"PEHP, which covers 160,000 public employees and family members, is offering plane tickets to San Diego, transportation to Tijuana, and a $500 cash payout to patients who need certain expensive drugs for multiple sclerosis, cancer and autoimmune disorders.

PEHP has been offering free airfare for any members willing to fly out of the country to get medical operations and prescriptions for some time now. This is just the first time that they’ve actually offered to pay them to do it.

“It’s cheaper for us to pay for the drug down there, send them down there and then give them $500 than it is for us to do it here,” Loftis said.

Any PEHP member in need of one of the 13 high-cost drugs approved on the plan will be flown out to San Diego, driven through the border into Mexico, and brought right to a high-end pharmacy in Tijuana to pick up their medication.

The Health Insurance Right To Shop bill, sponsored by Rep. Norm Thurston and Sen. Todd Weiler, explicitly requires Utah’s Public Employee’s benefit and Insurance Program to offer a “savings reward” program to customers who take their business to cheaper providers.


Rep. Thurston has told the Deseret News that he plans on pushing another bill in January that will encourage providers to import certain prescription medicines in from Canada."

That's a lot of work for the patients to fill their prescriptions. Can see how the high costs affect the decision making going into such policies.

I saw that article. It's a sad day when Americans have to leave the country to get drugs at a reasonable cost.

precisely !

Isn't it an option for them? I didn't see where it is mandatory?

Those are just the ones who have insurance. The rest either go without or pay out-of-pocket.

Some of them are through the roof. The one I recently began costs more than $1500 a month retail. Without insurance I wouldn't be able to afford it.

I have a PPO. This means that I have very good insurance when in-network, but little to no coverage out of network. But on those few times when I had to go out of network, I paid a fraction of what someone without any coverage would pay. I only pay slightly more than my insurance company would have paid the provider if I were in-network. In those cases, someone with no insurance would have paid five to ten times what I actually had to pay. The point is that the term 'coverage' is relative. A weak program where you pay everything yourself at pre-negotiated rates (what the insurance company would have paid) is still a good plan sometimes. Too many people with no insurance never even attempt to pay their medical bills. The insurance companies make up their losses by marking-up everything by 5x or 10x or more, for people with no insurance. These are real losses that they can deduct on their tax returns. But it really sucks when you have a choice of paying for ten people on anything you have done, or have to bankrupt the debt. Even weak medical coverage is often way better than no coverage.



Edited 1 time(s). Last edit at 11/04/2018 04:59PM by azsteve.

Preschoolers in Vietnam get a common deworming pill that costs $1. Its price in the UK is $2. Its price in the US is $400. Production cost is between $0.002 and $0.02.

“Pharma Boy” Shkreli didn’t go to jail for price gouging. It’s an accepted practice. That should tell you who’s actually running this country. Enjoy that midterm election.

To take the manufacturer’s side, the regulatory burden in the US is pretty ridiculous. They might have to charge that much.



Edited 1 time(s). Last edit at 11/04/2018 09:47AM by babyloncansuckit.

You're exactly right. I take 3 medications. I have good insurance. 2 of the drugs cost me $10.00 each, after co-pay, for a 30 day supply. The 3rd one is $348.00/ month after co-pay. $610.00/month, without. My neighbor is a commercial pilot and flies to France and Amsterdam 3 times a month. That EXACT same drug, in the exact same package made by the exact same drug company, cost $5.00 for a 40 day supply in Europe. He can buy a 4 month supply (3 boxes at a time) for $15.00. (Cost me an extra 12 pack for his trouble.) Americans are getting the shaft from health care providers, insurance companies and drug companies. All businesses that "donate" to our politicians. It's criminal.

(As long as this non-lds themed thread is allowed)

How wouly Babylon change u.s. pharm regulations?

Take away the Safe & Effective standard?

Copy the Europeans. They seem to know what they’re doing.

