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Who Do We Trust?

One thing the pandemic has highlighted is a general lack of trust in our government when it comes to how to stay healthy. We have been instructed by two presidents, by multiple federal agencies and by the governors of our states as they sought to influence us on how best to make our way safely through this pandemic. We heard that masks weren’t important and then they were, that we needed to wipe everything down and then that it wasn’t that critical, that it would take over two years to get a vaccine and then it took 6 months, that we needed to get 60% of Americans vaccinated to reach herd immunity and then 70% and maybe higher. I don’t know if any of this contradictory guidance was politically motivated, was done to guide public behavior or resulted from the lack of good information. What I do know is that each of us had to decide for ourselves who we trusted.

We are fast approaching the time when there will be vaccines available for all who want them – many states already have opened up their vaccines to anyone 16 or above. This means that soon the only thing keeping us from vaccinating everyone will be those who are refusing to get vaccinated. Our government has started a campaign to convince those that are hesitant to get vaccinated, to step up and get their shot. There have been advertisements, speeches, and blogs (like this one I authored), encouraging people to get vaccinated. It quickly became evident that the best was to influence people to get vaccinated was to get them to talk with people they trust . . . their doctor, their religious leader, or a close friend or relative.

While I hope that if you are hesitant to get vaccinated you talk to someone you trust for advice on getting vaccinated, I have another reason for making this point – the people that know us and our individual health status, especially our doctors, are bound to be the most accurate when they give us advice on what will keep us, each one of us, healthy. We are correct in trusting those people.

While the federal government handled the coordination of finding an effective vaccine and providing stimulus money to help our economy, it was up to the governors of each state to decide how their state would guide its citizens on mask mandates, business openings, and the distribution of the vaccines. It just is logical that the closer those who advise us or make decisions on our behalf are to us, both physically and individually knowledgeable, the better those decisions will be.

I’m afraid that our government has forgotten this powerful fact and continues to try to control our healthcare from Washington through one-size-fits-all solutions. The most powerful approach we can have for our health is to give our local health providers more choices so they can treat us as individuals. For instance, our healthcare shouldn’t be subjected to the price control strategies like importing prescription drug pricing schemes from foreign countries. When we control prices, we chill investment and stymie innovation. Scientists continue to give us tools to personalize our healthcare; what we need are more choices, not fewer. Our doctors and local healthcare providers shouldn’t have fewer choices because they are hesitant to prescribe prescription drugs that have been imported without the tracking and safety guarantees that we rely on.

One method of price fixing is for the government to insert itself into the negotiations between insurance companies and drug manufacturers. This once again is an approach that seeks to negate the free-market functions that have been working in Medicare for 15 years. If it ain’t broke, don’t fix it.

It is evident that our trust in the government has suffered during this pandemic, it seems foolish to sit back and let this same government have more control over our healthcare. As you hear about proposals to change our healthcare, ask yourselves whether their proposed change will give those we trust the most, your doctors and other local healthcare providers, more choices and tools to treat your individual health needs most effectively. We’ll work to keep you informed about proposed changes that affect your healthcare.

One more thing, at Seniors Speak Out we periodically survey seniors and find out how they feel about healthcare issues that affect them. We recently sent out a survey and got over 400 responses. We will be talking about the results of that survey at a virtual town hall webinar this Wednesday at 2:00 pm ET. You can register for the town hall here. You don’t have to turn on your camera on if you join on your computer and there is also a phone option if you prefer that. Hope to talk with you then.

Best, Thair



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National Minority Health Month

The blog this week puts the spotlight on National Minority Health Month, and it couldn’t be timelier. Before I get into the details, I want to offer a little background. It’s evident that the mere fact that there is a minority health month, and an Office of Minority Health (OMH), created in 1985, within the U.S. Department of Health and Human Services, indicates that there has been and remains a disparity in the treatment of minorities within our healthcare system. This fact is confirmed by the mission statement of OMH, “The Office of Minority Health is dedicated to improving the health of racial and ethnic minority populations through the development of health policies and programs that will help eliminate health disparities.”. The facts show that minorities have not received the same level of care within the U.S.

The reasons for this disparity in treatment are many and varied — they can be financial, level of education, housing, the lack of adequate insurance, biological differences, and discrimination. The COVID-19 pandemic has brought many of these disparities to the forefront and, hopefully, will hasten the resolution of these disparities.

The OMH has worked unceasingly to ensure that minorities receive the same care as the rest of America. They provide grants, create programs, sponsor research, and establish guidelines, all toward eliminating disparities in care.

National Minority Health Month is especially important during this critical vaccination phase of our battle with COVID-19. It has been shown that some minorities have been more reluctant to get vaccinated than the general population. The OMH offers information about how you can ensure you are #VaccineReady when the time comes.

