$90 copay on a $110 prescription

[jgraz]

Up from $10 last month.


Remind me again which part of the Obama Healthcare Bill will fix this?

Is it the part where the government is prohibited from negotiating lower drug prices?

Is it the part where we can't import cheaper drugs from Canada?

Is it the part where the drug companies get to hold monopolies for 12 years on their most expensive products?

Or is it the part where I'm forced to pay for shitty insurance with no price controls or competition?


THANK GOD IT PASSED. :eyes:

[Mimosa]

1. THANK GOD IT PASSED. :eyes: Indeed!

Partner and myself: $895 a month for BC/BS $10,000 (each) annual deductible 70/30 in network policies, co-pays, and no Rx coverage unless we spend over $1,000 deductible for presceiptions. Both over 50, we can't drop it because of pre-existing conditions. (Remember the pre-existing exclusions for adults aren't ending until 2014.)

I don't know if we can afford to keep this up. We're afraid if some catastrophe happened our home could be taken. That happens to people because of medical costs they can't afford.

There isn't help for many. Who knows what will happen in 2014?

[ihavenobias]

2. Relax, you just have to hold out for another 4 years.

And hope no negative changes are made over that time with potential shifts of power in Congress, etc.

[jgraz]

3. Cool, that's only $4320 more in copays

And then what?

Oh right... more of the same. :banghead:

[Name removed]

28. Deleted message

Message removed by moderator. Click here to review the message board rules.

[NHDemProg]

153. Or hope that...

you don't live in a red state that is trying to take away our rights and benefits that have been passed into law.

[Missy Vixen]

4. Imagine how much worse it would have been if HCR hadn't passed!

:sarcasm:

jgraz, I'm so sorry this is happening to you.

[jgraz]

5. Don't feel sorry for me. At least I still have a job and some health coverage.

There are millions of people who are worse off and getting zero help from this administration.

[keepCAblue]

76. Yeah, feel sorry for me...

Self-employed. Not denied insurance but the premiums are so high, must choose between paying rent or paying for health insurance.

My asthma meds alone are over $250.00/month (just for two prescriptions). Still, that's way cheaper than what'd cost me for health insurance ($600+ per month premium -- due to my age and pre-existing asthma and degenerative spinal disease.) And then there's that $12,000 I am trying to pay off--$100 each month--to the county for two days of hospitalization for pneumonia in August 2009.

I'd move to Canada in a heartbeat, but can't afford the immigration fees (and would likely have a hard time getting accepted due to my age and medical status). Being a member of the working poor in Ameriker sucks.

[pansypoo53219]

6. don't you see?

this is how the insurance industrial complex truely gets destroyed because people will finally demand better.

[jgraz]

8. Yeah, and then we'll elect a Change President and give him huge majorities in Congress

Oh wait...

[fogonthelake]

12. it is the slow bleeding that is killing so many.

[Scurrilous]

69. Well said!

:P

[Desertrose]

7. Yeah, thank god it passed.

I'm just glad I'm close to medicare & can hopefully stay healthy - or relatively so until then.

I can't afford "health insurance" and telling me I *have* to buy it doesn't change that fact one iota.

[smalll]

9. You know, the best name for that HCR bill is the title of a right-winger book --

"The Road to Serfdom" --

(Apologies to F. A. Hayek.) :shrug:

[spinbaby]

10. Tell me about it

I have "good" insurance and even fairly minor trips to the doctor plus a prescription now routinely cost $50.

[denimgirly]

11. What the hell is a copay?!? It's Good to be Canadian!

I actually had to use the dictionary to look it up...lol..

Wow, each point you made is crazy! Even when it goes into affect in 4 years none of those things iwll be resolved. Seems the best option is to either marry up with a Canadian or leave the country, or as the republicans say: "if you get sick...die quickly".

[CLANG]

92. Are you available? I'd marry you sight unseen to move to Canada.

[Lorien]

93. Do you know any single 40-something men up there?

I'd move in a heartbeat if I could find a Canadian to marry!

[Liberal_Stalwart71]

194. Find me one, too! n/t

[Warren Stupidity]

112. Oh noes you have to wait in line for 10 years to get an aspirin.

Don't lie to me. I've heard all about your death care system. Sarah told me it was scary bad.

[Fruittree]

13. I hesitated to write because the point on so many posts...

seems to be to bash Obama but I would like to offer a couple of suggestions..I don't know that they'll work but - First, I've called my insurance company in the past and they've re-evaluated claims and what they're willing to cover. Second, a friend of mine is on an expensive drug treatment and she contacted the manufacturer and they're helping her (substantially) pay for it. Good luck...

[CTLawGuy]

14. Bernie Sanders didn't think it was that bad

nor did Russ Feingold,
nor did Alan Grayson,
nor did Dennis Kucinich.

But I guess they're all corporate-owned huh? :eyes:

[jgraz]

25. Pure crap

Listen to any interview with Sanders or Grayson and they're slamming the HCR bill. They voted for it because they knew it was the best they were going to get from this administration.

[CTLawGuy]

46. so you agree it was better than nothing?

and btw Congress passes the laws, the President signs or vetoes them. US government 101.

want to blame someone for the health care bill not being better, blame Joe Lieberman and Senate Republicans.

