Medicare beneficiaries should be aware that open enrollment season, a three-month period that offers options to change or add to existing health care plans, has finally begun.

The annual open enrollment period for Medicare allows Americans to revise their insurance plans during Oct. 15 to Dec. 7.

Medicare plans have a variety of different parts. It’s important to know the basics of each one.

Participating In Open Enrollment

Open enrollment begins in October and ends in December.
Image: Cusd

Each year, the terms and costs of Medicare plans chance drastically. Millions of beneficiaries could save large amounts of money with better plans that offer more coverage in the new year.

If one in five people choose to select a new Medicare plan, there would be a significant shift. Because Medicare is difficult to understand, most people don’t bother with changing plans.

For existing patients, the current plan will automatically renew… even if it’s not the best fit.

An Alphabet Of Plans

Medicare is broken up into different parts identified by a letter.
Image: Boomer Benefits

Making A Decision

Image: Sexual Health Men

The plans are split into a few basic choices. The Original Medicare beneficiaries may also purchase a Medigap policy. These supplemental policies fill the holes in the Original Medicare plans.

The post The Different Parts Of Medicare Open Enrollment appeared first on Citizens Report.

The International Federation of Health Plans concluded that Americans are paying six times more for prescription medication than the rest of the world.

The unreasonably high price of pharmaceuticals in the United States has shined a bright light on the drug industry, exemplifying the fact that Americans are paying much more for medication than patients in other countries.

The government healthcare budget for prescription drugs is low in comparison to other nations.

Structural Inequalities

Americans are paying more for brand-name drugs across the board, but cancer patients and those in need of specialty medications are the hardest hit.
Image: Jaron Associates

American insurance companies pay about $215 per customer each month for the acid reflux drug Nexium. In the Netherlands, an equivalent prescription costs about $23.

Data from the International Federation of Health Plans shows that pharmaceuticals in the United States are six times more expensive than in other countries.

The priciest drugs are specialty and cancer medications, but standard prescriptions are costly as well. Cancer treatment pill Gleevec costs patients about $6,214 per month in the United States, compared to $1,141 in Canada and $2,697 in England.

Rheumatoid arthritis drug, Humira, is $2,246 in the United States, compared to $881 in Switzerland and $1,102 in England.

Americans who suffer from depression could pay $194 for Cymbalta, but the price is $46 in England and $52 in the Netherlands.

The health care system in the Unites States is more competitive than other countries. Fewer players would allocate more purchasing power to certain groups, which would give them the ability to negotiate a reduced cost.

The United Kingdom’s National Health Service supplies the country’s drugs through bulk purchases called formularies. The U.S. has multiple unregulated private insurance firms, hospitals and plans that buy for individual groups of consumers. Through different plans, consumers allow companies to negotiate prices with the pharmaceuticals on their behalf.

But a smaller pool of negotiators yields more power to the consumer, allowing patients to decide what they are willing to pay.  In a system like this, companies are forced to make fair negotiations if they want to be a part of the marketplace.

The Root Of The Problem

Pharmaceutical companies have the power to set drug prices without explanation.
Image: Budding Into Fullness

Pharmaceutical companies are in control of setting drug costs, and it’s clear that they are putting profits before people.

A Kaiser Family Foundation poll found that 72 percent of Americans think drug costs are unreasonable and want drug companies to release information on how they set prices. The current system leaves consumers without a choice or an explanation.

Pharmaceutical trade group PhRMA attributes the high prices to the funding of research and development. According to PhRMA, companies invest almost $2.6 billion dollars on average for more than 10 years to bring a drug into the marketplace. Many new drugs never make it.

But critics disagree. Many medical experts believe that drug companies set the prices high solely because they can.

“We have no rational system in the U.S. for managing prices of drugs,” Dr. Peter B. Bach, director of Director of Memorial Sloan Kettering’s Center for Health Policy and Outcomes told CNN.

Medicare provides drug treatments for a majority of Americans, but the provider is prohibited from negotiating with drug companies. Presidential candidates Hilary Clinton and Bernie Sanders have addressed necessary industry changes as a  core of their platforms.

“People should not have to go without the medication they need just because their elected officials aren’t willing to challenge the drug and health care industry lobby,” Sanders said in a statement on his official website. “Between our government’s unwillingness to negotiate prices and its failure to effectively fight fraud, it’s no wonder drug prices are out of control.”