  1. Understand how the COVID-19 vaccines work.
  2. Learn more about what to expect after getting the vaccine.
  3. Check with your doctor if you have questions or concerns about side effects.
  4. Use VaccineFinder to find out where you can get vaccinated.
  5. If you have questions about receiving the vaccine at a specific location, please contact that location. Vaccine availability is subject to change and appointments are required at most locations. Follow instructions for each provider listed on VaccineFinder Exit Disclaimer.
  6. Get the vaccine when it is your turn.

I know this is good information for those of us who have already decided to get vaccinated. For those of you, especially minorities, who are still undecided I offer a few items of advice.

  • Do your own research – Get your information from trusted sources. There are two videos that might help you understand more about the vaccine or give you links to obtain more information. Those videos are here and here.
  • Talk to someone you trust – Ask them why they got vaccinated and what their experience was, both during and after they were vaccinated.
  • Talk to your doctor or healthcare provider – They are the ones that will know what is best for you.
  • As shown below, minorities were included in the clinical trials.
  • Consider the success so far – over 51 million Americans, about 15%, have been vaccinated with minimal side effects.
  • Consider your loved ones and your community – The more people who get vaccinated the quicker your community and loved ones will reach herd immunity and will be able to return to normal.

We are making great strides toward reaching our goal of vaccinating 70% of our population. We have increased the daily vaccinations to over 3 million and it looks like every state will open vaccinations to all age groups before May 1. I am looking forward to returning to some sense of normalcy by July.

The National Minority Health Month this year is concentrating on helping America’s minorities get vaccinated. It is critical that all Americans have the opportunity to be protected from this virus and to return to normal.

Register now for our next Medicare Virtual Town Hall on April 14 at 2PM ET. And take the poll on issues of importance to you. We will be reviewing the results at the Town Hall.

Best, Thair



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American Diabetes Alert Day

I’ve talked about kidney disease in an earlier blog and discussed its close relationship with diabetes. This week I’ll concentrate more directly on diabetes and ways we can identify our risk in getting diabetes and healthy steps we can take to prevent the onset of type 2 diabetes or ways we can minimize its affect.

First, a few facts. Diabetes impacts over 30 million Americans or about 10% of our population. Surprisingly, about 7 million of us don’t even know we have it. The older we get the more likely we are to get diabetes, but our ethnic background may also increase our chances of getting the disease. Consider the following percent of people with diabetes depending on ethnic group:

  • non-Hispanic whites: 7.4 percent
  • Asian Americans: 8.0 percent
  • Hispanics: 12.1 percent
  • non-Hispanic blacks: 12.7 percent
  • American Indians and Alaska Natives: 15.1 percent

As you can see, your ethnic group has a big impact on your chances of getting diabetes.

Diabetes is a killer! Almost 80,000 Americans die of diabetes; it is the 7th leading cause of death in the U.S. and has a huge impact on the overall health of those living with diabetes.

  • Adults with diabetes are significantly more likely to die from a heart attack or stroke.
  • More than a quarter of all Americans with diabetes have diabetic retinopathy, which can cause vision loss and blindness.
  • Each year, nearly 50,000 Americans begin treatment for kidney failure due to diabetes. Diabetes accounts for 44 percent of all new cases of kidney failure.
  • Each year, diabetes causes about 73,000 lower limb amputations, which accounts for 60 percent of all lower limb amputations (not including amputations due to trauma).

This month I lost a long-time friend and fellow scouter to the ravages of diabetes. Most of us know someone who has died of diabetes or is living with it.

So, the question is, can we do anything about this deadly disease? There are two types of diabetes, type 1 and type 2. Type 1 diabetes usually occurs in children and young adults, and there are ways to live with type 1 diabetes but there is no cure. Type 2 diabetes is preventable and there are steps you can take to lesson or eliminate its effects on your health. The first step is to see if you have the disease or are at risk to contract it.

March 23rd is American Diabetes Association Alert Day. This one-day “wake-up call” informs the American public about the seriousness of diabetes and encourages all to take the diabetes risk test and learn about your family’s history of diabetes. You can take the test here. I took the test and, because of my age and especially because of a history of diabetes in my family, I have some risk of contracting diabetes.

