The Inflation Reduction Act does a lot of good things, including capping insulin at $35/month, but it only allows govt to negotiate with pharma on the top 10 most common Medicare drugs. This will expand in the future. It’s a good start. More work is needed to reign in the PBMs and big pharma. There’s a link in the description for more info about the inflation reduction act
It's kind of interesting seeing this get brought up in your video since we were discussing this recently in my financial management class and talking about how it would affect various industries. It's nice seeing the government actually stepping in to issues like this. I just hope this isn't a "there we go, now we fixed it!" situation since this is really only step one to fixing the problem 🤔
The problem is that the PBM is NOT just a little gremlin! I wonder how many congresspersons will lose their reelection support. This new act is just a bandaid where major surgery is needed.
It's just like the bandaid applied to the Affordable Care Act by the Republicans that left it a shadow of it's original self. As long as there are immoral Republicans in the US, there will never be progress and there will always be corruption. There's only the corrupt and their sheep, MAGA.
@@kitsuneprincess4637 oh you did fail it? Are you sure? Oh you're sure, well you still need to try again. Oh you're allergic to it? Well did it give you anaphylaxis? No, then you need to try again. It made your symptoms worse? Why do I care? That's not a reason to not try a med again. 🤬 Of course this hasn't happened to me once, or twice, oh wait, it has, every freaking year. As if I will lose an allergy.
It's hard to avoid the language foisted on us by profiteers. Pharma won't "lose" money. They'll just make less money. It's an important distinction that allows business to control conversation for their benefit.
When you project future profits and take loans out on those projections to achieve those projections, and then those projections don't come true, the bill is still due on the loan. So, yeah, they do lose money, even in the strictest sense of the word. I don't care that they lost money; I'm just letting you know that they are actually losing money so we can revel in their modicum of pain together.
@@TurdFurgeson571however they already got the lower interest rates based on the better projections and banks are a lot more weary on jacking those up ridiculously mid-loan on big businesses. The principle they have to pay back doesn't change. At worse there is some fee in there for not meeting the targets but that's only if they were required to give the banks their books, otherwise just make the payments with the revenue on hand.
@@nfzeta128 You aren't really saying anything different from what I've laid out. You're just spelling out the process a bit more. Let's just be happy knowing they are feeling pain.
That's the problem with a lot of the desired regulations and programs people are asking for, they're band-aid solutions that don't fix the root of the problem. Now if this is only step one along the way to the solution, that is fine, you can't treat a disease all at once after all, but we can't let ourselves think "there we go, now we've fixed it" when all we've done is applied a bandage to a rather infected wound.
Totally agree. In this case, I do think it’s a first step. Nothing has been done about this for years. Happy for any progress, but it has to keep going
@@leadpaintchips9461 And that's the reality most people miss. Getting the government to step in certainly helps, but even the best policy makers can be corrupted if we don't have that shift
@@homerman76 And I don't see that happening unless something collapses. As of right now, big pharma and medical insurance are legally required to go for the biggest profits because of the burden they have to shareholders. As long as we think that businesses exist to make money instead of providing goods and/or services at a sustainable cost, things won't change.
Our country desperately needs a comprehensive Healthcare Financing Reform bill. Our incentives in healthcare are not aligned to maximize humanitarian aid
@@keanuxu5435 Which is why government has to put restraints on capitalism, but they won't because they are bribed by the rich. We, the people, will always lose.
@@virginiamoss7045 This is defeatist. Do nothing, and things will operate without you. Do something, and with some probability you can cause a change in outcome. So long as at least one mechanism exists, hope is not lost.
@@virginiamoss7045 Not unless we, the working class people, unite to overthrow the owner class and install a system that puts people over profits, namely socialism, then communism. We must keep up the fight, because if we don't, we let evil, ie capitalism, win.
a just reward for public ignorance and inaction until a problem hits citizens personally ... or can you honestly claim to have been an real activist for affordable healthcare before you experienced "hell"? Can you even claim be an activist now? the murrican people get what they ask for with inaction and ignorance, especially given that most of the real first world showed them how to do it better for generations already.
We had insurance, had a baby born with an issue, and between ductinle co-pays out of pocket costs, we will never own our own home. Everyone is one medical issue away from financial disaster. Oh you have lots of money, just wait when the insurance won’t cover that $100,000 a year medication, or the surgery needed that’s over $150,000, and that doesn’t include the anesthesiologist, the radiologist, cardiologist….all those are extra. The USA is horrible, but number #1 in it! 😮
I'm waiting for the scandalous accusations that he once gazed soulfully into the eyes of one of his patients. He'll be canceled faster than Russel Crowe.
Medicine was a for-profit business in those days too. Turns out, we've gotten a lot of benefits out of letting people earn a profit from selling stuff we all want and need. Notes: difference in life expectancy between 1776 and 1976. But let government grant and enforce monopolies on an industry and now you have what we have today. All Hail Lord Patent Law bringer of Competitionless Profit!
But there were phycisians and chemists who gave away novel price award level life-changing inventions we still use today with all the profit it involved in order to do a service to humanity and some of them were the actual founders of today's Big pharma
This is probably what they actually Didn't intend when they were talking about Capitalism. This is more like Tyranny and Treason, than the Free Market practices that they were hoping for us American Citizens.
I honestly believe my best friend died at 54 last year because he could not afford his insulin for a year and a half. It quickened his decline. I miss him and will never talk to him again.
Isn't it awful to think that insulin was made affordable by the last administration, and that was purposefully ruined at the start of this administration, just so it could later do it again and take credit for the idea?
@@AtlasReburdened Insulin was not made affordable by the last administration nor did it rise at the start of the current administration. Prices kept raising through 2019 and only started to come down following 2019, and are still (mildly) in a somewhat downward trajectory.
Here in the UK the government negotiates drug prices on the scale of a country, which is why we pay $4 for a month's supply of insulin. Either pharma agrees, or they lose the sales to an entire country. The max we personally pay for any med is around $10, even premium orphan-status drugs. Amazed an advanced country like the US puts up with their healthcare system and its corporate exploitative profit making.
