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Valued Social Butterfly
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Re: FUNDING SOCIAL SECURITY & MEDICARE

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Message 11 of 17

@umbarch64 wrote:

@GailL1  . 

 

Yes....all this needs discussion and eventual legislation. I doubt either you or any of your intended audience will be an actual participant in legislation.  November 6, 2018, the People will vote on who they think will best get them to where they want to be. 

 

Details such as you cite don't inform them adequately. They construct barriers exacerbating disagreement.  Agree on concept first.  Details to accomplish the concept will inevitably follow provided good faith is practiced.  You'd like to do that....wouldn't you?  A common goal?

 

No one will get there without agreement on where they are going.  The first of our founding documents did that.  They knew something.  I see lots of people at all levels of our society grinding their axe, setting up smoke screens and creating distractions.  I have to consider they know what they do and do it with purpose.  No matter who they may be, I can't go along with that.  How about you? 

 

 


You might be surprised at my input - regardless of political party if something saves the government money it gets notice.  Regardless of political party, reason and workability has to be paramount in the idea and concept without doing harm.

 

There is already agreement on the concept - medication cost too much money.

Most of the time when the concept is worded like this, people think they are talking about their pocketbook but they are not - they are talking about saving the government money.

 

This administration is making some strides but will have to reserve judgement on just how it will work in Medicare Part,D plans.  The last one which is getting kicked around is importing some medication to help,government save money.

 

One of the biggest reasons why we spend so much money on healthcare without equalization of out come is because we don't rate medication, treatments and procedures for approval based on a good, better, best methodology including price.  Pharma and developers of new treatments and procedures know that once we make price part of the equation they will have to consider it as important as the workability of the medication, treatment or procedure.

 

November 6,2018 will come and go and whatever change or not will happen - it doesn't change the concept, the purpose nor the proposals - these problems with SS and Medicare have been around a very long time - several Administrations, a couple of change overs in Congress - yet here we are - same ole problems - so the real problem here is not concepts or proposals but a bunch of politicians that refuse to make the hard choices which could cost them their job if it is not sold in such a way that it is good for you ( or good for the country's pocketbook ).

 

We are a society that wants what we want, when we want it, regardless of cost cause we also want others to help pick up the tab or a lot of it, because they think they deserve it.  To control it,  we have to decide what is offered so they aren't disappointed.  

 

 

* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: FUNDING SOCIAL SECURITY & MEDICARE

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Message 12 of 17

Funding Social Security and Medicare?

 

Social Security is an organization that manages a number programs. Medicare is one of those programs.

 

Each program is stand alone and has its own funding. If you want to talk about SS funding you have to identify the SS program that you are talking about.

 

 

 

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Re: FUNDING SOCIAL SECURITY & MEDICARE

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Message 13 of 17

@GailL1  Without a shared concept against which consequences of suppostions are measured, details are worse than worthless.  They become divisive, destructive and confusing to those unable or unwilling to connect detail to end results.  A tool employed as a  serious obstruction to eventual resolution. 

 

Yes....all this needs discussion and eventual legislation. I doubt either you or any of your intended audience will be an actual participant in legislation.  November 6, 2018, the People will vote on who they think will best get them to where they want to be. 

 

Details such as you cite don't inform them adequately. They construct barriers exacerbating disagreement.  Agree on concept first.  Details to accomplish the concept will inevitably follow provided good faith is practiced.  You'd like to do that....wouldn't you?  A common goal?

 

No one will get there without agreement on where they are going.  The first of our founding documents did that.  They knew something.  I see lots of people at all levels of our society grinding their axe, setting up smoke screens and creating distractions.  I have to consider they know what they do and do it with purpose.  No matter who they may be, I can't go along with that.  How about you? 

 

 

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Re: FUNDING SOCIAL SECURITY & MEDICARE

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Message 14 of 17

 4 TRILLION Dollars wasted on the Iraq War of Lies.

 

It ain't over yet, not even close.

 

Not to mention the refugee crisis it caused in Europe, and the blow back against refugees in the US.

 

It's almost like someone planned it that way.

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Re: FUNDING SOCIAL SECURITY & MEDICARE

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Message 15 of 17

 


@mandm84 wrote:

https://www.marketwatch.com/story/congress-would-not-have-to-raise-taxes-or-cut-spending-by-a-single...

 

Mr. Goldstein makes some good points. When I think of Gov't spending , I cant help but think of the lives and over 4 TRILLION Dollars wasted on the Iraq War of Lies. Imagine that money going towards S.S. and Medicare and all the lives saved and When will Congress stand up to the drug companies and negotiate drug prices ? Imagine that savings as well.

So much waste !!!


So...mandm....marketwatch is an internet resource.  A subsidiary of Dow Jones.  Their approach to the dollar is abstract. A thing to be manipulated for profit.  

 

The hours, minutes and seconds of a person's life a dollar represents are a

non-renewable resource, a commodity traded for the ability to continue to live.  Once gone, it absolutely cannot be replaced.  

 

IF certain 'so-called conservatives' truly understood that, their approach to 'using' a dollar might be different.  Presuming they truly understand ethics and conscience at all, which is highly questionable, to do what they do might not be possible.  Something akin to 'suspension of the ethical' has to happen.  That happens in war too.

 

Manipulating a dollar in the Wall Street Market Place mainipulates lives in reality.  It matters not a whit that it is done within a 'system'.  

 

CNN had an interview with an economist this AM.  A 'far left' economist.  At the outset of the interview, the notion that currency can be printed by a government as needed to satisy the government's needs came up.  Germany in the 1920s did that.  Ruinous inflation was the result.  Fun and games that led to a horrendous dictatorship which in turn led to genocide and war.

