Bad news for Medicare; good news for Big Pharma

One thing about which not only Medusa and Orangehead agree--and even Bernie--is the raw deal the American Public is getting from Big Pharma.

Big Pharma in control?

Maybe; maybe not. To upset this dire prediction of uneven bargaining we must think outside the box. One procedure, may be not the only one--or even the best one--would be for Uncle Sam to allow our citizens to buy pharmaceuticals outside this country--like Canada, for example. The Canadians get the same quality drugs as we do, although under different names at times.

Outsourcing? Isn't that bad? Isn't that really bad?? It is certainly no worse than letting giant corporations outsource workers and even their entire operations in other countries. A potentially beneficial effect of obtaining cheaper drugs elsewhere might be to free up enough money so that people don't have to bankrupt themselves paying for over-priced drugs. That "new-found" money can then be put immediately back into the economy, thereby stimulating it; as opposed to money hoarding by Big Pharma, which removes most of their income from the general economy and into their glutted bank accounts.

Another possible consequence of this arrangement would be to put pressure on Big Pharma to lower their domestic drug prices so as to compete with foreign-supplied pharmaceuticals.

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Where makers of "biological" drugs are pressuring for extended patent protection for brand-name drugs.

http://www.counterpunch.org/2015/10/07/tpp-big-pharmas-big-deal

I take a lot of different medications, and have gone for brand-name as long as we could hold out. The co-pays have increased by leaps and bounds. But I've had a few reactions going to generics, so have been switching them one at a time, for an extended period to see how it goes. I've had "success" with certain generic brands, so have tried to stay with them. Fortunately, the pharmacy we go to is connected with a health system hospital, so they are willing to order the ones I can take. So far that works. I am just glad that I don't need any of the new "biological" meds, wow, the prices. And now, of course generic prices are soaring. See any turnips that still have blood in them? I wonder where the customers will come from?

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MsGrin's picture

She claims she's FOR reducing drug costs, but we know she felt TPP was the gold standard, and she's already put at least two folks on her new team who endorse it. My assumption is that she's counting on Obama to finagle a way to get it signed before she takes over so the blame doesn't fall on her.

She could give a whup about those of us with physical ailments who may have a different definition of 'flat broke' than the one she used when they left the White House.

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'What we are left with is an agency mandated to ensure transparency and disclosure that is actually working to keep the public in the dark' - Ann M. Ravel, former FEC member

Anyone who has been a "user" of medical services sees that it's reaching a point of no return. The insurance companies rule the roost, but even so, I wonder how long the whole charade can last. Ever more people are the hostages. Shortly, it will claim nearly all of any average person's income. Seeing Obamacare blowing up is not a surprise, but now they have something set in stone (or in the tax code at least) requiring people to pay ever more for nothing, whether they "buy" one of the few plans or not. Nice work, Obama.

Obama=Clinton, I don't expect we'll be seeing too much of him again, hope not anyway. He's busy refining his "legacy".

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For those who don't yet know, the place to buy all generic medication is COSTCO.

You do not have to be a member of Costco to use the Costco Pharmacy I can't praise the Costco pharmacy enough. Had to take a generic medication called an aromatase inhibitor, the local pharmacies were charging up to $400. a month ( 30 tablets, CVS, Walgreens, etc.) telling me it was an "expensive generic." Knew the brand name was expensive, had taken it for a few years. Checked the next time I was at Costo = about $30 a month. Asked if I could get a specific generic, knew of friends having trouble with one of the generics, response : "Of course!" For the years I had to take the medication, the person checking me out at the register ALWAYS checked the "brand" to make sure it was the same as "requested by customer" on my record.

My Medicare Part D ( BCBS) raised the prices on generics - now CHEAPER for me to buy the ones I use at Costo for CASH, rather than pay the co-pay to BCBS. Still have to pay the $50. a month fee to BCBS, and yes, I will definitely be changing when option available in a few months. The "deductible" for BCBS Medicare Part D the past few years went from $90 to now $350. Yearly Deductible. Before you get to pay "just" the co-pay, evil!

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MsGrin's picture

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'What we are left with is an agency mandated to ensure transparency and disclosure that is actually working to keep the public in the dark' - Ann M. Ravel, former FEC member

MsGrin's picture

First of all, clearly, I answer (and, well even POSE) this question differently:

Who would you rather have bargaining for you, a private business executive representing 65 million to 85 million members, or a government bureaucrat representing roughly half as many?