Each of these videos deepens the sadness I feel about our healthcare system. I love my job, I love the patients I serve, and it seems pretty backwards that the primary thing standing in the way of my patient care is “cost.”
You have that a _little_ sideways. It's not "cost" that's standing in the way, it's for-profit capitalistic healthcare with a captive market (literally everyone) and no effective regulation to prevent monopolistic rents being charged for what almost every other country in. the. WORLD. is and should be a right given to every person, not just those that can afford it. It's capitalism, and crony capitalism specifically, that is standing in the way, not "cost."
I am really hoping some big media company picks up your video series soon and spreads the word. This whole thing needs to make the rounds to every old person in the country so we can all be on the same page.
All Republicans voted against the bill. All Democrats voted for it. Media companies have been blatant about what Americans need to do, just too many of them don’t listen.
This channel that I religiously follow, criticize the healthcare and make the problems seen in a mainstream way. It already has a huge power and will increase even more in power to be heard. I am wishing for similar channels to open up for education, mental health, poverty, addiction, justice, environment and many more. However, Dr. Glaucomflecken is being 100% honest about everything in this, so when and if others follow suit, I can only hope for the same level of honesty. With common sense, compassion, and fairness every country on earth can turn into an amazing place to be and live. Fingers crossed.
I'm enormously grateful for the scientists and civilians doing the work and supporting those that do the work required to develop the drugs and therapeutic regiments that save lives, improve lives, and protect lives. However, those that insist that a drug that has been on the market for over 10 years should still cost over $4000/month, are just the absolute worst. How long can they use the "cost of innovation" excuse? It's utterly ridiculous. Same with insulin that is unpatented. It's insanity how the drug companies exploit people in the name of bigger profits.
A lot of those innovations come from other sources such as university labs. The drug companies whine about the cost of R&D as if they develop the drugs from the start.
It is a terrible excuse, since most drug companies don't pay for their own R&D most of the time. They may put some of their own money in, but most of it comes from public funding. The profit margins are insane.
Because it's paying for all the other drugs that failed to make it to market... And marketing... And lobbying... And all the yachts and houses for the executives...
Being a european living and growing up in a (now) former "communist " country with every episode of this i gotta ask my American friends "this can't actual be referencing a real practice"
Unfortunately the "better dead than Red" propaganda has effectively brainwashed a lot of people into thinking that basic needs being behind a giant paywall is "the price of freedom."
@@LexYeensoo instead we should abolish private property and institute central planning? Because that worked so well to avoid corruption and provide high quality of life in the past? Your comment is no different than blaming democratic systems for it because American elected legislators fail to rein costs in. Government intervention to fix broken markets and establish rules to level the field between producers and consumers is a hallmark of capitalism. Failing to do so isn't a feature.
We don’t pay attention til it’s too late. We think we don’t have any power. There’s power in numbers, but not individually, and we are more individual focused. We have a tendency to think “us” vs “them” AND that something bad won’t ever happen to us, so… we are woefully underprepared when it does.
The PBM Gremlin is just scary. Dr. G has risen to new heights (or new lows)! On a serious note: This series on the inner workings of US health insurance and PBM is so needed to shine light on the underhanded actions.
Yup. It's a good lesson that you cannot really fix systemic problems one part at a time. The whole enterprise is corrupt. Change one small part of a huge systemic problem and the rest of the system will simply accommodate it. We need to eliminate private insurance. Making it slightly harder for them to grift will only make them work slightly harder to grift rather than simply sit back and take it while normal humans benefit from those changes.
I mean yes and no, to make major changes to systems like this you have to go one step at a time so you don't just create something worse in the process of creating something better (history has plenty of examples of this,) but it is true that we can't just expect things to be done after getting through one part. It's like treating a disease, you can't take the medicine all at once, but stopping part way through either won't help you or can make things worse since you haven't fully treated the problem and give it a chance to grow back with a vengeance. The system is rotted, but there are still some salvageable parts that would be bad to lose, we're not quite at a point where it is best to cut the whole tree down.
@@homerman76 I think we really are at the point we should cut it all down. Private insurance should not mathematically exist, in any industry whatsoever. Everyone should chip in with their taxes, and the government covers it all. We need to reclaim the $200 billion profit for the people. I have no sympathy for anyone working for any of those companies, being a leech to each and every American, let them all be fired and put on unemployment benefits, I’m sure $200 billion can cover that as well. The only better solution would be to illegalize Lobbying (which is bribery straight up), like other civilized countries have done.
This patriotic touch at the end about the founding fathers intentions touches my heart. I hope not for long because I can't afford to visit the cardiologist
Greed is one hell of a drug…That isn’t insured by the insurance company. I wonder how much they would charge if they could market greed in the already insane market
No, the Inflation Reduction Act is still a big win for those it effects, but the insurance companies, as there is almost zero oversight, as such a terrible thing as capping prescription prices for medications that have become cheaper to make, have been on the market for 20 years + and have not had any improvement in effectiveness and have gone up far in excess of expect CoL increases, would be all communist or something. Until (as much as I don't want to make it BvR) the majority of people opposing healthcare reform, who happen to be Republicans, get voted out, it will be piecemeal victories and mitigating losses as the medical beast turns to crush patients in a new and horrid way.
Until we repeal Citizens United corporations are going to do whatever they want regardless of what the government says. We don't have a "free market capitalist" society we have an "oligarchical corporate socialist state". The government is allowed to pick and choose who will win and lose, and they pick the ones that pay them over the ones that they serve. If the inflation reduction act wanted to fix this problem, then it would have had language to enforce oversight, not just negotiate prices.
"We've never had money taken from us before" and you. Still haven't. Money you haven't earned can't be taken away from you, because it isn't yours. It's like asking someone for five dollars, having them say no, and then accusing them of stealing five dollars from you. A drop in profits isn't losing money
Ugh. Sadly many people think like this. My grandma would demand free food from servers in restaurants, and when they (obviously) refused she'd demand their manager and demand the entire table be comped because the customer was always right. Like no, being refused free food does not entitle you to free food. Oddly enough I stopped going out with her once I had any say in my life, aka when I became an adult.
not too many countries left in the world where you can be doing everything right all your life, work hard, have good insurance, save up for retirement. then just when you're thinking of retiring, something out of your control needing healthcare comes up and insurance won't cover on a technicality or don't cover enough and your entire life's work gone straight into a corporation's pocket for a drug or procedure that costs them a tiny fraction what they charged you.
