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Pharma’s Reform Bounce: How Big A Boost Will $80 Bil. Buy?
By Lauren SmithThe introduction of the Senate Finance Committee's health care proposal turns the focus from what the pharmaceutical industry will contribute to reform efforts toward what manufacturers stand to gain.
The introduction of the Senate Finance Committee's health care proposal turns the focus from what the pharmaceutical industry will contribute to reform efforts toward what manufacturers stand to gain.
The pharmaceutical industry could see an increase of approximately $115 billion over 10 years in U.S. drug sales as a direct result of the Senate Finance Committee's health reform legislation - at least by one way of slicing up the numbers used in economic analyses underlying the bill.
That calculation is based on how the Senate Finance Committee explained the rationale for the specific fees due from each health care business sector that stands to benefit from expanded health coverage.
Senate Finance Committee Chairman Max Baucus, D-Mont., unveiled details of the legislation, America's Healthy Futures Act of 2009, in the form of a "chairman's mark" on Sept. 16.
According to Democratic Finance Committee staff, members believe three major industries will experience "significant expansion" in the form of "new customers" that will be created by the committee's health reform bill: insurers, pharmaceutical companies, and hospitals.
Staffers say that they conducted an economic analysis of how much each industry stood to profit from the impact of the committee's health reform legislation over the 10 years.
Market expansion would stem primarily from picking up millions of new customers with drug coverage who previously did not because they were not insured, Medicaid expansions, and a shift toward use of more brand drugs in Medicare Part D because of the diminished deterrent of the self-pay donut hole coverage gap.
The committee agreed to look at recovering "15 to 20 percent" of the estimated new business through the specific industry segment fees. The pharmaceutical industry fee is set at $2.3 billion annually or $23 billion over 10 years.
If that $23 billion fee is calculated from a 20-percent fee assessment, then it suggests that the Finance Committee analysts estimate that pharma's market should grow by $115 billion in new business over the next 10 years as a result of the legislation.
In that vein, the industry would net $35 billion over the same period, or $3.5 billion annually, after subtracting pharma's $80 billion pledge to help pay for health reform.
If the $2.3 billion per year fee is based on an estimate of 15 percent of new business, then that suggests a projection of new business as high as $153 billion for the drug industry over 10 years.
No Simple Answers To Size Of Bounce
After explaining the rough formula for calculating the fees at the unveiling of the bill, the Finance Committee staff cautioned in follow-up comments against trying to calculate the new business figure directly from the percentage fees.Specifically, the staff said, "in determining allocations, an economic analysis was done on a range of factors, including long-term industry revenues, profitability, benefit from reform, the contribution of government revenues, as well as a number of other factors. The $23 billion fee was a portion of the overall $80 billion contribution agreed to by the pharmaceutical industry, which came about as a result of the analysis and negotiations with the industry. Other contributions focused on the donut hole, as well as increases in rebates to Medicaid," Further, "the fee is not a tax rate on the new business expected to be generated from reform, and the committee believes that the contribution from the industry will outweigh any benefit from expansion."
The staff statement recognizes the political sensitivity of large estimates of the positive impact of new business on different industries. A big new pool of money for an industry could stimulate further attempts to seek payments from that sector to pay for the cost of added coverage and upset some of the fundamental agreements on which the bill is advancing.
People familiar with the Finance Committee drafting process note that pharma's contributions were calculated differently, to take into account the industry's early offer to make a total package of contributions up to $80 billion. The $80 billion represents the total pharma contribution: the fee was added to help reach that commitment.
By comparison, the special fee on medical device manufacturers is higher, $40 billion over 10 years. The medical device industry is smaller than the drug business so it would seem that the fee should be smaller. However, the $40 billion number presumably reflects the total hit to medical devices - half of pharma's overall contribution.
Estimates of new business for pharma resulting from reform legislation run the gamut from no gain to $200 billion over the same period of time.
An analysis of House health reform legislation by Avalere Health, for example, found the changes would have minimal positive impact on the pharmaceutical industry. Working off the House Energy and Commerce Committee bill in mid-summer, Avalere found a 0.1 percent increase in net revenues to the drug industry, disputing estimates that "health reform legislation would generate a windfall of revenues" from the "millions of newly covered patients into the health care system."
Apportioning The Fees To Individual Companies
The chairman's mark would require heads of Medicare, Medicaid, the Department of Veterans Affairs and TRICARE to report domestic sales of branded prescription drugs for each drug manufacturer for the prior calendar year to the Secretary of the Treasury.The Treasury secretary would then establish individual assessments by determining the relative market share for each company. A company's relative market share would be its total covered U.S. sales from all government programs as a percentage of the total covered U.S. sales from all government programs for all companies.
In determining each company's relative market share, covered domestic sales will be taken into account as follows: 0 percent of sales up to $5 million; 10 percent of sales over $5 million and up to $125 million; 40 percent of sales over $125 million and up to $225 million; 75 percent of sales over $225 million and up to $400 million; and 100 percent of sales over $400 million.
The fee assessed is determined by the firm's market share in the preceding calendar year and would be a surcharge not deductible for U.S. income tax purposes.
