Healthcare Insurance Coverage Information
The Kaiser Family Foundation has put up comparisons of one new way (if passed) to obtain healthcare coverage and two existing ways of obtaining healthcare coverage (subsidized coverage) for those who lost job-based health insurance since in the Covid-19 pandemic. I had talked about two of the ways previously.
The two existing options (besides over priced Cobra) are:
- Medicaid, for which 47% of those lacking insurance are eligible (Kaiser’s estimate) and,
- ACA Subsidized Marketplace Coverage, for which 31% may be eligible dependent on income.
A third possible option alluded to above is the subsidization of 100% of the cost of COBRA (now 65% subsidized of cost of employer sponsored healthcare) premiums as provided in the House HEROES Act recently passed. This new bill could win some Republican backing in the Senate even with McConnell blocking it and calling for a stipulation to be inserted in the bill to release companies, providers, hospitals, etc. of liability. As written, the Heroes Act would be a windfall for employers, healthcare providers and insurers as well as individual recipients. The first three pluses favoring Republicans are likely to support.
To compare, COBRA and Medicaid are similar in provision. Both pandemic available options would be zero-premium in almost all cases (a few states have imposed premiums on higher income Medicaid enrollees). The tradeoff between the two plans being the employer sponsored insurance typically has larger provider networks and a higher deductible and out-of-pocket costs while Medicaid’s has zero-to-minimal out-of-pocket costs and fewer insurance company options.
The average actuarial value determined by Kaiser) of an employer-sponsored plan is 85% and is designed to cover 85% of the average enrollee’s medical expenses. The average deductible in employer-sponsored insurance is $1,655, and the average out-of-pocket maximum for individuals is about $4,000. The actuarial value for Medicaid is effectively 100% or close to it. Medicaid is a much better deal for taxpayers as company sponsored insurance plans (including self-funded employer plans) pay almost twice Medicare rates. When compared to Medicaid plans rates, employer plan rates are several times higher in costs than the costs of Medicaid.
The Lesser Plan
The clear loser when comparing costs in the comparison of all three is the ACA marketplace coverage. For most of those who lost job-based coverage, it requires higher premiums (which are zero in the other two options), higher out-of-pocket costs, and provider networks often as narrow as Medicaid’s. The $600/week extra unemployment benefit provided for up to four months by the CARES Act which is allowed for Medicaid or Cobra (it is not counted as income) is counted as income in the ACA Healthcare Marketplace Subsidy calculations.
If you are still fumbling around trying to decide, the HEROES Act has not been passed by the Senate yet so it may be a while before it content becomes available. If you are in a Medicaid expansion state, you are probably eligible as long as income is <138% FPL. If not, than it is <100% FPL Otherwise, there are the ACA Healthcare Exchanges. Some sites for more detail:
Medicaid For All Who Want It, Pandemic Edition, XPOSTFACTOID
Key Issues Related to COBRA Subsidies, The Kaiser Family Foundation
June 2, 2020
A mysterious company’s coronavirus papers in top medical journals may be unraveling
By Kelly Servick and Martin Enserink
I saw that also and several other articles on the topic. It appears the data has been manipulated to create the results. Two things I will point out or maybe it is three things? Most of the studies touting the dismissal of hydroxychloroquine as a cure ignore several things;
HCQ is not the cure and it is used as an ionophore for zinc which prevents the virus RNA(?) from replicating.
HCQ like the Gilead drug Remdesivir must be used very early on in the treatment of Covid. Less than a week or as soon as one tests positive which also may be too late for either.
HCQ dosage in each of these studies disproving its usefulness and causing death or other issues is far greater than what has been used successfully with zinc.
HCQ is cheap and will not make much profit for anyone. Remdesivir will be more profitable and there are “no” guarantees it will be sold at $5,000 for 10 doses as the ICER suggests. The companies bring to market can have higher prices in spite of what the ICER suggests.
Some anecdotal info from southern France: https://www.mediterranee-infection.com/covid-19/
Medscape Comments from Doctors: https://www.medpagetoday.com/infectiousdisease/covid19/86692?utm_source=Sailthru&utm_medium=email&utm_campaign=Weekly%20Review%202020-05-31&utm_term=NL_DHE_Weekly_Active
MedPage article and comments: https://www.medpagetoday.com/infectiousdisease/covid19/86642?utm_source=Sailthru&utm_medium=email&utm_campaign=Weekly%20Review%202020-05-24&utm_term=NL_DHE_Weekly_Active Again read the comments.
https://www.researchgate.net/post/Is_a_combo_of_chloroquine_and_Zinc_a_cure_for_coronavirus Is a combo of chloroquine and Zinc a cure for coronavirus? Kiran R Bangalore University Discussion from March 18th till May 30th by doctors.
I am a voracious reader on healthcare. Hopefully, some of this on zinc, HCQ and Covid makes some sense to you too.
Excellent and important in several ways; as to the problematic economics of patents for drug making.
A vaccine for the coronavirus appears to be feasible to a number of experts in China and Britain and testing of candidates in well underway. Supposing a successful vaccine is produced, especially in China but likely in Britain also, the product will be a “public good.” As a public good, such a critical product may have a profound influence on the economic structure of drug production.
