A Healthy America Saves Money
News and Actions June 2, 2023
Happy Friday Healthcare Advocates
Please enter requests for research using the comment button at the bottom. Remember our advocacy educates our representatives and lets them know what we want them to do for us.
Now that the debt crisis is behind us let’s turn our representatives' attention back to Universal Healthcare.
Pharmacy Benefit Managers
Recently there has been a lot of discussion about pharmacy benefit managers. This business was started as a way for insurance companies to outsource the prescription portion of the insurance plan. The idea was that the PBM would negotiate better prices for drugs (serving many insurance plans) and save the insurance companies the cost of administering the benefit as well as paying less for the prescription due to the discount for volume. Economy of scale would make the venture work.
As we reported in the past there are myriad problems as the scheme has progressed over the decades.
A part D Medicare Drug plan was invented that provided a prescription benefit for Medicare subscribers. When part D was created part of the giveaway to the PBMs and the drug manufacturers was a clause in the law that precluded the government from negotiating drug prices for all 65 million Medicare retirees. If we did then that would be economy of scale. Last year the government was able to get negotiating power for 10 drugs. That’s it - the smallest of baby steps.
PBMs take rebates from manufacturers to put a drug on the formulary (what is covered by insurance). It is not always the best drug for you and your doctor’s choice may not be available at all. There are many pieces of legislation floating around the House and Senate that address these shady bribery/kickback schemes. The best of the lot is S.1339, but it still only passes the rebates that PBMs get from drug makers back to insurance plan sponsors (like employers). It does not share with the policy holders or those that purchase the drugs at overblown prices.
Best option is Universal Healthcare like HR 3421 which has the negotiation with drug makers built. Not only does it clawback the government’s right to negotiate fair drug prices but it does so for all of us. Personally, I favor the house bill for Universal Healthcare (HR 3421) as it has a 2 year implementation plan while the senate bill takes 4 years.
ACTION 1
Call or email your congressional representative and senators and tell them to co sponsor and vocally support HR 3421 or S. 1655 Enhanced Medicare for All. Their contact info is below in the references. Use Resistbot to send the same message - Type Sign PRWNOT to 50409.
Here is a sample text:
“Hi, My name is [name] and I am your constituent, in [zipcode]. Let’s not mince words, PBMs are sticking it to the American public. They take bribes to put drugs on their formulary because they are paid to by drug makers and that increases the price of the drugs to cover the bribe , and it is not necessarily the drug your doctor wants you to have as we have seen in Congressional Testimony. It’s nice that the government can negotiate for 10 drugs on Medicare but that is not helping all Americans. I want you to actively support HR 3421 Improved Medicare for all or S. 1655 because they will allow the government to negotiate all drugs for all of us. Do it.”
Restricting Access to Healthcare
Florida and several other southern states are in the process of implementing anti-immigrant legislation. Some of these bills are clearly racist and won’t allow allow ownership of certain types of land, others require people like healthcare providers to determine immigration status before treatment. Florida just did that. This kind of anti-immigrant behavior is not new, there were similar sentiments dating back 100 years, however, our focus is healthcare and laws like this will dissuade patients from seeking care. They will make immigrant parents of citizen children think twice about going to the doctor. When there is another pandemic they will be the first victims and will spread illness to the general population. There is a healthcare goal in our advocacy, better health, lower prices, everyone covered, will make us a better place for our residents as well as an economic powerhouse. These fascist techniques of terrorizing minorities that have a hard time pushing back have no place in our country. Look out for them and speak up because evil flourishes when good people are quiet.
ACTION 2
Call the governor of Florida and tell him his racist and anti immigrant policies will dissuade people from going to the doctor and will increase illness amongst the general population. Personally, I will mention, that they will not get dollar one from me as a tourist as long as this fascist behavior continues. Here is his phone number, (850) 717-9337 email here.
Sick Leave Is Healthy
(Thanks to Susan Rogan). According to the Centers for Disease Control and Prevention 40% of restaurant food poisoning outbreaks could be traced to food workers who showed up to work while sick or contagious. Pay is low for them and they have bills like all of us so it is hard to take a day off work if there is no sick leave. Almost one in four workers in the private sector don’t have a single paid sick day, including only about half of food service and accommodations workers. There is no federal law guaranteeing the right to paid sick time, and only 14 states and Washington DC do. I talk about universal healthcare all the time and it is one of the things that is included in health care in so many countries, like Germany. There federal law provides 6 weeks of sick leave and after that your health insurance pays sick leave. It’s time for a change. The bill provides for earning a week of paid sick leave in larger companies and unpaid leave in smaller ones. Is it as good as it can be? No, it is a start. Let’s start.
ACTION 3
Let’s contact our members of Congress and tell them to support the Healthy Families Act (yet unnumbered) introduced by Rep. Rosa DeLauro (D-CT) and Sen. Patty Murray (D-WA), and let our legislators know we want them to back these efforts. Legislator contacts are also in the references below.
Sample Text - Hi I’m [name] in [zipcode]. There is no federal requirement for sick leave in the US. I want you to support the Healthy Families Act (no number yet) it is in both the House and the Senate. It is a start at providing sick leave that workers desperately need. I need you to do this for all of us.
References
Find My Elected Officials
Contact the White House https://www.whitehouse.gov/contact/
Contact State and Federal Representatives
https://www.commoncause.org/find-your-representative/addr/
Important Healthcare Resources
League of Women Voters Healthcare Reform Toolkit
Our Newsletter resources including reproductive healthcare
Healthcare Advocacy Reading List
Organizations to Contact
NARAL - Pro Choice America
Planned Parenthood
Physicians for a National Health Plan
Claims Denials and Appeals & What to Do
Appeal a Healthcare Decision
Appeal/Negotiate a Hospital Bill
Save Democracy
Chop Wood, Carry Water by Jessica Cravens
RESISTBOT
Link to the RESISTBOT site to learn more
Link to Chop Wood, Carry Water Resistbot write up