Another Obamacare Poison Pill: You Can’t Keep Your Meds Either

On last Sunday’s edition of The Teri O’Brien Show, we played you the audio of the very creepy, icy architect of Obama’s heinous health care scheme, Ezekial Emanuel, telling you that the One was not lying when he said “If you like your doctor, you can keep your doctor,” because you can, PROVIDED you are prepared to pay more. Now, we learn that the same logic may apply to your medications. From Forbes:

Simply put, many drugs may not be covered at all, and the costs patients incur by buying them with cash won’t count against out of pocket caps. This has repercussions for drug makers with big portfolios of specialty and primary care drugs (more on that later). But most of all, it has implications for patients.

Drugs on your health plan’s formulary will typically have fixed co-pays. These costs usually count toward your deductible and the out of pocket and lifetime limits on the total amount of money that your health plan can ask you to spend.

As the Wall Street Journal recently reported, these co-pays can already be substantial, pushing people quickly to their annual out-of-pocket limits — $6,350 for individuals and $12,700 for families (after which insurers pay the full tab).

Take, for example, the drug Copaxone for multiple sclerosis.

Someone on a bronze plan would be responsible for paying about 40% of the drug’s costs out of pocket, on average. That comes out to about $1,980 a month.

If you buy the highest cost platinum plan, the out of pocket costs drop to $792 a month. But you’re probably better off with the cheaper bronze plan anyway.

Since you’re going to hit your out of pocket cap regardless of your plan, you might as well save money on the premium (which doesn’t count against your deductible or out of pocket limits) and race to the $12,700 spending cap as quickly as your family can.

People whose annual income is at or below 250% of the Federal Poverty Level will qualify for cost-sharing reductions. (That comes out to families of four earning less than about $60,000, or individuals earning less than $30,000). But people qualify for these cost-sharing subsidies only if they enroll in a higher cost, “silver” Obamacare plan.

After all, the provider networks (and formularies) used by low cost “bronze” and high cost “platinum” plans are often the same. The only thing that varies between different “metal” plans is typically the co-pay structure. Why pay higher premiums just to lower your co-pays when you’re going to hit the out of pocket caps anyway.

By purchasing a costlier, gold or platinum plan, you typically can’t “buy up” to a higher benefit. What you’re really doing is just prepaying the cost sharing.

But at least — in this model case — the drug Copaxone was partially covered under the Obamacare plan’s formulary. Consider an even bigger problem lurking inside the law.

The out of pocket caps on consumer spending only apply to costs incurred on drugs that are included on a plan’s drug formulary. This is the list of medicines that the health plans have agreed to provide some coverage for.

If the drug isn’t on this formulary list, then the patient could be responsible for its full cost (with little or no co-insurance to help offset that cost). Moreover, the money they spend won’t count against their deductibles or out of pocket limits ($12,700 for a family, $6,350 for an individual).

These are the ways that Obamacare cheapens the health coverage in order to pay for all of its expensive mandates. Obamacare is a throwback to the old HMO model of the 1990s, which promised a broad package of coverage for primary care benefits like vaccines, and routine doctor visits. But to pay for these benefits, the Obamacare plans skimp on other things – principally the number of doctors you’ll have access to, and also, the number of costlier branded drugs that make it onto formularies.

Many Americans rejected these restrictive HMO model plans in the 1990s, in favor of PPO-style plans that had higher cost sharing for routine health services, but offered broader access to doctors and have bigger drug formularies. What Obamacare says, in effect, is that Americans made the wrong choice when they rejected those HMO plans in favor of PPOs. The President thinks the more comprehensive, but restrictive HMOs were the better choice after all.

You should read Dr. Scott Gottlieb’s whole piece. It is an eye-opener about the details of this law and how they may affect your or your loved ones’ ability to get the life-saving medications that they rely on.

How’s the hope and change working out, by the way?

Death To the Deniers!