[NorthCarolina]

97. So that's the best we should expect from Democrats? "Well

it's better than nothing". Send that to Obama...maybe he can use it as his campaign slogan in 2012.

[CTLawGuy]

98. not why I said that

some people around here think HCR was worse than doing nothing (notwithstanding that progressive hero Bernie Sanders voted for it), and I was trying to see if Jgraz disagreed with that.

[Warren Stupidity]

113. that is as low a bar as one can set without going negative.

and btw the president took a pass on advocating for anything with respect to HCR, letting congress do its thing, until there was nothing left to advocate for.

other presidents have managed to push their agenda through reluctant congressional chambers. For example, bush.

[CTLawGuy]

115. 9-11 had almost everything to do with Bush's "success"

no coincidence his "successes" almost all occurred in the FP/antiterrorism arena. 9-11 crushed (most) media/Democratic opposition to Bush's FP/antiterrorism ideas.

His domestic agenda-a different story.

Hell, his crowning domestic "success", the tax cuts, are going to expire this year. He couldn't even get permanent tax cuts.
privatized SS? Not done
immigration reform? not done
federal marriage amendment? not done

What, really, did he do on the domestic front.

NCLB? (worked a lot with Ted Kennedy on that.)
Medicare part D?

------------------------------

Don't compare Obama's situation with George Bush's. If not for 9-11, Bush would have been a lot weaker than he was.

[Warren Stupidity]

118. odd as his first major success, the one you mentioned, his stupid ass ruinous tax cuts

were in advance of the attack they needed to launch their fucked up war.

"Hell, his crowning domestic "success", the tax cuts, are going to expire this year" - yes indeed and that would be 10 years after enactment,

"The Economic Growth and Tax Relief Reconciliation Act of 2001 (Pub.L. 107-16, 115 Stat. 38, June 7, 2001)"

which would make it - June 2001 - BEFORE 9-11 "changed everything". Odd that.

9-11 didn't change everything, we just use it as an excuse for the capitulation of our party to the right.

[CTLawGuy]

121. I never tied the tax cuts to 9/11

and would you call it a victory if Obama signed single payer health care, but it was to expire after ten years?????

and 9/11 did have an effect. It stunted media criticism of Bush and the Republicans and cowed Democrats to tone down criticism in the name of unity. If you watch "Fahrenheit 9/11" Michael Moore agrees with me that Bush was mostly ineffective during his first year, until 9/11.

[Warren Stupidity]

124. " 9-11 had almost everything to do with Bush's "success""

ok

[CTLawGuy]

127. "almost"

key word.

and, regardless, do you consider tax cuts that are about to expire "success"?

[Warren Stupidity]

128. whatever

yes the bush cuts achieved their purpose.

[CTLawGuy]

136. for a little while

not after next year.

[juajen]

148. Well, I would, as I am sure by then I'd be dead. Richer but dead.

[CTLawGuy]

149. I guarantee you you wouldn't

single payer, but after ten years it goes away?

[Donnachaidh]

117. the one who should really be blamed is Baucus

that motherf*cker is in so deep with the medical industrial complex he totally screwed any chances of public options or low drug prices. He's got a special place in hell waiting for him.

[CTLawGuy]

122. there were two bills

Baucus and Kennedy's (the HELP bill). Kennedy's had the public option. The final bill to go before the whole senate was to have the public option, but then Lieberman threatened to join a Republican filibuster and it was taken out.

So it really is the Republicans (of course) and Lieberman who should be blamed.

[NJmaverick]

48. You are putting words into their mouths

they voted for the bill because it was a good thing.

[jgraz]

52. No, I'm not.

I'm talking specifically about what they've said when interviewed on the Thom Hartmann and Stephanie Miller shows. Both are unhappy with the final bill but voted for it anyway.

[NJmaverick]

53. Show me exact quotes please

[NYC Liberal]

58. Sounds like Bernie Sanders REALLY, really hates the bill:

http://sanders.senate.gov/newsroom/news/?id=a43cdb4e-f731-4a66-a75c-729b587e11df

Health Care Reform Passes

March 22, 2010
Landmark legislation overhauling the nation's health care system is to be signed by President Obama on Tuesday. It will extend coverage to 32 million uninsured Americans and reduce federal budget deficits by $143 billion in the coming decade. The package includes a provision by Senator Bernie Sanders to dramatically expand community health centers that provide primary care, dental care, mental health counseling and low-cost prescription drugs for 20 million Americans. The health center expansion will save taxpayers billions of dollars by treating more people before they get sicker and need to be hospitalized. Millions of workers, families, seniors, small business owners stand to benefit from lower health care costs, improved coverage and strong consumer protections.

:rofl:

[CTLawGuy]

67. Sanders only said that about the health care bill because

Obama installed a chip in his brain during his sleep so that Rahm Emmanuel could control what he says via remote control.

[NYC Liberal]

70. Kucinich only voted for it because Obama threatened him

and his family.

No :sarcasm: because that's what some were posting here...believe it or not.

[CTLawGuy]

87. he threatened to send Bill Ayres

after him....

ROFL!

[ljm2002]

161. So are you denying that Obama had to twist Kucinich's arm?

Because I seem to remember a little tete-a-tete between the two of them that took place of Air Force One, before Kucinich changed his vote to Yes.

