Bush and Healthcare

[DJPoopypants]

—Los Angeles Times, Sept. 14, 2004, page A17
"This 30-second television commercial, unveiled Monday by President Bush's campaign, is scheduled to run this week. ... Female voice: 'On healthcare, President Bush and our leaders in Congress have a practical plan: Allow small businesses to join together to get lower insurance rates big companies get. Stop frivolous lawsuits against doctors. Health coverage you can take with you. The liberals in Congress and Kerry's plan: Washington bureaucrats in control; a government-run healthcare plan; $1.5-trillion price tag. Big government in charge. Not you. Not your doctor.' "

Would Kerry really support bureaucrats telling you what drugs you can and cannot take? Or how to get them? Anyone who would take away freedom of heathcare choice for me or my family would be equal to pondscum, IMHO.

—Los Angeles Times, Sept. 14, 2004, same page (snicker)
"President Bush on Monday repeated his opposition to allowing seniors to buy U.S.-made prescription drugs from Canadian pharmacies as a way to save money, calling it unsafe for consumers. 'It's an interesting idea, but remember, my job is to protect you as best I can,' Bush told about 500 supporters at a campaign event. ... "

Words straight from the bureaucrat in chief.

Is this a world record for speed flipflopping?

[bmurphyfl]

Would Kerry really support bureaucrats telling you what drugs you can and cannot take? Or how to get them?

This gets into detailed issues that I doubt Kerry has or will address because nobody on a campaign trail gets into this level of detail.

With regards to your first question, there are two ways that drug plan administrators restrict drug choices:

The first is through the use of a drug formulary which is a list of preferred drugs. If you want to get a drug that is not on the formulary list, you'll often have to pay a higher copay than you would for a formulary drug. So, nobody is stopping you from getting a drug, they are just trying to financially persuade you to use a different drug. This is commonly done for drugs where there are numerous therapeutically similar drugs.

The most common example is Lipitor and Zocor. Both drugs treat high cholesterol with similar results but Lipitor is less expensive. Therefore, drug plan administrators will often put Lipitor on their formulary and require you to pay more for Zocor. This is a comon practice these days and it wouldn't be suprising to see this in place with a federal universal drug benefit.

The other kind of drug restiction is typically for clinical reasons. A lot of drugs have horrible side effects when they are mixed with other medications. And with people seeing multiple doctors for various ailments, it is possible for a doctor to prescribe a drug that would cause a severe drug-drug interaction without knowing it. Therefore, drug plan administrators often have clinical edits in place that check a patients drug history when they try to fill a prescription at a pharmacy. If the drug they are trying to get triggers one of these edits, then a message is sent to the pharmacist and the claim is blocked. The pharmacist then has to call the doctor's office and get the prescription changed to another drug.

So, while this is done for a patient's benefit, there is a large gray area regarding what would be a "bad clinical situation" and it often annoys the patient and doctor. Patients feel angered that some nameless, faceless "bureaucrat" is stopping them from getting the drug that their doctor, who they trust, has prescribed for them. However, despite these complaints, these edits are commonly used and it would be likely that any government sponsored plan would use them too.

So, the answer to your question is: Yes, the government could tell you what drugs you can and can't get but it likely wouldn't be any different or more restrictive than a typical current employee sponored drug plan would be.

With regards to your second question, the answer is yes they could tell you where you can and can't get your drugs but it would be very unlikely. Most current drug plan administrators don't place restrictions on the choice of pharmacies. However, there are an increasing number of plans that do include these restrictions in an attempt to control cost.

The most common restriction involves the choice of retail pharmacies. There are about 55,000 pharmacies in the US. If every pharmacy in the country is allowed into a retail network for a benefit administrator, the pharmacies will often give a discount off of list price for brand drugs around 13%. However, retail pharmacies really want to sell you shampoo, Halloween candy, and all of the other high margin crap in the store. So, if a benefit administrator is willing to cut a portion of those 55,000 pharmacies out of their network and drive their patients to the remaining stores, the in-network phamracies will give them a discount of about 15% on brand drugs. Since most people have 3 or 4 pharmacies within a few miles of their house, they can often find a "in-network" pharmacy without too much disruption. But it is still fairly uncommon for administrators to restrict the network too tightly and I'd be amazed if a federal plan ever did.

There are also possible restrictions that force people getting long-term maintenance medications for chronic diseases to go through mail service pharmacies rather than retail stores like CVS, Rite-Aid, Walgreens, etc. The mail service pharmacies offer deeper discounts than even tightly restricted networks. So, while I'm sure mail service pharmacies would be an option of choice in any federal plan, it's highly unlikely people would be forced to use them.

So, while not knowing any specifics, I'd expect there to be some formulary and clinical restrictions on your drug choices but none on where you could get them.

Murf

[mozilla]

Would Kerry really support bureaucrats telling you what drugs you can and cannot take? Or how to get them? Anyone who would take away freedom of heathcare choice for me or my family would be equal to pondscum, IMHO.