I don't know to whom (other than his stockholders) that executive is beholden - except it generally is NOT his/her 'members'.

Sure, Part D confounds being able to lower prices - it was SET UP to do just that. It can be rewritten or revoked with enough support.

Which part of the following quote does Doxycycline fit into with regard to rising prices?

So why do people believe drug costs are out of control and need government intervention? Because prices are soaring for some new highly effective drugs and some older ones that small numbers of patients depend on.

Sudden increase in cost of common drug concerns many

Doctors use doxycycline to treat a wide range of issues, including everything from acne to Lyme disease, anthrax exposure and even heartworm in our pets.

However, the once cheap and effective drug has now dramatically gone up in price, and that has health professionals concerned.

Hospitals like Vanderbilt University Medical Center keep doxycycline in stock, but some folks worry the cure for their ailment could now be financially out of reach...

Not long ago, the pharmacy at Vanderbilt's hospital could purchase a 50-count bottle of 100 mg doxycycline tablets for $10, but now the same bottle costs a staggering $250.

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'What we are left with is an agency mandated to ensure transparency and disclosure that is actually working to keep the public in the dark' - Ann M. Ravel, former FEC member

riverlover's picture

and everyone forgets to warn patients that doxy is a photosensitizer, you'll get nasty sunburns in sun.

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Hey! my dear friends or soon-to-be's, JtC could use the donations to keep this site functioning for those of us who can still see the life preserver or flotsam in the water.

LeChienHarry's picture

for six months in the spring and summer a couple of years ago when I was in remission (L. Borreliosis) and no sunburn! So there must be more to it. It does seem to increase sensitivity in those of us with infection.

Speaking of leeches: they are beginning to reintroduce their use especially for would clotting in Europe. Creepy I know but apparently effective.

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You may choose to look the other way, but you can never say again you did not know. ~ William Wiberforce

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Alligator Ed's picture

It used to known as Terramycin or something like that. No one prescribes brand doxycycline because the generics are just as good. Yet Big Pharma is managing to boost prices mercilessly--and I use that word advisedly. Valium's been around 40+ years, and even though there are multiple suppliers of generic diazepam, the patent owner is raising brand Valium prices to absurd heights.

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MsGrin's picture

as well. Is that not correct? My primary care doc was quite upset about it.

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'What we are left with is an agency mandated to ensure transparency and disclosure that is actually working to keep the public in the dark' - Ann M. Ravel, former FEC member

Citizen Of Earth's picture

as the number of Lyme cases has exploded. Do people really think the Healthcare System gives a crap about their health?

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Donnie The #ShitHole Douchebag. Fake Friend to the Working Class. Real Asshole.

Citizen Of Earth's picture

It's Immoral.

That is the bitter pill your esteemed representatives in congress (and Obama) have shoved down the US commoners throats.

According to the CDC, lyme disease is the fastest growing vector-borne, infectious disease in the united states. CDC reports: Lyme disease infects 300,000 people a year. 10 times more Americans than previously reported.

Throw the bums out. All of them. The longer they stay elected, the more corrupt they become.

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Donnie The #ShitHole Douchebag. Fake Friend to the Working Class. Real Asshole.

MsGrin's picture

Last I was paying attention, they were admitting to 200K cases. And that reference was actually in a footnote from quite a number of years ago now.

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'What we are left with is an agency mandated to ensure transparency and disclosure that is actually working to keep the public in the dark' - Ann M. Ravel, former FEC member

Citizen Of Earth's picture

http://www.ilads.org/lyme/lyme-quickfacts.php

And from CDC - "In this study, researchers estimated that 329,000 (range 296,000–376,000) cases of Lyme disease occur annually in the United States."
http://www.cdc.gov/lyme/stats/humancases.html

And lots of cases go un-diagnosed because doctors are dumbasses to Lyme symptoms. I had late stage Lyme a couple years ago. Doc told me I had osteoarthritis. I asked if it could be Lyme. He said noooo, not with those symptoms. He was dead sure of himself. I nagged him and he agreed to prescribe a Lyme test. Sure enuff, the doctor was wrong. And the osteoarthritis therapy he had planned to put me on would have destroyed what was left of my joints. If you read the Lyme forums, stories like this are quite common.

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Donnie The #ShitHole Douchebag. Fake Friend to the Working Class. Real Asshole.

