing the video on the news of a man stabbing a woman and her child on a city street. So do we outlaw knives..? That would have stopped O.J. right..? What about the child abductors and pedophiles…? Do the use guns..?

    3. chitown2020

      I was reading a study that cholesterol medicines give you Alzheimer’s because cholesterol acts as a protection for the brain and that Blood Pressure meds have rat poison in them. Most Americans need to change their diets. Stress is another bad thing for the body and that is not easily avoidable. Stress negatively effects every organ in the body.

        1. chitown2020

          Its the aluminum in the antipersperants that is unhealthy is what I have read. There are a lot of good qualities to baking soda as well. The aluminum free kind that is. The alkaline diet is supposed to be the key..less acid..mostly alkaline. We need to eat lots of watermelon and lemon.

  6. Woodrow Wilson

    “I don’t trust Big Pharma as far as I can throw it” -

    And you shouldn’t.

    Simular to Wall Street, enforcement is lax to say the least. At Merck KGaA recently had yet another kickback scheme exposed, and were fined just over $40 million, subsequent offense, a fraction of the money made off the drug. There’s no incentive to stop cutting of corners or sketchy studies in order to make a profit.

    The good/bad news? The offending division (EMD Serano) has nothing in the pipeline (so much for R&D). However, while HQ in Germany won’t be seeing layoffs, the “reorganization” in The U.S. has already commenced. Meanwhile, Merck KGaA is enjoying it’s near highest stock price ever.

    Oh, and the irony? Gov. Patrick thinks it’s a great idea to subsidize pharma here ($1 Billion initiative). So on top of supporting/subsidizing crooked pharma, employees are paying (through state tax witholding) to their own corrupt employer! Did I mention they donate to area CONgress Members (Tsongas) as well?

    The greatest fraud upon Americans will continue.

  7. Noni Mausa

    Good God. My first thought went to a disabled friend of mine who is on a couple of psychiatric drugs, antidepressants and mood stabilizers, and who also needs omeprazole to deal with severe heartburn as a side effect of his other meds. This is especially important because of a family history of stomach cancer.

    Which of his drugs would be kicked off medicare? The last mentioned, I would think, because I cannot imagine America loosening up on psychiatric meds.

    His disability pension is in the range of $300 a month. Even though omeprazole has gone OTC, he gets his prescribed because the cost is around $30-40 a month OTC, 10% of his disposible. I imagine he would abandon that med and ineffectively medicate with handsful of Tums instead.

    So in addition to the cost burden, another effect of moving these common meds off coverage is to push the poorest, those with the fewest resources, further into poverty and closer to homelessness, ill health and early death.

    Which, perhaps, is another “feature.”

    1. Walter Wit Man

      Yep.

      Some of us were pointing out that Obamacare cut Medicaid and put pressure Medicare. Some of us knew Obama’s Romneycare was designed to shift costs to beneficiaries under the guise of “reform”.

      At the time Obots like one sees at Daily Kos would scream about these inconvenient facts being Republican talking points.

      They happen to be true facts but Obama and his progressive scumbags care more about Obama political victories than they do old peoples’ access to drugs.

      1. Walter Wit Man

        Oops, it cut Medicare and put pressure on Medicaid.

        Obamacare promised to expand Medicaid but I haven’t heard shit about that since Obama passed his giveaway to pharma/insurance companies.

        In fact, I’ve only heard about Medicaid cuts.

        Again, fuck you if you are a Democrat or support Obama. I hope you enjoy the insurance company death panel you brought to America via your scumbag president. That is if you’re lucky enough to get to a death panel.

        Obama and his progressive zombies basically screwed America’s health system forever. Fuck you Democrats and fuck the insurance and pharma companies that own you.

        We should stop calling it the Democrat party and call it the CorpoRAT party–filled with corporate rats like Obama, Rahm, Harold Ford, William Daley, Geithner, Summers, etc. Fucking scumbag Democrats.

        1. Sharon

          You are forgetting one important aspect about healthcare in this country. Pharmaceutical companies and medical device and equipment manufacturers poison with impunity. I really don’t have a problem with what is being done because my guess is that over 90% of the drugs on the market are useless. Our health is going to improve is we get both insurance and pharma out of healthcare.

