Medicare-D: GWB Socialist Disaster

**barbaro** · 23-08-2009, 01:10 AM

Yes, BO is socialistic.

But up to this point not as socialistic as GWB and the GOP in 2003 and later in 2006 when Medicare-D was enforced.

The GAO David Walker said the US Gov needed $17 Trillion invested then, to cover it.

How much did the US Gov have?

$0.

Medicare was a disaster before Medicare-D. It's finished now.

WASHINGTON (CNN) -- After days of impassioned debate, the U.S. Senate Tuesday approved a $400 billion plan to overhaul Medicare. Supporters say it will give prescription drug coverage to 40 million older Americans, while critics warn that it could destroy the system.

The 54 to 44 vote was not along party lines -- 11 Democrats voted in favor and nine Republicans voted no.

The bill now goes to the White House, for President Bush's signature.
At a speech Tuesday at a hospital in Las Vegas, Nevada, Bush called the vote a "major victory" and thanked members of Congress for their hard work.
"We inherited a good medicare system. It has worked, but it was becoming old and needed help. Because of the actions of the Congress, because of the actions of members of both political parties, the medicare system will be modern and it will be strong," Bush said.

Supporters of the bill -- including some Democrats who, like Sen. Dianne Feinstein of California, said it was better than no bill at all -- hailed the vote as a victory for senior citizens.

"This bill is an extraordinary day for seniors and indeed all Americans," said Senate Majority Leader Bill Frist. "The legislation we just passed is consequential, it is far reaching. ... It is epochal in the sense it modernizes Medicare to provide 21st century care for our seniors."

Opponents, however, vowed that the fight isn't over. Senate Minority Leader Tom Daschle predicted that once seniors learned how the bill worked, they would mobilize as they did 38 years ago for the original Medicare bill.
"I was struck by how vacant the galleries were and so few seniors citizens looking down," Daschle, D-South Dakota, said after the vote. "What you saw instead were lobbyists packing the halls. They will do well. Our seniors will not, and that is why the fight will go on."
Drug benefit starts in 2006

The measure, a centerpiece of President Bush's domestic agenda, adds a prescription drug benefit to the program, provides billions of dollars in subsidies to insurance companies and HMOs, and takes the first step in allowing private plans to compete with Medicare.

It is the largest expansion of Medicare since it was created in 1965, although most of its provisions won't take effect for several years. The drug benefit, for example, does not take effect until 2006. Before that, seniors will be able to purchase, within six months, a discount card that could provide 10 to 25 percent off prescription drugs. (Interactive: Prescription for change)

Link: CNN.com - Senate passes Medicare bill - Nov. 25, 2003

**barbaro** · 27-08-2009, 04:10 AM

Worthy of a bump in an effort to generate discussion.

**Muadib** · 27-08-2009, 04:26 AM

Nationalize all the drug companies... The cost of prescription drugs goes to zero... Problem solved...

**DrB0b** · 27-08-2009, 05:04 AM

Originally Posted by Muadib

Nationalize all the drug companies... The cost of prescription drugs goes to zero

And so does research and development of new drugs.

I find the whole US debate on this issue very strange. Socialized medicine, in the countries which have it, works well and is reasonably cost-effective, it's certainly more cost effective than medicare. Much of what I've read and heard about the current debate in the USA seems to be ignorance, hysteria, and flat out lies. It's quite bizarre to see a nation shooting itself in the foot in this way.

**Muadib** · 27-08-2009, 05:34 AM

Sorry, forgot the

Originally Posted by DrBob

"current debate in the USA seems to be ignorance, hysteria, and flat out lies."

nail, head...

**sabang** · 27-08-2009, 07:53 AM

The fight, long term, has to be taken to the 'added cost centres' to contain and ultimately reduce costs as a percentage of GDP. In no particular order these include the Pharma's (having paid nearly $200 for some prescription drugs once in the US, I can tell you they are outrageous), HMO's, paramedics, health insurers, Doctors & specialists, attorneys & malpractise actions. So basically the whole system, top to bottom.

Of course, they know this- which is why they are actively PR spinning behind the scenes in many cases, while doing what sweetheart deals they can with the government on the surface. They pretty much all- publicly at least- agree on the need for HC reform, whilst actively working to protect their own corner. I guess you'd say thats business.