MsGrin's picture

I don't remember us interacting on this topic at TOP. We used to have a Lyme Disease Awareness group, and for a couple years we did a diary series in May.

Took me 5 years and 24 docs before someone suggested Lyme - I was unaware of it. Was CDC positive. Figured out I'd been infected 16 years before I was diagnosed, but I'd only really been debilitated the last 5. Since we know pretty clearly when I was infected (because of a medical incident which came about soon after), I also suspect my father's Parkinson's diagnosis was incorrect. He was seated next to me in tall grasses when I was infected. He and my stepmother refused to complete testing. Every time he would get abx for various infections, he would rally from the shape he was in due to 'Parkinson's'. It was torture for me that they refused to see somebody who could rule it in or out. He passed on a few months ago now. I'm furious at what they do to obfuscate this disease.

I trust you're aware there are at least a small handful of Lymies (or people with family member Lyme) here who were previously at TOP. I tried for two or three years to get a panel at NN on the topic. Never made the first cut. Dr. Dworkin believes it's CT, of course, and that belief pervades.

I once had a running tally of people who said they got tested when they read the Lyme diaries - pretty sure it was more than a half dozen.

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'What we are left with is an agency mandated to ensure transparency and disclosure that is actually working to keep the public in the dark' - Ann M. Ravel, former FEC member

Citizen Of Earth's picture

Sorry to hear about the family members that did not get diagnosed. I sometimes wonder if some doctors suspect Lyme and do not diagnose it just to keep the chairs in their waiting room full. Yes, I've grown cynical.

This summer Kris Kristofferson finally got a Lyme diagnosis after 7 years. Docs previously diagnosed him with Alzheimer's disease. So mis-diagnosis can happen to anyone, no matter how fancy your doctor is. Doctors are truly clueless. I think I read somewhere that it is the second largest disease epidemic in the US (after AIDS).

http://www.cbsnews.com/news/kris-kristofferson-misdiagnosed-alzheimers-h...

I have mostly recovered (~90%). It took a couple years to rebuild joint strength. Praying that it does not come back.

I've read a couple Lyme diaries at TOP in the past. I stopped reading at TOP over a year ago, just occasional visits. So I missed your May diary. I think awareness is key and people need to be educated b/c doctors clearly are not. I had a couple TOP friends who also had Lyme. I hope you have recovered or are in recovery.

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Donnie The #ShitHole Douchebag. Fake Friend to the Working Class. Real Asshole.

MsGrin's picture

My brain issues have gotten a bit thicker and I'm looking for more medical assistance with that. But I survived. That was a lot of years of deep fog for me.

We did the May series in 2009 and 2010. The group is still up: http://www.dailykos.com/blog/Lyme%20Disease%20Awareness I've sent you and invite.

Glad you've done so well.

Gonna fix your sentence: Misdiagnosis happens to nearly everyone (with Lyme) initially.

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'What we are left with is an agency mandated to ensure transparency and disclosure that is actually working to keep the public in the dark' - Ann M. Ravel, former FEC member

Citizen Of Earth's picture

Mine was treated about 8 months after the initial infection, so one month of Doxy did the trick. I know it is much harder to recover the longer it goes untreated. So I was lucky in that respect.

Since the TOP March edict for "Bernistas to Get the Hell Out" , I rarely go there. So don't feel ignored if I don't accept the TOP invite. But if you cross post future Lyme essays here, I will certainly attend.

All the best, COE.

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Donnie The #ShitHole Douchebag. Fake Friend to the Working Class. Real Asshole.

LeChienHarry's picture

new numbers, is that these are annual New cases. So what is the actual total case load? It must be in the hundreds of thousands especially with doctors in places like, ahem, Lyme, Connecticut saying there is no L. Borreliosis.

Dumbasses indeed.

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You may choose to look the other way, but you can never say again you did not know. ~ William Wiberforce

If you can donate, please! POP Money is available for bank-to-bank transfers. Email JtC to make a monthly donation.

People who require doxycycline to treat Lyme disease, toxoplasmosis, etc, can send a hardcopy prescription to one of several Canadian online pharmacies and get a three month supply for under 30 cents a pill... Which is about an order of magnitude more than the generic used to run, but an order of magnitude less than it costs in this benighted country.

My personal theology does not include a hell, but the oligarchs are making me rethink that philosophy....