[jgraz]

163. They aren't denying anything

They're just throwing up their usual snark in the hopes that we'll forget what's really going on.

[Gormy Cuss]

131. Link to quotes where each said that, please.

[dionysus]

59. no, what you wrote is pure crap. it's up to the congres to write the bill, not the president.

and you know that damned well. you should be blaming the senate.. you know, the people who wrote the bill.

[jgraz]

62. Sure, the president has no power whatsoever.

That's why he was able to organize a *Democratic* filibuster of Dorgan's amendment to allow drug reimportation from Canada. :eyes:

You guys really need to ask for a fresh set of talking points.

[Fruittree]

88. Or maybe Obama backed this bill because he thought...

it was the best the was going to get from this legislature...

[jgraz]

104. Or maybe he just never tried.

Cutting deals with for-profit hospitals and Big PHRMA weeks after inauguration doesn't sound like a good-faith effort to me.

[krawhitham]

100. has any other administration done better?

You people are unfucking real, you would bitch if someone handed you 1 million bucks

Dems tried for 40+ for a HCR and this administration got it done

Canada's HC was not great when it started they built on top of what they had. Now we can do the same thing do thanks to this administration

[Fruittree]

101. Posts like yours are the reason I keep coming back to DU...

Thank you!!!

[jgraz]

102. Yes. Lyndon Johnson, for one.

Or did we forget about Medicare?

[Warren Stupidity]

114. shhh that was 'old democrats' now we haz new democrats

and they run away in fear from the socialism of medicare.

[Fruittree]

132. I suspect that most of the people complaining about Obama would..

have been complaining about Johnson. Every president has had their pluses and minuses and most progress is far from quick or smooth. Criticism is fine but a blind and consistently negative spin on every success Obama has leads to nothing. Who would you say would be doing much better and keep in mind the reality of politics and a democracy?

[jgraz]

133. You mean the ones who believe in participatory democracy?

That must be such an affront to your way of thinking.

[Fruittree]

139. Absolutely not...

I mean the ones who pigeon-hole and look down on anyone who doesn't agree with them and those who see an evil intention behind everything Obama does..

[jgraz]

143. And since those people don't actually exist...

I have to assume you're referring to the majority of posters on this site who are good-faith critics of this administration.

[Fruittree]

144. Maybe I'm misunderstanding your intention - In writing that..

can always be the case. Do you in fact think that there are things that the administration has done that are positive? If so, what? And, do you think they are also working in good faith and if not why not?

[Name removed]

146. Deleted message

Message removed by moderator. Click here to review the message board rules.

[DevonRex]

36. wrong spot.

[Enthusiast]

77. Of course they

voted for the damn thing because it was that or nothing. Besides they didn't want President Obama to be saddled with the Republican talking points that "He failed on health care." Remember they have been doing that to Hillary for almost twenty years.

It is painfully clear that the liberals you cite above were all VERY unsatisfied with the HCR legislation.

[keepCAblue]

79. They all have great insurance coverage -- paid for by us taxpayers.

Ironic that my taxes pay for the best health care coverage money can buy for U.S. politicians, yet I can't afford even shitty health care coverage for myself. I know I'm not alone...millions of working, tax-paying Amerikans in the same boat.

[golfguru]

189. Does it matter who was for it when the HCR bill is UGLY?

For profit private insurers (FPPI) win 40 million additional paying
customers, most of whom will be subsidized by working middle class via taxes and premiums.

Not a single restraint on premium hikes by FPPI is in the bill.
Annual rate hikes as high as 34% are already showing up this year.
(Versus average premium hikes of under 9% for last 10 years)

No competition to FPPI from public option to keep rate hikes under control.

Competition to FPPI from across the state lines by other FPPI missing in bill.
So each state has it's FPPI operating as a monopoly without outside competition.

Nothing in the HCR bill to restrain frivolous malpracice suits which end up
costing all of us more.

No wonder democrats all over the country running for election are running away
from it and I can't blame them one bit. How many commercial s have you seen recently
by democratic politicians running for congress touting their vote on health care bill?

[old mark]

15. Hey, I have PA state sponsored health insurance for uninsured people under medicare age...

it recently jumped to $629 a month from $235, just for myself...and the co-pays increased for doctors visits as well as prescriptions.

Might be time to cut my social security, too - I eat too much anyway...


mark

[nxylas]

16. You just want a pony

:sarcasm:

[Laelth]

17. Good questions. k&r n/t

-Laelth

[jefferson_dem]

18. YEAH! Doing nothing would surely have been so much better.

The teabaggers told me so!

I'm sure if the Patient Protection and Affordable Care Act reforms were not passed, your co-pay/prescription costs would have gone down, or stayed the same at least!

Here - http://www.youtube.com/watch?v=Z9obgyYB1IU

[jgraz]

29. No, doing *something* would have been much better.

As opposed to actually doing nothing and pretending it's something.

[cordelia]

19. I'm sorry to hear that

One of my co-pays increased from $10.00 to $50.00 after HCR passed, so I don't have it so bad.

Not much I can do about it anyway. The medication is keeping me alive - it must be true - big Pharma says so!

[Kdillard]

20. I was under the impression that rising costs had nothing to do with HCR. Also I thought that any

new poliies due to HCR were going into effect in September and continue to be rolled out over the next few years. Correct me if i am wrong but that was my understanding.

