Who Will Pay For The Expensive Drugs?


There are more problems on the way for the Affordable Care Act.  It turns out that “some states are allowing insurers to charge patients a hefty share of the cost for expensive medications used to treat cancer, multiple sclerosis, rheumatoid arthritis and other life-altering chronic diseases.”   In California, patients would pay up to 30 percent of the cost of some specialty drugs. In other words, the sickest patients may be unable to afford their prescriptions and that is not what this plan was all about.   Or was it?  What people forget is that there is no endless bucket of money somewhere paying for all this.  WE are paying for all this and no matter what plan was created, there cannot be an empty check to cover everything.   Do you really need a drug that costs a lot more but has only minimal benefits over a generic?  Do you really need a robotic surgery because it sounds cooler but may not be better than the old-fashioned way?  Do you really need an MRI for your ailing back or do you wait a couple of months to see how things turn out?  Should every health plan cover massages?  They feel great but do they really do much?   The easy thing to say is COVER EVERYTHING but that breaks the system and then nothing gets covered.  The hard thing to do is say NO to anything but unfortunately, that is what has to be done.   There is no perfect system and there has to be some boundaries that are NOT affected by political pressure.   Will the ACA be that system?   Will the gov’t stick to its guns?   Time will tell but if you see rule changes start happening due to a lawyer going to the press because his client can’t get a medication then you know it is a lost cause.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  1 comment for “Who Will Pay For The Expensive Drugs?

  1. Kathy Wire
    May 14, 2013 at 10:54 am

    Query: is that the government’s problem or does most of the population try to live in that alternate universe where you can have it all?

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