The main problem with Bush' Medicare reforms is that an expensive social program was passed, with no thought given to funding. Which was typical of the Bush admin- fiscally culpable. Of course the beneficiaries- Seniors- are both a 'pro-Republican' demographic, and some of the most vociferous opponents of HC reform now- 'I'm alright Jack'.

But you are not alright, Jack, unless meaningful HC reform is passed, costs reduced, and a larger pool of younger people contribute to Health insurance costs (effectively subsidising their care when they get older). Otherwise, as the critics say, it is sending the country and Medicare broke- there will be no choice but to reduce benefits. In the eyes of many foreigners at least, when this happens the USA's status as an advanced as opposed to Developing country will be in question.

It is hard to know what is in the mind of Joe Average, given all the spin and hysteria surrounding this. Certainly, a lot of the debate seems split along partisan political lines. But overall, it is very surprising (and if I were Amerkin, concerning) how shortsighted, divisive and ultimately damaging the actual public debate is on this extremely critical issue.

Perhaps Obama should just present a 'Fait accompli' to seniors- if HC reform is not able to be passsed, we will have to repeal the subsidies of your drugs. We can no longer afford it.

DaffyDuck · 27-08-2009, 12:06 PM

Originally Posted by DrB0b

And so does research and development of new drugs.

Actually, R&D will do just fine -- it's just the slick marketing guys will drive less German sports cars, and get less six figure bonuses .... A *HUGE* percentage of pharmaceutical revenues goes towards marketing bonus', and marketing budgets - which still leaves even more profit, and a healthy amount of R&D budget.

Originally Posted by DrB0b

I find the whole US debate on this issue very strange. Socialized medicine, in the countries which have it, works well and is reasonably cost-effective, it's certainly more cost effective than medicare. Much of what I've read and heard about the current debate in the USA seems to be ignorance, hysteria, and flat out lies. It's quite bizarre to see a nation shooting itself in the foot in this way.

Insanity - I find myself in 100% agreement with DrB0b...!!

**GooMaiRoo** · 27-08-2009, 07:16 PM

The reason Medicare-D is a disaster is that it prohibits the US government from negotiating drug prices. The Veteran's Administration, which is allowed to negotiate these prices, pays 58% less for drugs on average. Medicare-D is simply a way for Big Pharma to expand its already obscene profits.

Obama's current negotiations with the pharmaceutical industry suggest that his health care plan would not allow the government to use its massive leverage to negotiate lower drug prices or import identical (and much less expensive) drugs.

The way that Bush and Obama have dealt with the drug companies is not socialism, it's corporatist economic policy much closer to the Italian fascism of the 1930's. Under socialism, Medicare-D and future government health schemes by Obama would at the very least use government leverage to negotiate lower drug prices and import cheaper, identical drugs. Any government health plan that merely enhances corporate profits without any restraints can't really be called socialism in any sense.

Internal Memo Confirms Big Giveaways In White House Deal With Big Pharma

**chitown** · 27-08-2009, 10:13 PM

**Muadib** · 27-08-2009, 10:37 PM

More like...

**barbaro** · 27-08-2009, 11:00 PM

Originally Posted by GooMaiRoo

The way that Bush and Obama have dealt with the drug companies is not socialism, it's corporatist economic policy much closer to the Italian fascism of the 1930's. Under socialism, Medicare-D and future government health schemes by Obama would at the very least use government leverage to negotiate lower drug prices and import cheaper, identical drugs. Any government health plan that merely enhances corporate profits without any restraints can't really be called socialism in any sense.

Internal Memo Confirms Big Giveaways In White House Deal With Big Pharma

What I see, is the government Medicare-D, transfering taxpayer dollars to the pharmaceutical companies.

As for corporatist fascism: GooMaiRoo or anyone, can you explain Italian fascist corporatism and how it relates to current US policy for me?

I am not doubt it. But I want to be able to explain it to people, and it's hard for me to do.

Thanks if GooMaiRoo, or anyone can offer concise comparisons to help me understand and explain it.

**GooMaiRoo** · 28-08-2009, 12:48 AM

Originally Posted by Milkman

Originally Posted by GooMaiRoo

The way that Bush and Obama have dealt with the drug companies is not socialism, it's corporatist economic policy much closer to the Italian fascism of the 1930's. Under socialism, Medicare-D and future government health schemes by Obama would at the very least use government leverage to negotiate lower drug prices and import cheaper, identical drugs. Any government health plan that merely enhances corporate profits without any restraints can't really be called socialism in any sense.