This makes me sad, but at least President Biden is trying to do something. If he could get the House and Senate to support him he might actually able to fix the other half that measure!
President Trump had signed a executive order doing the same thing, and then Biden overturned that executive order causing the prices to skyrocket again.
Increase prices only as fast as inflation? Man, I wish my pay would increase as fast as inflation too... They have the audacity to pretend 3% is a raise when we all know it's a LEAST a 7% pay CUT.
Here in Europe, all governments negotiate all drug prices. They also don’t allow the sale of drugs that aren’t proven to actually help significantly and companies can’t charge more for a new drug unless it’s proven to be better than the existing drug.
Dr G, I tagged you about a case where a family became medical refugees or their son would be institutionalised! Thumbs up for Dr William to see please 😢
Reminds me of that one CEO who jacked up the price of one med (I can't recall the name) over 400%, just because he wanted to make up for the losses of the last quarter
Thanks Dr. G !! American system of “ healthcare” is broken -When will they have enough ? CEO’s so greedy …all of them at the top of the chain --greedy, selfish , closing hospitals in inner city bc it doesn’t make a profit …(Philadelphia) we didn’t go into medicine for money , we did it to help other people …
At this rate, Teddy Roosevelt is going to rise from his grave, become the president and do some good ol' trust-busting. Or his resting place will become a power plant because he is rolling in his grave so fast, it's enough to power all of New York.
Saying it on every one of these videos. This is why people are vaccine hesitant. Doctors need to take back control of their industry and get back to 'do no harm'.
Multiple problems upon multiple problems, all caused by government. Reduce patent lifetimes to a few years and then reduce the cost of getting a drug approved.
Just in case you wondered which party to vote for in the next election, here's the breakdown of how which party voted for the Inflation Reduction Act: The House voted 220-207 to pass the bill on August 12, 2022.[2] All 220 Democrats voted yes. 207 Republicans voted no. 4 Republicans did not vote. [show]House vote to approve the motion to concur on the Inflation Reduction Act (August 12, 2022)
The inflation reduction act covered about 700 bases in one. So instead of congress putting forth bills that were digestible and open for discussion, they do shit like this. The bill covers medicare to home/vehicle energy to business tax law. It's an idiotic way to propose a bill and cram as much bullshit in it as possible. 95% of the bill is climate related, which is fine, but it's disguised as an inflation reduction act when inflation reductioin ISN'T EVEN IN THE BILL. To be clear, I did watch the video and it's regarding price caps for medications, which has nothing to do with inflation because (as stated in the video) prices are skyrocketing well past inflation rates.
I wonder if this is why my insurance doesn't cover my head nerve blocks specifically for migraine and headache pain. Went into effect in April, which seems odd...no way to sneak in any back doors with prior auths either. If headache is anywhere in my record they will deny it. That pisses me off so bad.
When our oldest was born, I asked for an itemized bill. I found several things we were billed for that never happened (like BP medication for my wife, who was never higher than 115/70 our entire stay). I called our insurance company and told them about these items. The person actually said that they didnt care. You don't care that the hospital is fraudulently billing you?
I get an injection from a specialist every month that costs $470, for free. In addition, I get some other medicine that would cost a total of $300 a month, but because the pharmacy always asks if they should take the cheapest version, I get away with $20. And this is even before reimbursement from the central reimbursement-register have been calculated.
Much ❤ to all the MD's out there fighting the good fight against Coroprate run Health Care against their best interests! To everyone else, THIS is the PROPER use of the 1st Amendment!!!
I just think its funny....we pay taxes, so the government can fund insurance companies...which WE then pay directly for insurance....but also have to pay a deductible because you know, our insurance payments already arent enough. So we pay 3 times to get health care.
Just got letter from clinic saying they will now bill through the hospital and claim nursing time and facilities cost for office visits. As retired by disability RN who know they have replaced most RNS with MA and was billed $359 for mandatory welcome to new PCP visit which was historical review rendering no care only chiding that MUST have colonoscopies and mammo on schedule, must have annual physical here not with NMD specialist and understand MD doesn't need to know about MyastheniaGravis because it has no consequences. Um yeah,NO! Wasn't that stupid when was young and actually blonde.
Ah the Inflation reduction act, that does the exact opposite of reducting inflation. If they name all their bills this backwards, I'd ve very worried if they ever passed a law titled "no more horse slaughter act" cause it would probably make slaughtering horses mandatory.
So this video misunderstands something rather important about the IRA and its ability to negotiate prices. It applies only to drugs that have been on the market for 9 years and don't have generics available. This is relevant because if you keep up with how the FDA approves drugs and generics, usually the drug comes out. There is a 10-year period where it is a monopoly, and then the FDA allows a generic to hit the market. You read that right. The IRA will only regulate the cost of a drug for a single year of its government enforced monopoly life span and then forget it exists once the generic hits the shelves. To say it's lacking is an understatement.
That's the thing, we keep applying "fixes" like this and then going "alright, we fixed it" with almost no follow through to prevent companies from making up the difference somewhere else. Another good example is minimum wage, sure it seems like a good ideal to make sure everyone is paid "fairly," but we run into a few issues when it is the only solution, such as companies increasing prices on goods to make up the difference, hiring less and expecting more from employees, decreasing costs in production and delivering a worse quality product, other more demanding jobs not raising wages to follow suit (leading to fewer and fewer people taking stuff like factory work in some areas, which is its own can of worms,) etc. etc. The ideal is there, but an ideal with no follow through is worthless and sometimes even harmful.
@@homerman76the only problem with that argument is that the other times we raised the minimum wage, spending power increased more than the rise in prices did. So it's not a good reason to just not increase minimum wage at all.
12.5 secs later... Oh Jimothy!!! Great news!!! Our loophole department found a new way to circumvent the IRA! We get to charge whatever we want for ALL our medications again! Isn't it exciting!!!