There are steps we can take right now that will lower our risk of contracting diabetes. By

  • Eliminate sugar and refined carbs
  • Work out regularly and avoiding a sedentary lifestyle
  • Make water the primary beverage
  • Maintain a healthy weight
  • Quit smoking
  • Eat a high fiber diet
  • Optimize Vitamin D levels
  • Take natural herbs, such as curcumin and berberine, that increase insulin sensitivity

Now I know this sounds like the same advice we get from our doctor no matter what is ailing us. The important thing here is that rather than just making us feel better these steps could prevent the onset of diabetes. It is especially important to maintain a healthy weight. Obesity and diabetes have a strong correlation . . . losing weight when you’re overweight can have a huge impact on preventing or controlling diabetes.

You can even find a certified diabetes educator who can help you find practical solutions that fit your personal needs. Click here to find a Diabetes Education Program near you.

In reading about diabetes and being involved with different diabetes groups over my years in public policy, I have been struck with the lack of focus and resources we allocate to the prevention and treatment of diabetes. We have greatly reduced the deaths attributed to AIDs and we have many, many fund raisers and money spent on research for breast cancer, but diabetes kills more people in the U.S. than AIDs and breast cancer combined. It’s an area that would benefit from more government funds. The National Institutes of Health (NIH) should evaluate its allocation of resources to ensure these resources are focused where they could have the most impact on our country’s health. I’m sure this reevaluation would result in more resources devoted to the study of the prevention of and possible cures for diabetes.

I encourage all of you to take some time and evaluate your risk for diabetes and become smarter about things you can do to lower your risk. I know that’s what I’m going to do.

Best, Thair



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COVID-19 – What We Know, When is Normal Coming, What Risks Remain?

A year’s worth of pandemic has changed all of our lives in one way or another. Each day we’ve had to wade through a mountain of information, filtering it the best we could so we could decide what we should do that day to protect ourselves from the virus. There have been many advisements, directives, guides, even mandates, but in the end, each of us had to decide for ourselves what the true risks were and how much risk we were willing to take. It was so difficult to ascertain what the true risks were. I remember in the beginning that masks were deemed not too important and wiping off your Amazon delivery boxes was. It’s evident now that wearing a mask is far more important than sterilizing surfaces. Many were wary of even the CDC’s advisements, fearing they might be politically motivated. We had conflicting information on vaccine development, some thought scientists were cutting corners and vaccine hesitancy was high, some, including me, trusted the process and the FDA. It was a confusing time.

So, here we are, a year into the pandemic and things are certainly not back to normal or even the “new” normal. What do we know, when is normal coming and what risks remain?

Here’s what we know:

  • The fact remains that a vaccinated person will not go to the hospital and, more importantly, will not die from COVID-19. That has been proven in the tests and in the real world.
  • So far, the virus has killed 531,855 people in the United States. I remember when there were dire predictions of 200,000 deaths. Who would have thought we would have over double that number and still counting?
  • The numbers have dropped precipitously since the highs in the first part of January, but the drop has moderated in the last few weeks.
  • Vaccinations have accelerated, going from a goal of 1 million per day to almost 3 million a day.
  • President Biden set a goal of everyone over 16 having the chance to get vaccinated by May 1st. Many states will begin vaccinating everyone over 16 in the next few weeks. It seems the May 1st goal will be easily met.

When is normal coming?

  • Some have predicted that this July 4th holiday will be much more “normal” than the last July 4th.
  • Some states have begun talking about loosening mask wearing mandates.
  • My prediction is that by June 1st we’ll feel safe to meet and greet without masks (remember, I’m not an expert, I didn’t even spend a night in a Holiday Inn, it’s just my personal prediction.)

There’s the facts and some predictions. The big question now is,

What risks remain?

There are two reasons that would delay our return to normal – people choosing not to get vaccinated and one of the variants being resistant to one or more of the vaccines.

The biggest threat is people choosing not to get vaccinated. This problem slows down our progress toward herd immunity (the state where enough people have developed immunity through either contracting the virus or having been vaccinated so that the virus doesn’t have enough new people to infect to spread.) The quicker we reach this state the less time the virus has to mutate and develop a resistant variant. It is critical that people understand that refusing to get vaccinated not only threatens their well-being, but also threatens the well being of all of us (the herd). There are studies and polls that indicate that politics has played some part in this vaccine resistance. Getting vaccinated should not be a political decision; it should be like obeying traffic laws – something we do so we all can be safe. Scientists are already working toward ways to combat virus variants, but it won’t do any good if people choose not to not vaccinated.

I am a big fan of choice, but the consequences of that choice should be borne by the chooser. Choosing not to get vaccinated affects the health of all of us. People are still dying everyday; they should not continue to die as a consequence of our choice. We all need to study the facts and make the choice to speed up America’s march toward normalcy by getting vaccinated.