          Single payer is not the answer. Pharma owns our government and that would mean more payments to them. I’m glad it worked out the way it did; it means less poisoning for all.

    2. chitown2020

      High acid diets give you heartburn. It is a warning …Pharmaceuticals make the body become acidic. He should change his diet if he needs the meds. He should cut back on proccessed foods and white flour and white sugar.

  8. sissy

    Yves,

    I was poisoned with the drug called Levaquin, Cipro and Avelox are the same. The FDA has had a black box warning on it since 1975, when Japan kept warning people about the drug. Most Doctors don’t know about this drug, but people are dying in emergency rooms all over this country. The drug causes extreme insomnia and it has 30 to 50 symptoms. I normally wear a size 8, but my feet were do swollen I had to go out and buy size 10 shoes. This drug and the others I mentioned are call Quinolone drugs. Please inform as many people as you can about the dangers of this drug. There are thousands of class actions suits all over our country and throughout the world. Thanks.

    Sissy

    1. Kmurp

      This is Medicare that’s doing this to save $? Is our national health insurance program more expensive per patient than the rest of the world ? I thought I read somewhere that we pay around 8-9000/year/beneficiary. Maybe that’s old data. I guess comparisons to other countries would be invalid anyway as the populations covered are so different.

      1. LucyLulu

        We currently pay a little over $8000/year for healthcare costs PER CAPITA. That figure includes everyone, those with private insurance, public insurance, and none at all, and covers both premiums and out-of-pocket expenses. And yes, it is substantially more than any other developed country, most (maybe it was all) of whom have plans that cover healthcare for everybody. We spend 50% more than Norway, who has the second most expensive healthcare system. We spend twice as much or more as Germany, Sweden, France, UK, and Australia. Here is a link to figures for 2008.

        http://www.kff.org/insurance/snapshot/oecd042111.cfm

  9. Bridget

    It’s hard to believe that insulin would be made available over the counter. Besides which, Type I diabetes is not the dagger pointed at the throat of healthcare costs in the US. Type II diabetes is the one that’s going to take us down.

  10. Lyle

    Consider that the most likley candidate drugs would be the ones on the discount lists at major stores, such as the $10/3 months list. At that level of course the insurance just plain does not pay as the co-pay is greater.
    Generics also have the big advantage of having been out longer so that adverse reactions in the larger group have likley shown up. For example the major statins are now all generic (except for the new combinations that got patents, note how the lipitor adds have vanished).

    So in summary for generics on the various $10 lists it will likley be no more out of pocket than today.
    And you will not likley have to insist that the physician pick the generic rather than the expensive version.

    1. alex

      “the most likley candidate drugs would be the ones on the discount lists”

      Or so you assume. That would probably be the case if this change was done judiciously and with good health care outcomes (as opposed to good profits) in mind. If you believe that’s necessarily the case, then I’ve got a bridge to sell you.

    2. patricia

      Yes, that is a pleasant but baseless assumption. Anecdote: FDA took out an old generic migraine medicine that cost $17/mth and it came back 2 yrs later at $110/mth. Nothing else works for me–I can choose to have three 3-day migraines a month or pay this. Medicare doesn’t pay because it’s not on their list, same as two other generic medications I take. I cannot be recipient of “negotiated deals” between insurance and bigpharma because I am on Medicare.

    3. LucyLulu

      Having taken medications that went OTC in the past, I can also affirm that going OTC does not imply costs remain the same. Invariably, once a med goes OTC the cost has gone up. They won’t sell for $10 for a 90 day supply, perhaps 21 days instead.

    4. bob

      Personal experience was that the cost doubled initially. I was on a generic, the only equivalent product is “branded”.

      Since going OTC, the price has gone up over 400% in about 5 years.

  11. alex

    Two things that haven’t been mentioned:

    1. Insulin already doesn’t require a prescription in New York and a number of other states. Anyone know how about how much it costs and what the reimbursement situation is?

    2. If I recall correctly (corrections welcome) in Australia, even OTC meds are paid for if they’re recommended by a doctor.