Hold on, even if the PBM goes to the insurance companies, they can't just jack up rates because they feel like it. If their blocks of business charge more than an extra 25% (roughly) over claims on domestic major medical policies, the ACA requires them to pay out rebates. They need claims to increase somewhere to justify a price increase to regulators and clients.
@mixiearmadillo7452 Each state has its own rules in addition to the federal rules. They can "disapprove" insurance rates, and prevent an insurer from issuing or renewing policies in their state.
Hi Dr. G! Great presentation. Squeezing a balloon analogy is appropriate. If some drugs are going to be price controlled, then those that are not are going to have greater than exponential price increase. Another factor is that depending on where the drug is in its life cycle, the brand manufacturer may just stop production, thus leading to increased use of non price controlled meds. This has been attempted before. See oncology drugs infused the physician's offices. The unintended consequences which occurs is that physicians offices now cannot keep their doors open with these generic meds. Physician offices will look for other hustles to keep the cash flow (e.g. growth factors and other supportive care meds).
Ultimately a bad thing. It's impossible to tell if any good is coming from anything because money printer go BRRR. Ultimately the stores of value we have and the assumptions we make are getting shifted and skewed. The debt needs to be taken under control, not hiding it's symptoms with more printed money.
Making 10 billion in profit seems like a lot compared to the 214 billion in revenue. I think pharam is allowed to use a lot more loopholes than just a negation of drug negotiation; the tax system is complex enough to allow a lowering of taxing profits. But if pharma is no longer as profitable, we could see a reduction in invetsments in the pharma sector. Less research into rare diseases, gene therapies, and stuff like making a malaria vaccine can slow down. Something has to happen, obviously, but idk what the consequences will be long term
I'm 90% positive that the democrats passed this law just so they can get more votes, because on the surface it looks like it can help patients. At most this will only mask problems in the short-term, long term it will be a disaster
Like trying to herd cats , just when you think you're normalising pricing , off they dart in a different direction . What can you do , when vested interests even own supreme court justices.
First I have to say this I love your stuff, but watching these videos makes me incoherently angry and very happy that I live in a country with proper Healthcare
The Inflation Reduction Act does a lot of good things, including capping insulin at $35/month, but it only allows govt to negotiate with pharma on the top 10 most common Medicare drugs. This will expand in the future. It’s a good start. More work is needed to reign in the PBMs and big pharma. There’s a link in the description for more info about the inflation reduction act
Honestly, 10 products is low but its a start .. hopefully congress can add to it over the years
That should awfully like socialism... Where has the crony capitalism in USA gone?
It's kind of interesting seeing this get brought up in your video since we were discussing this recently in my financial management class and talking about how it would affect various industries. It's nice seeing the government actually stepping in to issues like this. I just hope this isn't a "there we go, now we fixed it!" situation since this is really only step one to fixing the problem 🤔
Day Three of Asking when does US Healthcare become Eugenics against the poor
It's 10 every year though, right?
The problem is that the PBM is NOT just a little gremlin! I wonder how many congresspersons will lose their reelection support. This new act is just a bandaid where major surgery is needed.
The surgery has been denied by insurance because less effective treatments haven't failed yet.
The inflation reduction act is 6 weeks of physical therapy when you need a lung transplant.
An operation to remove the cancerous growth of lobbyists, special interests and corporate greed… Not so much a scalpel as a scythe needed..
It's just like the bandaid applied to the Affordable Care Act by the Republicans that left it a shadow of it's original self. As long as there are immoral Republicans in the US, there will never be progress and there will always be corruption. There's only the corrupt and their sheep, MAGA.
@@kitsuneprincess4637 oh you did fail it? Are you sure? Oh you're sure, well you still need to try again. Oh you're allergic to it? Well did it give you anaphylaxis? No, then you need to try again. It made your symptoms worse? Why do I care? That's not a reason to not try a med again. 🤬
Of course this hasn't happened to me once, or twice, oh wait, it has, every freaking year. As if I will lose an allergy.
It's hard to avoid the language foisted on us by profiteers. Pharma won't "lose" money. They'll just make less money. It's an important distinction that allows business to control conversation for their benefit.
Oh sure they'll lose money, they have to pay for all the advertising somehow.
When you project future profits and take loans out on those projections to achieve those projections, and then those projections don't come true, the bill is still due on the loan. So, yeah, they do lose money, even in the strictest sense of the word. I don't care that they lost money; I'm just letting you know that they are actually losing money so we can revel in their modicum of pain together.
@@TurdFurgeson571however they already got the lower interest rates based on the better projections and banks are a lot more weary on jacking those up ridiculously mid-loan on big businesses. The principle they have to pay back doesn't change. At worse there is some fee in there for not meeting the targets but that's only if they were required to give the banks their books, otherwise just make the payments with the revenue on hand.
@@nfzeta128 You aren't really saying anything different from what I've laid out. You're just spelling out the process a bit more. Let's just be happy knowing they are feeling pain.
That's the problem with a lot of the desired regulations and programs people are asking for, they're band-aid solutions that don't fix the root of the problem. Now if this is only step one along the way to the solution, that is fine, you can't treat a disease all at once after all, but we can't let ourselves think "there we go, now we've fixed it" when all we've done is applied a bandage to a rather infected wound.
Totally agree. In this case, I do think it’s a first step. Nothing has been done about this for years. Happy for any progress, but it has to keep going
@@DGlaucomflecken- Part D in general is a ridiculously cumbersome program.
'Fixing it' would be a fundamental shift in how we think and do business.
@@leadpaintchips9461 And that's the reality most people miss. Getting the government to step in certainly helps, but even the best policy makers can be corrupted if we don't have that shift
@@homerman76 And I don't see that happening unless something collapses. As of right now, big pharma and medical insurance are legally required to go for the biggest profits because of the burden they have to shareholders.
As long as we think that businesses exist to make money instead of providing goods and/or services at a sustainable cost, things won't change.
Our country desperately needs a comprehensive Healthcare Financing Reform bill. Our incentives in healthcare are not aligned to maximize humanitarian aid
I'm sure we can count on our republican leaders to do it.