Some final notes. Seniors Speak Out is conducting a poll. We want to know how the pandemic has affected you and how you feel our government and healthcare providers have performed. We’d love for you to take the poll. Click here to give us your valuable opinions. Also, we will be holding a virtual Town Hall on April 14th from 2:00 pm to 3:00 pm ET to discuss the results of the poll. You can register for that town hall here.

Spring always promises a rebirth, I hope this spring includes a chance to once again be physically close to those we love.

Best, Thair



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SPECIAL ALERT: Adopting Foreign Price Controls is a Destructive Way to Address Drug Affordability

Some bad ideas, no matter how harmful they are, just keep coming back around. We’re seeing that now with an ongoing effort on Capitol Hill to tie drug prices in the United States to those of foreign countries that rely on heavy-handed government price controls.

Just months after the Trump Administration tried to advance regulations that would have linked Medicare Part B (drugs that are administered by a physician) prices to those of other nations – that effort is currently placed on hold by the Biden Administration and now Senator Bernie Sanders (I-VT) is pushing an even more damaging version of this approach through legislation.

Senator Sanders – and Representative Ro Khanna (D-CA) in the House – is recruiting cosponsors for his “Prescription Drug Relief Act.” Under the Sanders bill, market-based negotiations would be thrown out the window and the government would mandate that prescription drugs in the U.S. could not cost more than the median price of those drugs in five countries – Canada, the United Kingdom, France, Germany, and Japan. If the U.S. price exceeds that ceiling, the government could swoop in and wipe out the manufacturer’s patent exclusivity.

Senator Sanders and Representative Khanna are selling this as a pro-patient idea. Actually, it’s anything but. Trying to make our healthcare system imitate those of Europe and Asia is an extreme apples-to-oranges comparison. There is a reason that the lion’s share of biopharmaceutical innovation – and, with it, pharmaceutical access – takes place in the United States. Over the last 10 years, 90 percent of all new medicines developed are available to patients in the U.S. In France, that number is only 50 percent. In Canada, even less than that. Our current system enables us to benefit from the development of new and more effective pharmaceuticals.

If the Sanders bill became law, it would have a devastating effect on the innovation taking place to develop new treatments and cures for diabetes, heart disease, Alzheimer’s, cancer, and many other health conditions. Investors will not devote dollars to the development of therapies that will be subject, directly or indirectly, to harsh government price controls.

It’s right to pursue greater affordability but not at a tradeoff that includes a diminished ability to fight disease. Government can take steps to address patient out-of-pocket costs and can also use trade negotiations to push other countries to pay more of their fair share toward drug development, but we shouldn’t sacrifice our current level of medical innovation. It’s important that we encourage our Senators and Representatives to NOT cosponsor the Sanders or Khanna bills.

Best, Thair



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Springtime Medicare Refresher

The pandemic has demanded our undivided attention for a year, and rightfully so, but it doesn’t mean that other important things should be ignored. It’s time to review one of our most important benefits . . . Medicare.

Medicare is a government program that affects a large number of Americans, including those who care for those of us who are over 65, those that are approaching 65, younger people who are planning their retirement and those who are disabled. Spring is probably a good time for a Medicare refresher. It seems that some of us get caught up in the minutia of Medigap plans or Medicare Advantage before we really understand the basics of Medicare. While I’ll try to keep it simple, and some of you will know a lot of the Medicare basics that I cover, you may be surprised when you find that there are things you didn’t know or had forgotten about Medicare.

Anyone who is 65 in America, even permanent residents who have lived here at least 5 years, qualify for Medicare. People who have qualified for 24 months of disability under Social Security are also eligible. When you turn 65 you qualify for Medicare, even if you haven’t started taking Social Security benefits. Original Medicare was signed into law in 1965 and consists of Part A and Part B and are provided by the federal government. You will enroll in these two parts (and only these two parts) through the Social Security office. The third part is a benefit that was added later, in 2006, which is Part D, your prescription drug benefit. You must sign up for this benefit when you turn 65 unless you have private health insurance, like insurance through your employer.

Medicare Part A is your inpatient hospital coverage. It supplies a room and meals along with medications, lab services and medical supplies required while you are hospitalized. Part A also covers medically necessary short term home healthcare and skilled nursing. And It covers hospice services and some relief care for caregivers. Medicare does NOT cover long-term care or long term stays in a nursing home. There are some things, like outpatient surgeries, that don’t fall under Part A. It is always good to get guidance as you determine what is inpatient and outpatient services.

If you are already receiving Social Security benefits when you turn 65, you will automatically receive your Medicare card. If you have postponed your Social Security benefits then you must sign up for Part A; you can do this on the Social Security website. If you have worked for at least 40 quarters (10 years) then Part A has no cost to you.