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My policy will no doubt cease to be offered. I will have virtually nothing affordable to replace it. In May next year, I will go on Medicare. I figure there will be some glitch (trap) that allows me to switch, but penalizes me for discontinuing the new policy.
Has anyone made the switch that can sort of clue me in on how to get out of the Marketplace without penalty? Or am I worrying about nothing?

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"We'll know our disinformation program is complete when everything the American public believes is false." ---- William Casey, CIA Director, 1981

riverlover's picture

but in under 2 years I face the same dilemma. No idea what UHS is doing, no mailings yet. I think Medicare ($120/month now?) is the correct route, any other "insurance" policies extant may disappear by then. Sorry, let us soon-there know your outcome.

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Hey! my dear friends or soon-to-be's, JtC could use the donations to keep this site functioning for those of us who can still see the life preserver or flotsam in the water.

I could, and wound up, keeping my group insurance from work. Medicare only pays 80%, and has deductibles, which was a lot better deal before costs of everything went out if control. So far, Medicare is just a lot of paper every time I have a prescription refilled. Not that I want to give it up.

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riverlover's picture

I am looking at looming hospital bills (Yes! 2 nights, I think) and need to see what UHC is paying and what Non-participator's bills I need to submit. One wicker basket now, on the dining room table. Already have an instant radiology bill for $53.

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Hey! my dear friends or soon-to-be's, JtC could use the donations to keep this site functioning for those of us who can still see the life preserver or flotsam in the water.

It's always the same things so far, but I do at least skim it, just in case. So yes, time.

I read that people should ask about and fight being admitted "on observation status" (even if you're told you're admitted, and have been given a bed) in the hospital, because Medicare considers you an outpatient then, and won't pay for everything - some drugs, I think, and no nursing home care if you need it after your stay.

Many Catch 22s in our system.

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The supplemental insurance I will have to buy is sure to put me on a steady cat food diet.
I have given up on ever retiring.

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"We'll know our disinformation program is complete when everything the American public believes is false." ---- William Casey, CIA Director, 1981

Unabashed Liberal's picture

out that we could be disqualified from enrolling in a Medigap supplemental insurance policy once Mr M retires.

It made us furious--since our current Group Health Plan coverage, combined with the Traditional Medicare plan, would not only be cheaper, the coverage would be far superior.

(It's true that the upfront annual plan deductible would be higher, but it would be offset by the much lower monthly premiums.)

Also, Mr M's group health plan is comprehensive--it includes RX coverage, except that Tier 4 is somewhat limited. But, for that matter, so is the coverage in most of the Part D plans that I've checked out. (And I've logged in countless hours--and still doing so-- vetting the scores of Medigap and RX plans available to us.)

Unless something changes dramatically--and, if anything, with more 'reform,' premiums will likely increase, not decrease--we'll be looking at minimal monthly health premium increases of approximately $1000 when we enroll in Traditional Medicare.

Obviously, this would not be the case if our lawmakers hadn't sold us out (to the insurance industry).

And, enrolling in Medicare Advantage (MA) is absolutely off-the-table, since those plans are basically a crap shoot, with their (mostly) incredibly narrow in-network providers--especially if one doesn't live in a major metropolitan area.

Bottom line--for us, enrolling in Medicare is a rip-off.

Help

Mollie


“I believe in the redemptive powers of a dog’s love. It is in recognition of each dog’s potential to lift the human spirit, and, therefore, to change society for the better, that I fight to make sure every street dog has its day.”
--Stasha Wong, Secretary, Save Our Street Dogs (SOSD)

National Mill Dog Rescue (NMDR) - Dogs Available For Adoption

Update: Misty May has been adopted. Yeah!

Misty May - NMDR

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Everyone thinks they have the best dog, and none of them are wrong.

And (so far - we have a GOP governor) it still covers vision, dental, and prescriptions. I could even keep a supplemental plan I got at work that covers half the cost of things like crowns. It does cost more than the officially "Medigap" plans, though, but way less than the ACA plans. Even including the Medicare payment.

I don't think you'd need another Medigap plan on top of your group health one.

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Unabashed Liberal's picture

that we would almost certainly knock ourselves out of eligibility for Medigap Insurance, if we postpone enrollment until Mr M retires--likely by the end of next year.

Since we'll both become eligible for Medicare by next Spring, I'm still checking out all the Medigap and Part D plans.