[jgraz]

30. The problem is that HCR has nothing to do with rising costs.

A real reform bill would have dealt with those costs and done it immediately.

[LiberalFighter]

21. Since you have a story to tell. You need to tell it to your Representative and Senators.

And your local officials as well. Oh, and anyone else that would do some good.

But more importantly keep working to improve the HCR law so that it becomes more of a Single Payer that eliminates the current involvement of insurance companies.

[flpoljunkie]

22. What kind of prescription drug plan pays so badly?

[jgraz]

33. Anthem Small Business PPO

They do it because they can.

REPORT: Anthem made $4.75 billion in '09, CEO got 51 percent raise during proposed rate hike
The Maine People's Alliance calls the numbers "staggering and unconscionable".

A new report shows health insurance giant Anthem made $4.75 billion in 2009 and the CEO received a 51 percent raise at the same time, putting her salary at $13.1 million a year - all while insisting it needed to hike insurance rates by nearly 23 percent. The state would later reject that proposed rate hike, and a judge sided with the state in April after Anthem filed suit.

Anthem said at the time that it needed to keep up with rising health care costs.

http://www.wgme.com/newsroom/top_stories/videos/wgme_vid_4658.shtml

[ProSense]

42. Interesting, so this is a small business plan? Here's what will solve that problem

The small business subsidies and the fact that small businesses get to participate in the exchanges, which will include a non-profit plan run by the OPM.

Lower Premiums, Stronger Businesses: How Health Insurance Reform Will Bring Down Costs for Small Businesses

[Spheric]

49. I say cut costs for small businesses by completely removing health care from their obligations.

That would save them a lot more money. Real money.

The root problem with the HCR bill isn't that it didn't go far enough, it's that it took the wrong approach. It has placed a myriad of insurance companies (be they profit or non-profit) and their bureaucracies in between patients and their doctors.

This approach will never be the most effective. It's like trying to build a boat out of anchors. It's probably possible to make something that floats, but it ain't exactly the best method.

Single payer is not some untested theory. We know damn good and well that it works and works well. There is no system that has ever been tried that works better. This has been proven over and over again worldwide.

For anyone who actually puts patient access and care above a few people making money off of others' misfortunes, single payer is the only rational place to start.

IMHO

[ProSense]

50. "Single payer is not some untested theory. We know damn good and well that it works and works well."

And we know damn good and well it was never going to pass. Ask Bernie Sanders and Dennis Kucinich.

[Spheric]

51. This is why we can't have nice things. /nt

http://www.youtube.com/watch?v=18EAqHx2lMk

[Warren Stupidity]

129. ask LBJ

oh wait that was before our party leaders went all corporate-corrupt on us.

[CTLawGuy]

150. also

no two countries' "single payer" health care systems are the same, Canada's is different than England's, which is different than France's which is different than Germany's. That suggests to me that "single payer" isn't cookie cutter as we are led to believe. Then you have to ask yourselves, "why are they so different?"

[dflprincess]

156. That doesn't explain why it couldn't even be discussed

especially as the public liked a Medicare for all option.

You don't start bargaining from what should have been the compromise position - unless you were pulling a scam all along.

[Zenlitened]

165. Excellent post. Everything you say there is FACT, it just is.

Too bad our political leaders are more interesting in "finding" consensus than building it.

:grr:

[ProSense]

43. That was an excellent question.

The OP failed to mention that this was a small business plan, and this group was one of the primary reasons that the health care system needed reform.

[Frumious B]

23. A few possibilities from someone who works for a pharmacy

Are you covered by Medicare D and just hit the doughnut hole?
Do you have a split deductible type policy where you have one deductible you have to pay off at the first of the year and another starting in July?
Has a generic been recently introduced for the drug you are taking?
Has the formulary for your policy recently changed to where the drug you are taking is now non-preferred? Are there other covered drugs in the same class, possibly with generics available, that your Doctor could prescribe to achieve the same results?

[jgraz]

35. Thanks for the help, but none of those apply to me.

I'm lucky that I can handle the jump in expenses. For many people, this would be devastating. I thought I was voting to help those people.

[SemiCharmedQuark]

24. Starting in September, my cousins and many other young adults will have healthcare

My aunt is fighting myeloma and they absolutely cannot afford insurance for their adult kids who are in school. So yes, thank God it passed.

[QC]

26. {replied in wrong place}

[jgraz]

32. And what keeps her carrier from doubling her premium when she adds her kids?

:shrug:

[LostinVA]

85. Nothing, and they probably will jump very, very high

[Vinca]

64. I sincerely hope your cousins will be covered, but don't be shocked

if the premiums are upped to the point of unaffordability. I assumed I would be covered under the pre-existing conditions pool. It seems I won't unless a flaming pie comes out of the sky with a large pile of money.

[QC]

27. Don't worry, we can fix it later! n/t

[jgraz]

31. Yeah, Liz Fowler will get right on that.

:eyes:

[QC]

91. But the bill was HISTORIC!!!

Isn't that enough for you?

[Phx_Dem]

34. My co-pays are $5 thru Aetna.

If your co-pay is $90, you probably have a cheaper monthly premium.