Baucus Alone For Now; Hopes For GOP Support
Baucus formally introduced the proposal standing alone in front of a banner that read "Health Care Reform." No other members, Republican or Democrat, were present at the historic unveiling."No Republican has offered his or her support at this moment, but I think by the time we get the final passage in this committee it will have bipartisan support," he said.
Baucus has delayed introduction of a formal legislative proposal for months in hopes of putting together a truly bipartisan bill. The committee chairman, along with two fellow Democrats, has been negotiating with three Republicans in an attempt to craft a bill that would be attractive enough to gain some support from the other side of the political aisle. The group of negotiators on the Finance Committee is dubbed the "Gang of Six."
"I've worked very hard to get that bipartisan support and I think we will get it," he continued. "I think that certainly by the time the committee in this room votes on passing health care reform, there will be bipartisan support."
Sen. Olympia Snowe, R-Maine, thought to be Democrats' best shot at gaining Republican support, did offer some hope of bipartisanship: "As one of three Republicans in the Group of Six, I have appreciated the chairman's leadership of the only bipartisan effort in any committee in either the House or Senate, which has laid real and substantial groundwork for bipartisan cooperation during this ongoing process."
She said that this bill was only a "first step in the process" and that members of the Gang of Six will keep meeting in order to craft a bill that she and other Republican members of the committee can support.
"I believe the chairman's legislation moves in the right direction away from a government-run system contained in bills that have passed other Congressional committees, but a number of issues still need to be addressed - including cost assumptions and ultimate affordability to both consumers and the government as well as ensuring appropriate competition in the health insurance exchange," she added.
The Congressional Budget Office scored the Baucus proposal as costing $774 billion over 10 years. However, CBO concluded the bill would reduce the federal deficit by $49 billion over the same period.
While Baucus hopes to get Republicans on board, he made clear that he does not need them.
"I know this bill will pass," asserted Baucus. "The choice now is now is up to those on the other side of the aisle."
The RPM Report
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Health Care Insurance Corporations CEO Compensation
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August 26, 2009 Skip to content
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Mad About Medicine
Dr. Ira Kirschenbaum's Mad About Medicine blog has now been retired. We appreciate all the wisdom and support Dr. Kirschenbaum has brought to the WebMD community throughout the years.
Thursday, August 23, 2007
CEO Compensation: Who Said Health Care is in a Financial Crisis?
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Those of you who are struggling to pay for your generic medicines or wondering why the doctor is charging you a $5.00 co-pay, give some thought to these facts about how our health care dollars are allocated. At the end of this post, there is a list of 23 health companies I found on Forbes.com, what the CEO was paid in 2005, and the average paid to the CEO in the past five years.
Imagine adding vice presidents, Board of Directors, stock holders and the other 200-300 other companies all cashing in on your health to that total at the bottom.
Based on this, the next time you want to argue with your Primary Care doctor's front desk about a $5.00 co-pay, remember that he makes an average of $149,000.00 per year. On the other hand -- using United Healthcare as an example -- your insurance company paid their CEO -- one man -- $324,000,000 over a recent five year period.
If you are uninsured, try calling any one of these 23 CEOs and see if they will give you free insurance.
BTW: 10% of 14.9 billion is 1.4 billion. If basic insurance costs $8,000/year for a family then taking 10% from just these CEO salaries would insure 35,000 Americans a year for five years. That is a lot of people that can be helped just by 23 men. Looking at the companies as a whole that profit from health care, we can probably pay for every uninsured person in this country for decades to come.
The numbers are numbing, which is why we should do something about this.
* United Health Group
CEO: William W McGuire
2005: 124.8 mil
5-year: 342 mil
* Forest Labs
CEO: Howard Solomon
2005: 92.1 mil
5-year: 295 mil
* Caremark Rx
CEO: Edwin M Crawford
2005: 77.9 mil
5-year: 93.6 mil
* Abbott Lab
CEO: Miles White
2005: 26.2 mil
5-year: 25.8 mil
* Aetna
CEO: John Rowe
2005: 22.1 mil
5-year:57.8 mil
* Amgen
CEO: Kevin Sharer
2005:5.7 mil
5-year:59.5 mil
* Bectin-Dickinson
CEO: Edwin Ludwig
2005: 10 mil
5-year:18 mil
* Boston Scientific
CEO:
2005:38.1 mil
5-year:45 mil
* Cardinal Health
CEO: James Tobin
2005:1.1 mil
5-year:33.5 mil
* Cigna
CEO: H. Edward Hanway
2005:13.3 mil
5-year:62.8 mil
* Genzyme
CEO: Henri Termeer
2005: 19 mil
5-year:60.7 mil
* Humana
CEO: Michael McAllister
2005:2.3 mil
5-year:12.9 mil
* Johnson & Johnson
CEO: William Weldon
2005:6.1 mil
5-year:19.7 mil
* Laboratory Corp America
CEO: Thomas MacMahon
2005:7.9 mil
5-year:41.8 mil
* Eli Lilly
CEO: Sidney Taurel
2005:7.2 mil
5-year:37.9 mil
* McKesson
CEO: John Hammergen
2005: 13.4 mil
5-year:31.2 mil
* Medtronic
CEO: Arthur Collins
2005: 4.7 mil
5-year:39 mil
* Merck Raymond Gilmartin
CEO:
2005: 37.8 mil
5-year:49.6 mil
* PacifiCare Health
CEO: Howard Phanstiel
2005: 3.4 mil
5-year: 8.5 mil
* Pfizer
CEO: Henry McKinnell
2005: 14 mil
5-year: 74 mil
* Well Choice
CEO: Michael Stocker
2005: 3.2 mil
5-year: 10.7 mil
* WellPoint
CEO: Larry Glasscock
2005: 23 mil
5-year: 46.8 mil
* Wyeth
CEO: Robert Essner
2005:6.5 mil
5-year: 28.9 mil
TOTAL 2005: 559.8 mil
TOTAL 5-Year: 14.9 billion
Related Topics:
* Group Pushes Universal Health Care
* Is Health Insurance a Right?