If it weren't for the Medigap policy glitch, we would do the same thing (that you're doing), since we have extensive health insurance offerings--dental, eye, mental health, supplemental, cancer, etc.--through Mr M's employer.

Of course, our medical plan benefits have rapidly deteriorated since the ACA was enacted. OTOH, it would work really nicely as a 'primary' insurer, with Part A (which has no premium) and Part B as the 'secondary' insurer. It would have been less expensive, and better coverage for us, as well.

But to do that, we'd have to risk carrying twenty percent of the uncovered Medicare expenses, once Mr M retires. And we're not prepared to take that risk.

We can already see that we'll be 'taken to the cleaners'--compared to only carrying Medicare Part B, and our Group health premiums--when we enroll in Traditional Medicare, plus the other two types of plans.

BTW, some of the better, or more comprehensive first and/or high dollar Medigap Plans will be discontinued in 2020--due to the 'Doc Fix' legislation passed last Spring. We're keeping that in mind, as we make our selections.

Nice to chat with you!

Postscript: Did the Medicare folks inform you that you can be rated, or denied coverage altogether, if you don't sign up during your one-time initial Medigap enrollment period?

Mollie


“I believe in the redemptive powers of a dog’s love. It is in recognition of each dog’s potential to lift the human spirit, and, therefore, to change society for the better, that I fight to make sure every street dog has its day.”
--Stasha Wong, Secretary, Save Our Street Dogs (SOSD)

National Mill Dog Rescue (NMDR) - Dogs Available For Adoption

Update: Misty May has been adopted. Yeah!

Misty May - NMDR

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Everyone thinks they have the best dog, and none of them are wrong.

because it still sounds like my situation. I don't understand how you'd knock yourself out of Medigap policy eligibility. As far as I know, they'll sell a Medigap policy to anyone anytime. I agree we can't risk that uncovered 20%, which is why I kept my work policy, for that 20%, plus the extras. Doesn't yours let you do that? I worked to 67, and the work benefits people asked me to sign up for the free part of Medicare as soon as I was eligible for it, but it never got used.

I know we do have to continuously carry Part D, for pharmaceuticals, but my group work plan counts as a qualified plan for that. So I'm confused, but I'm not an insurance expert. Am I going to be in some kind of trouble?

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MsGrin's picture

I'm under 65, and most states do not make Medi-gap policies available to those of us who qualify for Medicare (which I've been on since about age 30). That means if the young-uns want any 'extra' coverage, we have to do replacement plans. Which have a lot that is not desirable.

If one turns down Medi-gap in the window when eligible, that's it. Must be a concession to the insurance companies who do not want to pick up extra enrollees when they get sick and realize they need more expensive coverage. I become eligible for those plans when I hit whatever the age is for my cohort - I think 67 (which is likely past my lifespan if one were to ask statisticians).

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'What we are left with is an agency mandated to ensure transparency and disclosure that is actually working to keep the public in the dark' - Ann M. Ravel, former FEC member

More awfulness.

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The federal guidelines for Medicaid & SNAP (food stamps) currently do not consider assets, only income. (They do draw the line, however, on vacation property, boats & expensive vehicles.) You may want to look at the income guidelines just to see if you're eligible for Medicaid.

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They'll go after your estate for it when you die. Which probably won't bother you at that point, unless you had other plans for it.

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Unabashed Liberal's picture

for Medicaid monthly capitation fees, common to Medicaid managed care plans (HMOs, ACOs, etc.) That is only if an individual is age 55 or older, though.

IOW, even if you are never seen by a health care provider, a lien could be placed on your estate to recover the fees. (age 55 or older)

If you ask me, lifting the asset test was basically a 'racket.'

Other than Washington or Oregon (sorry, it's been a while--can't remember which), I don't know of any states which followed through with changing their laws to exclude folks who are enrolled in Extended Medicaid, from MERP.

Of course, IMHO, it is unconscionable to set up a health care program for anyone--much less the lowest income Americans--and lien their estates for payment upon their death.

Mollie


“I believe in the redemptive powers of a dog’s love. It is in recognition of each dog’s potential to lift the human spirit, and, therefore, to change society for the better, that I fight to make sure every street dog has its day.”
--Stasha Wong, Secretary, Save Our Street Dogs (SOSD)

National Mill Dog Rescue (NMDR) - Dogs Available For Adoption

Update: Misty May has been adopted. Yeah!