Welcome to capitalism, where profits are valued over people
@@keanuxu5435 Which is why government has to put restraints on capitalism, but they won't because they are bribed by the rich. We, the people, will always lose.
@@virginiamoss7045 This is defeatist. Do nothing, and things will operate without you. Do something, and with some probability you can cause a change in outcome. So long as at least one mechanism exists, hope is not lost.
@@virginiamoss7045 Not unless we, the working class people, unite to overthrow the owner class and install a system that puts people over profits, namely socialism, then communism.
We must keep up the fight, because if we don't, we let evil, ie capitalism, win.
As someone who has been going through medical HELL the past year and a half… I will be in debt for forever.
a just reward for public ignorance and inaction until a problem hits citizens personally ... or can you honestly claim to have been an real activist for affordable healthcare before you experienced "hell"? Can you even claim be an activist now?
the murrican people get what they ask for with inaction and ignorance, especially given that most of the real first world showed them how to do it better for generations already.
If it’s an insurmountable amount, perhaps personal bankruptcy might be an option
We had insurance, had a baby born with an issue, and between ductinle co-pays out of pocket costs, we will never own our own home. Everyone is one medical issue away from financial disaster. Oh you have lots of money, just wait when the insurance won’t cover that $100,000 a year medication, or the surgery needed that’s over $150,000, and that doesn’t include the anesthesiologist, the radiologist, cardiologist….all those are extra. The USA is horrible, but number #1 in it! 😮
@@sciencebunny- What a sad commentary on our country.
@@trishayamada807 *"Everyone in the US is one medical issue away from financial disaster." There, I fixed it for you
We need more than 30days!! This has been the most important playlist I’ve ever watched.
Yes! But, uh, maybe a series of medical specialty couples therapy first to give us a mental health break!
Dr. G, keep it up and keep yourself safe. Shouting truth like this from the digital rooftops tends to be dangerous.
He is a brave soul to be speaking the truth on these here interwebs for all to see!
I'm waiting for the scandalous accusations that he once gazed soulfully into the eyes of one of his patients. He'll be canceled faster than Russel Crowe.
@@runninggag1077did you mean Russell Brand?
@@Oxibase ya. Him too. 🤣
Tired: The system is broken and must be fixed.
Wired: The system is functioning as intended and must be dismantled.
"The shareholders will get their profits just as our founding fathers intended" -- This line.
Hardest hit of all
Spooooky. I got chills.
Medicine was a for-profit business in those days too. Turns out, we've gotten a lot of benefits out of letting people earn a profit from selling stuff we all want and need. Notes: difference in life expectancy between 1776 and 1976. But let government grant and enforce monopolies on an industry and now you have what we have today. All Hail Lord Patent Law bringer of Competitionless Profit!
But there were phycisians and chemists who gave away novel price award level life-changing inventions we still use today with all the profit it involved in order to do a service to humanity and some of them were the actual founders of today's Big pharma
This is probably what they actually Didn't intend when they were talking about Capitalism.
This is more like Tyranny and Treason, than the Free Market practices that they were hoping for us American Citizens.
I honestly believe my best friend died at 54 last year because he could not afford his insulin for a year and a half. It quickened his decline. I miss him and will never talk to him again.
Isn't it awful to think that insulin was made affordable by the last administration, and that was purposefully ruined at the start of this administration, just so it could later do it again and take credit for the idea?
@@AtlasReburdenedthats polictics 101. I've seen trees chopped down so they could plant another one for this same reason 😢
@@AtlasReburdened Insulin was not made affordable by the last administration nor did it rise at the start of the current administration. Prices kept raising through 2019 and only started to come down following 2019, and are still (mildly) in a somewhat downward trajectory.
@@AtlasReburdenedBlatant lie as republicans worked to not allow insulin to be affordable.
@@Emilio1985
Pfft. Get out of here with your facts and logic, we wanna be tribalistic and deliberately ignorant!
Here in the UK the government negotiates drug prices on the scale of a country, which is why we pay $4 for a month's supply of insulin. Either pharma agrees, or they lose the sales to an entire country. The max we personally pay for any med is around $10, even premium orphan-status drugs. Amazed an advanced country like the US puts up with their healthcare system and its corporate exploitative profit making.
Us paying high prices is what funds the research to make the drugs that you basically steal.
Each of these videos deepens the sadness I feel about our healthcare system. I love my job, I love the patients I serve, and it seems pretty backwards that the primary thing standing in the way of my patient care is “cost.”
CVS is striking, take note.
I agree, and it seems pretty backwards to me that cost is the main thing standing in the way of people having housing, and food, and education, too.
You have that a _little_ sideways. It's not "cost" that's standing in the way, it's for-profit capitalistic healthcare with a captive market (literally everyone) and no effective regulation to prevent monopolistic rents being charged for what almost every other country in. the. WORLD. is and should be a right given to every person, not just those that can afford it. It's capitalism, and crony capitalism specifically, that is standing in the way, not "cost."
I am really hoping some big media company picks up your video series soon and spreads the word. This whole thing needs to make the rounds to every old person in the country so we can all be on the same page.
Have you noticed all the “big media companies” are financially dependent upon the marketing divisions of big pharma? Be careful what you wish for.
All Republicans voted against the bill. All Democrats voted for it. Media companies have been blatant about what Americans need to do, just too many of them don’t listen.
They don't care. As long as their religion tells them to vote right, and it harms younger people, They'll keep voting the way they always have.
@@ZincOxideGinger you're seriously out of it if you think this is a left vs right issue.
The media is in the hands of whoever has more money. Don't get your hopes up
This channel that I religiously follow, criticize the healthcare and make the problems seen in a mainstream way. It already has a huge power and will increase even more in power to be heard. I am wishing for similar channels to open up for education, mental health, poverty, addiction, justice, environment and many more. However, Dr. Glaucomflecken is being 100% honest about everything in this, so when and if others follow suit, I can only hope for the same level of honesty. With common sense, compassion, and fairness every country on earth can turn into an amazing place to be and live. Fingers crossed.