Kerry Voted At Least Six Times In Support Of Cutting Billions From Medicare Funding. (H.R.2015, CQ Vote #209: Adopted 85-15: R 43-12; D 42-3, 7/31/97, Kerry Voted Yea; S.Con.Res.57, CQ Vote #119: Rejected 45-53: R 0-52; D 45-1, 5/16/96, Kerry Voted Yea; S.Con.Res 13, CQ Vote #215: Rejected 39-60: R 0-54; D 39-6, 5/25/95, Kerry Voted Yea; H.R. 2264, CQ Vote #247: Adopted 51-50: R 0-44; D 50-6, With Vice President Al Gore Casting A “Yea” Vote, 8/6/93, Kerry Voted Yea; S.1357, CQ Vote #523: Rejected 19-80: R 0-53; D 19-27, 10/27/95, Kerry Voted Nay; S. 1134, CQ Vote #178: Rejected 15-83: R 1-42; D 14-41, 6/24/93, Kerry Voted Nay)

Kerry Voted 4 Times Against Health/Medical Savings Accounts. (S.1028, CQ Vote #72: Adopted 52-46: R 5-46; D 47-0, 4/18/96, Kerry Voted Yea; S.1344, CQ Vote #210: Passed 53-47: R 52-2; D 0-45; I 1-0, 7/15/99, Kerry Voted Nay; H.R.1, CQ Vote #457: Motion Agreed To 70-29: R 47-3; D 22-26; I 1-0, 11/24/03, Kerry Voted Nay; H.R.1, CQ Vote #458: Motion Agreed To 61-39: R 49-2; D 11-37; I 1-0, 11/24/03, Kerry Voted Nay)

Kerry Voted Against Tax Credits For Small Businesses To Purchase Health Insurance. (H. Con. Res. 83, CQ Vote #83: Rejected 49-51: R 48-2; D 1-49, 4/5/01, Kerry Voted Nay)

Kerry Twice Voted Against Allowing Self-Employed Individuals To Fully Deduct Cost Of Their Health Insurance On Their Federal Taxes. (S. 1344, CQ Vote #202: Adopted 53-47: R 52-2; D 0-45; I 1-0, 7/13/99, Kerry Voted Nay; S.1344, CQ Vote #210: Passed 53-47: R 52-2; D 0-45; I 1-0, 7/15/99, Kerry Voted Nay)

Kerry Twice Voted Against Bill Providing $10 Billion Funding For State Medicaid Programs. (H.R.2, CQ Vote #196: Adopted 51-50: R 48-3; D 2-46; I 0-1, With Vice President Cheney Casting A “Yea” Vote, 5/23/03, Kerry Voted Nay; H.R.2, CQ Vote #179: Passed 51-49: R 48-3; D 3-45; I 0-1, 5/15/03, Kerry Voted Nay)

Kerry Opposed Or Voted To Block Medical Liability Reform At Least Ten Times. (H.R. 956, CQ Vote #137: Motion Rejected 39-61: R 10-44; D 29-17; I 0-0, 5/2/95, Kerry Voted Yea; H.R. 956, CQ Vote #140: Motion Agreed To 65-35: R 24-30; D 41-5, 5/2/95, Kerry Voted Yea; H.R. 956, CQ Vote #141: Motion Agreed To 56-44: R 13-41; D 43-3, 5/2/95, Kerry Voted Yea; H.R. 956, CQ Vote #144: Passed 53-47: R 48-6; D 5-41, 5/2/95, Kerry Voted Nay; H.R. 956, CQ Vote #151: Motion Rejected 46-53: R 44-10; D 2-43; I 0-0, 5/4/95, Kerry Voted Nay; H.R. 956, CQ Vote #152: Motion Rejected 47-52: R 45-9; D 2-43; I 0-0, 5/4/95, Kerry Voted Nay; H.R. 956, CQ Vote #160: Motion Agreed To 54-44:: R 46-7; D 8-37, 5/10/95, Kerry Voted Nay; H.R. 956, CQ Vote #161: Passed 61-37: R 46-7; D 15-30, 5/10/95, Kerry Voted Nay; S. 1052, CQ Vote #212: Motion Agreed To 52-46: R 2-45; D 49-1; I 1-0, 6/29/01, Kerry Voted Yea; S. 812, CQ Vote #197: Motion Agreed To 57-42: R 6-42; D 50-0; I 1-0, 7/30/02, Kerry Voted Yea)

Kerry’s Health Care Plan Could Cost As Much As $895 Billion Over 10 Years And Still Would Not Cover All Currently Uninsured Individuals. (Kenneth E. Thorpe, “An Overview And Analysis Of The Democratic Presidential Candidates’ Health Care Reform Proposals,” 9/7/03; “Health Insurance Coverage In The United States: 2002,” U.S. Census Bureau, 9/03)

****

In 2001, Kerry Voted Against Amendment Providing $70 Billion For Tax Credits For Small Business To Purchase Health Insurance. (H. Con. Res. 83, CQ Vote #83: Rejected 49-51: R 48-2; D 1-49, 4/5/01, Kerry Voted Nay)

Now, Kerry Promises Refundable Tax Credits To Small Businesses For Health Coverage. “Refundable tax credits for up to 50 percent of the cost of coverage will be offered to small businesses and their employees to make health care more affordable.” (“John Kerry’s Plan To Make Health Care Affordable To Every American,” John Kerry For President Website, www.johnkerry.com, Accessed 1/21/04)

[BlueMeanie]

Kerry Voted

...blah, blah, blah...


Again (see Bush/Kerry Environment thread), you're putting out voting records without descriptions of the measure subtexts, which often explicitly tell you why a politician voted one way or another. If you're not going to do the research (and post the explanations), stop posting the voting records.

[DJPoopypants]

Anyone else want to volunteer to completely miss the point that the current bureaucrat in chief is making medical decisions on where people can get their drugs?