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.

34570cookie-checkWho Will Pay For The Expensive Drugs?