 

That can happen here as well.  IF, somhow, the idea becomes widespread in people's minds that anything goes.  Wall Street would initially think that was the greatest thing since sliced bread.   So would economists and wanna-bes who operate outside ethical constraint.  And, of course, 'the donald' and his ilk.  The words cynical, amoral and immoral come to mind.

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Re: FUNDING SOCIAL SECURITY & MEDICARE

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Message 16 of 17

Not to discount the author but the SS and Medicare law also states from where these operating funds come from - payroll taxes, taxes on SS benefits, premiums on Medicare and how much percentage wise comes from the General Fund.

 

You mentioned Medicare negotiating drug prices  - or even the government negotiating all drug prices.  Negotiations (definition:  to deal or bargain with another or others or in preliminaries to a business deal) to get the best benefit have to be done from a position of strength.

 

These are the proposals under consideration for the best way to do this:

KFF 04/26/2018 Medicare - Searching for Savings in Medicare Drug Price Negotiations

(which one do you like? - It needs to be one that gives us savings, don't you think)

What are various approaches to allowing Medicare to negotiate drug prices?

  • Some proposals to allow Medicare to negotiate drug prices would strike the MMA’s non-interference clause and authorize the HHS Secretary to negotiate drug prices on behalf of Medicare beneficiaries enrolled in private Part D plans.
  • Others would allow the Secretary to negotiate drug prices by establishing a public Part D plan to operate alongside private Part D plans and administered by HHS under the oversight of the Secretary.  Under this approach, the Secretary would establish a formulary for the public Part D plan and negotiate prices for drugs on that formulary.
  • Some recent proposals designed primarily to expand health insurance coverage (including Medicare-for-all and Medicare buy-in proposals) or improve the stability of the Affordable Care Act marketplaces include provisions that would authorize the HHS Secretary to negotiate drug prices.
  • A middle ground approach, and one that responds specifically to recent concerns over high-priced specialty drugs, would authorize the HHS Secretary to negotiate prices solely for a limited set of relatively expensive drugs, including unique drugs that lack therapeutic alternatives. 
  • A recent proposal directs the HHS Secretary to prioritize negotiation on specialty and other high price drugs, but also includes a fallback for achieving savings if the negotiation process fails. The fallback is to essentially use the VA price, which has a narrow formulary and secures much steeper discounts than private payers do. The bill also proposes to give the Secretary authority to establish formularies in Medicare and use other pricing tools he currently lacks. This bill has not been scored by CBO.

What has CBO said about the potential for savings?

  • CBO has said that giving the Secretary authority to negotiate lower prices for a broad set of drugs on behalf of Medicare beneficiaries would have “a negligible effect on federal spending.”  It based this assessment on its view that the Secretary would not be able to leverage deeper discounts for drugs than risk-bearing private plans, given the incentives built into the structure of the Part D market, where plan sponsors bid to participate in the program, compete for enrollees based on cost and coverage, and bear some risk for costs that exceed their projections.
  • CBO has suggested that savings could potentially be achieved under a defined set of circumstances. For example, in addition to simply removing the non-interference clause and allowing the Secretary to negotiate drug prices, CBO has said that in order to obtain price discounts, the Secretary would need authority to establish a formulary that included some drugs and excluded others and imposed other utilization management restrictions, in much the same way that private Part D plans do. And yet, CBO has questioned whether the Secretary would be willing to exclude certain drugs or impose limitations on coverage, as private plans do, “given the potential impact on stakeholders.”
  • Savings could also be achieved if the Secretary were authorized to set drug prices administratively or take regulatory action against companies that did not offer discounts of a certain magnitude. CBO has not estimated the potential savings associated with these options.
  • In addition, CBO has suggested there is some potential for savings if the Secretary had authority to negotiate prices for a select number of drugs or types of drugs, such as unique drugs that lack competitor products or therapeutic alternatives. This would include many of today’s high-priced specialty drugs and biologics. But according to CBO assessment of this approach in 2007, if only a small share of Medicare drug spending was attributable to the selected drugs, overall federal savings from price negotiations would be “modest” and manufacturers could offset potential losses by setting higher launch prices for their drugs. Although this approach was included as a provision of President Obama’s proposed budgets for FY2016 and FY2017, neither the Office of Management and Budget (OMB) nor CBO scored any savings associated with this provision.

read more at the link provided ~

 

Anyone interested in knowing more might also read this paper too

PewTrust - 12/05/2017 - Policy Proposal: Allow Medicare to Negotiate Drug Prices in Part D -  A seri...

 

We need to do a lot to hold down cost  - speaking specifically of medicines -

  1. we need an approval process that includes cost in the efficacy review.
  2. we have to devise the way we want to get this strength in negotiating prices

You don't get the best price by covering everything - therefore, we need to negotiate for the best product for the price.  In essence, Medicare covers most every drug now under one insurers formulary or another.

 

* * * * It's Always Something . . . Roseanne Roseannadanna
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FUNDING SOCIAL SECURITY & MEDICARE

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Message 17 of 17

https://www.marketwatch.com/story/congress-would-not-have-to-raise-taxes-or-cut-spending-by-a-single...

 

Mr. Goldstein makes some good points. When I think of Gov't spending , I cant help but think of the lives and over 4 TRILLION Dollars wasted on the Iraq War of Lies. Imagine that money going towards S.S. and Medicare and all the lives saved and When will Congress stand up to the drug companies and negotiate drug prices ? Imagine that savings as well.

So much waste !!!

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