Pharmacy Benefit Managers Escape Justice
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A Good Day To Advocate for Better Healthcare
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PBMs Skate By Again
Recall that Pharmacy Benefit Managers are middlemen in the prescription. drug world. They decide what your health insurance will cover, how much you have to pony up as a copay, take kickbacks from drug makers to include drugs on the approved list for your plan (formulary), demand and get low reimbursements to drug stores and cheat the real insurance companies by charging more than was reimbursed to the drug store. Three PBMs control between 80% and 90% of all prescriptions in the US.
Anyway, there is a lot of legislation in Congress to rein in their practices which are another bad example of money interests standing between you and your doctor.
But sadly, a healthcare package that would have advanced pharmacy benefit manager legislation and other healthcare priorities including enhanced community health center funding will not move alongside the next round of federal appropriations. Committee leaders who hoped to build a legislative package around bipartisan PBM measures and other popular items were unable to come to agreement, and Senate and House leadership declined to add healthcare legislation to the fiscal 2024 government funding bill they are expected to release mid week.
They are not encouraged to move forward because of the flood of money into the campaign chests of our elected representatives. According to OpenSecrets.org, that tracks campaign contributions, the pharmaceutical and health products industry provided $89,091,362 in contributions to super PACs and other outside spending groups in 2020.
All of that goes away with Universal Healthcare. Then we get negotiate drug prices for all prescription drugs with no bribery middlemen strangling the system.
Inhaler Cost’s Down
AstraZeneca joined Boehringer Ingelheim as the second inhaler manufacturer to announce they are capping the out-of-pocket cost for their inhaler products at $35 per month in the United States. This news comes after Wisconsin Senator Baldwin and her colleagues launched an investigation into the high costs Americans pay for inhalers, demanding answers from the four biggest inhaler manufacturers – including AstraZeneca and Boehringer Ingelheim – on why they charge hundreds of dollars more for their products in the United States than elsewhere.
Starting June 1, 2024, AstraZeneca will cap their US inhaled respiratory medicines at $35 per month for eligible patients. Earlier this month, Boehringer Ingelheim also announced they are capping prices for their inhaler products on June 1.
Extra Credit
Let’s call Senator Baldwin and thank her for encouraging manufacturers to drop the price of inhalers. You can call her Washington Office here (202) 224-5653.
Arizona Lawmaker Needs an Abortion - She Can Get It - Can Others?
A pregnant Arizona lawmaker who revealed in a speech at the state Senate that she was planning to get an abortion says she wanted to share with her colleagues and the public the practical effects of abortion restrictions passed over the years. Democratic Sen. Eva Burch of Mesa told fellow lawmakers in a floor speech Monday that she was going to get an abortion because her pregnancy is no longer viable. The first-term lawmaker, who previously worked as a nurse practitioner at a women’s health clinic, described a “rough journey” with fertility and recounted a miscarriage she had suffered.
Arizona has laws that interfere with a woman’s ability to get an abortion. The state law requires an ultrasound that her doctor didn’t order and that she was given what she regards as disinformation about alternatives to abortion. A lot of good that does with an unviable pregnancy.
Arizona’s reproductive health laws are, as they say, a hot mess. There is a pre statehood law that precludes all abortions. It conflicts with other laws. The Arizona Supreme Court is thinking about the matter. A constitutional amendment to make abortion a private matter between a woman and her doctor would help but only if the US government does not impose am abortion ban - that would of course, come from the Taliban Wing of the Maga party.
Action
Call or email your Member of Congress and Senators and let them know women are more than half this country and deserve to be treated as citizens, not property. Urge them to pass the Women’s Health Protection Act. Their contact info is in the Resources section below or
Use Resistbot to send them the email below. Text SIGN PKHGJF to 50409.
“I am your constituent and I know you get tired of hearing about how women are treated like property and not citizens. Well, me too. I want you to be loud and vocal and get the Women’s Health Protection Act passed so women again have bodily autonomy and are a step close to full citizenship. Lives depend on it. Act like it.”
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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Instead of controlling pharmaceutical corporation practices, let’s question the efficacy of pharmaceuticals in the first place. Are drugs really the best alternative for healthcare?
Thanks for your response, Eileen.
In healthcare, im pretty sure I’m not just being naive in thinking that the patient is the point? Or were.
But when patient/doctor time together is limited, the quickest thing seems be to decide which drug to use. I wouldn’t even bother with allopathic medicine if insurance paid for anything else.