The Truth About 22 “Studies” that Claim “Medicare For All” Would Save Money

There’s a lot not being revealed in a recent oped in The Hill touting new “evidence” that “Medicare for All” would be a financial boon.

https://thehill.com/blogs/congress-blog/healthcare/484301-22-studies-agree-medicare-for-all-saves-money

For example:

PLOS Survey Is A Selective Review Of Prior Studies From Single Payer Proponents

• The authors of the PLOS survey used a flawed and incomplete review process that only included studies supporting implementation of Medicare for All, rather than comprehensively and objectively examining the significant economic impact and other negative tradeoffs of single-payer proposals.
• The PLOS survey included 22 studies, more than half of which were written by the same four authors, some of which dated back to 1991.
• The PLOS survey excluded 35 studies of single payer proposals.

The Nonpartisan Congressional Budget Office (CBO) Found Medicare For All Would Reduce Access To Care And Eliminate Choice For Consumers, While Dramatically Increasing Federal Spending At A Time Of Record Deficits And Debt 

https://americashealthcarefuture.org/new-plos-survey-provides-a-biased-and-flawed-overview-of-medicare-for-all/

The oped also flat out ignores history.

Looking at NHS spending in the UK  over time puts to rest any claim that government run medicine is economical.

And here is spending per capita adjusted for inflation:

Not to mention, the author disproves her own point by concluding, “The government already pays for about two-thirds of health care costs.”

We already largely have a single payer system and it hasn’t achieved lower costs. Will pushing the remaining third under government control make things better or exacerbate the existing problems.

The expectation that spending will drop when patients do not pay deductibles or coinsurance flies in the face of basic economic theory.

Screams from MSM about “Slashes to Medicare and Medicaid,” are this week’s #fakenews.

President Trump released his budget proposal today for 2021 through 2030.
And just like last year (and the year before) Democrats and the main stream media are screaming about how he is planning to slash Medicare and Medicaid.

For example:

Newsweek’s headline: MEDICARE, MEDICAID, SOCIAL SECURITY: TRUMP’S PROPOSED BUDGET SLASHES ENTITLEMENTS—AND CAMPAIGN PROMISES

“TRUMP’S NEW BUDGET PROPOSAL SLASHES MEDICAID, MEDICARE,” states Vanity Fair.

Meanwhile, NBC News reports:

Joe Biden, said it “eviscerates Medicare,” while top Senate Democrat Chuck Schumer of New York said Trump is planning to ”rip away health care from millions of Americans” with cuts to Medicare and the Medicaid health program for the poor.

What’s the real story?

Under President Trump’s budget, Medicare spending in 2030 would be almost 200% of 2019 spending while Medicaid would approach 150% of 2019 levels.  How can any rational person describe that as a slashing. Sounds like fake news.

Without any changes by President Trump, interest on the debt in 2030 would be more than double the 2019 payment of $409 billion and would alone eclipse Federal Medicaid spending. Does that sound sustainable?

The real headline should be that President Trump is taking steps towards a desparately needed balanced budget.

MOC Feeds Big Data, Means Big Dollars, and Patients Suffer

It’s all tied together… Because pushing MOC on us is how they’re able to collect data… And the PBM’s, a.k.a. Optum, CVS, express scripts are big data collectors. So are the GPO…Granddaddy GPO Premire is the MOC data collector. 

Another facet: Pharmacist prescribing….The big box pharmacies are totally behind the dumbing down of who can prescribe.  Physicians have become an un-necessary tool.  The big boxers need an army of new pawns…. 

If you dig around CVS’s website you’ll discover they are offering scholarships for employees to go to pharmacy school.

Meanwhile, Walmart trains low level admin for $1 a day. (Warning- have nitro handy before you read this next link:) https://www.fiercehealthcare.com/finance/a-focus-primary-care-clinics-walmart-offering-its-employees-healthcare-workforce-education 

Walmart, the WORLD’s LARGEST company by revenue is about to subsidize the EXPANSION of a dumbed-down administrative state (is that even possible?) and add to optometry and pharmacy tech degrees.  

CVS now taking over PBM role for Walmart https://cvshealth.com/newsroom/press-releases/cvs-health-and-walmart-announce-new-pbm-pharmacy-network-agreement

And on top of it all, CVS and it’s vertical mergers are a wealth (literally) of conflicts of interests that perpetuate all of the above and more: https://thehill.com/opinion/healthcare/421697-put-the-brakes-on-the-cvs-and-aetna-merger-to-sustain-competition-and

Insurers going into the drug manufacturing business? Imagine Hershey starting a milk farm.

Friend of IP4PI Bob Campbell, MD writes in:

BCBS announced this week it is planning to become a manufacturer of generic drugs. This bizarre market behavior is a direct result of the anti competitive secret contracts. It is not at all how normal markets work. 

Hershey Foods is based in my town. Let’s say cocoa beans and milk and almonds and sugar were unavailable due to some form of anticompetitive cartel. Hershey might buy land in Africa and start cocoa bean farms and buy land in Brazil and begin growing sugar cane and buy land in Iowa and stock it with dairy cows and buy land in California and plant almond trees. The problem here is they do not have the resources experience and expertise to do this well. They know nothing about almond farms and nothing about African politics and farm workers.

Markets encourage efficient specialization. This lowers cost and improves the value equation for the customer. Free markets enhance supply chain productivity.  Think if Dow chemical had to drill for its own oil to make its plastics and materials. They know nothing about drilling for oil. Bad for Dow and bad for consumers.

Insurance companies last time I checked were not running their industry very well. I pay a $27k per year premium for embarrassingly bad coverage. They should fix their own industry before they become a pharmaceutical manufacturer. This bizarre inefficient market behavior is a predictable outcome with the Safe harbor in place. It is what is called a broken marketplace.

Read the American Antitrust Institute White Paper on the GPO/PBM Safe Harbor. The drug shortages are a predictable outcome. They will persist as long as the safe harbor for racketeering persists. 

Bloomberg just came out in favor of eliminating all PBM kickbacks. He said we will make pharma manufacturers compete again with no payments to PBMs distorting the marketplace. Remember Azar our in a new fixed rate kickback to replace the traditional % of revenue kickback in the Trump PBM Rule. Trump does not want to be seen backing down from his prescription to lower prescription costs plan and he does not want to have a Bloomberg lite watered down plan. Trump should be even more bold than Bloomberg in this issue. 

Another everyday PBM failure; patient forced to be without meds

A physician-friend of IP4PI reports:

Our senior age patient with a Medicare Part D plan from @ExpressScripts mailed in a controlled substance prescription to the Express Scripts Mail Order Pharmacy on 01/13/20.

Two weeks later? The patient has not received the medicine and is unable to transfer the script to a different pharmacy. The patient called Express Scripts and logged onto their website to find that the plan received the Rx on 01/20/20.

We called Express Scripts. After being on hold for 15 min, Barbara R, said she was on the commercial side and couldn’t help with Medicare claims and put us back on hold. Then, we talked to Jerry C., a supervisor who informed us, in a condescending manner, that Express Scripts recorded that they received the Rx (erroneously) on January 26 it wouldn’t be ready for shipment for another week after today (01/27/20).

Yet another #PBM failure.

I had to give the patient another controlled script he could fill at local pharmacy. PBM added cost to all parties in terms of time and money, and another Rx for a controlled substance for the government to complain about.