“The US has chosen unfettered capitalism as its foundational economic system”

I thought the US chose crony capitalism as its foundational economic system. If you want unfettered, go to China.

Specifics, please

I was very much impressed by what I saw of the European medical system when I was in Italy.

I had developed a cold and then (as usual) a cough that just went on and on and on. Colds invariably turn into bronchitis with me; this has been true since childhood.

Since I was taking a series of tours through various countries, I had no clue (thinking as an American) as to how I would be able to see a doctor and then fill a prescription.

Buddies from the tour group suggestion I speak with a pharmacist while we were in Italy. My Italian is pretty shaky, but the pharmacist had heard me coughing while I waited in line. I already knew how to say "Please, I need medicine for - - -" in Italian. I only had to look up the word for "cough," which I have forgotten, but I had my dictionary.

The pharmacist reached under the counter, fished out something called "Sobrepin," (which is given under another name to patients with cystic fibrosis in the U.S.) and told me to take one with food, three times a day. Halfway through the second day, the cough was noticeably lessened. After three days, it was gone altogether. The Sobrepin plus a tube of toothpaste cost me about $22. No doctor involved.

I was, and remain, VERY impressed.

I learned later that pharmacists are allowed to treat some things like colds, coughs, blood pressure issues, etc. without the doctor having to see the patient. This frees up the doctors to deal with much sicker patients.

This strikes me as an extremely effective way to dispense medical care.

There are elections going on here in NM (like they are everywhere else in the U.S.) and several Democratic candidates are being bad-mouthed by their opposition as supporting "Government-run medical care" (as if that were the very Devil himself.) Hey, from what I've seen, Government-run healthcare isn't a bad thing at all. Easily accessible, available to everyone, affordable - what's not to like?

Perhaps require the pharma companies to sell to U.S. pharmacies at X% of the average rate that they negotiate with Canada, England, and the EU. The rate could be adjusted to allow for a reasonable markup for the pharmacies.

I can see the Mexican President on TV. "We need to build a wall! Make America pay for it!. They're over running our borders to buy drugs. They're not sending us the best people, they're coming for drugs! Make Mexico Great Again!"

You laugh.

The US can't be over-regulated and have unfettered capaitalism at the same time.

There are plenty of regulations against monopolistic pricing. Companies have figured out how to game the current system. Utah is just reverse-gaming the system, rather than fixing it. To be fair, it is a national problem and Utah lacks the clout to fix it. Utah, Orrin in particular, did offer plenty of help in creating the current system, such as it is.

ETA: oops, wrong placement. See SL skipper post below



Edited 1 time(s). Last edit at 11/04/2018 01:17PM by Brother Of Jerry.

It is, BOJ, possible to be both over-regulated and excessively capitalistic at the same time. It all depends on who writes the laws.

Obama's healthcare legislation as originally written had cost controls (European, Japanese, Canadian sort) based on what Romney did in Massachusetts. But he proposed the bill at the wrong time, when the economy was still in the tank and he needed everyone's support to get stimulus done.

Suddenly he realized that he would have to choose between the two initiatives and that he could not fight the pharmaceutical companies. So he talked to them, took out almost all of the cost controls, and passed Obamacare. That is why the eponymous law proved so dysfunctional over the following years.

The upshot is that the pharmaceuticals effectively established the regulatory framework within which they operate. That gave them the power to maintain excessively high prices (penalizing Americans) with impunity. It was Russian-style capitalism: using the legislative system to give themselves oligopolistic power over their industry.

That's what I meant by pharma companies gaming the system. Various attempts have been made to balance patent rights versus fair pricing over the years. The US has so far been singularly unsuccessful at working this out in the pharmaceutical industry. It is a complicated problem. That doesn't mean we can't do significantly better.

It would be hard to do worse.

The problem is that the political will to address the healthcare system comes along roughly every two decades. Hillary botched her chance in the early 1990s and Obama made only marginal progress in 2009.