Technorati Tags: health care, health care reform, CEO compensation, health insurance
The opinions expressed in the WebMD Blogs are of the author and the author alone. WebMD does not endorse any specific product, service, treatment or political point of view.
Posted by: Doctor K at 3:45 PM
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35 Comments:
Anonymous Anonymous said...
The problem is that medicine is rooted in capitalism (as is everything else). Without getting into long discussions relating to the that thread topic, universal healthcare plan (such as Canada's) would considerably equate to socialism (on the way to communism - and we all know how that works). The problem with the capitalism based system is high costs/prices, but there are numerous medical advances made every day. When Canadian citizens are stricken with cancer, do you really think they get in line at the local cancer center? If they can afford it, they come to New York to be treated at Sloan-Kettering. Now, I know that many of you reading this who just so happen to have Hillary bumper stickers on your Audi A6, are beginning to tune me out; my argument is not for or against a universal healthcare plan - but simply to make a point that money is the root of all (evil or otherwise). The currents systems is costly for those who are or aren't insured, but the advances in medicine are there. Were the current advanced trends in open heart surgery, total knee replacements, infertility treatments, cancer treatments, bloodless surgery, etc. etc. etc created in Canada? How about China? How about any other socialist country? If the United States went to socialized medicine years ago, several of the advances that are so costly today wouldn't even exist yet, so where is the loss? Sure, I think it is wrong for some nit wit pharmaceutical sales rep with a high school GED to make $200,000/year to wine and dine Doctors to get them to prescribe specific medications. Is is so wrong for pharmaceutical companies to charge for their research? For every new drug created, there have been huge costs put into the research and development of such drugs, not to mention the same costs for those drugs researched that never pan out. Without the capitalism model in which greed is (unfortunately) the driving factor, what is the incentive for the creation of world class drug products? Sure, the CEO's can make a bit less, how can you force that? If you think the drugs cost too much, don't buy them. But you NEED them???? - well then I guess you have to pay the price. If the pharmaceutical companies never created the drug in the first place, you still wouldn't have it - as far as I am concerned, the drugs that they develop and possess are intellectual property for them to market and sell as they see fit. Is is morally right? - than depends. I hope they can sleep at night; if not, they should lower their drug prices to make them more affordable. Otherwise, keep making advances.....
As far as insurance CEO's - they are the ultimate scum - but they are still in business for a reason: People keep buying their product (or lack thereof). We need a few moral based individuals to start insurance companies and do the RIGHT THING. The answer is not FREE HEALTCARE - as nothing is ever ever ever ever ever ever free. The middle class will be taxed to pay for everyone's healthcare. Instead of my paycheck showing xxxxxxx to taxes and xxxx to healthcare, it will read xxxxxxxxxxxxxxxxxxxxxxx to taxes and ____ to healthcare. what is the difference, other than the reduction in medical advances and longer waits at the doctor? Insurance reform is the key. We need a few moral based individuals with $$$ (of course) to start insurance companies that are not profit based. Sure, they should make one million dollars per year, but not 400 million over 5 years. This would initiate some competition (another factor of capitalism) and force the current companies to drastically reduce their costs (and useless baggage staff - further reducing costs) and health insurance would be more affordable.
Many people seem to blame doctors; why don't they charge less? why can't they see me for free? why do I have to pay a copay? WAAAaahhhh!!! People don't realize that doctors invest a great deal of time and money just to be called "doctor". They should have a nice house and drive a BMW 730i, regardless of their patient's social status. They have put a great deal of time and money into their education. What would help is if the government appoint representatives to negotiate pricing for the uninsured as insurance companies do. If a doctor bills $300 for a visit and the insurance company pays $90, that is because of pre-negotiated pricing and contracts. I agree that an uninsured person should not be held to the full $300 when my insurance company would have paid $90 for the same result.
And as fr as copays are concerned, I have no problem with them. They serve a very good purpose: They keep people from going to the doctor needlessly. If there were not any copays, people would go to the doctor for a simple headache. Copays exist to invoke some though as to whether or not it is necessary to go to the doctor.
Aug 26, 2007 7:07:00 PM
Anonymous Doctor K said...
The above post hits the nail on the head on the issue between the negotiated price a physician accepts and a "retail" fee. There is little in between.
I disagree with the insurance company compensation because they ae generally not regulated as they should be. There are no laws dictating a definition of minimum coverage. In fact, if the law would l=simply state that all insurers and HMO's must give, as a minimum the same package as Medicare which has no restrictions on who you can see and no precertification or clinical carriers that may the the entire solution after all.
