In article ,
"Robert Green" wrote:

"Kurt Ullman" wrote in message
"Robert Green" wrote:

stuff snipped

And Part D
(1). Cut the prices for seniors substantially because the individual
insurance companies were able to negotiate better prices than Grandma
and Grandpa could on their own. In the first 3 years, it actually came
in UNDER projections.

Projections are interesting, but as you pointed out with Krugman, they may
be constructed poorly and not really reveal the true state "on the ground."
But still it went against pretty much every recent policy addition
(including the original projections for SS and MCare where the outlying
decade projections were met after two years). Or even the short term
projections that they use to put one year's budget together. That alone
made it newsworthy.


What I noticed helping my neighbor with her Part D problems (they are
substantial) was that the veryt same meds she was taking in 1998 have almost
tripled in price. I believe that a lot of that rise was meant to compensate
for any future discount the drug companies might have to give to Medicare.
You have to use this drug's profits to pay for the next drug's
development. The costs of that have been going up, too. I am reminded of
a line from West Wing. Josh and Toby are discussing drug prices. One of
them holds up a pill and notes that this one cost 14 cents. The other
agrees but then added that the first one cost over $500 million (and
that was years ago).
Also most of the low hanging fruit has been picked in the
pharmaceutical industry as we can see by the more expensive to find, get
approved and then make biologics and similar medications. We have seen
the obstacles just over the last couple months when drug companies have
pulled the New Drug Applications for 3 late-stage drugs because the
studies did not show efficacy. VERY expensive failures.
When price fixing occurs (and no matter how you want to paint the
picture when government decides how much they will that is price fixing)
in the US one of two things HAS to happen. Prices elsewhere will have to
go up or innovation will dry up. (And either way we might get an answer
to the nagging question of exactly to what extent has the US consumer
been subsidizing overseas drug costs.) There are no other viable
alternatives.
Drug costs should go down substantially over the next few years
anyway. Of the top 10 meds, something like 5 go off patent in the next 3
years (starting this week with Lilly's Zyprexa.


FWIW, she's finally spent so much out of pocket that she's out of the donut
hole and into what Medicare calls "catastrophic" coverage. She smiled when
I said that the government says she's a catastrophe, now.

The legislative history of the donut hole is sorta interesting. That
was essentially put in there for Dem votes as a sop to not paying for
the bill through other means.

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