The ultimate equilibrium point is pretty obvious, but it's going to take years before the opportunity arises. Until then, medical tourism to Mexico is likely to continue.

Healthcare already consumes a quarter of the GDP. Can we wait another 20 years?

Surely don't know. But for some reason healthcare in the US is three times as expensive as in other rich economies. . .

It's crippling the country.

I think because the US has a weak political system. It’s not diverse enough to stave off hostile control. States rights could ultimately save us.

The economy really only climbed out of the Great Depression after FDR instituted reforms to limit the power of capital and strengthen labor. Now that those reforms have been rolled back, the same old problems are returning. The US political system can’t handle 1920-style capitalism. This is where Trump may be turning things around. A big enough Un-Trump critical mass could reign in the Healthcare industry.

...typically, the DEA or FDA will allow an individual to import up to 90 days worth of non-Schedule drugs (narcotics). As long as the items are claimed and inspected at US border crossings, MOST products are OK. Amounts which would be in excess of a typical 90 day supply would be suspect, and might be questioned or confiscated. The US Postal Facility in Richmond, VA, is tasked with sorting most incoming mail from Europe, Asia, and the Mideast. Offshore pharmaceuticals often arrive there for sorting. I have never had any my Euro-purchased products seized or confiscated. The volume is just too massive to be inspected properly.......about a 1 to 10 ratio of actual hands-on inspection. Nor, have I ever had any credit card issues, or gouging. Farmacia Vida in Tijuana has amazing deals on most meds, and the Border Inspectors seem to be sympathetic...go figure.

" Utah, Orrin in particular, did offer plenty of help in creating the current system, such as it is."

Orrin Hatch has taken more money from Big Pharma and their PACS than any member of congress-ever. He's also passed laws to eliminate FDA inspections of supplements? Why do you think that Utah is ground zero for snake oil medicines and MLM's? Other states outlaw such deceptive practices. Utah encourages them.

...Big Pharma is probably the largest lobbying group in DC. The one thing DJT SHOULD have done in addition to his "Right To Try" legislation, would have been to open up the offshore pharmacy market to Americans. This would have immediately forced the Pharma-Mafia to drop pricing to compete with the foreign drug manufacturers. I have VA drug benefits, which are comparatively cheap, when compared to Medicare pricing, but the actual cost of the identical foreign generic drugs is about 45-55% cheaper.

That is very good.

Once again, like with religion, it all comes down to dollars!!!

I am sick of the hoops and decisions being made by insurance companies and deals with big pharma.

I recently had to have extra dental x-rays because my insurance "recommends" it or they won't pay. They are setting the algorithms based on what deals and money they can make together, not on actual health needs.

IMO, it's time for one basic standard of care without all the shopping around. Sick people shouldn't be expected to go to another state or country to play the insurance game.

Drug pricing is complicated. One reason they are expensive in the US (remember that "expensive" is a relative term) is that the manufacturers use the revenues from their US sales to offset the losses they incur (or at least, the reduced profits) from selling to countries like Mexico and Canada where the prices are monitored by the governments.

The US has chosen unfettered capitalism as its foundational economic system, and then the citizens are surprised when it performs as intended.

slskipper Wrote:
-------------------------------------------------------
> The US has chosen unfettered capitalism as its
> foundational economic system, and then the
> citizens are surprised when it performs as
> intended.

If it had performed as intended would we all be dying early because of the lack of food and drug regulations that we didn't have in the 19th Century?

What about all sorts of "fettered" small companies?

What exactly is "performs as intended?"

Healthcare shouldn't be an option. It really should be a right for all.

That's one thing our country is backwards on, that and gun reform.

If we removed all state borders with respect to healthcare coverage, then the most competitive (best deal for the average person) would win. Giving healthcare providers monopolies within certain states, leads to the current situation. It is the removal of regulations that lowers prices. Obamacare wouldn't appeal to anyone if prices were lowered enough by the free market.