Doctor K.
Aug 28, 2007 9:07:00 AM
Anonymous Anonymous said...
For those who think healthcare is a privilage take a look at these CEO numbers. Whatever privilage it was has been taken away by these ridiculuous salaries. It is like Jon Q. Public is getting the scraps off the table from these companies after they steal as much money as they can from the healthcare system.
I think if there is anyone out there who is having trouble getting healthcare, why don't you write one of these CEO's a letter a see if they will pay the few hundred a year to get you coverage or will they buy yet another jet to fly them to go skiing.
Aug 29, 2007 10:13:00 AM
Anonymous Fried Liver said...
Would I rather have a system that encourages me to be fat and sedentary, and when I need open heart surgery for my clogged arteries, I get the best top notched care while others die outside the emergency room? Or would I like to have a system enables me to take responsibility for living healthy and avoid that surgery?
Now the average Canadian probably goes to the cancer center in Canada. The rich Canadian come to the U.S. Some Americans goes to the average cancer center and some of them get now treatment.
I didn't realize Canada was communist.
Where I live, there is one company that manages power. I need power to run my computer and telvision and to take a hot bath. There are no competing companies for power and so this particular power company has a monopoly. It could charge 10 times as much and I would probably still pay for power because I like to take a hot bath. I wonder why no one protests this situation as a communist way of life. One power company-where's the capitalism in that.
With our overweight, sedentary society and our polluted world, we have created a need for open heart surgery, total knee replacements, infertility treatments, cancer treatments.
If money is the root of all evil, I would rather see everyone with basic health care spending all that money on preventable diseases.
I don't drive an Audi A6. I ride a bicycle.
Aug 29, 2007 8:07:00 PM
Anonymous Fried Liver said...
Also, a good business plan for a pharmaceutical to develop medications that treat diseases instead of cure them. Why get rid of all your customers.
Aug 29, 2007 9:40:00 PM
Anonymous Anonymous said...
Fried Liver,
I going to take a leap and assume that you didn't like my post.
I will tell you this; I am in excellent physical condition and will never need open heart surgery due to obesity. I will probably need a total knee replacement some time in my life, but again not a result of obesity or pollutants (this would be a result of traumatic injury). All this, and yes, I currently pay a great deal for healthcare coverage for me, my wife, and my children. The system is flawed, but I pay enough for other people through welfare and social security - I don't need to pay more for their health coverage, also (which would result in me still needing supplemental coverage).
I get randomly drug tested as a condition of my employment - think of it a pre-requisite for the honor of paying taxes. Then there are those who sit on their ass and collect off the system which my taxes support; do they get drug tested before they pick up their bi-weekly check? No. (And this is not a rant against welfare - The welfare system is necessary to help people get on their feet or get through unfortunate circumstances - BUT IT IS ABUSED BY MANY). Would recipients of "universal healtcare" be drug tested and denied if their "illness" was a result of illicit drug usage. I would have to say no, and I don't want to hear that it is an illness either....it becomes an illness after a very distinct choice. I grew up with nothing, received no financial aid for college, no free passes, rides, etc. I worked to get where I am and have a serious problem taking from my 2 children to FURTHER support those with 5 or 10 who can't afford it on their own, but scrape up enough for a pack or too of cigarettes every day. I would like to have 4 or 5 children, but a logical and responsible choice was to have 2 children because I am not sure that I can properly provide for additional children they way a responsible parent should. I would like for everyone to have health coverage, but my point is that nothing is free. The concept of a universal healtcare is too often referred to as FREE Healthcare (free for them........because they are not paying for it). I agree that we should focus on prevention rather than waiting to treat an illness, but that doesn't work with alcohol and nicotine abuse; how will it work with healthcare? I learned that cigarettes were bad when I was in the first grade, as did everyone else my age. Yet, many still chose to smoke. As I grew older, I learned that big macs were bad, yet many still chose them as a primary staple to their diet. This prevention that you speak of is taught in school and elsewhere - people make their own choice. We do not need another government funded project paid for by the middle class. Why should I have to pay more for their bad choices? The thought aggravates me just as hearing someone sue Phillip-Morris for their throat cancer (and I am against smoking, by the way). How does one voluntarily breathe smoke into their lungs (after paying to do this) and somehow be surprised when they find out that it was killing them - people die in house fires from smoke....duh! Then it is somehow somebody else's fault. My increased tax dollars should pay for their treatment, too? In addition, what about the esteemed individuals who work, but off the books (i.e. - no work records, no paid taxes, etc.)? They get on the "free healthcare" gray train also? They are obviously able bodied as they do work, but somehow don't contribute because they do not pay their share of taxes. You can't cut them out because it would no longer be FREE, umm, errr, I mean universal. I know of numerous individuals who work "off the books" and thus have extra income (from saving taxes) for their boat and other amenities which myself and most other tax payers do not have. I should pay for their healthcare?
BTW, I never stated Canada was communist......you made that leap. I merely mentioned Canada, China, and "other socialist countries" in the same sentence.
As far as you power situation, that sounds similar to Con-Ed in New York City. I grew up in long Island where there was Lilco, which was a similar monopoly. The isue was that they were awarded the monopoly for installing the power lines, etc. throughout the entire area (which I would assume would be rather costly). If they never did this, there would be no electricity to pay a high cost for in the first place. If the high cost is a problem, move to an area where you can chose your electric supplier.
