Trump’s plan to ‘lower drug costs’ is a bait-and-switch that leaves seniors paying more.

On Thursday, January 31, the Department of Health and Human Services (HHS) led by Secretary Alex Azar, announced a proposal that will have the biggest impact on the American healthcare system since the Affordable Care Act passed in 2010.

The Trump Administration aims to lower drug prices for recipients of Medicare and other government programs by banning drug makers from paying rebates to pharmacy benefits middlemen known as PBMs.

Ironically, Azar is the former president of Lilly USA, a pharmaceutical company that has been criticized for raising its prices. During his decade with Lilly, the company notoriously tripled the price of insulin.


via Brookings Institution / Flickr

Unfortunately for seniors, the new policy is a huge bait and switch that leaves most paying more — a fact the HHS admits in its own report.

THE BAIT

The HHS claims that its new policy will lower out-of-pocket drug costs from 9 to 14%.

“This proposal has the potential to be the most significant change in how Americans’ drugs are priced at the pharmacy counter, ever, and finally ease the burden of the sticker shock that millions of Americans experience every month for the drugs they need,” Azar said in a statement.

But are PBMs really the price gouging bogeymen the HHS claims them to be?

According to Forbes’ Policy Editor Avik Roy, the attack on PBMs for high drug prices is “balderdash” — a classy term for "bullshit" — and a PR strategy cooked up by drug companies to shift the blame for their high prices.  

THE SWITCH

While the Administration has been touting the over-the-counter cost savings of its new proposal, they’ve been quiet about the increase in premiums for Medicare drug plans the proposal will create.

Health insurance companies work with PBMs because they do an effective job at keeping their prices down by providing patients with medications at the lowest possible price. So without these protections, insurance premiums for Medicare drug plans will rise.

Over 77% of people on Medicare are also enrolled in a prescription drug Part D plan and, according to Bloomberg, premiums for Medicare drug plans under the proposal could increase anywhere from 8% to 22%.

The HHS admits in its own report that 70% of Medicare part D users will pay more after the new policy.

However, the authors of the report spun it as a positive.

“An estimated 30% of Part D beneficiaries have drug costs high enough that their out-of-pocket savings will likely exceed any premium changes,” the report reads.

That means 70% of Part D beneficiaries will pay more for insurance premium increases than they will save from the potential drop in drug prices.

“The majority of Medicare beneficiaries will see their premiums and total out-of-pocket costs increase if this proposal is finalized,” House of Representatives Ways & Means Committee Chairman Richard Neal of Massachusetts and Energy and Commerce Committee Chairman Frank Pallone of New Jersey said in a joint statement. “We are concerned that this is not the right approach.”

The proposal has zero protections against drug manufacturers raising their prices.

via Rural Health Professions Action Plan

“Azar said Friday that the rule would deprive drug makers of an excuse for not lowering list prices. But the rule says manufacturers could reset their pricing strategies,” Bloomberg said.

Peter Bach, director of the Memorial Sloan Kettering Center for Health Policy and Outcomes, told Politico that drug makers don’t increase their prices due to PBM rebates, but “to increase their revenues.”

“From the start, the focus on rebates has been a distraction from the real issue,” Matt Eyles, president and CEO of America’s Health Insurance Plans, told Politico. “The problem is price. Manufacturers have complete control over how drug prices are set. Already this year, more than three dozen drug makers have raised their prices on hundreds of medications.”

IT'S HARD TO TRUST THE TRUMP ADMINISTRATION ON HEALTHCARE

While running for president in 2016, Donald Trump promised voters that his Affordable Care Act repeal-and-replace bill would provide insurance for everyone. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us," he said.

Instead, the proposal would have caused 14 million people to lose their healthcare immediately and another 10 million people to lose it over the next decade.

Luckily, it failed to pass the Senate.

In October 2018, the Trump Administration imposed new rules to make it easier for insurance providers to discriminate against sick consumers. While on the same day, he told supporters at a Philadelphia rally, “We will always protect Americans with preexisting conditions.”

WHAT HAPPENS NEXT?

The new rule includes a 60-day period for public comment. The new protections could go into effect as soon as that period passes.

It's unlikely that this proposal will affect working Americans' healthcare in the near future because it has been criticized by two committees overseeing healthcare in the Democrat-controlled House.

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Welcometoterranova and P&G Good Everyday are teaming up to find the people who lead with love everyday.

Know someone in your neighborhood who's known for their optimistic attitude, commitment to bettering their community and always leading with love? Tell us about them for the chance to win a $2,000 grant to keep doing good in their community.