In Germany, nonprofit health insurers are able to bargain with pharmaceuticals and health providers to get the best price possible. Medicare should be able to use its buying power to set prices by negotiating directly with pharmaceutical companies to find a reasonable cost.

The United States lacks a central agency, federal or non-governmental, to conduct research that focuses on drug efficacies. A system in Canada allows providers to compare drugs to similar treatments on the market to determine an accurate price.

Only by regulating the drug industry and gaining the power to negotiate with pharmaceutical companies will the price of pharmaceuticals in America decline.

“Those guys are profit driven. That’s a big problem,” said Kesselheim.

The post Why Are U.S. Patients Paying More For Pharmaceuticals? appeared first on Citizens Report.

New census data shows the percentage of uninsured people in the United States has declined from 41.8 million in 2013 to 33.0 million in 2014.

The annual health insurance report was released last week, confirming the prediction that the number of uninsured people living in the United States had declined.

The report, released by the U.S. Census Bureau, generally matched other insurance-related surveys from the past year.

Accurate Predictions

The policy changes that took place in 2014, including Patient Protection and the Affordable Care Act, extended health care coverage to millions of Americans.
Image: Hive Wallpaper

The report, released on Sept. 16, was based on survey data detailing changes in income, poverty level and insurance coverage in 2014. The data was gathered from the 2015 Current Population Survey Annual Social and Economic Supplement.

There was no significant difference in household income or official poverty rates since the last survey was conducted, but researchers did confirm the amount of people without health insurance has declined. The data was separated by age, household income, race and other demographics.

The 2013 report of Health Insurance Coverage In The United States showed that 42 million people, or 13.4 percent of the population, had no health insurance. In comparison, about 271.4 million people were covered. Out of the insured group, about two-thirds were privately covered by their employers or through the individual market.

The most recent report shows that the percentage of people without health insurance coverage for the entire 2014 calendar year was 10.4 percent. The number of people without health insurance declined to 33.0 million from 41.8 million in the last year.

The percentage of people with health insurance in 2014 was 89.6 percent, higher than 86.7 percent in 2013. Employment-based insurance covered the most people, ranking at 55.4 percent, followed by Medicaid at 19.5 percent, Medicare at 16.0 percent, direct-purchase at 14.6 percent, and military health care at 4.5 percent.

The report includes data on the Affordable Care Act and how it has impacted the insurance market this year. The act has allowed 10 million people to attain coverage, in addition to the millions of Americans who received insurance through Medicaid.

“Over time, changes in the rate of health insurance coverage and the distribution of coverage types may reflect economic trends, shifts in the demographic composition of the population, and policy changes that impact access to health care. Several such policy changes occurred in 2014, when many provisions of the Patient Protection and Affordable Care Act went into effect,” according to the report.

Conflicting Data And Racial Inequalities

The report notes that racial differences in uninsured populations still exist, with Hispanic groups ranking the lowest in health insurance coverage.
Image: Barista Net

There are a number of conflicting surveys that show millions remain uninsured or underinsured, specifically non-white populations.

In June, the Centers for Disease Control and Prevention released the National Health Interview Survey. It showed that 36 million people, or 11.5 percent of the population, was uninsured in 2014. April’s Gallup-Healthways Survey showed that 11.9 percent of the population was uninsured in the beginning of 2015.

From 2013 to 2014, the overall number of insured increased for all races. The increase was comparable for blacks, Asians and Hispanics at more than 4 percent.

In 2014, 92.4 percent of non-Hispanic whites were covered. In comparison, 88.2 percent of blacks and 90.7 percent of Asians were covered. Hispanics had the lowest rate of health insurance coverage at 80.1 percent.

In addition, the state of Texas housed the highest number of uninsured individuals at 19.1 percent. This may be because undocumented immigrants are still largely uninsured. Because of their status, they are ineligible to receive premium subsidies or buy on exchanges.

“In 2014, the uninsured rate of noncitizens was over three times that of the native-born population (31.2 percent for noncitizens compared with 8.7 percent for the native-born population),” the report states.

Although fewer people are uninsured, many may still be underinsured. While most plans pay deductibles and co-payments to cover preventative tests, some consumers are forced into high-deductible plans with a lot of out-of-pocket payments.