  12. ella

    Medicare savings occurs because the OTC drugs are not covered by medicare. Thus, the consumer will pay the full cost of the drugs. I am not sure what the profit margin will be for the OTC. Interestingly, the profit margin on prescribed drugs varies with different insurance plans because of the negotiated price cuts between the manufacturers, distributors and insurance companies. It is difficult to know what the true cost of health care and pharma is because the negotiated price varies according to the different insurance plans. WHAT A MESS.

    1. Walter Wit Man

      This is the way it was designed.

      Obamacare isn’t about saving costs or making our system more efficient.

      It’s about making elite rich white men even richer. It’s fascism.

      We will collectively pay more for drugs, is my guess. So the government won’t be paying for it, thus appearing to save money, but it will actually cost more money because average people are thrown into the shark infested waters of dealing directly with the drug companies rather than have the government bargain for the best deal. As mentioned before, they will simply up the mind control via the commercials and get people to pay more.

      This is sick because fascist war criminals, like Obama, are harvesting the American people’s health for profit.

      Obama and his scumbag party need to be put in jail.

      If you vote for Democrats you are voting for the Nazi party. Like the “good Germans of the 1930s”, American Democrats of the 21st century have been bamboozled into supporting massive death and destruction via fascism. They’ve been tricked into sending old people to a death panel when they think they’ve “reformed” health care.

      1. Cynthia

        Obama is guilty of a lot of crimes, Walter, especially with regards to the war on terror, as was the case with Bush. But since he is the face of Empire, he’ll never be prosecuted. TPTB will make certain of that. They did it to Bush, they’ll do it to Obama. They’ll do it to protect the Empire.

  13. Soma Inc

    “I don’t trust Big Pharma as far as I can throw it. ”
    Drugs are excellent agents for social control, Big Pharma is on the front lines of poverty you see. Running out of money can put the fritz on anyone’s perspective, and there are a number of diagnosis that accompany the criminalization of poverty – profit obfuscates the real issue and creates a new one – set up a system where a scrip for a powerful sedative will ‘cure what ‘ails ya’. Helps destroy health and maintain compliance!

  14. ep3

    Heck yeah, Yves. Great post.

    Don’t forget that the less I see my doctor, the more is income shrinks. So when I actually go see him, he is incentivized to prescribe more visits and more tests to make up for those lost visits.

    1. Susan the other

      Doctors started advertising here about a year ago. I too quit going to the doctor and it did not take me long to realize I really didn’t need one. Other people are clearly coming to the same conclusion. A computer can diagnose your symptoms; a lab can run your tests. You can wrap your own ankle or put a cold pack on your forehead. It would be fine with me if generic drugs were over the counter; a pharmacist could advise on the best drug. Or a computer. My experience is that nothing but antibiotics work anyway. It would be lovely if everyone simply stopped going to doctors and stopped using all those useless “drugs.” How long before we put them all out of business? 6 months?

  15. Jeff N

    I am currently on generic lipitor, and the label says something like “your insurance saved you $300″. (=3 mos supply) I can’t see how they can switch something that costs $100+/month to “over the counter”

    1. Walter Wit Man

      What do you mean you can’t see how they can do this?

      The system is designed to harvest as much money from you as possible. They don’t give a fuck about your health other than making sure they bleed as much money out of you before you die.

      This is why Obama made a secret deal with the pharmaceutical industry and pretended to his juvenile and naive “base” that he was taking the industry on. On many fake speeches did Obama give where he railed agianst pharma? Well, jokes on us because pharma tells the government what to do and the actor hired to sucker the American poeople, Obama, did his job and suckered the American people.

      Well, he suckered the left half. With an assist from people like Daily Kos and Digby. They are the ones that did the hard work of getting this fascist health care system passed.

      Get used to this. This is our future for decades. Fascism. We will all start paying more and more for the drugs and food and housing we need as fascist warmongering criminals laugh all the way to their private island resorts.

      Again, if you support Democrats (or Republicans for that matter), you are part of the problem.

      Obama and the Democrats like Nancy Pelosi are doing this to you.

      1. John

        Look, I could take you seriously if you included the corrupt, evil Repulicans in your rants too but when you only rant about one side I know you are just another sap who’s foolded by the Kabuki theater of the “two party” system.

        Get a clue.

        1. Walter Wit Man

          You should get a fucking clue and realize I do include the Republicans in my rants.

          Let me guess . . . you’re a Democrat.