Nomination ends November 22, 2020

Courtesy of Macy's

Brantley and his snowman

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"Would you like to build a snowman?" If you asked five-year-old Brantley from Texas this question, the answer would be a resounding "Yes!" While it may sound like a simple dream, since Texas doesn't usually see much snow, it seemed like a lofty one for him, even more so because Brantley has a congenital heart disease.

On Dec. 11, 2019, however, the real Macy's Santa and his two elves teamed up with Make-A-Wish to surprise Brantley and his family on his way to Colorado where there was plenty of snow for him to build his very own snowman, fulfilling his wish as part of the Macy's Believe campaign. After a joy-filled plane ride where every passenger got gift bags from Macy's, the family arrived in Breckenridge, Colorado where Santa and his elves helped Brantley build a snowman.

Brantley, Brantley's mom, and Santa marveling at their snowmanAll photos courtesy of Macy's

Brantley, who according to his mom had never actually seen snow, was blown away by the experience.

"Well, I had to build a snowman because snowmen are my favorite," Brantley said in an interview with Summit Daily. "All of it was my favorite part."

This is just one example of the more than 330,000 wishes the nonprofit Make-A-Wish have fulfilled to bring joy to children fighting critical illnesses since its founding 40 years ago. Even though many of the children that Make-A-Wish grants wishes for manage or overcome their illnesses, they often face months, if not years of doctor's visits, hospital stays and uncomfortable treatments. The nonprofit helps these children and their families replace fear with confidence, sadness with joy and anxiety with hope.

It's hardly an outlandish notion — research shows that a wish come true can help increase these children's resiliency and improve their quality of life. Brantley is a prime example.

"This couldn't have come at a better time because we see all the hardships that we went through last year," Brantley's mom Brandi told Summit Daily.

Brantley playing with snowballs

Now more than ever, kids with critical illnesses need hope. Since they're particularly vulnerable to disease, they and their families have had to isolate even more during the pandemic and avoid the people they love most and many of the activities that recharge them. That's why Make-A-Wish is doing everything it can to fulfill wishes in spite of the unprecedented obstacles.

That's where you come in. Macy's has raised over $132 million for Make-A-Wish, and helped grant more than 15,500 wishes since their partnership began in 2003, but they couldn't have done that without the support of everyday people. The crux of that support comes from Macy's Believe Campaign — the longstanding holiday fundraising effort where for every letter to Santa that's written online at Macys.com or dropped off safely at the red Believe mailbox at their stores, Macy's will donate $1 to Make-A-Wish, up to $1 million. New this year, National Believe Day will be expanded to National Believe Week and will provide customers the opportunity to double their donations ($2 per letter, up to an additional $1 million) for a full week from Sunday, Nov. 29 through Saturday, Dec. 5.

There are more ways to support Make-A-Wish besides letter-writing too. If you purchase a $4 Believe bracelet, $2 of each bracelet will be donated to Make-A-Wish through Dec. 31. And for families who are all about the holiday PJs, on Giving Tuesday (Dec. 1), 20 percent of the purchase price of select family pajamas will benefit Make-A-Wish.

Elizabeth living out her wish of being a fashion designer

Additionally, this year's campaign features 6-year-old Elizabeth, a Make-A-Wish child diagnosed with leukemia, whose wish to design a dress recently came true. Thanks to the style experts at Macy's Fashion Office and I.N.C. International Concepts, only at Macy's, Elizabeth had the opportunity to design a colorful floral maxi dress. Elizabeth's exclusive design is now available online at Macys.com and in select Macy's stores. In the spirit of giving back this holiday season, 20 percent of the purchase price of Elizabeth's dress (through Dec. 31) will benefit Make-A-Wish.You can also donate directly to Make-A-Wish via Macy's website.

This holiday season may be a tough one this year, but you can bring joy to children fighting critical illnesses by delivering hope for their wishes to come true.

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A lot of people here are like family to me," Michelle says about Bread for the City — a community nonprofit located in Washington DC that provides local residents with food, clothing, health care, social advocacy, and legal services. And since the pandemic began, the need to support organizations like Bread for the City is greater than ever, which is why Amazon is Delivering Smiles to local charities across the country this holiday season.

Watch the full story:

Amazon is giving back by fulfilling hundreds of AmazonSmile Charity Lists, and donating essential pantry and food items to help organizations like Bread for the City provide to those disproportionately impacted this year.

Visit AmazonSmile Charity Lists to donate directly to a local charity in your community, or simply shop smile.amazon.com and Amazon will donate a portion of the purchase price of eligible products to your charity of choice.
via Twins Trust / Twitter

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