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Pepin’s Pharmaceutical Prattle for 05-12-2003
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Quote of the day: If Darwin's Theory was anything more than a theory then why are there still any monkeys? Annon.
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Good morning!
Energy…most people confuse the SOURCE of energy with the FORM of energy. There are many forms of energy such as electricity, steam, the potential energy of water (to use in hydroelectric), fossil fuels, biomass, hydrogen, wind, and several others. But there are few SOURCES of energy: solar and nuclear. The fuel cell cars of the future are not really any cleaner, the dirt is produced elsewhere so the car OPPERATES without emission. In fact, whether oil, gas, coal, or nuclear fuel is expended to separate water into hydrogen and oxygen, each produces some form of waste. So what does this all have to do with pharmaceuticals or pharmacy benefits?
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Employees confuse money matters equally. The SOURCE of most money (energy) is an employer (for our purposes we will consider states the employers of the aid recipients). Sure there may be some from investments but this is usually a small part (most especially in the recent stock market). Employees would like employers to foot 100% of the cost of health care and pharmaceutical. I contend that they already do, regardless of the copay charged. All (or most) of the money used for everything from tooth paste to toilet paper is paid for by the employer. My employers have purchased automobiles, gas, houses, electricity, and books for me. How? By way of a paycheck. I am then left to my own devices as to what I value and how I spend it (except for the taxes but that is another topic). How do we "sell" this reality to members who feel entitled?
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One recent way has been to consider pure DEFINED CONTRIBUTION as a way of funding healthcare. The employers would have a static identifiable expense for health care per employee. The members would be left to either live within this budget or use some of their wages to pay the difference. As costs increase, the member's share increases dollar for dollar.
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How simple would it be to calculate the amount paid for health care and add it to the paycheck and then drop all health care coverage? The employer would have the same outlay but it would be predictable. The members would be left to the reality of what health care actually costs and MAYBE be more prudent buyers. They seem to do alright in deciding what kind of car or house to buy…..why not health care? The reality is that members are people who, by in large, have little self control over spending and get themselves into debt. The other hole in the "no-benefit" approach is that no-benefit means no coordination of care, no bargained discounts, and no safety measures (such as use review). The third issue is, that while we can predict what housing or transportation will cost fairly accurately, health is fleeting and could decimate family finances.
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So we are left with the insurance option: spreading the risk over a larger group. Both the "sick" and the "well" bet that they will spend less on an insurance policy that on paying directly for care. In reality the "sick" pay less for the amount of care they receive and the "well" pay more. So how do we reverse this situation? How would an employer benefit? This is already too long so I'll provide a potential solution next week.
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1) sssssssaaassssssasssssssssssssjjjssaasssiiissssmmmmmmmmm
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Monkeys and typewriters ….The answer to infinity…. While this was done with six monkeys there doesn't seem to be much hope of a word let alone a manuscript. Unless you take rational control of your pharmacy benefit you are leaving the outcome to chance…..and don’t expect anything more organized that our primate friends produced.
…Click here for full text of story http://startribune.com/stories/1451/3873839.html.
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Have a GREAT week! Steve
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Disclaimer: "Pepin's Pharmaceutical Prattle" (AKA "The Prattle") is the property of PHARMWORKS, LLC and Steven M. Pepin, Pharm. D, BCPS. The opinions expressed are those of the bald-headed author. To start or stop any drug without the advice a supervision of you physician would be stupid. So don't do anything based upon what you read here without professional advice. To be added to or removed from the distribution list please e-mail your request to pharmworks@pharmworks.com . All insightful comments from readers are thoughtfully considered (the rest are callously discarded). Copyright 2003 PHARMWORKS,LLC all rights reserved.
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