[Beacool]

86. I have Aetna too.

I take 2 medicines regularly and my co-pay is $12 for each. I can't complain, I spend that at lunch sometimes.

[DevonRex]

37. With Blue Cross FEP I pay $65/3 mo supply of a $15,000 drug that keeps me alive.

I'm pretty happy about living.

[Tuesday Afternoon]

38. K&R

That bill is a mess. A big old mess.

[Dr.Phool]

39. They had a blueprint, and a chance to do it right.

HR 676.

But zero political will, and the lust for campaign contributions took care of that idea.

[great white snark]

40. My brother can now afford to stay alive. Sorry about your situation. (nt)

[jgraz]

57. Really? How, exactly, did the HCR bill help him?

[keepCAblue]

80. Is that crickets I hear chirping? No, just silence of a failure to reply. n/t

[Spheric]

41. K&R But, don't expect anyone to actually answer your questions.

You will probably get plenty of snark about your attitude, though. And lots of recommendations for how to jump through hoops just right to maybe save a few dollars.

Oh, and I have just one last question (in several parts). Exactly how do insurance companies improve health care? What is the purpose of allowing them to suck hundreds of billions of dollars a year out of the health care system? How does mandating a huge profit for them cure any illness or save any lives?

Just asking.

[ProSense]

44. Here's

one.

[Milo_Bloom]

45. You highlight why there are no real cost controls in HCR

This is the main problem with HCR and why it will be so ineffective. There are a million ways to "raise costs" outside of the few actions that are controlled.

Further, all you need is the industry to move in concert (much like the oil industry does) for cost controls on one branch to have little to no effect.

[jgraz]

82. Well, it's lucky that we killed that insurance anti-trust exemption, then.

Oh wait...

[4lbs]

47. Is this a personal insurance plan? I'm asking because my current crappy insurance plan is much

better than that.

I pay $400 monthly for 75% coverage, my copays are only $25 to visit the doctor and for prescription drugs.

I'm also in California, like yourself, so you might be able to get on it too.

[NJmaverick]

54. It's funny I had the exact opposite happen

my copays have been cut in half since the bill was passed.

[Name removed]

56. Deleted message

Message removed by moderator. Click here to review the message board rules.

[jgraz]

68. Hmm... what company and policy type do you have?

I'd like to look that up and see exactly what their current rates are and how they compare to three months ago.

[NJmaverick]

106. Should I post my SS# and credit card # as well?

I notice you didn't post any of that information that you are demanding from me.

[Name removed]

109. Deleted message

Message removed by moderator. Click here to review the message board rules.

[jgraz]

110. No, just the insurance company and policy type, as I posted in #33

I'll check on the rest. Thanks! :hi:

[NJmaverick]

111. That plan talks about a $20 co pay

as for me I went from Aetna to Medco

[jgraz]

119. I'm sorry. Did you say you switched insurance companies??

That's not what your original post said. You said your copays "have been cut in half" -- meaning, some company cut your copays. There's no way that switching insurance companies can be interpreted as your copays having been "cut in half". Once again, you're being deceptive.

And of course, your implication that your recent windfall is somehow due to Obama's HCR bill is laughable. But you knew that.

[dflprincess]

157. Medco also usually offers a deal where your copays are lower if you use their mail order service

I have Medco and have made the choice to pay more out of pocket and get my prescription (thankfully only one) at a local pharmacy. I do this from two reasons.

The first is that my doctor encourages all his patients to pick one pharmarcy and have all the prescriptions filled there. The pharmacists is your last chance for someone catching that you may have prescriptions that don't mix well with each other - especially if you have more than one doctor prescribing. He doesn't just the mail order houses to do this and if the prescritpion is something short term like an antibiotic no one may catch any problems.

The second is that coworkers ahd friends have had problems with mail order. They don't arrive on time, the wrong drug gets there or they're shorted on the number of pills (there never seems to be an overage).

[Coexist]

174. just an fyi

all claims run through your benefit show up whether you utilize your retail or mail order benefit. And pharmacies, including mail order, are often more in tune with medication interactions than your physician!

Mail order pharmacies have pharmacists who have time to specialize in specific conditions, as they are not actually placing pills in bottles on top of all of their other responsibilities.

[dflprincess]

177. My doctor doesn't like the mail order pharmacies because they won't

catch if a short term, "fill it today" prescription (i.e. an antibiotic) will interact badly with other prescriptions.

That's why he encourages his patients to use only one pharmacy (of their choice) for every prescription so interactions will be caught. He even admits that this could be between two drugs he's prescribed. BTW at most pharmacies, techs fill the prescriptions, the pharmacists are around for their expertise and to supervise.

And, again, I've had too many coworkers and friends have problems with mail order and those problems can't be corrected immediately with mail order the way they can if you've actually gone to the pharmacy.

And yes, I am aware that all claims show up but, at least with my "coveage", using Medco will result in smaller copays if I reach my deductible. But until I do that, I'm paying the entire cost of my prescription out of pocket & I won't save any money using Medco for that.

[harun]

183. Mail order pharmacies catch interactions, at least the good ones. And if you have a fill

-it-today prescription you wouldn't get it by mail order anyway because it would take a couple days.

I use both. Maintenance type stuff through mail order and if I need it right now the local place.