My issue with the current healthcare system is that insurance companies provide NOTHING. The get paid a great deal of money to do nothing but cash their checks and negotiate prices. They provide no real product or service - they merely pay out claims when they have to. It is wrong for the executive to make as much as they do when there is no true service.
Aug 30, 2007 12:22:00 AM
Anonymous Anonymous said...
I almost forgot about your pharmaceutical comment. As far as treating versus curing, you are absolutely correct. Maybe the government could also come up with a better plan. Here is an idea: Once a drug is created (after millions of dollars have been invested), the government should immediately make it generically available so there is no profit for the creator of that drug. That should motivate pharmaceutical companies to create some rather useful products.
Maybe instead we should stop spending so much money trying to figure out if water was present on Mars 89786363839056390 billion years ago and use that money to create of few useful drugs that would be competition for the existing companies to reasonable price their products. The government should also have it's own health insurance fund (similar to worker's compensation) in which individual can pay for coverage at a cheaper rate than the other companies listed by Dr. K. That would also force some competition.
Aug 30, 2007 12:37:00 AM
Anonymous Anonymous said...
can anyone tell me what the name of pills that don't have a name or number on it. the pills are red in color and are the shape of M&M's.
Aug 31, 2007 1:53:00 AM
Blogger WebMD Blog Admin said...
To anonymous at 10:53 PM:
That sounds like a question for a pharmacist to answer after looking at it, but you're welcome to try browsing our Drug Database to see if you can find the information there.
Aug 31, 2007 12:16:00 PM
Anonymous Fried Liver said...
"But John R. Seffrin, the chief executive of the cancer society, which is based here, said his organization had concluded that advances in prevention and research would have little lasting impact if Americans could not afford cancer screening and treatment."
Although there are individuals that need expensive treatment even though they live a healthy lifestyle doesn't negate the fact that an unhealthy lifestyle contributes to millions of wasted health care dollars. Maybe we could get this obesity thing under control and give all the money saved to the CEOs of the insurance companies.
"Why should I have to pay more for their bad choices?"
Obviously not a person of compassion. It's so easy to demonize someone who needs help so you don't have to help them. When I crash my bike, will you leave me on the side of the road for my "bad choice". Maybe we should deny health coverage for those who have accidents. No knee replacement for you. And lets go further, let blame all illness and injury on inferior genetic material and a weak soul. Why should I pay? I am a superior human speciman with strong moral values.
Aug 31, 2007 1:27:00 PM
Anonymous amyjh said...
To the initial anonymous poster on this subject:
Thank you for your post. I hold the same position on insurance reform and you stated it better than I ever could have.
Sep 1, 2007 3:01:00 PM
Anonymous Doctor K said...
The issue of CEO compensation is not a debate between capitalism and socialism. It is a comment on extreme greed of corporations that market insurance products and medicines we probably don't need and pay-off (read as "lobby") Congress to keep them bassically unregulated.
The pharmaceuticals and insurance companies have a free ride at the expense of the consumer. The compensation profiles are outragously greedy BECAUSE these companies deny care and produce many inferior drug products.
Doctor K.
Sep 1, 2007 8:35:00 PM
Anonymous Anonymous said...
US medical research isn't completely capitalistic anymore than growing corn is. The National Institutes of Health are funded through the US budget (meaning by US taxpayers0. Besides, aren't pharmaceutical companies allowed large research & development writeoffs, probably for inflated figures? Hope to see more on these topics. Meanwhile, thanks to the author for putting us on alert to the shocking, disproportionate figures for CEO compensation.
Sep 7, 2007 5:13:00 PM
Anonymous Anonymous said...
gbtlwamI've worked in healthcare both as hands on and in billing and receivables. I am well aware of the strange goings on between Healthcare Provider Companies (not doctors) and the various insurances that pay the bills. Bill a service at $100.00, insurance says I'll pay $50.00 and you can bill the patient for $30.00. Now, if you are a patient without insurance do you think there is any savings for you? Maybe, but it will depend on the doctor and the company he works for. Some places do offer a nice discount for upfront payments. Basically, there is no problem with healthcare; only the fact that the majority of it is now run as big (really big) business. I've heard of more than one doctor who has had to declare bankruptcy or decide to just leave healthcare completely. Strange things happened to me when I turned 65; I signed up for an advantage plan with Part D coverage. The first time I went to get my blood pressure pill, it was $13.00 more than what I had been paying when I was self pay and eligible for the pharmecutical discount from the pill maker. I also needed ostomy supplies (have used them for over 24 years) and could not find a DME on the vendor list that handled them. Since this is not something you can wait on, I made out of pocket purchases until I finally found out how to get my supplies through a mail order company and now the insurance company is balking at reimbursing me but I am planning on being a very squeaky wheel because they did not even contract with this company until months after I had made my first purchase and the customer service never advised me for even longer.
Sep 7, 2007 8:05:00 PM
Anonymous Anonymous said...
I believe that it was in one of the "Non Sequitur" cartoons that a disgusting blob on the floor was identified as "...just a bloated CEO."
That pretty well describes America's CEO's: bloated.