Part B is the outpatient benefit and usually involves services provided by your doctor. This benefit covers things like doctor office visits, ambulance rides, MRIs, cancer treatments (like chemotherapy), and dialysis. While some of these procedures may be performed in a hospital setting, they will fall under Part B because doctors perform the service. This benefit does come with a cost to you; the base rate in 2021 was $148.50. You may have to pay more depending on your income. Again, if you are already getting Social Security, you will automatically be enrolled in Part B. If not, you can sign up on the Social Security website, over the phone or in person. It is important that you sign up for Part B when you turn 65 unless you have other credible coverage since you could pay a lifelong monthly penalty if you fail to sign up. Part B does NOT cover routine dental, vision, hearing or foot care.

Part D is your prescription drug benefit. It covers many prescription drug costs and is purchased from private insurance companies. There are often 20 different insurance plans in each state to choose from. You are not automatically signed up for Part D and must sign up yourself. By going to the Part D plan finder (here) you can select a prescription drug insurance plan based on whether they cover the drugs you use, the premium cost and the estimated out-of-pocket costs. You could face a monthly penalty if you do NOT sign up for Part D when you are 65 or when you no longer have approved private prescription drug coverage.

There is a fourth part of Medicare, Part C. This part is the identifier for Medicare Advantage which is a program that allows those who qualify for Medicare to purchase Parts A, B and sometimes D through private insurers. This option is often less expensive than traditional Medicare and offers a predictable healthcare expense but can have higher out-of-pocket costs. This option often covers wellness benefits, vision and other services not provided through original Medicare. When you become eligible for Medicare, you can choose whether you would like original Medicare or Medicare Advantage.

Many people choose Medicare Supplemental (Medigap) insurance to cover some or all of the out-of-pocket costs of original Medicare.

Medicaid is sometimes confused as a part of Medicare. Medicaid is healthcare administered by the states primarily for low-income beneficiaries. Medicare is a federal program for everyone who qualifies by age or disability. Some people are eligible for both programs.

As with any health insurance, Medicare can be complicated depending on your unique circumstances. Medicare’s website, Medicare.Gov, offers more details and can help you as you make decisions about your Medicare. A basic overview can be found here.

Now for my soapbox. Medicare has worked well for a long time, the newest part of Medicare, Part D, has beat all of the initial premium estimates and remains one of the most popular parts of Medicare. Hospital costs went down substantially after Part D was implemented. It is up to us, the users of Medicare, to remain vigilant as Washington proposes changes to Medicare. The addition of choices and competition and the infusion of increased transparency can lower costs. The transition from fee for service healthcare to value-based care is another way to more closely match cost with benefit. There are ways that Medicare can be improved without limiting access. Many of the changes proposed by our government sacrifice access for cost savings.

There are proposals that could (will) have a negative impact on Medicare. For instance:

  • Government controlled single payer healthcare – a proposed change that would eliminate private insurance and any free market competition. While this healthcare option historically was not considered to be feasible, it lately has become an often discussed approach and was considered as a real option in the last presidential debates. It would have a huge impact on our freedom to choose.
  • The public option – This proposal purports to offer a choice of a government run public health insurance option as an insurance choice. This approach would only cause a downward spiral in access and quality which would end up in the government “rescuing” our healthcare system by instigating the single payer option.
  • Raise the Medicare enrollment age – This proposal has some validity but requires more studies to ascertain its impact on retirement planning.
  • Proposals to control prices – Using foreign prices, limiting price increases based on inflation, and setting new drug entry prices are all blunt instrument solutions that have proven to be ineffective and limit innovation.
  • Executive orders and regulations – The increased use of executive orders and intrusive regulations are simply ways to avoid the checks and balances of government and to govern by fiat. Not the way our democracy should function. 

My point is there has never been a time when our basic Medicare benefits have come under such a sustained attack. It’s up to us to remain vigilant, to speak out, and to combine our voices in the preservation of this basic benefit. In reviewing the parts of Medicare, we begin to understand how important these benefits are to our lives. It’s up to us to make sure they are preserved.

Best, Thair



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National Kidney Month – Find Out if You’re at Risk

As you might have noticed, almost every month I tell you about a special month/week/day that has been chosen by a health support organization in the hopes they can get people to think about their health issue. Over the last year we’ve talked about National Heart Month, Glaucoma, National Diabetes Month, Bone and Joint Action Week, Healthy Aging Month, National immunization Awareness Month, Alzheimer’s and Brain Awareness Month, and National Family Health and Fitness Day. I do this because these reminders can help us learn how we can avoid getting sick or how we can discover the health problem early and outline how we can treat the problem effectively. I’m a big believer in self reliance and accountability and it is important that we take charge of ourselves by knowing what our personal health risks are and making informed decisions on how to keep ourselves healthy. While there continues to be huge advances in healthcare treatments and cures, the biggest impact on our own wellbeing is how each of us understands and treats our body. I hope you have found, and continue to find, these periodic health blogs helpful.

