Don’t
hold your breath waiting for your “savings”
By
Will Collette
As
a seventy year old diabetic on insulin, I was very interested in Donald Trump’s
May
26 announcement that he had negotiated a terrific deal to “cap” the cost of
insulin for people on Medicare at $35 a month.
He
said he had worked out a fabulous deal with Big Pharma, insurance companies and
Medicare.
Now he is bestowing the fruits of his deal-making skills on older people, a major part of Trump’s 2016 voting bloc, but according to polls, are now abandoning him in droves.
Now he is bestowing the fruits of his deal-making skills on older people, a major part of Trump’s 2016 voting bloc, but according to polls, are now abandoning him in droves.
In
his announcement, Trump said:
"If you don’t take insulin, I just wrote this down, you go blind, stroke, amputation, kidney failure and other things. So we’re getting it out…I hope the seniors are going to remember it, because Biden was the one who put us into the jam because they didn’t know what they were doing. They were incompetent….I don’t use insulin. Should I be? Huh? I never thought about it, but I know a lot of people are very badly affected.”
And why not: after all, Trump took hydroxychloroquine to prevent
COVID-19 when medical experts and scientists said hydroxychloroquine not only doesn’t
prevent COVID-19 but was also a dangerous and ineffective treatment for the
disease. Maybe injecting a few hundred units of insulin would be just the thing to clear the fog out of his brain.
Surgeon General Dr. Jerome Adams had to come up to answer
continuing questions to Trump about why he thought he should take insulin:
“Your body, Mr. President, actually makes insulin endogenously and people such as you and I, we make our own insulin. So yes we do utilize insulin, but we make it ourselves.”
But this little display of Trump’s medical acuity was just a
sideshow. The real question is whether his announcement has any substance to reduce the brutally high cost of insulin - due in large part to actions by Trump's Health and Human Services Secretary Alex Azar, who ran leading insulin producer, Eli Lilly (see graphic, above left).
Spoiler alert: this plan is too little, too late.
Spoiler alert: this plan is too little, too late.
The Epi-Pen scandal was,
in turn, compared to rat-faced pharma CEO Martin Shkreli who, according
to the LA Times, “shamelessly raised the price of a six-decade-old
anti-infection drug called Daraprim from $13.50 to $750 a pill.” He is now in
prison for related crimes though he has asked to be released so he could go to
work on a COVID-19 cure.
So what about insulin?
Insulin generally comes
in an injection pen very similar to the EPI-Pen. You can get insulin in a
long-acting and short-acting form. Diabetes patients and their doctors have to
work together to try to figure out the best way to balance drugs, diet and
exercise to control the disease.
In the past few years,
insulin prices have gone up so much that this balancing act has been disrupted
as patients
have had to ration their insulin due to cost. Some died.
One
of the most popular fast–acting insulins is Humalog which cost $21 a month when
it was first introduced in 1996. Today, that same drug costs around $300 a
month. In Canada, it only costs $32.
Go figure.
Go figure.
The
price hikes for long-acting insulin injector pens have been even steeper.
So
what will Trump’s insulin plan actually do?
It won’t happen
for at least a year.
Knowing Trump and all his grandiose plans, this may NEVER happen. Since May 26, neither HHS nor the Trump campaign has said a word on this issue. Trump has moved, making defense of the Confederacy a higher priority. What we do know for sure is that you won’t be able to opt in to this deal until next year.
That’s when….
Knowing Trump and all his grandiose plans, this may NEVER happen. Since May 26, neither HHS nor the Trump campaign has said a word on this issue. Trump has moved, making defense of the Confederacy a higher priority. What we do know for sure is that you won’t be able to opt in to this deal until next year.
That’s when….
You must buy
pricier prescription drug supplemental insurance.
All Medicare recipients are required to buy what’s called Medicare Part D coverage to pay for approved prescription drugs. You will need a “participating enhanced” Part D plan to qualify for the $35 insulin price cap.
This is the way the insurance companies get their slice of this “deal” and your actual savings go down. The head of Medicare give a low-ball estimate of $17 a month in increased premiums, which is, in my opinion, wishful thinking.
All Medicare recipients are required to buy what’s called Medicare Part D coverage to pay for approved prescription drugs. You will need a “participating enhanced” Part D plan to qualify for the $35 insulin price cap.
This is the way the insurance companies get their slice of this “deal” and your actual savings go down. The head of Medicare give a low-ball estimate of $17 a month in increased premiums, which is, in my opinion, wishful thinking.
Big Pharma will not have to decrease their costs.
They will simply pass on their costs for this “plan” on to Medicare and the insurers. If the insurers find the deal isn’t working for them, you can count on them to drop out.
Both the
insurers and Big Pharma stand to get a
lot of public relations mileage out of this plan. Vanderbilt
health policy researcher Stacie Dusetzina put it this way: "If I were in the industry and didn't
want to see a larger reform package, this is one way to take some heat off."
Max
Richtman, head of the National Committee to Save Social Security and Medicare,
calls Trump’s insulin plan “a
nickel solution to a billion-dollar problem.” This shaky “deal” does nothing to address the core problems behind the
price-gouging.
Among the many flaws in Trump’s May 26 announcement is how few people this would actually help. Prescription price-gouging and out-of-control medical inflation affects just about everybody.
This plan only offers some relief to a sub-set of diabetes patients – those who are over 65, on insulin and holding “participating enhanced” drug insurance.
Big
Pharma says price hikes are driven by the complications involved in getting
paid under our complex public-private coverage system.
Further driving prices up are the complicated systems of rebates and discounts. Big Pharma uses coupons and deals to combat adverse publicity on its price-gouging - they crank up the price by two hundred bucks and give a $100 coupon to some people who qualify.
Further driving prices up are the complicated systems of rebates and discounts. Big Pharma uses coupons and deals to combat adverse publicity on its price-gouging - they crank up the price by two hundred bucks and give a $100 coupon to some people who qualify.
This
is not the way to run a medical system that literally means life or death to all
of us.
Let’s
go back to the cost difference for Canadian diabetes patients and Americans.
Canadians pay one-tenth the price for the same insulin Americans use.
Why
is that? What is it that Canada has that the US doesn’t? The answer is Canada has a
single-payer national health care system.
The
Medicare-for-all plans released during the primaries by Senators Elizabeth Warren and Bernie Sanders came with very high price tags. But both argued that
Medicare-for-all would actually be billions cheaper than Americans’
current cost for health care.
This
new, though transitory, interest in insulin prices by our Dear Leader really adds
to the evidence supporting Medicare-for-all. Even after Trump’s insulin $35 price cap happens, Canadians will still be paying
less for insulin under their national health care system.