Sep 7, 2007 9:32:00 PM
Anonymous Anonymous said...
This is hysterical. Blaming health care cost on 23 individuals; spoken like true socialist. Pull your head out and look around at the world. The US is the most SUCCESSFUL country in the world when it comes to standard of living. Go ask citizens in Canada, Cuba, Sweden, etc... which system they would prefer; the majority will select the United States. This article is a joke - do some serious research next time before spouting your uneducated thoughts across the blogosphere.
Sep 7, 2007 10:06:00 PM
Anonymous Anonymous said...
A universal health care system such as Canada's will lead to socialism and then to communism? What moronic nonsense! So the President, the VP, all members of the cabinet in Washington D.C., all members of Congress, the top judiciary, and all other top federal and local government officials and their families, as well as the entire military, are all "socialists" and "communists" because they get free health care? How about all these exorbitantly-paid CEOs who have their health insurance paid by their corporations? Citizens of Canada and Sweden, where there is free and universal health care, prefer U.S. treatment? Ha! Says who? Not according to public opinion polls, in which Canadians say they would not change their health care system for any other in the entire world. And how about the 50 million Americans who have no health insurance? Do they prefer our health care system to Canada's? What good are your "advances in medicine" to them? The U.S. has the "highest living standards in the world"? Says who? Not according to the IMF, the World Bank, and the OECD. Using currency exchange rates for their calculations, these U.S.-dominated institutions do not rate us even among the world's top 10. And the U.N., using purchasing power parity (PPP) instead, does not rate us even among the world's top 20. Also according to U.N. data, the U.S. was ranked 17th in the world in life expectancy (expected life span) in 2006--behind not just Canada and Sweden, but behind even Cuba. True, the U.S. is still number 1 in health-care per-capita expenditures, but we all know where most of that money goes--into the deep pockets of the 40,000+ private health-insurance corporations, especially their CEOs and other top administrators, doctors, nurses and other health providers. "Medicine is rooted in capitalism (as is everything else)"? What baloney! Are national security and defense, police protection, fire departments, primary and secondary education, etc. also "rooted in capitalism"? Why should public health be rooted in an economic system based on greed and private profit? Just watch Michael Moore's movie "Sicko". You might finally learn something
Sep 9, 2007 3:08:00 PM
Anonymous Doctor K said...
I always find it humorous how bringing out facts lead some people to one conclusion and others to another.
In answer to the pseudo-patriot who seemed to think that this blog-post blamed all of healthcare on CEO compensation of insurance and pharma execs then please take your head out of the sand. The post simply states a simple fact: companies that deny healthcare claims on a regular basis such as United Healthcare, continue to reimburse their executive out of proportion to any known formula except perception on Wall Street.
This country is great NOT because we are wealthy annd NOT because we have capitalism but because we always question those in authority and call our representative to task to correct a wrong. A high standard of living does not give Congress or Wall Street unresatricted license to act. The free market is free because of the freedom of intellectual ideas.
The healthcare debate is healthier for this country than any healthcare solution. The fact that the country as a whole has a high standard of living has no meaning for a large percentage living under the poverty line.
For profit insurance plans are copunterproductive to healthcare. For profit pharmaceuticals are not. Insurance companies produce no product. There is no reason why the insurance companies need to even be in business. If they went away, no product of substance would be lost. It is not socialism to have a two-tiered medical system of basic insurance supplied by the government on a sliding scale of payment and opting out for private plans.
Dr. K.
Sep 10, 2007 1:57:00 AM
Blogger anonymous said...
And they say drug costs are high because it is costly to develop drugs but it appears they are high because the money made on drugs goes into the CEO's pockets. Plus,
most of these CEO's probably don't know how to develop drugs.
The same is true with insurance companies. It would make you believe that it is better to line the pockets of one person then to save a life.
Most likely, an individual who was self-employed and carried out business as the big businesses do in health care would be in prison for conducting business the way they do.
Oct 5, 2007 9:30:00 PM
Anonymous Anonymous said...
Anonymous:according to me,most of the doctors around the world have forgotten the Hippocrate's Oath and it has become the HIPOCRISY OATH..
After, a malpractice, and you come out with pain from their cabinets, or hospitals:their weapon is "but, it is in your mind, you are deppressed, you need a shrink.....etc"
Oh, and the medication inserts don't write all the side effects that you can get by swallowing it,plastering it, sticking needles....
Well, I have an idea that I will not share with any of you......because this battle, I want to win.
Jun 23, 2008 2:05:00 PM
Anonymous Anonymous said...
Dear Dr K,
I read your article on Hip Resurfacing and would have to say you have NOT done your research. The Hip Resurfacing Manufacturer you refer to is using a product with 10 years of clinical success, with survival ship of 97-98% after 8 years. It was just recently introduced to the United States, but has experienced tremendous success for over a decade around the world. As for the fracture rates of 1-2%, it is favorable to the increased dislocation rates and revision rates of a total hip. Maybe you should do a little more research before you run your mouth.
My only question is what total hip manufacturer pays your mortgage these days???
Aug 2, 2008 1:47:00 AM
Anonymous Anonymous said...
"universal healthcare plan (such as Canada's) would considerably equate to socialism (on the way to communism - and we all know how that works)."
very well, for every first world country but the united states?