Misty May - NMDR

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Everyone thinks they have the best dog, and none of them are wrong.

Since the law says that everybody has to have Obamacare, this is forcing people to be indebted whether they want to or not.

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Beware the bullshit factories.

Unabashed Liberal's picture

test when they established Expanded Medicaid.

To gouge more people!

Talk about a windfall--allowing folks with substantial accumulated assets into the Medicaid Expansion program, therefore, expanding the pool of beneficiaries who are subject to MERP.

Uncle Sugar couldn't have asked for more!

Remember, as a technicality, a laid off/unemployed professional, or even CEO, once or if he receives no monthly income, can only qualify for Medicaid under ACA law (unless he/she has a spouse, who has income that puts him/her over the FPL up to 133 percent).

Law on that is sorta murky. I've read that one can be auto-enrolled in Medicaid, if one qualifies for it [by income, since there is not asset test].

But, there may be a way to opt out. Not sure.

For certain, though--you wouldn't qualify for premium assistance/tax credits in the ACA Health Exchanges. (if you are Medicaid eligible)

So, if an individual who by monthly income is Medicaid eligible can opt out--they'd likely be stuck with paying the penalty tax and going uninsured, or paying through the nose if they could afford to take out a private health insurance policy outside of the ACA Health Exchanges.

Not much of a choice, eh?

That why I called it a 'racket.'

Wink

Mollie


“I believe in the redemptive powers of a dog’s love. It is in recognition of each dog’s potential to lift the human spirit, and, therefore, to change society for the better, that I fight to make sure every street dog has its day.”
--Stasha Wong, Secretary, Save Our Street Dogs (SOSD)

National Mill Dog Rescue (NMDR) - Dogs Available For Adoption

Update: Misty May has been adopted. Yeah!

Misty May - NMDR

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Everyone thinks they have the best dog, and none of them are wrong.

can't possibly fix what's wrong with our healthCARE in this country, along with "allowing" Medicare to negotiate prices. The ONLY answer is Single Payer, and to nationalize the ENTIRE SYSTEM, INCLUDING DRUG RESEARCH AND DELIVERY.

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Hawkfish's picture

Near as I can tell from CDC data, the 50% premium we pay in this country over the UK is mostly 4 things:

  • Insurance profits (10%)
  • Drug markup (5%)
  • Hospital recoding (no data)
  • Physician salaries (50% higher, not sure of the impact)

So single payer helps with the first two (and maybe the third) but getting medical personnel on the payroll is needed to deal with the last.

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We can’t save the world by playing by the rules, because the rules have to be changed.
- Greta Thunberg

legislation passed that requires a foreign doctor to complete a residency requirement in the USA even though they've done that in their home country. Why would a doctor from Germany or Denmark(say) need redundant training before being allowed to treat patients? The answer, to me anyway, is to protect the too-high salaries of American doctors.

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"The justness of individual land right is not justifiable to those to whom the land by right of first claim collectively belonged"

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Twain Disciple

LeChienHarry's picture

in Europe, but must be re certified in the US. This is redundant. The real irony as was exposed in the flu shot shortage several years ago, is that many meds sold in the US are produced in other countries anyway. Germany for one. But Israel, the far east etc. Domestic production must be a small percentage of actual drugs made available for use.

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You may choose to look the other way, but you can never say again you did not know. ~ William Wiberforce

If you can donate, please! POP Money is available for bank-to-bank transfers. Email JtC to make a monthly donation.

We can never know, but federal agencies seem to be very much on the side of those they are supposed to regulate.

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But it isn't that recertification isn't a good goal-it's HOW and WHO does it, no?

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I made a different point. However, that point was relevant to what you posted about thalidomide.

Laws, regulations and government agencies, including the IRS, the SEC and the FDA, do not exist in a vacuum.

If the FDA or any part of government, uses my tax dollars to protect me, everything government does is all good. If, however, it's going to use my tax dollars only to lull me and make Merck even richer, then it's all bad, even criminal, but for ancient rules that "the king can do no wrong" (aka, sovereign immunity, which courts inexplicably passed from kings, who allegedly ruled by divine right, to allegedly representative governments, chosen to rule only by mere, fallible mortals). Important things in adult minds are rarely as simple as the two extremes I've cited, but a tipping point sure is in there somewhere.

Yes, whether recertification is good thing or a waste, perhaps even a con, depends on how well it's done, but that also means one word does not resolve the issue. Moreover, if it is not being done right and I/we don't know how to get government to do it right....