As the title says, this month is National Kidney Month. The National Kidney Foundation has chosen to focus on the connection of type 2 diabetes and kidney disease. Diabetes is a leading risk factor for developing kidney problems. By controlling the glucose (sugar) level you can help prevent kidney disease. Their campaign is titled, “Are you in the 33%” that is at risk for kidney disease. They have a tool, a one-minute quiz, that enables you to determine if you are in a risk group for developing kidney disease. You can click here to take the quiz.

Kidney disease is especially hard on minorities. African Americans are almost 4 times more likely to get kidney disease than white Americans. Hispanics or Latinos are 1.3 more likely to get kidney disease as non-Hispanics or Latinos. It is especially important for these ethnic groups to take steps to identify and treat diabetes that often leads to developing kidney disease.

It is estimated that 37 million Americans have kidney disease and an astounding 90% don’t know it! You are especially at risk for getting kidney disease if you have diabetes, high blood pressure, heart disease, obesity, or have a family history of diabetes.

There are resources for treating and caring for those with kidney disease, everything from dialysis to transplant. You can access helpful information here.

I’m amazed that 90% of those estimated to have kidney disease don’t know it. As with almost any disease, early detection is especially important. I urge everyone to take the one-minute quiz to determine your risk of developing kidney disease. I took it and the only risk factor I have is a family history of diabetes. I’m going to watch my diet and talk to my doctor at my next physical about diabetes and kidney disease. Hopefully, this month will help us focus on kidney health, and we’ll all live longer and healthier as a result.

Best, Thair



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H.R.3 – Legislation That Will Suppress Innovation

While COVID-19 has engulfed our lives and demanded our almost undivided attention, we can’t ignore pending legislation that is lingering in the wings just waiting for its chance to jump back into the spotlight. I’m referring to H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act, named in honor of the late Maryland congressman who fought for price controls on prescription drug prices.

The legislation was introduced in September of 2019 and passed the House along party lines (Democrats for and Republicans against) in December of 2019. The Senate, to this point, has never brought the bill up for consideration. President Trump issued some Executive Orders toward the end of his term that resembled parts of H.R.3, but they have been suspended or faced court injunctions. My fear is that the new administration, with the Senate and House majorities of the same political party, will open the path for H.R.3 to become law.

This legislation sought to implement regulations that would control drug prices and modify some of the benefits of Medicare. It consisted of three main sections.

  • Drug Price Negotiation – A free market term that in reality was nothing more than price fixing, a control mechanism that is anything but a free market process. The government would apply their pricing regulations on a minimum of 25 drugs and a maximum of 50 single-source drugs with high spending, including all insulins and any newly introduced high priced drugs. The prices would be set somewhere between the minimum and maximum prices of 6 comparator foreign nations. I’ve talked a lot about the International Price Index (IPI) and Most Favored Nation (MFN) pricing approach which is what this pricing method emulates (you can read more about IPI here and MFN here.) If a company does not accept the set price, they would face huge fines equaling up to 95% of their gross sales. Fixing prices is a sure-fire way to limit innovation.
  • Inflation-Based Rebates – Requires manufacturers to pay a rebate to the federal government if a drug’s price increases faster than the rate of inflation. This is just another way to fix prices with no consideration to the cost of development or the value that the drug brings to the patient or the long-term health care costs.
  • Medicare Part D Benefit Restructuring – Restructures the Part D benefit by establishing a yearly spending cap on a patient’s out-of-pocket costs. This is a positive, sensible approach – one I have proposed for almost 10 years.

It is estimated that using this legislation to fix prices will extract over a trillion dollars from drug manufacturers in the first five years, a move that will severely reduce the drug innovation that has saved millions of American lives. Consider this, countries with price controls also suffer a decline in pharmaceutical research and development.

In 1986, European firms led the U.S. in spending on pharmaceutical research and development by 24%. After the imposition of price control regimes, they fell behind. By 2015, they lagged the U.S. by 40%. It just seems wrong for us to trade some short-term savings for the lifesaving drug innovations that will benefit our kids and grandkids.