          At least the conservatives don’t have to lie and pretend that they support Medicare or single payer.

          I’m leaving them out of this rant because they are honestly evil while the Democrats are sneaky.

  16. Hugh

    The essence of any con is to make the mark think he/she is going to make money when, in fact, they are going to lose it. That looks to be all that is happening here.

    I am concerned about how this would affect the care of the elderly. Shifting more responsibility to them for their care or really anything that complicates that care is not a good idea.

    I would just not that all drugs have side effects, and some of these can be quite severe, even fatal. Additionally, some drugs work better for some patients than others. A lot of medicine is art masquerading as science. This is true of which drugs get banned as well as which drugs get prescribed to which patients.

    If we had universal single payer, aka Medicare for All, we would all have better and more frequent access to healthcare. This is important because preventive medicine and/or catching conditions early on reduces the need for much more expensive care later. Our healthcare system is completely perverse in that, as here, it seeks to reduce monitoring on the preventive side and continues to emphasize specialization and acute care both of which are considerably more expensive, all the while providing poorer care and outcomes.

  17. chitown2020

    Bloomberg news reporting that Goldman has raised AIG from neutral to buy. Wonder what they are up to?

  18. chitown2020

    Progress…CNBC reporting people are paying cash more often for their homes.

  19. chitown2020

    Local news reporting Nurses protesting outside of Mayor Emanuels city hall office over being booted from protesting from the Daley Center to the Protillo band shell. They say they are being pushed out of public view. People protesting outside of Holy Name Cathedral over the Vaticans remarks on nuns. People are waking up.

  20. issacread

    At the same time there is a move on to make as many supplements as possible, prescription only in the name of protecting the consumer, of course. This has already taken place in Europe via Codex I believe, and is in the pipeline if not already effected here.

    1. chitown2020

      Let them force a black market for natural cures and they will have more enforcement’s on their hands than they can handle. The people have had enough of their dictating and making decisions about what is good for us. Like one attorney told me that the real question in regards to fraudclosures is..Do we have a Constitution or not? I believe we wont if we keep letting them have their way with us.

  21. PaulArt

    Forgive me for saying this but anything that dips into the pockets of Seniors brings cheer to my soul. Begging the pardon of informed and literate Seniors who do not vote for Social issues I for one have long been convinced that apart from the middle aged white male vote the GOP has drawn the most sustenance from the Senior citizen vote. Old people vote often and vote all the time. It would not be an exaggeration to say that a majority of the Tea Partiers are in this category. So, if they are getting shafted for some meds money then I am all for it. Seniors have long lived in a bubble in this country. Their fail safe monthly Social Security checks and almost free Medicare has made them oblivious morons to what the rest of us go through. Its good if they feel a little bit of the pain.

    1. Prairie Rose

      Paul Art, I beg to differ. I just don’t know why you think that seniors are living High Off the Hog on a $1300 a month Social Security check. My recently deceased dad had no choice but to basically live off his SS check. He lived in a small town in rural America and he and Mom never made more than $20,000 a year after taxes. Precious little money left over to put away for savings on that amount, don’t you agree? Both of them had small pensions on which they could draw but not until they were 70. And for most of us Lower Middle Class Citizens, there is no such thing as a defined benefit pension plan anymore, anywhere, for anyone. The guv’mint took out $100 a month from the SS check for Medicare expenses. They both paid $250-$300 a month for supplemental insurance. They both paid their prescription co-pays and they were not taking many drugs. So by the time they got done paying their monthly utilities, groceries, gasoline, yearly property taxes on a paid-off home, home insurance, car insurance, phone/internet and yes, they did splurge for cable TV, there was precious little left over. And that was AFTER the children left home. They never went on expensive vacations, anywhere, EVER. It was just really, really hard to save and it got harder and harder once they retired (Mom was 68 when she retired, kicking and screaming) because inflation ate up any SS increases. And of course no one is going to hire a 70-year-old to do anything. So what, pray tell, are our seniors to do? I daresay that fully half of our population, senior or not, is in this same boat. Both my parents detested the idea of being dependent on the guv’mint. And honestly, do you really think anyone back in the 1970s or early 1980s expected “health care” (ha, ha, ha) costs to increase by 200%? No one expected to have to pay $2,000 a month for “health care” back then and unless you were making in the six figures for 40 years there’s no way to have saved enough to pay for it all. Please tell me what people like my parents should have done. Should they have been born smarter? Should they have had the sense to have been born into a rich family? Should they not have raised three children? (Shame, shame on them.) I might add that these people voted Republican every single election.

