Medicare Part D has not saved money for Medicare
http://www.northeastern.edu/news/2015/06/researchers-find-prescription-drug-benefit-did-not-save-money-for-medicare/
“We are concluding that Medicare Part D did not save the (Medicare) program any money overall,” said Briesacher, a health services researcher in the School of Pharmacy with nationally-recognized expertise in drug policy and medication use in older adults. “You have to be realistic about the fact that giving people access to medication is important, but it’s not going to substantially save money in other parts of the health care system or keep a significant number of people out of the hospital.”
Did Medicare Part D Affect National Trends in Health Outcomes or Hospitalizations?
http://annals.org/article.aspx?articleid=2322799
Results: Five years after Part D implementation, no clinically or statistically significant reductions in the prevalence of fair or poor health status or limitations in ADLs or instrumental ADLs, relative to historical trends, were detected. Compared with trends before Part D, no changes in emergency department visits, hospital admissions or days, inpatient costs, or mortality after Part D were seen. Confirmatory analyses were consistent.
Conclusion: Five years after implementation, and contrary to previous reports, no evidence was found of Part D's effect on a range of population-level health indicators among Medicare enrollees. Further, there was no clear evidence of gains in medical care efficiencies.
Comment by Don McCanne of PNHP: Although it was important to include a drug benefit in the Medicare program there was concern that the conservatives designing the program wanted to allow the market to work its magic. The program was to be administered by private pharmacy benefit managers (PBMs) rather than the government. In fact, the government was even prohibited from negotiating drug prices with the manufacturers. Further, it was thought that the benefits of improving access to drugs would make patients healthier thus reducing future costs for Medicare.
This study shows that the magic did not work in that the drug benefit did not save money for Medicare, and it did not measurably change the health status of Medicare beneficiaries. Specifically there were no changes in emergency room visits, hospitalizations, and inpatient costs, nor was there any change in mortality.
It would not be surprising to see conservatives propose that the Part D program be terminated since it supposedly isn’t doing any good. But there are innumerable studies that have shown that some medications do provide at least a modest benefit, though those benefits were not detected by this study.
At any rate, it is clear that PBMs are not as effective price negotiators as is our government, as demonstrated by the greater value in drug purchasing that we have through the VA and the Medicaid program. Also, the PBMs waste considerable funds in excess administrative activities, not to mention the added middleman profits that they divert to themselves.
Under an improved Medicare for all we would have a more efficient and less costly publicly-administered program that would ensure that the government was paying fair prices for our drugs. It is not that way now.
= new reply since forum marked as read
For the record, Hillary and Bernie both voted against it. Obama was not yet a US Senator.
another
needed to handle these things, hence Medicare Part D, Medicare Advantage, ACA, and similar initiatives go to private companies who can raise the necessary upfront capital. I wish it were different, but it's better than not doing it -- which is the only alternative if the Republicans in Congress have to come up with the money.
I think we agree on this, you just get get more ticked than me over private companies benefiting from our need for health care. I think the government could do it better, but no body wants to budget the startup cost or take on new staff. So it gets outsourced to greedy folks. We just have to keep suing them if their greed kills us.
I was one who had to take less than the prescribed dose and skip some drugs entirely to make my meds affordable. I really wonder about the ER visit and hospital admission stats, though. In my case the meds were to control my asthma: being able to afford the full doses under Medicare Part D has almost surely kept me out of the ER and hospital. Millions have asthma (or COPD), and the best meds to treat it have been very costly, so I am hardly alone in having improved health, and thus avoiding ER/hospitals.
A shout out for your last sentence: "Improve it, don't give the fools an excuse to eliminate it." AMEN.
