Health Care System Weaknesses Magnified During Pandemic

During the coronavirus pandemic, health care in the United States, or at least certain parts of it, has received more attention than ever before.  As a society we have paid a terrible price for the lack of preparation regarding public health.

Among other things, we have learned how inter-connected the parts of our health care system are and how complicated and difficult our system is.

We have seen that one part of the population can bear a horrible burden because another part of the population disregards safety measures that should be undertaken to protect one another.

And we have also seen the weaknesses in our system and how vulnerable we are because so much of what we need for our health care is manufactured in other countries and therefore, how little control we have over the things we need, from prescription drugs to protective equipment needed by health care professionals.

All of these, and more, have reminded us that there are serious problems with health care in our country and changes and improvements must be made.

That is what TSCL has been fighting to do for so long and what we are continuing to do.

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Study Shows High Drug Prices Result in Increased Deaths

A couple of weeks ago we told you about a recent study that made it clear that we are on the right track as we carry on the fight for lower prescription drug prices.  When prices are so high, not only does it affect the financial well-being of individuals, but it also affects their physical well-being and can even have fatal consequences.

As we reported then, the study by the National Board of Economic Research, (NBER) explored how “cost-sharing”, in other words co-pays and premiums, can affect patient choices and patient health. The researchers examined Medicare data and found that a relatively modest increase in drug costs ($10 per prescription) lead to a 33% increase in mortality.

We are covering this study again because according to an article on BenefitsPro.com, “The study is part of a growing body of evidence that cost-sharing, designed to encourage consumers to make smarter choices when shopping for health care, is not achieving that goal. Both anecdotal and statistical data suggest that health care, as it exists today in the U.S, is simply too complicated and opaque for Americans to approach as a simple consumer product.”

The article continued, “The NBER study zeros in on how increases in prescription drug costs among Medicare recipients affect patient choices and comes to a stark finding: ‘Patient cost-sharing introduces large and deadly distortions into the cost-benefit calculus,’ the report said.”

And then it added this, “In fact, the study found that some patients who see increased drug prices will indiscriminately cut back on all drugs—regardless of how impactful those drugs are on their health.

“’We trace this mortality effect to cutbacks in life-saving medicines like statins and antihypertensives, for which clinical trials show large mortality benefits,’ the researchers wrote.

“’We find no indication that these reductions in demand affect only ‘low-value’ drugs; on the contrary, those at the highest risk of heart attack and stroke, who would benefit the most from statins and antihypertensives, cut back more on these drugs than lower-risk patients.’”

As seniors know from experience, even as we face ever-higher prescription drug prices every year, we face increased Medicare premiums but also reduced Social Security COLAs.

That is why TSCL is fighting so hard for legislation to reduce drug prices and for increased COLAs that reflect the true cost of living for our nation’s seniors.

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Need Help With Prescription Drug Costs?

Medicare.gov lists the following options if you need help paying for your prescription drugs.

6 ways to get help with prescription costs

You may find it necessary to get help paying for prescriptions even after enrolling in Medicare drug coverage (Part D). For example, you may reach the annual spending limit and enter what is called the coverage gap. Here are 6 tips to consider if you think you might need to get help with the costs of prescription drug coverage.

1. Consider switching to generics or other lower-cost drugs.

There may be generic or less-expensive brand-name drugs that would work just as well as the ones you are taking now. Talk to your doctor to find out if these are an option for you. You might also be able to lower prescription costs by using mail-order pharmacies.

2. Choose a Medicare drug plan that offers additional coverage during the gap.

There are plans that offer additional coverage during the Medicare drug coverage gap, like for generic drugs. However, plans with additional gap coverage to help pay for prescriptions may charge a higher monthly Premium.

Check with the drug plan first to see if your drugs would be covered during the gap. Find health & drug plans.

3. Pharmaceutical Assistance Programs. 

Some pharmaceutical companies offer programs to help pay for medications for people enrolled in Medicare drug coverage (Part D). Find out whether there’s a Pharmaceutical Assistance Program that can lower prescription costs for the drugs you take.

4. State Pharmaceutical Assistance Programs.

Many states and the U.S. Virgin Islands offer help paying for prescriptions, drug plan premiums and/or other drug costs. Find out if your state has a State Pharmaceutical Assistance Program.

5. Apply for Extra Help.

Medicare and Social Security have a program called Extra Help—a way for people with limited income and resources to get help with prescription costs. If you qualify for Extra Help, you could pay no more than:

• $3.70 for each generic covered drug
• $9.20 for each brand-name covered drug

6. Explore national and community-based charitable programs like these that help pay for medications:  

• National Patient Advocate Foundation
• National Organization for Rare Disorders
• Benefits checkup

You can access the page online at https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/costs-in-the-coverage-gap/6-ways-to-get-help-with-prescription-costs

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Beware of Coronavirus Vaccination Scams

We have warned you before to be careful about scams when it comes to getting your coronavirus vaccination.  Getting cheated out of money during a time of crisis like this is the last thing we want to happen to anyone.  And even though the reports of scams have not been widespread, there have been some in various parts of the country.

With that in mind we remind you that the Federal Trade Commission has warned that anybody offering a chance to jump ahead on the statewide priority list for a vaccination in exchange for money is a scammer.

Here are a few important tips on how to avoid becoming a victim of phone scams or identity theft:

• Make a list of contact information for family members, close friends, health providers or anyone who calls regularly so you know the call is legitimate.
• Let a call go to voicemail if you do not recognize a phone number, as scammers rarely leave messages.
• Hang up if a stranger asks for personal or financial information.
• Government agencies will identify themselves.
• Do not share personal information such as your Social Security number to anyone over the phone.

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Legislation for coverage of hearing aids under the Medicare recently introduced in Congress.

Recently, U.S. Representative Matt Cartwright (Penn.) and Republican U.S. Rep. John Katko (N.Y.) re-introduced the Help Extend Auditory Relief (HEAR) Act H.R. 1106, to expand hearing benefits for seniors on Medicare.

Currently, Medicare Part B covers auditory examinations in the event of an accident or illness, but not routine checkups – which physicians recommend addressing gradual loss of hearing – or hearing aids. If prescribed a hearing device, the out-of-pocket expenses may be impossible to afford. Typical hearing aid models can cost over $1,000, with the most state-of-the-art devices topping $5,000. People who need devices for both ears face double the cost.

Specifically, the HEAR Act would amend the Social Security Act to include Medicare coverage for hearing rehabilitation, including a comprehensive audiology assessment to determine if a hearing aid is appropriate. It would also extend Medicare Part B coverage to hearing aid devices.

This legislation is co-sponsored by U.S. Reps. Yvette Clarke (D-N.Y.), Raul Grijalva (D-Ariz.), Alcee Hastings (D-Fla.), Sheila Jackson Lee (D-Texas), Betty McCollum (D-Minn.), David McKinley (R-W.V.), Jerrold Nadler (D-N.Y.) and Mike Thompson (D-Calif).

The language of the bill is not yet available but as soon as it is TSCL will review it to determine our position on the legislation.

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Despite the coronavirus emergency, TSCL is continuing its fight for you to protect your Social Security, Medicare, and Medicaid benefits.  We have had to make some adjustments in the way we carry on our work, but we have not, and will not stop our work on your behalf.

For progress updates or for more information about the Social Security and Medicare programs, visit our website or follow TSCL on Facebook or Twitter

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