      Please try to get a perspective. Just for a minute. Walk in the shoes of those who tried their best to live a modest, lower middle class life. Perhaps you’d like to change places with a senior for a month and see exactly how they do live, dear.

  22. Capo Regime

    Yves next book to follow the excellent Econned should be: “Nation of Rackets” or how we learned to get screwed left and right the moment we are born in the U.S.A……..FRom vaccines to 401ks its all a scam……

  23. Klassy!

    Here’s the thing– for those with jobs that offer such things, they’ll use their flexible spending account or their health care savings account to purchase the drugs so the taxpayer will be footing some of the bill but insurance companies will be off the hook for all the costs.

    1. Daniel

      Here’s the feces! Corporations seek profit, therefore they relentlessly promote flexible opportunities to make money off of their employees. Reduce liabilities via the slaves! Go Lockheed Murder!

    2. cgeye

      Nope, that’s not true, either — ObamaCare also eliminated the ability to easily purchase OTC drugs through FSAs. To use that account, they now have to be prescribed by a doctor, and renewed every plan year. And you haven’t lived until finding out that such prescriptions have no flexibility as to brand or dosage, so just throw shopping around out the window.

      I swear, his Big Pharma buddies started this pincers process with the OTC elimination, so patients would start getting used to all their drug costs being thrown to the wolves….

  24. Veri

    My friends 18 year old daughter went to the doctor with symptoms. An elevated white blood count was found and the doctor immediately wanted to perform a lumbar test for meningitis. A pricey procedure, dangerous, and not necessary. We were forced to conclude that the privately-run hospital was only looking for dollars.

    Turns out, my friend’s daughter has the flu. The lumbar was not performed.

    Furthermore, the doctor insisted and even tried to scare my friend’s daughter into having the procedure performed. The nurse was in on it to, but when the doctor was gone, the nurse counseled the daughter that the procedure was unnecessary.

    To top it all off, two prescriptions – tylenol and ibuprofen for simultaneous use were issued to the patient. You don’t mix these medications and it is advised that one wait four hours before using the other. Was the doctor being malicious?

    And this is the best health care system in the world? Please. Wake up. Only if you have the cash for our parasitic, money-grubbing health care corporations to suck out of you.

    1. LucyLulu

      Actually, tylenol and ibuprofen or aspirin have long been used together, especially in pediatric medicine to bring down fevers that don’t respond to tylenol alone. Usually they are alternated every two hours. OTC Excedrin contains a combination of tylenol and aspirin (along with some caffeine), with the aspirin working similar to ibuprofen.

  25. bear_in_mind

    Aspirin Seen to Be as Effective as Warfarin
    NY TIMES
    Well – Tara Parker-Pope on Health
    May 7, 2012, 4:14 pm
    By NICHOLAS BAKALAR

    People with congestive heart failure are often treated with warfarin to prevent blood clots, but a large randomized double-blinded trial has found that aspirin works just as well.

    Researchers recruited 2,305 patients with heart failure and normal heart rhythm. Half were given regimens of warfarin and dummy aspirin, the other half aspirin and dummy warfarin.

    The scientists followed them for up to six years, tracking incidents of stroke, hemorrhage and death. The study was published online last week in The New England Journal of Medicine.

    Over all, there was no significant difference between the two drugs. Patients who took warfarin were significantly less likely to have a stroke, but that advantage was canceled out by an increased likelihood of gastrointestinal bleeding and other hemorrhages. There were no significant differences in heart attacks or hospitalizations for heart failure.

    “The advantage is that aspirin is easier to take,” said Dr. Shunichi Homma, the lead author and a professor of medicine at Columbia University. “Warfarin requires a blood test every month, and because of its tendency to cause bleeding, it causes people to restrict activities.

    “Now we are trying to figure out if there is a subset of patients for whom warfarin is better,” he added.

    http://well.blogs.nytimes.com/2012/05/07/aspirin-prevents-blood-clots-in-heart-failure

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