(Disclaimer: I work for a mail order place)

[dflprincess]

184. That's the point - if you use mail order but have to fill an immediate

presecription at a local pharmacy, the local outfit won't be able to catch a possible interaction because they don't have all the information. If you need a prescription "today" you can't wait for the mail order outfit. Again there is the issue of the mail order outfit making mistakes when they fill maintenance prescriptions - it takes a while to get those straightend out and you can wind up without your meds because of it. Mail order can save a few dollars but sometimes that isn't worth the headaches.

[harun]

186. There are pro's and con's. Your doctor is just lazy.

[dflprincess]

187. How is my doctor lazy?

Either way he faxes a prescription to a pharmacy.

I give him credit for admitting he is human and could make a mistake despite his best efforts not to. Pharmacies often find out about things like drug recalls before the doctors do - and local pharmacies will contact the doctor so it can be changed immediately.

Most doctors, including mine, also have patients who have more than one doctor prescribing for them. If one of his patients neglects to let him know what has been prescribed by someone else the pharmacy is the last line of defense. It's also not unusual for someone to get a pain killer or antibiotic prescribed by a dentist if the patient hasn't told the dentist what other drugs they're taking does that make the DDS lazy?

You're just annoyed because you work for one of the mail order outfits and the only advantage to them is that you might save a few bucks. I notice you haven't responded to problems people can have when the prescription is mailed late or the wrong drug shows up or, most frequently, they've been shorted in the pill count.

[Mimosa]

140. NJMaverick, because of age ratings and pre-existing many cannot switch companies

Therefore we are stuck with whatever premiums and conditions the insurance companies impose on us.

Well before 2014 comes around this sick person will probably be forced (because of finances) to drop health insurance. I know I've told you about our $10,000 ann. deductibel, 70/30 in network policies with no effective Rx coverage (because of the $1,000 prescription deductible). This costs us $895.00 a month. That's almost $900 a month. There is no help for us and few million self-employed or unemployed who aren't wealthy but not poor enough for medicaid.

In Oct I will have another birthday. BC/BS -now transitioning to the name Anthem'- will probably raise my premium again.

The HCR bill could have been better. People wanted something different. The corporations and their vassals -our elected public servants(ha!)- did what they wanted to do. We DID try to pressure them. We wrote letters, emails, called on the phone. But we couldn't pay off the vassals.

[keepCAblue]

81. And likely your deductible quadrupled and your benefits coverage shrank. n/t

[Name removed]

89. Deleted message

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[Name removed]

90. Deleted message

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[Name removed]

107. Deleted message

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[Name removed]

108. Deleted message

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[unapatriciated]

120. mine went up- glad yours went down

out of pocket and co-pays went up and some covered cost are no longer covered.

[QC]

123. My insurance company now pays *me* for using drugs and medical services!

I am about to have an unnecessary heart transplant and use the proceeds to pay for a trip to Europe!

[superduperfarleft]

137. Really? More details?

What was your copay beforehand? What is it now? Are you an employee of a large company or a small one? Are you union?

I'm curious, because as someone who works in the health insurance industry, I haven't seen a company voluntarily increase benefits in years.

[Name removed]

142. Deleted message

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[Fire1]

55. You need "Medco." n/t

[CBR]

126. I love Medco. I just had to order

around $8500 worth of meds for a series of procedures I am having. I paid $400.

[SidDithers]

60. I just had a $473 co-pay on a bottle of Tylenol...

damn that Obama. Damn him to hell.

Sid

[jgraz]

61. At that price, you'd better take them all at once

You know, before they go bad.

[jenmito]

63. I have $100 co-pay on an $8,500 prescription. I'm happy. n/t

[nightrain]

66. isn't that rather absurd that a med could cost $8500? who's making money

on that? Oh, Big Pharma.. cuz Obama/Baucus etc. didn't want to disrupt their profit-making by importing or negotiating drug prices, or other cost-containment options.

Look deeper than your ability to pay, you're getting ripped off. Well... not just you, all of us! Those who can afford, get. Those who cannot afford, don't get. And mostly that now applies to the disappearing middle class, who get NO SUBSIDIES, just get screwed.

[jgraz]

73. I wonder how much it would cost if we could import it from Canada

Oh wait... we can't. :banghead:

[Beacool]

65. I'm so sorry!!

I hope that you were able to pay it.

I just don't know what to say anymore. I see this country falling down a chute and nothing to cushion the fall. We are becoming a second world nation. How much longer before people finally rise in anger? (other than the Teabaggers). How can we as a nation expect millions of people to subsist without a job and some even without unemployment benefits?

I'm just heartsick about everything.........

:-(

[jgraz]

71. It's not me I'm worried about

It's the other people who don't have the means to pay these exorbitant fees. I'd much rather have that $90 go to taxes to pay for Single Payer for everyone.

[Beacool]

84. I agree.

I despair at the state of the country and I don't see a light at the end of the tunnel, at least not in the near future. How many people are going to fall through the cracks?

:hug:

[VMI Dem]

72. If it wasn't for health insurance reform you would be paying $1000 for that scrip.

Whiner.

[jgraz]

74. I know you're being sarcastic...

but other posters have said almost the exact same thing with zero irony.

[VMI Dem]

75. Why give a shit about actual people and their problems when you can just say...

Promise Kept!