Also, the concepts of healthcare coverage needs to be separated from insurance. Healthcare coverage and insurance are two distinct and different things. With insurance, you pay in to a system that you hope you never need, in the unlikely event that you actually do come to need it some day, and that if you live long enough you will definitely need eventually. Then when you do eventually need it, you are covered by that insurance. This is different from healthcare coverage of pre-existing conditions, where there is a one-hundred percent chance of needing to have large medical expenses covered. We do need to help those who can not pay their own medical expenses somehow. But this is a different riskpool than those that are self-funded and self-sustaining. If we rob the self-funding/self-sustaining riskpools to pay for the expenses of the riskpools that are not self-funded, we get the Venesuela affect. Pretty soon, the concept of actual "insurance" when compared to "healthcare coverage", are indistinguishable from one-another. Too many people are carrying around so-called 'healthcare insurance' cards that are nearly worthless for what it can actually do for them. Large healthcare providers such as United Healthcare stop offering self-funded/self-sustaining programs in your state (like no food on store shelves in Venesuela), and the free markets die there. Overall prices for so-called 'insurance' goes up so that no one can afford them unless they can qualify for a government subsidy. That happens when we rob properly funded insurance plans to pay for the healthcare needs that were not previously a part of the properly funded plan. Then, when the market has been damaged enough by these practices, we need to start buying medications from other countries. What we need is a healthy injection of capitalism to the system, and the removal of regulations.

If medical coverage is a human right, then medical doctors and those who pay them become our indentured slaves. As things are now, no one is denied life-saving medical services, and medical debt can be bankrupted.



Edited 2 time(s). Last edit at 11/04/2018 04:38PM by azsteve.

A couple of points.

To begin with, in your second paragraph you insist there is a distinction between "healthcare coverage" and "insurance." That is of course wrong; the terms and systems are synonymous--and, in fact, in your first paragraph you use the word in the generally accepted sense.

But more important, you don't understand how healthcare economics work. The notion that state regulation helps the insurers and pharmaceuticals maintain higher prices is counter-factual in the extreme. It is those companies' influence over Congress and the Presidency, which in fact they have bought and paid for, that has created the mess the US is in. Fully opening up a healthcare system will merely transfer more power to oligopolistic companies that have no reason to respect market forces.

Finally, how do you reconcile your suggestion here that the federal government should enforce a national healthcare system against the wishes of the state governments with your usual insistence on states rights? Could it be that once the federal government is controlled by people you like, you want to dispense with the constitutional separation of powers and run the country like a dictatorship?

"We have given you a constitutional republic," Franklin said, "if you can keep it."

Here in Australia I am on a pension which everybody gets regardless -unless you are rich- and all drugs are about $5.75 a prescription.

And I was bitching about that!

Alan,

You only THINK you are getting good healthcare at decent prices. It is an illusion, however, a mirage created by the Adversary.

I would like to introduce you the One True Healthcare System. If you will give me 10% of your income in co-payments, you will gain your own testimony of the benefits--even health in your navel and marrow in your bones--and you will know genuine happiness.

While I await your credit card number, can I introduce you in an urban assault rifle?



Edited 1 time(s). Last edit at 11/04/2018 06:49PM by Lot's Wife.

Australia knows how to care for its people.

I now reside in a county with a large % of retired ppl; one of the best insurance comps, Humana, offers their 'advantage' program in other parts of the state (Washington), but not here.

So, it's not only state boundaries that matter!

Many of the surgeries & procedures that physicians do requires after-care, some foreseen, some not;

what happens when a patient needs unforeseen follow-up care after returning home?

I'm from the UK originally but live in the USA now. A drug I have to take for an autoimmune disease costs in the UK £120 per month, that's private, not NHS which is only £8.50 a month. In the USA it's $1200 a month. How on earth can that be justified? Without insurance I'd be saving loads of money if I flew back to the UK once a quarter and got a private prescription there.