Most medical advances are made through public funding, and then sold to private firms. The profit motive is not responsible for our scientific breakthroughs, evil nasty dirty socialism is.
Sep 30, 2008 7:54:00 PM
Anonymous Anonymous said...
I'll tell you what. The next time you go to the grocery store, just go ahead and send me the bill and I'll pay it for you.
Exactly how cost conscious are you going to be with your purchases? And what would you expect to happen to food prices?
Nov 22, 2008 12:31:00 AM
Anonymous Anonymous said...
i'm a united health care user that has been told by the pharmacy that i have to use mail order. i finaly found a drug that works for my cronic headaches but i can't a mail order i trust. i never done this before i dont know who to trust with my info. i'm going to be layed off in a month from job with ins.(furniture) i dont kown who to go with.
Dec 6, 2008 9:03:00 PM
Anonymous Anonymous said...
"I'll tell you what. The next time you go to the grocery store, just go ahead and send me the bill and I'll pay it for you.
Exactly how cost conscious are you going to be with your purchases? And what would you expect to happen to food prices?"
In regard to the above comment... You are forgetting that greed is a factor in this on the side of the Health Care Corp. Execs. The set up whole departments to deny claims so that they can have more big screen tvs, executive homes for their lavish parties, etc... They are the ones laughing all the way to the bank with the Healthcare business in the last 20 years or so. So that analogy does not compute. Free market in health care means the ones with the power takes all the eggs.
Apr 1, 2009 3:54:00 AM
Anonymous Anonymous said...
Thank you Doctor for posting this article. I had known CEO's make extraordinary fees, and had a fair idea (that wasn't too off the mark) for average doctor salaries, but hadn't put the numbers together to show what a frightening mess this is (although I knew it was) Your article added more clarity to the health care crisis.
And to the socialist phobes..OYe. There is no amount of common sense that these folks would ever accept. Some people have to be dragged into the future kicking and screaming.
FYI, pharmaceutical CEO's pay themselves MUCH more than they spend on research and development. And their ad campaigns absorb sometimes up to three times more than they invest in R&D.
And the other top 20 health care countries most certainly do not secretly wish to have our system. In fact, when health care discussions grow heated someone will often say, "do you want a system like the US" and it stops the debate in their tracks as they all laugh. (See Fred Friendly's Reinventing Health Care) NO nations are jealous of our health care system. Sorry, just not so.
And some with money get their health care elsewhere in the world as well. It's the nature of the rich, the globe is their shopping mall, including health care.
Apr 25, 2009 8:42:00 AM
Blogger Lee said...
This is a disgrace.
Jun 19, 2009 1:35:00 AM
Blogger Jesse said...
An answer to Anonymous. You had a great post, however I wanted to point out one thing. I do agree with you that any pharmaceutical company has the right to make a profit on their product. But R&D are only part of the equation to their prices. One of the big ones that you ignore is Marketing. You mention that the high school educated rep can make $200K by "selling" the drug to doctors. And of course we've all seen those drug commercials on TV, periodicals, etc. I still don't understand why prescription only drugs need to be marketed to the masses, especially when the list of unintended effects of the drug is longer than my arm. Doctors should do their due diligence on the available drugs on their own. They shouldn't be "sold" on them.
Anyway, all of this marketing, a lot of which is unnecessary is a major component of what makes drug prices so high.
Jun 26, 2009 2:05:00 PM
Blogger Andrew said...
With regard to the marketing of prescription drugs, I find the amount of money spent on direct-to-consumer marketing one of the most disturbing trends of all. As a medical student, I know that I'm going to face patients who demand a certain drug that they don't need, just because they saw an ad on TV. And I also know that, if I refuse to prescribe it, many of them will just look for some other doctor who will. In effect, Big Pharma makes an end run around even the requirement of prescriptions, in order to sell people unnecessary and often dangerous drugs.
Jul 1, 2009 8:31:00 AM
Anonymous Kit Burns said...
I suggest that you change an item in the text so that the salary differences you are pointing out are clearer. Please indicate the Primary Care doctor's salary at "$149,000" instead of "$149,000.00".
It is considerably clearer to the reader as the extra ".00" is not needed; the camparison when you see the "0's" is stark as it really is. Thanks.
Jul 5, 2009 9:22:00 AM
Anonymous Anonymous said...
My late mother-in-law was "covered" under UnitedHealthcare and when she needed it she was discharged before the tests to find the problem, cancer in her kidney, because UnitedHealthcare called Harris Methodist in Ft. Worth to send her home because she had reached her "cap" in late September 2008. She died December 30th, 2008.
Between her discharge and her death, approximately 90 days, she was given the normal runaround and made to pay up through 2008. In early December she was rushed to the hospital and finally it was discovered that her kidney needed to be removed but by December she was too weak to survive the surgery.
It's nice to know that decent people suffer and die so that people like William W McGuire can earn $342M over 5 years by denying payment to their customers. The stack of unpaid medical bills of over $25,000 from my late mother-in-law, along with this information, as well as the recent Washington Post article about the billions big insurance forced their consumers to pay as heard by the Senate Commerce Committee, and the $1 million a day spent by Congressional lobbyists I just get all warm and fuzzy inside.