Trading a lower monthly premium for a higher deductible seems to be a trend, but high-deductible exchange plans still affect insurance affordability.

Experts were hopeful that the most recent census would show more individuals are covered, but there is no doubt that many Americans are still in need of health care or burdened by medical debt.

The post Census Confirms A Declining Number Of Uninsured Americans appeared first on Citizens Report.

Presidential candidate Bernie Sanders has created a bill to regulate drug prices, including Medicare Part D negotiation, drug importation from Canada, Medicaid and Medicare rebates, the prohibition of pay-for-delay deals, penalties for fraud convictions and drug pricing cost and transparency.

“Feel the Bern,” the slogan of democratic presidential candidate and Vermont Sen. Bernie Sanders, is popularly exchanged among adolescents who favor his platform.

Sanders is known for his opinions on income inequality, universal healthcare, parental leave, climate change, and LGBT rights. The politician’s most recent endeavor, a bill to reduce prescription drug prices, addresses the issue of medicine affordability in an increasingly concentrated and competitive market.

All About The Bill

Bernie Sanders is the face, the creator and the biggest advocate of the bill.
Image: NY Post

The bill is titled the Prescription Drug Affordability Act of 2015. If the bill passes, network negotiations and price changes will begin on Jan. 1, 2016.

Focused on making changes to the prescription drug market, the bill includes nine major areas of focus, including:

• “Negotiation of lower covered part D drug prices on behalf of Medicare beneficiaries.”
• “Acceleration of the closing of the Medicare Part D donut hole.”
• “Prescription drug importation.”
• “Sense of the Senate regarding trade agreements.”
• “Requiring drug manufacturers to provide drug rebates for drugs dispensed to low-income individuals.”
• “Applying the medicaid additional rebate requirement to generic drugs.”
• “Preserving access to affordable generics.”
• “Conditions on award of drug exclusivity.”
• “Drug manufacturer reporting.”

Backing The Bill

Although Republicans notoriously disagree with allowing the federal government to gain a tight legislative grasp on the country, members of the political party have approved some portions of the bill.
Image: The American Nurse

Sanders frequently receives emails from individuals who can’t afford their medication. A 2014 Commonwealth Fund survey found that about 20 percent of U.S. adults didn’t file a prescription because it was unaffordable.

“Well, obviously, they will get sicker and in some cases, they will die,” Sanders said. “This is an unacceptable situation we must fix.”

Pharmaceutical companies allocate the majority of the budget to sales and marketing, leaving little funding for research and development. Sanders believes transparency is necessary to create pricing that has allows the company to make a fair profit at a fair price to consumers.

The bill is aimed at keeping generic drug prices as low as possible, using evidence from other countries to illustrate how serious the pricing problem is in the United States.

“It is unacceptable that Americans pay, by far, the highest prices in the world for prescription drugs,” Sanders said in a statement. “For years, generic drugs have made it possible for people to buy the medicine they need at lower prices. We need to make certain that generics remain affordable.”

In addition, he wants to outlaw the practice of allowing one company to pay another company to keep generics off the market, which stifles competition.

Robert Moffit, a senior fellow, opposes the bill. He asserts that federal regulation of prescription drugs would lower access.

“When the government fixes prices, the government excludes the companies that do not or cannot accept the fixed government prices from participating in Medicare,” Moffit wrote. “That means that all seniors would not get Medicare access to the drugs of those companies.”

Legislators expect to be faced with opposition from Republicans on certain key points. However, the importation of Canadian prescription drugs is supported by both parties.

It doesn’t make sense for a politician to advocate for free trade and market competition but not support that measure, Moffit said.

“The greed of the pharmaceutical industry is killing Americans,” he said.

The post A Bill To Regulate Prescription Drug Price appeared first on Citizens Report.

Hospitals, doctors and medical associations are attempting to prevent a big-time insurance merger that could negatively impact patients.

The American insurance market is dominated by five multibillion dollar conglomerates who have the power to set prices, reduce output and impact customer choice.

Two mergers have been proposed that would reduce the number of major insurers from five to three. The proposed mergers would allow Anthem to purchase Cigna and Aetna to buy Humana.

As these large companies attempt to swallow up their competitors, doctors and hospitals are becoming increasingly worried. Health professionals are now using various avenues to speak out against the mergers.

