The old saying, “Rob Peter to pay Paul” might easily apply when trying to grasp the infamous “gap” (aka The Donut hole) when it comes to Medicare and why it’s being used as leverage in the upcoming election.
The average senior citizen, receiving the 50% discount on their non-generic prescription drugs rightfully gets to keep more money in their pocketbook, but in reality who is it benefitting the most when it comes to closing the gap of the infamous “hole”? Prescription drug manufacturers, that’s who.
No drug company is simply going to cut their bottom line to help anyone and stay as profitable as they have in the past. Whether drug companies are indirectly leveraging the discount back into the bottom line through increased costs for over-the-counter drugs, prescription costs to non-Medicare recipients, they will redeem their losses to stay in business. Someone, somewhere down the line is paying for the closing-up of the doughnut hole. But who would that be? Everybody. However, politicians want us to think otherwise because it makes them look favorable especially during an election year.
4 Million Seniors = Drug company windfall
If drug companies were losing money, from tightening their belt via their discount program to seniors, it would have made the front page news (but it hasn’t). More likely than not, we’ll never read that column on the front page, but with 4 million seniors standing to gain a well deserved break in prescription drugs costs what we will hear is political rhetoric ringing loud and clear how the Affordable Care Act has benefitted seniors. Unless you are exceptionally adept at finding needles in haystacks no one would ever be able to, fully, grasp if the "discounts" to close the donut-hole theory cost the American public more than what it ever saved us, in the end.
Hidden profits
Over-the-counter drugs and anything related to the pharmaceutical companies will inherently increase drug costs across the board and continue to do so without the intervention of the government. Although “discounts for seniors” is a long deserved blessing, everyone pays for it in the end. Think about it: 4 million seniors went from spending thousands of extra dollars out of pocket to saving just as much and the lost profits just disappeared from the bottom line? I don’t think so. Most likely it will or already has reappeared through inflation and deferred expenses directly charged back to the general public through the healthcare system.
Obama-Care
So is the Affordable Care Act (aka Obama-Care) all that when it comes to what benefits everyone the most? Here are some areas where it falls short:
Regulating drug companies
Unless the government wants to get into the drug manufacturing business they will never be able to put a large enough lasso around the runaway profits these companies make and stand to profit from in the drug making industry. Once health insurance coverage becomes "law" then we all become customers, like it or not. Regulating profits made by the pharmaceutical drug companies is about the only way to save billions of dollars a year, a blessing that would far exceed the average savings seniors are now experiencing. It would also ensure that the benefits of controlling profits would not be interrupted by whoever is in the White House. A "good policy" never benefits just one sector of society, one political party, or one agenda (i.e. re-election).
Continuing nutritional education for doctors and healthcare providers
Unless we start requiring doctors and healthcare providers in general to become more educated in nutrition, drugs will always be the quick fix solution to our healthcare problems. The amount of nutritional education a doctor receives during their seven plus years is woefully inadequate (typically one semester on the basics of nutrition). Doctors are trained to practice “medicine” not “wellness”, thus feeding into the drug companies well lined pockets. I don’t blame the doctors, but the educational system for allowing the absence of more education in nutrition and its overall benefits to be an equal component in their educational requirements.
Regulating healthcare insurance rates
The Federal Government could better benefit everyone if they simply took one step in the right direction, regulating and capping what insurance companies charge their customers. Think about it: Government regulates every leading industry to some extent (banks, credit cards, lending, energy, etc.) that touches our lives every day. Can you imagine if the government said, "Everyone must buy a new car" how financially encumbering that burden would be for everyone? Yet, the government is essentially telling us that we must either be desperately poor to receive Medicaid or financially strapped to afford health insurance. The only sane way around the problem is to control health insurance premiums through regulating what insurance companies charge and how they rate the insured. Hmmmmm.....now that's a good topic for a Presidential debate!
*Incentives for staying healthy
Nowhere in Obama-Care is there a financial incentive or benefit for those of us who stay healthy through practicing nutrition and physical fitness, thus reducing the costs of healthcare. Obama’s plan allows for screening and wellness checks but does little to reward the outcome of living a healthier lifestyle.
No matter how the donut hole shrinks and swells through co-pays, gaps and negotiated discounts with prescription drug companies, the ultimate outcome will be a flat 25% co-pay by seniors when the plan matures in 2020. Can we only imagine what prescription drugs will cost then?
So why does the doughnut hole matter if it ultimately benefits well deserved senior citizens? Perhaps it’s the reality that somebody, somewhere at some time will have to pay the bill for all those savings, tagging the cost onto the backs of the next generation through taxation and indirect inflation. The more we treat our social woes like the minimum payment on our credit card balance, the more in debt we slide into through never paying down the principal of our initial balance. Both are a no-win situation.
Quick Tips for Wellness: The healthcare crisis cannot be treated like a political agenda. Responsible change requires us to look at the bigger picture and not just the current problems we face today.
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