[jgraz]

78. You'll notice that not one of them has directly answered my questions

They're just here to kick up dust and hope nobody figures it out.

[Dr.Phool]

94. Sign up with that company that will pay you to get prescriptions.

The one NJMaverick will have by tomorrow.

[jgraz]

105. Why bother?

By tomorrow, he'll have a deal where we just get magically cured of whatever ails us.

[naaman fletcher]

83. Don't worry.

Keep supporting the party at all costs, one day we will get a progressive president and large majorities in Congress and then we can take back the health care system from the insurance companies.

[dave29]

95. Sweet, we're back to bashing HCR again!

I had almost forgotten how much we hate it

[TheKentuckian]

96. It still blows goat chunks

[jgraz]

103. And now I have a monthly reminder of how much it sucks.

I bet I'm not the only one.

[jefferson_dem]

152. Just wait... They'll dust off Reverend Wright and "fingergate" next...

[jgraz]

164. Or maybe you can answer a single, specific criticism from the OP.

Oh right... you can't. That would be a post of substance.

[olegramps]

99. Hey man quit bitching. Welcome to Obama care. He says it wonderful.

I will continue to vote Democratic. But it will be will the realization that we got fucked royally.

[eilen]

116. Me too

"It's better than Nothing" and "We're not batshit crazy teabagging republicans" seem to be their winning platform this year. The least they can do is to start handing out government cheese. Hellya, people are hungry. If I have to buy retro blue and gold NYS license plates to help balance my state's budget, the least they can do is hand out the gov't cheese... I'll play some old Eagles music, park near some urban blight and close my eyes, it will be 1977 again.

[frazzled]

125. Sounds like you drug was dropped from their formulary

Ask your doctor to prescribe something your insurance company puts on their formulary list (nine times out of ten there is another equivalent drug you will only have to pay the $10 for). It happens all the time. This is old news.

This entire thread shows vast amounts of ignorance about how health insurance works, what is in the Affordable Care Act, when various provisions go into effect, etc. Too bad there's no ignorance insurance.

By the way: there is no "Obama" health care bill. There was a bill that was passed by Congress after much bickering and horse trading. The president signed it. The fact that you would talk about an "Obama Health Care Bill" suggests you've been watching Fox News too much.

[Coexist]

135. also, depending on the plan

if an employer receives a request to make an exception for a medication that is not on a formulary, or is on a higher tier, they often have the option of granting an approval for a specific medication at a set copayment. Sometimes if a member has failed a generic, they can get the physician to submit supporting documentation. Sometimes, if a plan has an employee with a family member who has medical issues, they can opt to cover a non-covered medication. Some plans refuse to, and some plans are incredibly generous to their employees; you have to ask.

[superduperfarleft]

138. He already said he's on a small business PPO with Anthem.

What you're talking about is for very large companies, who self-fund their own claims up to a point. When you're a smaller business in the fully-insured market, neither the employee nor the company has very much pull over what gets kicked off the formulary or what gets added to it, if they have any pull at all.

[Mimosa]

141. Insurance companies do what they want and nobody can stop them. n/t

[Coexist]

172. actually thats not correct

its what I do for a living. Often smaller companies make the most generous exceptions, as they know their employees and their dependents in a more "up close and personal" way.

How much leeway they have often depends on the original benefit set up.

[superduperfarleft]

182. It's what I do for a living as well.

And you're assuming that the OP's employer has a self-insured or partially self-insured plan, something that very few small employers have. Even with a self-insured plan, it's dangerous for the employer to "make exceptions" because of discrimination concerns, but with a fully-insured plan, it's 100% the insurance company's call.

[slackmaster]

130. Technically it was a $90 co-pay on the entire prescription experience

Much more than just a prescription.

[Coexist]

134. that's your benefit design.

would you like the President to call your HR department directly on your behalf?

[jgraz]

145. More snark over substance

With supporters like these, how can Obama lose? :eyes:

[jefferson_dem]

151. You're not interested in substance.

If you were, you would srop parroting the fib that health care reform was not real *progressive* reform.

[jgraz]

155. How would you know? You've never talked to me about substance.

For example, I posted 4 key problems with the current healthcare legislation. I didn't say anything about progressive or conservative, real vs not real. Yet, you'd rather pretend I was "parroting (a) fib" than deal with objections for which you have no answer.

When Obama does something I like, I have no problem praising him for it (e.g. his speech on the Cordoba Center). Why do you seem physically incapable of facing reality when he does something wrong?

[Binka]

154. I For One Would Love To See That Happen

With your handle of Coexist and your Teddy avatar why wouldn't you? :shrug:

[Coexist]

173. lol.

I would rather have him working on larger issues that can help the most people, than requesting specific exceptions for a few.

[golfguru]

147. Like I have posted before, there are NO COST CONTROLS in HCR

IOW it is a free pass to the private insurers to hike rates
to their hearts content.

That single thing if was included in HCR would have made it good.
Now it is bad, worse & worst.

[becxx]

158. Yes, crap health care reform is one reason Obama is sinking in the polls

Obama shilling out on the public option was the beginning of his Waterloo. When he did that, I took his bumper sticker off of my car and started thinking about how to primary him.

[Mimosa]

159. Even moderates and conservatives wanted a big change in health care

becxx, welcome to DU, btw.


