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This occurs for three reasons: traditional Medicare requires three separate insurance plans for comprehensive coverage; traditional Medicare drug plans are required to community rate, without adequate risk adjustment; and pharmacy benefit managers (PBMs) are able to calculate patients’ coinsurance based on list prices, rather than on the actual discounted prices the PBM pays the manufacturers. In addition, beneficiaries in all Medicare plans will pay more for drugs and drug insurance because the IRA removes more than $300 billion of government funding from Medicare Part D over 10 years—leaving the market with no alternative but to shift costs to beneficiaries. More.

Although Big Pharma and big business agree on the end result (people get the lifesaving drugs they need), they don’t always agree on who should bear the bulk of the cost. Enter the politicians to tilt the scale. A bipartisan push would allow drug companies to sell brand-name drugs at monopoly prices for virtually all patients with employer-provided health insurance. The result would be higher drug company profits and lower employee wages. More.

More than half of all seniors in Medicare obtain health insurance from a private Medicare Advantage plan. Yet many on the left are hostile to these plans. Yet this hostility is misplaced. A new study finds that the migration of people from traditional Medicare to the Medicare Advantage program over the last decade has saved the federal government $144 billion. More. 

Writing in Health Affairs,  John Goodman says there are a number of ways to make HSAs available to more people and to serve more needs. Included:

1. Roth-type HSAs for seniors on Medicare.
2. Roth HSAs for people who buy insurance in the exchanges.
3. Use of HSAs to obtain 24/7 “direct primary care.”
4. HSAs for chronic care.

Here are four surprising facts: (1) the subject on which there is the most disinformation is “taxes”; (2) almost all the disinformation comes from the left; (3) it is spread to the general public by the mainstream media; and (4) it is almost never fact-checked. More.

In 2011, Tom Saving and John Goodman pointed out in Health Affairs that Medicare was setting 6 billion prices on any given day. Writing at Forbes, Goodman says that today that number has almost doubled — to 11 billion. And the way Medicare pays, is the way employers and insurance companies also pay. Of all the things that are bad about our health care system, this probably should rank near the top. Yet it rarely gets the attention it deserves. See: What’s Wrong with the Way We Pay Doctors?

Yet it is the critics who don’t understand how Obamacare is working and how it needs to be reformed. What Trump and Vance are talking about doesn’t mean we have to return to the (pre-Obamacare) bad old days. It means we can look forward to a much better future. More

Even though the United States has the most expensive health care system in the world, we have fewer doctors per capita than most other developed countries, and they are seeing patients less often.. The average wait to see a new doctor in this country is 3½ weeks. At the worst-performing hospitals, one in ten visitors to the emergency room leave without ever receiving medical attention – apparently because they get tired of waiting. Solutions: Let nurses practice to the top of their training and open new avenues for foreign-trained doctors and medical school graduates without residencies. More.