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Hawkfish's picture

We have a family friend who is a licensed pediatric nurse from Germany, and she couldn't practice in this country. Of course its not like there's a shortage of that specialty or anything...

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We can’t save the world by playing by the rules, because the rules have to be changed.
- Greta Thunberg

Granma's picture

Are partly the time and office help needed to deal with insurance companies. Single payer lowers their costs.

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health care companies. The day of doctor-owned practices is fading fast.

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"The justness of individual land right is not justifiable to those to whom the land by right of first claim collectively belonged"

We pay for most of the research, and then pay again so the drug companies can make huuuuge profits.

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Sorry, double post.

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The greed is right out there now for all to see. So, a token attempt to block their deal this time (wink, wink) gets at the truth, no beating around the old bush.

Aetna CEO To Justice Department: Block Our Deal And We'll Drop Out Of Obamacare

http://www.npr.org/sections/health-shots/2016/08/17/490202346/aetna-ceo-...

Here's the actual letter:

http://big.assets.huffingtonpost.com/AetnaDOJletter.pdf

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I thought the US government didn't negotiate with terrorists?

But they've proven that they cannot cannot be allowed a monopoly, especially after already threatening to pull out of apparently less profitable areas. Immediate nationalization is clearly the only answer, as they've just shown. Healthcare is a right, not a privilege.

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Psychopathy is not a political position, whether labeled 'conservatism', 'centrism' or 'left'.

A tin labeled 'coffee' may be a can of worms or pathology identified by a lack of empathy/willingness to harm others to achieve personal desires.

Alligator Ed's picture

which, translated means "You're not letting us plunder the populace as much as want."

Before I retired, Obama, mandated that all physicians adopt EHR (electronic health records) or face financial penalties. This is a total scam and leads not to better medical practice but actually worse. I won't dwell on details. In my own practice that experience was a disaster. I purchased the EHR recommended by the American Academy of Neurology. The program was so complex that when IT guys from two different companies tried to debug it, they each said they had never seen anything like that and were unable to correct whatever glitch was there. This episode cost me $38,000, although I could write much of it off as a business expense.
Another tidbit

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Pluto's Republic's picture

…the government will no longer come between we, the patients, and our drug maker's profits. /snark

This sacrifice (penalty) will be paid by citizens of the countries signing the TPP. Pharmaceutical corporations are currently asset stripping USians for a "kick start" into their new role as a TPP enforcer.

Please be aware (as is the rest of the world) that the TPP is not a trade agreement. It is a geopolital weapon installed to block commercial development in China and Russia. It creates a potential physical block to Pacific trade by China and Russia. The TPP is also a weaponized sanctions machine formed by the nations that lining the Pacific Rim.

The TTIP is the Atlantic cohort of a physical two-pronged attack on the "idea" of Eurasia and a multi-polar world.

The countries that are coerced to sign on will get nifty war machines for fighting potential boogymen, along with protection-racket offers of military back-up from the US. (Do you recognize the Clinton-Foundation-style deal, with credible whispered promises of future perks?) Each nation's signers know that their people will be asset-stripped to underwrite the costs of this US quest for Empire. It's the kind of offer these leaders dare not refuse.

Under the TPP, certain US corporations are weaponized, and will act as "enforcers" against the countries that join, should they not comply. The pharmaceutical makers are big players in geopolitical enforcement. They have been harshly punishing the people of Crimea by withholding the drugs they need, for example, since their majority vote to Reunify with their ethnic mother country, Russia.

Sanctions against Russia and China, because their development stands in the way of the Neocon Dream of a US Global Dictatorship, will shoot these countries into famine, at best. At worst, we should recall Pearl Harbor, which happened the last time the US used weaponized sanctions. I call it a little "9/11 moment."

… Speaking of PNAC, did you ever read PNAC !!? It was written in 2009 and it lays out, the bloody step-by-step path to Empire that the US has embarked on in the Pacific. The author of PNAC II is that high-ranking Neocon, Hillary Clinton.

I was so shocked when I read it at the time, that I started my own blog to spread the word about it. Not that it matters. In fact, it's probably better that the people don't know the cause of the fall out they are dealing with. They are blocked politically from any remedy.

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Populations don’t like wars. They have to be lied into it.
That means we can be “truthed” into peace. — Julian Assange