There is something else that strikes me as a strange dichotomy. A little less than a year ago we began to understand how dangerous this pandemic could be. Estimates at that time for developing a vaccine for COVID-19 ranged from a low of one and half years to four years. Nine months later we had two vaccines approved and being distributed. Manufacturing numbers continue to be increased, goals of one million shots per day have been exceeded, new estimates indicate that improvements in manufacturing could support 3 million shots per day. These great accomplishments were possible because America’s regulatory environment had enabled the creation of the most efficient innovation industry in the world. Over half a million Americans have died due to COVID-19. What would have happened if a strapped and weakened pharmaceutical industry would have needed the low-end estimate of a year and a half to develop the vaccines? With the new variants invading our shores, how many more people would have died if our vaccines would have taken twice as long to be developed? With the imminent passage of another 1.9 trillion-dollar rescue and stimulant package, our government will have spent 5.3 trillion dollars this year on COVID-19. Adding this to the lost wages and company income and the financial impact is staggering. Is the loss of the innovation that brought us a vaccine in nine months really worth the 200 billion this legislation would extract each year from the pharmaceutical industry?

The bad parts of H.R.3 are really bad. They will hobble an innovation environment that is on the verge of many breakthroughs in many diseases. I will keep my eye on H.R.3 and will keep you informed on its status and the status of any moves the Administration makes toward implementing any part of H.R.3 through Presidential edict or under the guise of a nationwide “test.” This will certainly be a situation where we will need to “Speak Out” loud and clear.

Stay safe and healthy, Thair



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Virtual Townhall on Vaccinations – Recap

Last Wednesday, Seniors Speak Out and Medicare Today held a virtual town hall focusing on the importance of being vaccinated against COVID-19. For this townhall I was joined by Janet McUlsky from the COVID-19 Vaccine Education and Equity Project. The entire virtual townhall can be viewed here.

I started off by giving an update on my own experience with getting vaccinated. I stated that I had received my second Pfizer-BioNTech COVID-19 vaccine six days earlier and, like my first vaccination, the only side effect that myself and my wife had was a slightly sore arm at the injection site for a day. I mentioned how I felt relieved and hopeful after both of my shots. I finally felt like I was finally doing something, taking some action rather than being at the mercy of the virus. I did describe the convoluted scheduling process. There is no nationwide app that would offer one place to schedule your shots. This means it will take time and effort in most cases to schedule.

I then introduced Janet McUlsky, from the COVID-19 Vaccine Education and Equity Project. I mentioned I have known of Janet for over 20 years and worked closely with her for the last 12 years. She has spent most of her career working with advocacy organizations to ensure their constituents have access to prescription drugs.

Janet began her presentation with slides about the COVID-19 Vaccine Education and Equity Project. She discussed how they started in late August and now have over 150 partners who have joined the Project. She then discussed the core objectives of the vaccine project which are to:

  • Provide education.
  • Raise awareness.
  • Promote the impact.
  • Lead a conversation.

Janet then talked about the many resources available on the project’s website, https://covidvaccineproject.org. They offered a series of one pagers discussing different aspects of the virus, most also in Spanish, and infographics that offer information in concise and easy to understand formats. The information discussed things like how to talk to your families about the vaccine and the process the vaccine went through to get approved. I encourage you to go take a look at this great website.

Janet then reviewed a webinar that was completed earlier that day with the CNBC D.C. affiliate. This webinar brought together renowned experts to discuss building vaccine confidence in diverse communities. You can see this special webinar here.

Janet ended her presentation by discussing the Count Me In project which will be the statements and photos of individuals and organizations stating why they want to get vaccinated. I have already sent my statement and photo to the Project. This project will be released later this month and she encouraged everyone to participate when that project is kicked off.

The town hall was then opened up for questions and I took participant privilege and jumped in for the first question. I referenced Janet’s statement that no one that received the Pfizer vaccine in the clinical trials died from the virus. She verified that it was true I stressed the need for that to be emphasized in the news. I stated that there should be two-inch headlines or breaking news headline runners on my internet news feed declaring, “Get vaccinated and you won’t die from COVID!”

The next question dealt with whether we have to pay for getting vaccinated. Janet stated that no one will pay out-of-pocket for the vaccine. Your insurance company or the government will pay the full price.

The next question asked if there was a difference between the two vaccines and should we be concerned with which one we receive? Janet commented that the health professionals she’s talked with have all said, take which ever one you can get the quickest. They are both based on the same mRNA science.

I then asked if there was a supply problem that might keep people from getting their second shot? Janet said that she had not heard of problems with people getting their second shot. Many states are scheduling the second shot at the time people get their first shot. She mentioned that other pharma manufacturers who have not developed a vaccine are stepping up to help manufacture both vaccines.

Someone had a question about her father. She stated that her father was allergic to penicillin and his doctor recommended that he not get vaccinated. She asked if there was a place to get a second opinion. Janet said that she would call the manufacturers’ 800 help lines. There would be doctors standing by who could give her more detailed information. Janet said that the CDC was another place to go to get answers to her questions.

