“Imagine what it would be like if a grocery store never displayed the price of anything. And the price you’re charged might be totally different from the price the next customer is charged for the same product. In fact, suppose you couldn’t even pick your own groceries.” This is how drugs are sold to people in the United States, according to Dr. David Belk in his truecostofhealthcare.org website.
Dr Belk writes about the scam being perpetrated by pharmacies and insurance companies – and the victims are people with health insurance and Medicare Part D. Folks paying $15 to $30 per month (or more) for a Medicare Part D plan should pay attention to this.
Dr Belk points out that many drugs are now generic, and pharmacies get them for pennies per pill. And yet, Part D plans require seniors to pay a $4 to $10 co-pay using their Part D card. According to Dr. Berk:
“The co-pays are still based entirely on the insurance plan, so the same medicine in the same pharmacy might cost $5, $10 or $25 for a months supply. What’s more, people might pay several hundred dollars a year to get prescription drug coverage on their insurance, even though that coverage increases the cost of many medications and cost the insurance company nothing. It’s like buying a book of coupons that say “one for the price of two” at your local grocery store. You can see why they didn’t want to tell you about it.”
I find myself apologizing to clients who are signing up for Part D even though they don’t need it. They don’t take any drugs, or use one or two generics. I tell them Part D is voluntary – but they will be penalized if they decide to wait to enroll at some later date. I tell them, if they want to get into the Part D system, they should enroll in the lowest-cost plan – but that plan has a $320 deductible. That means these healthy people will probably never meet the deductible throughout the year.
They will pay $15 per month but will still pay full price for their drugs – until they pay their $320 deductible. And, if they don’t use their Part D card to purchase their generics, they will get a lower price (as described above by Dr. Belk). But if they want their drug purchases to be applied toward their deductible, they need to use their Part D card – and pay a higher price.
What’s wrong with this picture?
The problem is that there are 1,100 Part D plans offered across the county (30 in Arizona), and insurance companies negotiate prices and set the co-pays for each drug. I wrote about large price differences from plan to plan last week, using the Lipitor generic as a prime example.
Part D is one more example of how messed up the American health care system is – and why it is so much more expensive than other countries’ systems. Why do Americans, those with health insurance and Medicare, allow themselves to be ripped off?