Can you explain what you mean, Riverwild? What do mean by "reversed the decision" and 'how' they are going to reduce budgets off the back of the disabled on Medicare, etc.?



Well, if you can't trust your government to look after the people, who can you trust? What a horrible predicament.

The only way something is going to change is if Americans all band together and demand equal health care for all your citizens. Of course this costs money (increased taxes) and will likely have to result in lower expectations . . but it ensures that everyoine is taken care of.

On American Idol last week, they said that 50 million people in the US are under-insured now. That's a lot of people that need a lot of help . . . and doesn't even include the one's that might be adversely affected by reductions to co-pays, etc. that might happen.

Cherie

I have posted on a number of occasions just how much people who are on Medicare with a Medigap and RX coverage are expected to pay for these drugs - Copaxone would run about $7000 yearly with BSBC - that's ridiculous - and no one really knows if these drugs work - I read these posts and many of you who are on one of them still have flares - so -what to do - it's a very expensive lottery !! And one that a lot of people can't afford and it won't get any better with the government hopping in with their idea of affordable health care - look to Maine and read about Dirigo -

I just did a rough calculation . . .

If there are currently 25,000 people on Tysabri (6% of PwMS in the US), at an average cost of $75,000 per patient, the health care costs for that new drug alone are astronomical:

25,000
$75,000
$1,875,000,000 per YEAR

That doesn't include steroid treatments, twice per year MRI's, several phone calls and visits to doctors and neurologists, etc.

We have a ridiculously expensive disease to treat, and once the R&D is paid, the pharma's are making HUGE profits off us. Perhaps this is where the anger should be directed!?

If we want to reduce costs, this can be partially in our control too by not incurring unnecessary costs. For example, do we really need to know if we have one more lesion every 6 months (new MRI)? Do we need to get back to work one week earlier by using steroids every time? Do we need to reduce our average of 1.5 relapses every two years by 68% (instead of 30% with the CRABs) vs. 0% with no drugs . . .?

Part of the philosophy behind a "user pays/co-pay" approach is to put some amount of onus on the "user" to make reasonably cost-effective decisions . . . or PAY.

(Not saying this is my opinion, as I sit in my ivory tower not having to pay any costs for anything . . . I'm just saying that's how it works in a capitalist economy).

Cherie

I understand your point, Cheri, and don't disagree..The problem is, how can one be "cost effective" when the drug companies are charging $1500 to $2000 a month or even more for the only drugs available for your medical condition? My insurance is decent, but I rarely get MRI's because even with insurance, I have to pay $2000-$3000 (depending on how extensive the MRI is)..I still have to pay ridiculously high monthly premiums, but don't get the medical testing I probably should and stick to the cheap drugs like LDN because of the high co-pays/deductables..It really is outrageous.

i switched from cobra to medicare this month.
shared solutions called me and told me my co-pay for my copaxone was going to be $600! i used to pay $20.

i'm going to ask my dr if he thinks i really need it.
but if it's working do i dare stop?
the risk may not be worth it.

It is outrageous, I agree completely. I blame the pharma's mostly, although I must admit I don't know how much profit the insurance companies are making there either.

Some people just can't cut back. I cost my insurance company $25 a month for LDN, and have had only one MRI once over 17 yrs. I don't have to pay for testing or meds either . . . so it's not a personal cost issue for me.

Some people will take, take, take though . . . and those are the one's that could make some changes to benefit others, or pay slightly higher premiums for the better of all. Unfortunately, some people can be fairly self-centered about this kind of issue though.



If I was doing well on my med of choice, and I could somehow afford to continue to use it, I would. It is a very difficult situation . . . when finances can be the deciding factor over health.

Cherie

According to the full article about the woman who went to pick up her meds and found that her private pay insurance co. had increased the "Tier 4" copays, the insurance company backed off their increase ( reversed the decision) and refunded the money to everyone who had paid the new copay.

As far as how MY state is going to reduce their budget shortfall, whether it will be on the backs of the poor and disabled, the budget hasn't been signed yet and there are ongoing fights right now in the state government...we shall see. I personally think they should get rid of half the state workers and there would be money left over!

Oh dear, Karen...LOL!!

Don't EVEN get me started on Dirigo!!!!!

(Let's talk about Massachusetts! Aren't they requiring their citizens to either GET insurance, or sign up for their new state insurance policy or be FINED for not having insurance???)

I am just so darned thankful that I had my head in the right place for once and I kept my full service BCBS policy when my employer was trying to push everyone to HMO, PPO, Comp plans and Managed care plans! BCBS doesn't even sell full service plans anymore!

Thanks, RW.

From what I've heard around the forums, there are people who are already seeing these increases lately.

I hope that they can find another way . . . most of us can't afford to live on what we get now.

Cherie

here's a snippet of an interesting Op-Ed in this morning's NYT:

There is little doubt that the so-called tiered formularies, in which co-payments rise along with the cost of the drugs, are a sensible approach for encouraging consumers to use the cheapest drug suitable for their condition. But the system seems to break down when it moves to Tier 4 drugs where co-payments can be huge and suitable alternatives don’t exist.

The insurers say that forcing patients to pay more for unusually high-priced drugs allows them to keep down the premiums charged to everyone else. That turns the ordinary notion of insurance on its head. Instead of spreading the risks and costs across a wide pool of people to protect a smaller number of very sick patients from financial ruin, insurers are gouging the sickest patients to keep premiums down for healthier people.

http://www.nytimes.com/2008/04/15/op...html?th&emc=th