Protesting The Merger

If the merger is successful, the five major insurance companies would be concentrated into three powerful conglomerates.
Image: CNN

Last week, the American Hospital Association sent a letter to the Justice Department that protested the merger between Aetna and Humana. The letter informed the department that the deal would cause harm to Medicare patients by reducing their options for private Medicare Advantage plans.

Private Medicare Advantage plans, defined as “a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits,” provide an alternative to traditional Medicare.

Out of the 55 million Medicare patients, more than 30 percent have elected to enroll in these plans. The proposed mergers could affect 154 metropolitan areas in 23 states, according to the American Hospital Association.

Medical associations have turned to federal antitrust guidelines to argue against the merger. These guidelines assert “mergers should not be permitted to create, enhance or entrench market power.”

“A merger enhances market power if it is likely to encourage one or more firms to raise price, reduce output, diminish innovation or otherwise harm customers as a result of diminished competitive constraints.”

If Anthem is able to absorb Cigna and Aetna is permitted to purchase Humana, the market would become more concentrated. The American Medical Association also believes this would reduce the kind of competition necessary to drive fair prices and promote medication diversity.

But supporters of the merger suggest that criticism may be inspired by a self-interested fear. If insurance companies gain more power, doctors and hospitals would have less. The larger companies could potentially reduce payouts to medical professionals.

However, studies shows that the predictions from the medical associations match data from the Government Accountability Office.

The Affordable Care Act released a study that proved “enrollment was concentrated among the three largest insurers in most states.” The three largest companies insure 80 percent of patients in 37 states. The measurements were taken using the Herfindahl-Hirschman Index, a formula that discerns market concentration.

“In more than half of these states, a single insurer had more than half of the total enrollees,” the Government Accountability Office said.

The Power To Regulate Power

The Department of Justice will investigate how the effects of the merger will impact consumers and the insurance market as a whole.
Image: Tech Crunch

The Justice Department will be able to access additional data when reviewing the mergers. Both houses of Congress are calling for an investigation into the possible effects of the mergers.

The medical association has analyzed competition in insurance markets for 15 years. The president of the American Medical Association, Dr. Steven J. Stack, urges the Obama administration to carefully review the proposed mergers.

“A lack of competition in health insurer markets is not in the best interests of patients or physicians,” Stack said.

A new study from the American Medical Association that details the dangers of the mergers will be published next week.

Insurance companies believe the mergers will help them to collaboratively reduce costs and work more efficiently.  But who would benefit from the cost reduction?

Melinda R. Hatton, senior vice president of the American Hospital Association, isn’t certain that the savings would trickle down to consumers.

The post Medical Associations Speak Out Against Insurance Mergers appeared first on Citizens Report.

A recent poll from the Kaiser Family Foundation shows that Americans want pharmaceutical companies to lower drug prices. The poll gathers public opinion on pharmaceutical companies and options for cost reduction.

Hepatitis C is a blood-borne virus that infects, damages and causes cancer in the liver. But the good news is that a cure does exist.

The bad news is the pharmaceutical manufacturer of the Hep C treatment,  called Sovaldi, is charging $1,000 per pill.

About half of Americans report using prescription drugs. According to a new poll, Americans need these drugs and are fed up the with excessive, unfair pricing that runs rampant in the nation’s health care industry.

Unreasonable Prices From An Unlikable Industry

Polling shows the American pharmaceutical industry is the least popular service group because drug companies put profits over people.
Via: Conscious Life News

Health maintenance will always be a necessity, and so will the American pharmaceutical industry. Pharmaceuticals have the power to treat and cure illnesses that range from mild to serious, which means that the companies manufacturing the drugs have leverage to keep prices high.

But Americans are not oblivious. In fact, most are aware that pharmaceutical prices are much higher than they should be. In August, the Kaiser Family Foundation conducted a poll that found 72 percent think drug prices are unreasonable.

Out of the group that believes the cost of drugs should be lowered, 77 percent are currently taking pharmaceuticals. But 66 percent who aren’t using prescription drugs are also in agreement.

In addition, 3 out of 4 Americans believe they’re paying higher prices in the United States than they would in Canada, Mexico and Western Europe for the same prescription drugs. Going further, 72 percent of Americans believe Canada should be allowed to import prescription drugs to the United States. Americans want their drugs, and they want them at a fair price.