Another listener asked if this vaccination would become a yearly requirement and, if so, will the access migrate to the primary care provider? Janet said that it was possible but that the mRNA technology is easier to modify and we might have a booster that covers any variants that come along.

I asked Janet if it was OK to get together with other vaccinated people in a closed environment without wearing our masks? She said that Doctor Fauci, the guy we all seem to listen to, said that if everyone had been vaccinated it was OK to meet together inside without masks.

Debbie Witchey from the Healthcare Leadership Council stated that it seemed that people were having problems getting appointments. She asked Janet if she had any tips for people trying to get appointments. Janet said her solution was to sign up everywhere. The state handles the appointments but there could be multiple sites giving the vaccinations. It was certainly the situation in my case. Janet thought that there would be more opportunities as the logistics get ironed out.

I then asked Janet about how we are going to get the vaccine to minority communities. She mentioned that the people in the Project have been thinking about this. They wanted to go into the churches in minority communities and in the rural areas that also have been adversely affected. The Project will be going to the historically African-American sororities and fraternities to encourage their involvement. She said that it would be a challenge, but she knew that our country would be up to it. Everyone should have the opportunity to get this life saving vaccine.

I hope that you get the opportunity to review the town hall and the webinar mentioned above. We will continue to bring you informative blogs and townhalls.

Best, Thair



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Medicare – What Can We Expect Under the Biden Administration

While it’s a new year with a renewed hope for a return to normalcy, we also have a new President with new power, given that the Democrats hold the majority in both the House and the Senate. The big question is, what impact will this administration and control of both Houses of Congress have on Medicare?

As you might remember, one of the big discussion issues among the Democratic Presidential hopefuls had to do with healthcare. Some of the more progressive candidates pushed for a single payer, government-controlled healthcare system. The more moderate candidates, President Biden being one of them, campaigned for an expansion of Affordable Care Act (sometimes called Obamacare) and some cuts to some parts of Medicare and an expansion of benefits to others.

One of the changes to Medicare that President Biden has talked about is adding a public health insurance option to the healthcare choices for those under 65. It would be administered by the traditional Medicare program. It is opposed by hospitals and many doctors because it would likely fix many of the prices of healthcare at or below the already low Medicare prices. This would especially impact rural hospitals since many are already teetering on insolvency. With the small majorities in both houses this approach will be one of the harder ones to get passed.

The President has also proposed that the Medicare age be lowered to 60. This is just another way to open the way for more people to rely on the government for their healthcare; some say it is merely a steppingstone to a single payer system. It just doesn’t seem logical to lower the Medicare age, putting more pressure on an already financially strapped program, when people are staying healthier longer. This will also be difficult to get done.

Drug prices is another area that President Biden has promised change. This is one area where he and former President Trump were most alike. He also wants to use methods like using foreign prices to set our drug prices and allowing the unregulated importation of drugs. I’ve discussed in further detail these and other approaches in earlier blogs, here and here. There is one place where President Biden differs from the former President on drug pricing. President Biden wants to allow the government to negotiate the drug prices in Medicare Part D. Now this sounds like something that every free-market advocate would embrace, but what it really means is the government would merely be setting the prices and would not save much money according to the government’s own non-partisan accounting office, the Congressional Budget Office.

One area that might get some renewed attention is a change that could help older Americans immensely. That change would put a cap on a Medicare beneficiaries yearly out-of-pocket prescription drug costs. This change would help those who are the sickest amongst us and who are often in no position to afford huge drug costs. I hope that a new bipartisan effort to consider this needed change will be one of the positive things that this administration champions. 

It will be interesting to see if President Biden uses the Executive Order route favored by President Obama and President Trump or the legislative route to enact his administration’s policies. I have said many times that our Representatives on Capitol Hill need to be involved in issues that have such a profound effect on our lives. Whatever happens, we will help you stay informed on any proposed changes to your healthcare and continue to be a conduit for your voices to those on Capitol Hill.

A reminder, tomorrow we will hold another virtual town hall. We will be focusing on our country’s COVID-19 vaccination effort. The information below will discuss the town hall in more detail and how you can register for the event.

Best, Thair

Medicare Today Town Hall
Wednesday, February 17
2:00 p.m. ET

Guest Speakers
Thair Phillips
former President and CEO of RetireSafe
And
Janet McUlsky

COVID-19 Vaccine Education and Equity Project
They will discuss:

  • The latest information on COVID-19 vaccines
  • The impact of vaccination uptake
  • Efforts to ensure equitable access to authorized
    and approved vaccines

Register Here

After registering, you will receive a confirmation
email containing information on joining the Town Hall.