I support Obama when he's right but he and Congress did sell us out on health care reform. Even moderate independents and conservatives were hoping Obama would lead on changing the health care system so people wouldn't be as helpless against the unilateral power the health insurance corporations have over us. We got screwed, everybody pretty much recognises 'politics as usual' when they see it.

[harun]

160. Your experience is irrelevant without all the facts. Particularly

how much you pay for your coverage, state you are in, why you think HCR has anything to do with what a private organization is reimbursing for your prescription, etc.?

[Name removed]

162. Deleted sub-thread

Sub-thread removed by moderator. Click here to review the message board rules.

[kjackson227]

166. +1

I agree. Not much information to go on, i.e., is this a group plan, individual, medication type (some medications like the "purple pill" are priced extremely high because insurers would rather you take a generic). Not much to go by, so we can't argue the fact one way or the other.

[jgraz]

167. Honestly, would it make any difference?

The information you pretend to be interested in is posted in many threads above. However, how would that affect the specifics of my post?

If I had a group plan, would the government be allowed to negotiate drug prices?

If I had a specific type of medication, would we be allowed to reimport drugs from Canada?

If I used a generic, would the new guaranteed monopolies on drugs be shortened?

Or maybe there's some way I can have my physician write the prescription that will suddenly make cost controls appear in the legislation. You seem to be the expert here, so maybe you can help me out.


In my case, I have a drug, not available as generic, that cost me $10 last month and cost me $90 this month. On the same policy. Now how does that affect the central point of my post?

[kjackson227]

168. You mean the same as you "pretending" not to know...

why the cost of your medication is up, when all you had to do (if you were REALLY interested in finding an answer to your question), was to ask the pharmacist, or your physician, or better yet YOUR insurance company???

[jgraz]

169. Yeah, let's stay focused on why I didn't call my insurance company on a Friday evening

Rather than the fact that you have zero ability to answer the actual point of my post. :eyes:

[kjackson227]

171. And, I'm not going to answer your question...

The actual so-called "point" of your post is to "TRY" to bash HCR, so I'm not playing your game. But, carry on- I'm sure someone will give you the answer you're actually looking for (even though it's incorrect).

[jgraz]

176. Allow me to express my deep lack of surprise

:eyes:

[jgraz]

170. Tell me how any of those oh-so-relevant questions would change the point of my post

Or maybe you could tell us why you'd rather discuss the specifics of my insurance policy than the specifics of our national healthcare policy.

[Balbus]

175. Sounds like, to me, the O-man saved you $20

Some people are never happy.

[dflprincess]

178. Jgraz said he had a $90 copay on a $110 prescription

and that it was up from $10 last month.

In what world does paying $80 more in a copay save you $20?

[Balbus]

179. I try not to use sarcasm tags...

Be that as it may, if someone can't tell that my post is sarcasm, then the failure is all mine.

[jgraz]

180. Your only failure is underestimating how ridiculous some of the "serious" responses have been.

I confess I didn't think you were kidding when I read it.

[dflprincess]

181. Sorry.

What Jgraz said about your post goes double for me. Some of the things supporters of this faux reform say are so outlandish it is hard to tell when someone is being sarcastic.

[Name removed]

185. Deleted message

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[JVS]

188. What's your monthly premium?

[Onlooker]

190. People are linking to your question!

http://www.conservativecave.com/index.php?action=printpage;topic=47777.0

[JCMach1]

191. If the Federal government only had the cojones to put in-place price controls

on drugs this wouldn't happen...

I can most likely purchase that drug at full price (no insurance) for less than the amount your insurance paid.

How's that free market workin' for ya... you betcha :sarcasm:

-note sarcasm not directed at OP

[Mimosa]

192. The truth is nothing has changed for the majority

The truth is nothing has changed for the majority

For example all adults can be denied health insurance coverage because of preexisting conditions. Premiums are still unaffordable and go up according to age.

There are plans which the insurance companies (mainly Blue Cross/ Blue Shield, which is now calling itself 'Anthem') are offering in states which will accept people with pre-existing conditions who have been UNINSURED FOR 6 MONTHS. But they are exactly like the expensive high deductible sub-standard plan my partner and I have right now which runs us $895 a month with a $10,000 per person annual deductible. I think in GA the 'exchange plan' runs $500-$600 a person a month for $5,000 deductible plans, 80/20 coverage. For 2 people that would be nearly $10,000-$12,000 a year.

There are millions of people whose insurance payments are literally BREAKING us. We can't afford to save for our old age, we can't afford to go out to dinner or even a weekend trip. *Seriously, think of the stress and the struggle of having to work harder to pay increasing premiums you can't really afford.* Every month we consider dropping it and getting out from under the grinding wheel. BUT if something happened we could lose our house.


And because of the high deductibles some people still go bankrupt if they get a catastrophic illness.

Keep telling us how good this 'health insurance reform' is. In 2014 it will still be unaffordable for many. But before then people who can't afford insurance but aren't poor enough for Medicaid (or don't qualify because of varying incomes) will still get sick and not be covered.

Please quit trying to tell us this is a GOOD plan because it clearly isn't.

[Lost4words]

195. dont you get tired of folks who tell you crap doesnt smell? nt

[Liberal_Stalwart71]

193. Obama health care bill? I didn't know Obama was still in Congress. n/t