April 29, 2020
First China-made HPV vaccine will hit the market
China’s first domestically produced vaccine against the cancerogenic human papillomavirus (HPV) will be available by appointment from May, making China the third country in the world to achieve an independent HPV vaccine supply after the U.S. and the UK.
The two-valent vaccine, jointly developed by Xiamen University and a Xiamen-based biotech company Innovax, marks progress by China in HPV vaccine production, considering the complexity in production techniques in genetic engineering vaccine and multiple-valent vaccine, an expert said.
The new vaccine is designed for use by females aged nine to 45 and protects them against HPV 16 and 18 types, the two most common viruses that lead to cervical cancer.
Vaccination for women aged from 15 to 45 requires three doses, for those aged from 9 to 14 years old it only requires two doses, according to a press release published on the company’s website.
Prior to the new vaccine, HPV vaccines available in China were all imported ones, produced by a British pharmaceutical company, which makes a two-valent HPV vaccine and a U.S. drugmaker that produces a four-valent vaccine and a nine-valent HPV vaccine, according to a December notice published on the official website of the National Medical Products Administration.
The vaccines, especially the nine-valent one, have been in short supply in China, compared to the high demand. Statistics show that a total of 1.46 million doses of HPV vaccines were issued in China in 2017; 7 million issued in 2018; and 8.7 million issued from January to November in 2019. But there are currently 356 million people aged from 9 to 45 in China who are potential candidates for HPV vaccination, according to media reports.
A staff member at a health service center in Jing’an district of Shanghai told the Global Times that people now need to wait about two to three months to get four-valent and nine-valent vaccines at their center.
“I registered for vaccination with the four-valent HPV vaccine at the health service center of my community in October last year and have not been vaccinated yet,” Zhang Yanli, a Shanghai resident, confirmed with the Global Times.
The new vaccine is much cheaper with each dose priced at 329 yuan (about 46.5 U.S. dollars), compared to imported ones….
June 3, 2020
Why Should Anyone Care About Paying Big Bucks for Vaccine Government Funded?
By DEAN BAKER
The New York Times ran a piece * on the second round of government funding for the development of a coronavirus vaccine. The piece only mentions in passing the issue raised by some Democrats in Congress about the price of any vaccine that gets developed through this funding.
This is probably too simple for the New York Times reporters and editors to understand, but the reason the government grants drug companies patent monopolies is to give them a way to recover their research costs. In this case, according to the piece, the government has already paid $2.2 billion for research. The article makes clear that the government will be putting up considerably more money.
This is a huge amount to pay for research. At no point does the piece give any indication of how much of their own money, if any, the companies are putting up. Fans of the free market might be saying that if the government is paying the money, why on earth should the drug companies then have a patent monopoly?
But, reporters don’t seem interested in asking questions like this when the beneficiaries of government handouts are rich people (generally white). They generally are far more concerned about a few hundred dollars that might improperly be paid out to someone on food stamps rather than the hundreds of billions that the government hands out every year with its patent and copyright monopolies.
There is a strong or stronger argument sup[porting what you and Dean have said. Have you read the WHO report(s)?
Power Point: https://www.healthpolicy-watch.org/who-report-on-cancer-medicines-pricing-detailed-info-on-findings/ Risk Adjusted Sales Greatly Exceeded R & D Costs.”
Full Technical Report: https://apps.who.int/iris/bitstream/handle/10665/277190/9789241515115-eng.pdf?ua=1 “Pricing of cancer medicines and its impacts”
Basically in 2 – 5 years, pharmaceutical recoup the costs of R&D as calculated from risk increased Sales.
Anne, this was my post (partial) here: http://angrybearblog.com/2020/01/sales-income-for-drugs-have-exceeded-r-d-costs.html
Anne, Dean is agreat writer and economist who gets more exposure than I do. For that, I am grateful.
The post and descriptive comment on the graph are excellent and I am grateful to have read this. Now to read the World Health Organization report.
Yes, on this matter you and Dean Baker are arguing together. I find that encouraging.
The full WHO report is 170 pages long. Let see if you catch it, which two drugs are numbers 1 and 2 in cost per molecule? One of them has been used on me.
Executive Summary, read and which I will read again, then think about the Options Table. The full report would be too much for now, but the summary gives me a framework for thinking and I have a guide of what to look for in the full report.
I assume the book and this chapter is at least known (the book is free):
Rigged: How Globalization and the Rules of the Modern Economy Were
Structured to Make the Rich Richer
By Dean Baker
The Old Technology and Inequality Scam: The Story of Patents and Copyrights
This book should complement the WHO Technical Report and vice versa. The report is extensive in detail. There are some other papers I will give you to read also. You will have an extensive background in pharma as a lay person..
ACCESS TO MEDICINES, VACCINES AND PHARMACEUTICALS
Pricing of cancer medicines and its impacts
A comprehensive technical report for the World Health Assembly
Resolution 70.12 Operative paragraph 2.9 on pricing approaches and their impacts on availability and affordability of medicines for the prevention and treatment of cancer
June 4, 2020
WHO: hydroxychloroquine coronavirus trials to resume
Another Medscape article with 300 replies by doctors, etc. https://www.medscape.com/viewarticle/927033
Dan and I have an idea. We believe we can give you some space right now to do exactly what you are doing right now with these commentaries by Krugman, etc. and on other topics as well. We are working on getting things rearranged to support current news and blog events.