The polling shows that Americans are aware that pharmaceutical companies provide an important service. But that doesn’t mean the public has to like them.

Pharmaceutical companies are the least liked service group, falling below doctors, food manufacturers, banks and airlines. Fewer than half of the public sees these companies as positive. Only 42 percent of Americans have a favorable view of drug companies, in addition to the fact that 74 percent believe pharmaceutical companies put profits before people.

However, 62 percent of Americans believe that drug companies play a pivotal role in bettering people’s lives.

There has to be a way to create balance between the consumer and the producer.

Potential Ways To Lower Drug Costs

One proposed idea for lowering drug costs would be to allow medicare representatives to negotiate prices with pharmaceutical companies. 83 percent of Americans are in agreement with this option.
Via: KATV

As the presidential election draws near, candidates are speaking out about their opinions on prescription drug prices. Representatives from different political parties are in favor of lowering drug costs, but the way they plan to do it differs by partisan affiliation.

Republicans favor allowing market competition to regulate drug prices, whereas Democrats would prefer to look to the federal government for regulation. The public leans toward market competition, but only by 51 percent or a little more than half.

A few different strategies were included in the poll to introduce possible solutions and gather public attitudes on the current price reduction options. About 86 percent of Americans would like drug companies to provide information to consumers about how they set their prices, which would help to uncover the reasons why they’re so high. If there was an explanation as to why the drugs are so costly, working toward ways to lower the cost would be easier.

The poll addresses that it’s more difficult for sick and lower income individuals to afford pharmaceuticals. To combat that, more than 7 out of 10 people want to put price restrictions on expensive but life-saving drugs used for sicknesses like hepatitis or cancer.

In addition, 83 percent of Americans would like the federal government to negotiate lowered prices for people on Medicare. Allowing cost negotiations with Medicare is supported by the majority of both Republicans and Democrats, which means that it will be a likely and unarguable policy move.

Another option for lowering drug costs would be initiating a system of price choice that would be similar to the one already in place. People would be encouraged to buy cheaper drugs, but would have to pay more if they chose a similar, more expensive version. Only 48 percent of people are in favor of this option, which may be because it is similar to the generic medication options already offered. However, presidential candidate and Senator Bernie Sanders has been highlighting the rising price of generic drugs in his campaign.

Pharmaceutical companies aren’t looking forward to pricing restrictions, claiming that a more regulated marketplace would place limits the amount of new drug discoveries and sponsorships. But more affordable drugs would benefit the public as a whole.

Pharmaceutical companies should repeat this mantra: people over profits.

The post American Majority Disagrees With High-Priced Pharmaceuticals appeared first on Citizens Report.

Alexis Benter

The Obama administration recently revealed its new $3.99 trillion budget for 2016. It announced its plans to negotiate prices for costly drugs and biotechnology treatments under the Medicare Part D program, which offers private coverage for senior citizens and the disabled. Before this plan can be put into effect, it first needs to be approved by a Republican Congress. However, the new Congress has been very vocal about supporting market forces over government intervention as a means to control healthcare costs.

Obama’s budget plan has already come under attack from one of the drug industry’s biggest lobbying groups, Pharmaceutical Research and Manufacturers of America. This company feels that the plan contains, “harmful proposals that fundamentally alter the structure of the Medicare Part D program,” according to Reuters.

Biotechnology Costs More

Specialty drugs and biotechnology treatments, which are genetically engineered drugs that are often found to be more effective than traditional medicine, have increased in cost. As an effect, Obama’s budget is projected to increase from $63.3 billion to $82.5 billion in 2016. The Obama administration recently proposed $215 billion in government funding to support genetically-based treatments, which will play an important role in precision medicine by offering tailor-made treatments to patients that are based on genetic makeup.

Sovaldi Urges Negotiation

The recent push to allow drug price negation comes after a campaign against an expensive, life-saving drug. Solvaldi, a drug designed to fight against hepatitis C, has the ability to cure nearly all patients currently suffering from the liver-wasting disease, but that cure comes with a very hefty price tag. With the ill looking for good health, and executives looking at the balance sheet, the question once again rises whether Big Pharma cares about profit or people.

The post Obama’s New Budget Aims to Make Biotech Treatments More Affordable appeared first on Citizens Report.