Good News for Pharmacy Benefit Managers - Not So Good For The Rest Of Us
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Congressional Circus Makes Fools of Us
Livid is not the right word for me. Congressional funding will run out this Friday for many programs. This because more than half the House and nearly half the Senate wants to upend democracy instead of improving the lives of their constituents.
Please recall that a Pharmacy Benefit Manager is a company that runs prescription portion of a health insurance plan. They are largely responsible for deciding what drugs are available to you and how much you get to pony up in copays. They do this by taking bribes from drug manufacturers (rebates). They also put the screws to the drug store demanding that they accept low reimbursements (sometimes below cost) and screw the insurance company by having them pay more than the drug store received.
Also worth noting that three companies control about 90% of the US insurance prescription market. Some of them even own their own medical networks and health insurance companies. CVS is one of them.
Anyway, there are a lot of bills at federal level to try and control PBMs. Now all that has gone by the wayside as we contend with a spending bill. Congress has abandoned its attempt to reform how pharmacy middlemen operate in an upcoming package to fund the federal government, 11 lobbyists and sources following the talks told STAT.
If there were universal healthcare, say a public insurance trust, that paid all the claims then all the drug prices could be negotiated to fair levels without PBMs standing in between taking their cut on every transaction.
ACTION
Let’s remind our Senators and Members of Congress that Universal healthcare means all the prescriptions are negotiated to a fair price for all of us. Their contact info is in the Resources section below. Or, use RESISTBOT and text SIGN PHXILT to 50409 to send them the email below.
“I am your constituent and I’m so disappointed that the Congress has given up creating legislation to rein in Pharmacy Benefit Managers (PBM) who increase the price of drugs in this country by taking bribes and who determine what drug is right for you, instead of your doctor.
Solve the problem this way, pass Universal Healthcare like HR 3421, the greatly improved Medicare for All Act, and we can negotiate all the prescriptions for everyone of us, urban or rural, cradle to grave. at hundreds of billions of dollars less than we pay now (per the Congressional Budget Office). Thank you.”
Medical School Tuition Gift
According to the Wall Street Journal, the Albert Einstein College of Medicine will now be tuition-free for all students, thanks to a historic $1 billion gift from a former faculty member and board chair. The donation comes from Ruth Gottesman, who after joining the faculty at the Bronx, N.Y.-based Einstein in 1968 developed widely used tools to screen children for learning problems and launched an adult literacy program. Gottesman, 93 years old, and her husband, the late billionaire-investor David “Sandy” Gottesman, were longtime donors to the medical school, and Ruth Gottesman serves as chair of its board of trustees. Einstein’s tuition this year is nearly $60,000, and the school recommends students budget at least another $35,000 a year for living expenses, books and other incidentals. The program lasts four years. ...Students assembled Monday morning to hear Gottesman announce the gift jumped up to hug one another, cheered, and grew tearful upon learning their new financial fate.
My wife and I were in Croatia a while ago and was discussing cultural differences between our countries with the tour guide. The subject turned to education and he told us that all education was available to all citizens without cost, even medical school. Their tax burden is much like ours. They just spend it by investing in the future. Word to the wise.
RESOURCES
Healthcare Advocacy (Us)
Website
Our Newsletter resources including reproductive healthcare
Healthcare Advocacy Reading List
Find My Elected Officials
Contact the White House https://www.whitehouse.gov/contact/
Contact State and Federal Representatives
By phone: (202) 224-3121
By email: democracy.io
Important Healthcare Resources
League of Women Voters Healthcare Reform Toolkit
Organizations to Contact
National Nurses United Medicare4All
Physicians for a National Health Program
One Payer States
Healthcare Now
Reproductive Health
NARAL - Pro Choice America
Charley. chatbot abortion resource - make sure to use a secure incognito browser if you live in a state that has banned abortion
Planned Parenthood
Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.
United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.
Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.
If you need financial help with an abortion try abortionfunds.org
Claims Denials and Appeals & What to Do
Appeal a Healthcare Decision
Appeal/Negotiate a Hospital Bill
Disinformation Management
Cybersecurity Infrastructure Security Agency
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
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