I am often reminded of this quote:
Liberalism is a disease, just like tuberculosis of the spine. Liberalism works like that on the soul. Appearances become deceptive and the consequences of clearly present causes are dismissed as superstition. There are people even now who don’t believe that Napoleon was in Moscow. … The most shameful products of godlessness destroy human feelings of nobility … Black becomes white, darkness is called light …. I have, as in the case of physical disease, mentioned the mental symptoms of the final stages. God forbid that you, my friend, should be seriously ill. But you seem to me to be sick, because disbelief in conspiracy is the first unmistakable symptom of the liberalism that dessicates the soul.-Letter of Friedrich Wilhelm IV to Christian Bunsen, Prussian Ambassador to England, March 1848.

But never so much as when I read this.

In this article I am going to suggest that the death penalty is an appropriate punishment for influential GW [Glowbull Worming] deniers. But before coming to this surprising conclusion, please allow me to explain where I am coming from.


Gulp.

This guy is Richard Parncutt, a Professor at the University of Graz, Austria. Parncutt, an expert on the psychology of music, originally from Australia. Maybe he spent too much time in Austria, or rap ‘music’.

I have always been opposed to the death penalty in all cases, and I have always supported the clear and consistent stand of Amnesty International on this issue. The death penalty is barbaric, racist, expensive, and is often applied by mistake. Apparently, it does not even act as a deterrent to would-be murderers. Hopefully, the USA and China will come to their senses soon.

Blah, blah.. Wait! Barbaric? That’s racist! The Barbary Coast is now Libya and Tunisia.

GW deniers fall into a completely different category from Behring Breivik. They are already causing the deaths of hundreds of millions of future people. We could be speaking of billions, but I am making a conservative estimate.

My estimate of “hundreds of millions” is based on diverse scientific publications about GW.

A “conservative estimate”?  About GW? See how he tosses that in there conjuring ideas of George W. Bush and Conservativism?

…it is clear that there is a dividing line somewhere between murders for which the death penalty is appropriate and murders for which it is inappropriate. I am proposing to make that dividing line concrete at about one million people. I wish to claim that it is generally ok to kill someone in order to save one million people. Similarly, the death penalty is an appropriate punishment for GW deniers who are so influential that one million future deaths can with high probability be traced to their personal actions. Please note also that I am only talking about prevention of future deaths – not punishment or revenge after the event.

Why should I even bother with a leftist screed if it doesn’t contain any Christian bashing? Oh. Wait. Never mind. It is Christmas Day.

There is a clear causal relationship between the Vatican’s continuing active discouragement of the use of condoms and the spead [sic] of AIDS, especially in Africa. We are talking about millions of deaths, so according to the principle I have proposed, the Pope and perhaps some of his closest advisers should be sentenced to death. I am talking about the current Pope, because his continuing refusal to make a significant change to the church’s position on contraception (more) will certainly result in millions of further unnecessary deaths from AIDS in the future.

 How refreshing! A leftist rant without a mention of Nazism! Oh wait. There’s more…

Those who deny the holocaust certainly belong behind bars. The death penalty would be too much for them, because holocaust deniers are not directly causing the deaths of other people. The holocaust is in the past, not the future. Those who died in the holocaust cannot be brought back to life.

How magnanimous. As Teri always says, you have to look all the way at the bottom to get the “money quote”.

 I would just like my grandchildren and great grandchildren, and the human race in general, to enjoy the world that I have enjoyed, as much as I have enjoyed it. Andto achieve that goal I think it is justified for a few heads to roll. Does that make me crazy? I don’t think so. I am certainly far less crazy than those people today who are in favor of the death penalty for everyday cases of murder, in my opinion. And like them I have freedom of speech, which is a very valuable thing.

Indeed. A very valuable thing until the State deprives you of it. Nothing screams “Shut up!” like “we will kill you”.In fairness, this moron has revised his article, here. I didn’t bother to read it. Idiocy, like Glowbull Wormening is contagious, studies would show.