I'm enormously grateful for the scientists and civilians doing the work and supporting those that do the work required to develop the drugs and therapeutic regiments that save lives, improve lives, and protect lives. However, those that insist that a drug that has been on the market for over 10 years should still cost over $4000/month, are just the absolute worst. How long can they use the "cost of innovation" excuse? It's utterly ridiculous.
Same with insulin that is unpatented. It's insanity how the drug companies exploit people in the name of bigger profits.
A lot of those innovations come from other sources such as university labs. The drug companies whine about the cost of R&D as if they develop the drugs from the start.
R and D also often funded by tax payers. More is spent on marketing than R and D for some medications.
It is a terrible excuse, since most drug companies don't pay for their own R&D most of the time. They may put some of their own money in, but most of it comes from public funding. The profit margins are insane.
@@cbpd89yup, I've seen figures that put it north of 20%, even after R&D.
Because it's paying for all the other drugs that failed to make it to market... And marketing... And lobbying... And all the yachts and houses for the executives...
So glad you decided to make this series, and that more and more physicians are speaking up about this. ❤
Being a european living and growing up in a (now) former "communist " country with every episode of this i gotta ask my American friends "this can't actual be referencing a real practice"
But it is. Sadly.
oh, it is.
remember, under capitalism anything can be bought if you have enough money - like laws and politicians!
Unfortunately the "better dead than Red" propaganda has effectively brainwashed a lot of people into thinking that basic needs being behind a giant paywall is "the price of freedom."
It doesn't even scratch the surface.
@@LexYeensoo instead we should abolish private property and institute central planning? Because that worked so well to avoid corruption and provide high quality of life in the past?
Your comment is no different than blaming democratic systems for it because American elected legislators fail to rein costs in.
Government intervention to fix broken markets and establish rules to level the field between producers and consumers is a hallmark of capitalism. Failing to do so isn't a feature.
I pay like £10 something a month for unlimited prescriptions and that annoys me, how are Americans not constantly rioting?
Because the police will make it where you can’t physically protest again … unfortunately
Apathy. Acceptance.
Oh we tried rioting over a lot of things, and in response they increased the police "kill people in the street whenever they feel like it" budget.
We don’t pay attention til it’s too late.
We think we don’t have any power. There’s power in numbers, but not individually, and we are more individual focused.
We have a tendency to think “us” vs “them” AND that something bad won’t ever happen to us, so… we are woefully underprepared when it does.
Because we have all become so numb. We can riot all we want but money talks. The government isn't here for the people. They just want their cut.
I gotta wonder how Todrick and Jimothy got their jobs. Soulessness is generally a prequisite to work at any BigPharma or UnitedHellthcare.
The PBM Gremlin is just scary. Dr. G has risen to new heights (or new lows)!
On a serious note: This series on the inner workings of US health insurance and PBM is so needed to shine light on the underhanded actions.
Yup. It's a good lesson that you cannot really fix systemic problems one part at a time. The whole enterprise is corrupt. Change one small part of a huge systemic problem and the rest of the system will simply accommodate it. We need to eliminate private insurance. Making it slightly harder for them to grift will only make them work slightly harder to grift rather than simply sit back and take it while normal humans benefit from those changes.
I mean yes and no, to make major changes to systems like this you have to go one step at a time so you don't just create something worse in the process of creating something better (history has plenty of examples of this,) but it is true that we can't just expect things to be done after getting through one part. It's like treating a disease, you can't take the medicine all at once, but stopping part way through either won't help you or can make things worse since you haven't fully treated the problem and give it a chance to grow back with a vengeance. The system is rotted, but there are still some salvageable parts that would be bad to lose, we're not quite at a point where it is best to cut the whole tree down.
@@homerman76 I think we really are at the point we should cut it all down. Private insurance should not mathematically exist, in any industry whatsoever. Everyone should chip in with their taxes, and the government covers it all. We need to reclaim the $200 billion profit for the people. I have no sympathy for anyone working for any of those companies, being a leech to each and every American, let them all be fired and put on unemployment benefits, I’m sure $200 billion can cover that as well.
The only better solution would be to illegalize Lobbying (which is bribery straight up), like other civilized countries have done.
This patriotic touch at the end about the founding fathers intentions touches my heart.
I hope not for long because I can't afford to visit the cardiologist
Greed is one hell of a drug…That isn’t insured by the insurance company. I wonder how much they would charge if they could market greed in the already insane market
Ah, the American Healthcare System, where everyone loses, even when you get what sounds like a win
No, the Inflation Reduction Act is still a big win for those it effects, but the insurance companies, as there is almost zero oversight, as such a terrible thing as capping prescription prices for medications that have become cheaper to make, have been on the market for 20 years + and have not had any improvement in effectiveness and have gone up far in excess of expect CoL increases, would be all communist or something. Until (as much as I don't want to make it BvR) the majority of people opposing healthcare reform, who happen to be Republicans, get voted out, it will be piecemeal victories and mitigating losses as the medical beast turns to crush patients in a new and horrid way.
*almost everyone
"mmmhhh your debt is my pleasure" says the corporate elite
Everyone except the soulless corporations. They always win, no matter how much suffering is created in the process.
Until we repeal Citizens United corporations are going to do whatever they want regardless of what the government says. We don't have a "free market capitalist" society we have an "oligarchical corporate socialist state". The government is allowed to pick and choose who will win and lose, and they pick the ones that pay them over the ones that they serve. If the inflation reduction act wanted to fix this problem, then it would have had language to enforce oversight, not just negotiate prices.
"We've never had money taken from us before" and you. Still haven't. Money you haven't earned can't be taken away from you, because it isn't yours. It's like asking someone for five dollars, having them say no, and then accusing them of stealing five dollars from you. A drop in profits isn't losing money
Ugh. Sadly many people think like this. My grandma would demand free food from servers in restaurants, and when they (obviously) refused she'd demand their manager and demand the entire table be comped because the customer was always right. Like no, being refused free food does not entitle you to free food. Oddly enough I stopped going out with her once I had any say in my life, aka when I became an adult.
not too many countries left in the world where you can be doing everything right all your life, work hard, have good insurance, save up for retirement. then just when you're thinking of retiring, something out of your control needing healthcare comes up and insurance won't cover on a technicality or don't cover enough and your entire life's work gone straight into a corporation's pocket for a drug or procedure that costs them a tiny fraction what they charged you.