Internal Memo Confirms Big Giveaways In White House Deal With Big Pharma

What I see, is the government Medicare-D, transfering taxpayer dollars to the pharmaceutical companies.

As for corporatist fascism: GooMaiRoo or anyone, can you explain Italian fascist corporatism and how it relates to current US policy for me?

I am not doubt it. But I want to be able to explain it to people, and it's hard for me to do.

Thanks if GooMaiRoo, or anyone can offer concise comparisons to help me understand and explain it.

MM - My analogy to corporatism and fascism is less than perfect, but it's closer to what's going on than socialism, where the government owns or controls the means of production for the benefit of the people (in theory). My post also indicates my disappointment with Obama, who I thought would be a little more like Franklin Roosevelt and steer the USA clear of disaster. Corporatism and corporate fascism are elusive terms. But basically, corporations are viewed to be functionally necessary and work in harmony with a single governing body, the government, which is an arbiter and facilitator of their legitimacy and a means to promote the smooth functioning of corporate entities.

Gerald Celente, a futurist and founder of the Trends Research Institute, has spoken frequently of the analogy between Italian fascism and the current state of US political affairs. Here's a short interview of Celente (my apologies that this interview is from the Fox network, which has a lot less legitimacy than the guest):

**Muadib** · 28-08-2009, 12:52 AM

^ Gerald will pop up in the strangest places... I first heard of him and began following his work after I saw him on,.....ok, I'm embarrassed,.........Glen Beck...

**Jet Gorgon** · 28-08-2009, 01:16 AM

Anyone have the stats on new drug development? Country by country like? Only costs about a $bil to develop a noobie and put it through all the FDA tests.

**GooMaiRoo** · 28-08-2009, 01:29 AM

Originally Posted by Jet Gorgon

Anyone have the stats on new drug development? Country by country like? Only costs about a $bil to develop a noobie and put it through all the FDA tests.

Not sure what the answer is, but in the USA pharmaceutical companies spend almost twice as much on marketing as they do on research and development. And if these ads are meant to influence one's personal physician (either directly or through his 'informed' patients), one had better get a new physician.

"The researchers’ estimate is based on the systematic collection of data directly from the industry and doctors during 2004, which shows the U.S. pharmaceutical industry spent 24.4% of the sales dollar on promotion, versus 13.4% for research and development, as a percentage of US domestic sales of US$235.4 billion."

Big Pharma Spends More On Advertising Than Research And Development, Study Finds

**Jet Gorgon** · 28-08-2009, 02:16 AM

^ Well, if you have a new drug, say like Avastin that works on cancer, if you don't promote it, who will know about it? No diff from any industry. How would automakers sell cars, ice cream makers sell new products, etc. It's part of the biz.

**GooMaiRoo** · 28-08-2009, 04:16 AM

Originally Posted by Jet Gorgon

^ Well, if you have a new drug, say like Avastin that works on cancer, if you don't promote it, who will know about it?

Perhaps physicians who read medical journals?

**sabang** · 28-08-2009, 11:49 AM

My sister is an MD, and I can tell you the constant flow of free samples, goodies of various types (most of which she gives or throws away) and 'conventions' to nice places by the sea are out of all reasonable proportion to the monetary value of the goods being marketed.

You certainly do not need to be a doc of any type to work out that this is an industry that could be a lot more cost efficient.

And, if you ask me, Obamas deal with Big Pharma stinks. I suppose $10bn pa of cost savings is nothing to sneeze about- but it still means Americans will be paying more for their drugs than they should, and continues to protect the US pharma industry (cartel) from foreign competition.

One more thing- I have a friend here in Pattaya who is a senior Pharmaceutical engineer, does work all over the world. He confirms what I already knew- a lot of the reason for these bloated 'marketing' costs is to push 'brand' as opposed to lower cost generic drugs at the point of sale- the Doctor. More often than not, they are made in the same damn factory, and in a lot of cases the big Pharma owns a controlling equity in the generic drug 'manufacturer' anyway- but actually he just gets his controlling shareholder to manufacture that same drug in the same factory without the brand name, and it is then sold at less than half the price. The Doctor has no incentive to recommend the lower cost but identical alternative- he's a beneficiary of the drug companies largesse, and the cost is covered by 'insurance' anyway.

In short, it's a scam.

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