This makes me sad, but at least President Biden is trying to do something. If he could get the House and Senate to support him he might actually able to fix the other half that measure!
President Trump had signed a executive order doing the same thing, and then Biden overturned that executive order causing the prices to skyrocket again.
I don't think President Biden is capable of doing much to help us unfortunately. He has advanced senile dementia.
Please, Biden ain't shit
Chocolate Chocolate Chip :)
@@MrToddino Chocolate ice cream with chocolate chips in it. Discuss policy, would you?
I've been pounding the table on Part D for years.
Increase prices only as fast as inflation? Man, I wish my pay would increase as fast as inflation too... They have the audacity to pretend 3% is a raise when we all know it's a LEAST a 7% pay CUT.
Here in Europe, all governments negotiate all drug prices. They also don’t allow the sale of drugs that aren’t proven to actually help significantly and companies can’t charge more for a new drug unless it’s proven to be better than the existing drug.
Dr G, I tagged you about a case where a family became medical refugees or their son would be institutionalised! Thumbs up for Dr William to see please 😢
I feel sorry for people who need medication but can't afford it because of bullshit like this
Reminds me of that one CEO who jacked up the price of one med (I can't recall the name) over 400%, just because he wanted to make up for the losses of the last quarter
Martin Shkreli
Oh my... That transitioned from a Mr. Smith Goes to Washington vibe to The Shining in record speed!
Thanks Dr. G !! American system of “ healthcare” is broken -When will they have enough ? CEO’s so greedy …all of them at the top of the chain --greedy, selfish , closing hospitals in inner city bc it doesn’t make a profit …(Philadelphia) we didn’t go into medicine for money , we did it to help other people …
At this rate, Teddy Roosevelt is going to rise from his grave, become the president and do some good ol' trust-busting. Or his resting place will become a power plant because he is rolling in his grave so fast, it's enough to power all of New York.
I feel smarter after watching this. So well made. And I'm from a country with a great public health system (if not the best), BR
Saying it on every one of these videos. This is why people are vaccine hesitant. Doctors need to take back control of their industry and get back to 'do no harm'.
Love that you play both angles on this issue.
Love the eye-opening education I get here! Along with the laughs. Thank you Todrick for all your hard work
It makes me so angry because raising insurance rates is exactly how they will compensate for this loss
Multiple problems upon multiple problems, all caused by government. Reduce patent lifetimes to a few years and then reduce the cost of getting a drug approved.
As the days go by, things are getting worse. It seems almost hopeless 😢
"Because healthcare corporations don't lose in this country." Fucking haunting...
I really appreciate you getting into pharmacy stuff too. It will help my patients understand things better.
Just in case you wondered which party to vote for in the next election, here's the breakdown of how which party voted for the Inflation Reduction Act:
The House voted 220-207 to pass the bill on August 12, 2022.[2]
All 220 Democrats voted yes.
207 Republicans voted no.
4 Republicans did not vote.
[show]House vote to approve the motion to concur on the Inflation Reduction Act (August 12, 2022)
The inflation reduction act covered about 700 bases in one. So instead of congress putting forth bills that were digestible and open for discussion, they do shit like this. The bill covers medicare to home/vehicle energy to business tax law. It's an idiotic way to propose a bill and cram as much bullshit in it as possible. 95% of the bill is climate related, which is fine, but it's disguised as an inflation reduction act when inflation reductioin ISN'T EVEN IN THE BILL.
To be clear, I did watch the video and it's regarding price caps for medications, which has nothing to do with inflation because (as stated in the video) prices are skyrocketing well past inflation rates.
I wonder if this is why my insurance doesn't cover my head nerve blocks specifically for migraine and headache pain. Went into effect in April, which seems odd...no way to sneak in any back doors with prior auths either. If headache is anywhere in my record they will deny it. That pisses me off so bad.
I know we have problems with the NHS here in the UK but American healthcare TERRIFIES me! 😳
When our oldest was born, I asked for an itemized bill. I found several things we were billed for that never happened (like BP medication for my wife, who was never higher than 115/70 our entire stay). I called our insurance company and told them about these items. The person actually said that they didnt care. You don't care that the hospital is fraudulently billing you?
I get an injection from a specialist every month that costs $470, for free.
In addition, I get some other medicine that would cost a total of $300 a month, but because the pharmacy always asks if they should take the cheapest version, I get away with $20. And this is even before reimbursement from the central reimbursement-register have been calculated.
Amazed Todrick hasn't been fired yet for not being a yes man.
Or having a soul
I'm very afraid for Bimothy and Jimothy too
thanks for being so real.
You just gave me goosebumps at the end.
Much ❤ to all the MD's out there fighting the good fight against Coroprate run Health Care against their best interests! To everyone else, THIS is the PROPER use of the 1st Amendment!!!
Daily ragefit accomplished!
Thanks, Doc!
One of your best.
I just think its funny....we pay taxes, so the government can fund insurance companies...which WE then pay directly for insurance....but also have to pay a deductible because you know, our insurance payments already arent enough. So we pay 3 times to get health care.
No more halfmeasures!
Full price transparency and caps on ALL medicines,
Affordable healthcare NOW
Medications dont need price controls, but true marke competition. Insulin could be imported by much less than the price capped by the gov.
Just got letter from clinic saying they will now bill through the hospital and claim nursing time and facilities cost for office visits. As retired by disability RN who know they have replaced most RNS with MA and was billed $359 for mandatory welcome to new PCP visit which was historical review rendering no care only chiding that MUST have colonoscopies and mammo on schedule, must have annual physical here not with NMD specialist and understand MD doesn't need to know about MyastheniaGravis because it has no consequences. Um yeah,NO! Wasn't that stupid when was young and actually blonde.
Ah the Inflation reduction act, that does the exact opposite of reducting inflation.
If they name all their bills this backwards, I'd ve very worried if they ever passed a law titled "no more horse slaughter act" cause it would probably make slaughtering horses mandatory.
Time for my Daily Dose of (US Healtcare) Depression... give it to me, Doc
Incredible how much I simultaneously love and absolutely hate this series
Dammit, I was ready for a win 😭
(Neurologist voice) You thought it would be that easy?
It would be nice to make epi pens affordable again. After all it can be life saving
At least we're got price caps for Medicare. Unfortunately the GOP blocked price caps for everyone
@@ensanesane of course the GOP blocked it, they have a vested interest in big pharma
“You’re experiencing govt oversight, just breath. You’ll be ok” 😂😂😂😂
These videos are facts 💯 and they make me sick to my stomach.
Thanks to you, I now know more about US Healthcare systems than my country's 😂😂😂
So this video misunderstands something rather important about the IRA and its ability to negotiate prices.
It applies only to drugs that have been on the market for 9 years and don't have generics available.
This is relevant because if you keep up with how the FDA approves drugs and generics, usually the drug comes out. There is a 10-year period where it is a monopoly, and then the FDA allows a generic to hit the market.
You read that right. The IRA will only regulate the cost of a drug for a single year of its government enforced monopoly life span and then forget it exists once the generic hits the shelves. To say it's lacking is an understatement.
I’ve been waiting 3 months for an emergency urologist visit (scheduled appointment)
Damn. Just when I thought you were making a video on something the healthcare industry has done right.
Through the Australian PBS, my 8 prescription medications costing me a little over $200, would cost at least $1200 a month.
damn, just when i was about to say "finally some good news"....
That's the thing, we keep applying "fixes" like this and then going "alright, we fixed it" with almost no follow through to prevent companies from making up the difference somewhere else. Another good example is minimum wage, sure it seems like a good ideal to make sure everyone is paid "fairly," but we run into a few issues when it is the only solution, such as companies increasing prices on goods to make up the difference, hiring less and expecting more from employees, decreasing costs in production and delivering a worse quality product, other more demanding jobs not raising wages to follow suit (leading to fewer and fewer people taking stuff like factory work in some areas, which is its own can of worms,) etc. etc. The ideal is there, but an ideal with no follow through is worthless and sometimes even harmful.
@@homerman76the only problem with that argument is that the other times we raised the minimum wage, spending power increased more than the rise in prices did. So it's not a good reason to just not increase minimum wage at all.
This series is a thriller.. I tell you - one should make a Netflix documentary about it with you in a leading role
12.5 secs later...
Oh Jimothy!!! Great news!!! Our loophole department found a new way to circumvent the IRA! We get to charge whatever we want for ALL our medications again! Isn't it exciting!!!
I'm so happy to have VA healthcare that allows me to bypass the entire insurance industry.
Hold on, even if the PBM goes to the insurance companies, they can't just jack up rates because they feel like it. If their blocks of business charge more than an extra 25% (roughly) over claims on domestic major medical policies, the ACA requires them to pay out rebates. They need claims to increase somewhere to justify a price increase to regulators and clients.
Wait... there are regulators?
@mixiearmadillo7452 Each state has its own rules in addition to the federal rules. They can "disapprove" insurance rates, and prevent an insurer from issuing or renewing policies in their state.
Hi Dr. G! Great presentation. Squeezing a balloon analogy is appropriate. If some drugs are going to be price controlled, then those that are not are going to have greater than exponential price increase. Another factor is that depending on where the drug is in its life cycle, the brand manufacturer may just stop production, thus leading to increased use of non price controlled meds.
This has been attempted before. See oncology drugs infused the physician's offices. The unintended consequences which occurs is that physicians offices now cannot keep their doors open with these generic meds. Physician offices will look for other hustles to keep the cash flow (e.g. growth factors and other supportive care meds).
Truly the stuff of nightmares, that closing line.
We should have a system of state run hospitals and universal healthcare.
GRRRRRRRrrrrrrrrrrrrrr.....
(and thank you Doc Glauc!)
I wonder how many months until the "negotiators" are all senior board members at pharmaceutical companies.
How will we pay someone to feed our children for us? Lmao that was awesome
Ultimately a bad thing. It's impossible to tell if any good is coming from anything because money printer go BRRR. Ultimately the stores of value we have and the assumptions we make are getting shifted and skewed. The debt needs to be taken under control, not hiding it's symptoms with more printed money.
My Medicare advantage plan is increasing copays on everything next year
I am so down for big pharma getting a fade. And I'm on no medication what so ever.
At this point of the videos I feel a very strong « fuck it, let’s scrape everything and start back up » urge
Spot on.
Express Scripts is a blight not just on our family, but on our country
Wonder if insurance company executives watch these videos and make notes for "improvement"
Don’t give them any ideas
Making 10 billion in profit seems like a lot compared to the 214 billion in revenue. I think pharam is allowed to use a lot more loopholes than just a negation of drug negotiation; the tax system is complex enough to allow a lowering of taxing profits.
But if pharma is no longer as profitable, we could see a reduction in invetsments in the pharma sector. Less research into rare diseases, gene therapies, and stuff like making a malaria vaccine can slow down.
Something has to happen, obviously, but idk what the consequences will be long term
I'm 90% positive that the democrats passed this law just so they can get more votes, because on the surface it looks like it can help patients. At most this will only mask problems in the short-term, long term it will be a disaster
They should develop a pill for Sudden Government Oversight Syndrome and charge themselves exorbitant rates.
Infinite profit
Like trying to herd cats , just when you think you're normalising pricing , off they dart in a different direction .
What can you do , when vested interests even own supreme court justices.
Well it's nice to get some good news amidst all the horror!
Exactly. As long as drugs, healthcare insurance, equipment etc is on the stock market, we will continue to pay one way or another.
Powerful.
Who is Todrick?
What happened to Bimothy? Is Bimothy ok?
#FreeBimothy
First I have to say this I love your stuff, but watching these videos makes me incoherently angry and very happy that I live in a country with proper Healthcare
please write your own government and encourage them to take diplomatic action against us. We need more insults at trade summits and travel bans.
@@lh3540 it's no point is it? For anything to change you have to stop the legalised corruption aka lobbyists