Before her death my mother-in-law stood in line for 4-hours to vote for "change" in tremendous pain. This was one of her last acts before entering a hospital she'd never leave, alive, and she did it so that no one else would have to suffer as she suffered. Not only was she dying but she was financially ruined, especially if she lived, because we know that 62% of bankruptcies in America are health care related and 80% of those are middle class with insurance "coverage", on top of the increasing pile of United's unpaid bills, the system doesn't move fast enough to get aid to people who are too young to retire and disability is too slow to avoid maxing out credit cards to live on being out of work for 6 months.
What a shame that thanks to lobbyists her suffering and the efforts of others will probably go in vain thanks to people like Sen. Max Baucus (D-MT), Sen. Chuck Grassley (R-IA) and others especially in the Senate Finance Committee where 350 of their former colleagues and staffers are back as lobbyists for the health care industries.
America ranks behind "Third world" countries in life expectancy (down from 11th to 42nd over past two decades), infant mortality (37th) and a host of other indicators to determine the quality of our health care system so where this is concerned America is not #1. However, America is #1 on what we spend on health care and the number of bankruptcies as a result of health care.
What a shame.
Jul 10, 2009 9:33:00 AM
Blogger Tighe said...
Until medicine becomes a right and not a "for profit" enterprise, we will always have the problem of lack of access to those who cannot afford it. That reads as "Rationing" to me folks. We need a system similar to what veterans have, if we so choose to use it. Citizens and soldiers alike deserve health care, AND sickness care. Perhaps putting a pacemaker in an 80 year old woman (my mom) is not the best use of health dollars now is it? Prescribing lipid lowering drugs for her at age 79 is also foolish. These kinds of waste make those who have needs that medicine will help go unserved. Socialist? What is wrong with taking care of each other anyway. We are a SOCIETY!
Jul 21, 2009 4:02:00 PM
Anonymous Anonymous said...
No one should profit excessively on managing peoples finances or health. We entrust both the financial institutions and the health care industry with our most important assets. I see a similarity in both industries in that greed has replaced ethics. I listen to the justification of the outrageous compensations from the leaders in these industries saying that this is what is needed to recruit and retain top talent. I think that there are plenty of talented individuals willing to work for a fraction of the cost and my common sense says that people willing to work for a reasonable salary is what we really want. People who have a greater sense of entitlement than concern for those they serve are not the people we want caring for our hard earned money or our health.
Jul 28, 2009 7:53:00 PM
Anonymous getreal said...
Anonymous has some good points. There are a few common fallacies in his/her arguments, though:
1) No matter how groundbreaking or advanced, under our present health care system many people who could benefit from such research, procedures, products, or drugs, simply don't have access to them financially. How can we justify keeping our current (inadequate)system, which will just result in more marvelous discoveries and life-saving procedures, but available to fewer and fewer lucky patients who can actually afford them?
3) Increased profits for pharmaceutical/medical research companies and UHC are not mutually exclusive! Rest assured that pharmaceutical companies and their lobbyists will always find many innovative and profitable ways to charge for their research This is a no-brainer.
4) Canadian companies, too, profit from new drug and surgical innovations--the only difference there is that, contrary to here, all of their citizens actually have access to these. No, probably not immediately, and undoubtedly not at the fanciest private hospitals/clinics nor using the priciest specialists. But they do receive the basic and specialized care that they truly need, and do not have to go bankrupt in the process.
5) UHC will stimulate the free market health care system to be more innovative and profitable than ever. Why shouldn't health insurance companies, hospitals, and drug/medical research laboratories have to compete on the free market? Having to cater (finally!) to CONSUMER-DRIVEN preferences, needs, and budgets should actually make them MORE, not less, profitable, especially if the health care focus is much more on preventative care. Yes, health insurance companies will have to spend much more on routine physicals and diagnostic tests than is the case now. Long-term, though, though, their profits should just continue to increase, since they will also not be shelling out millions/billions of dollars on drastic, costly procedures that could have been avoided by earlier diagnosis and an emphasis on prevention and healthier lifestyles. So who loses here? Socialism, schmozialism. Capitalism, free market. Call it what you will. Who cares? Give the American consumer what he needs/wants, at an affordable price, from a wide and well-administered array of government run AND private health insurance plans.
6) As far as I know, NO health insurance company profits are now currently allocated to medical or pharmaceutical research. If I am wrong about this, I am sure that somebody out there will set me straight. So, how is offering UHC going to change this (i.e.,cause research companies to lose money)?
7) The "if you think drugs cost too much, then don't buy them" argument just doesn't hold water. Most patients who are prescribed costly drugs do not CHOOSE to buy/take them, they are actually a life-sustaining measure for them. No industrialized nation today should ever have to put anyone in the position of having to CHOOSE between rent, food, or needed medication. We are too rich and resourceful a country for this to be viewed as acceptable. If EVERYONE is not covered under UHC (medications included), eventually NONE of us will be be adequately covered. Please, this is not rocket science, only common sense.
8) UHC is not "FREE" medical care. Even the most flexible and liberal of government run, or cooperative, health coverage plan/s will always require you to pay SOMETHING towards your medical care.
I agree with Anonymous' comments about co-pays, and many of his other comments as well. But let's get real about some common myths about health care that are pervasive today, and de-bunk them once and for all, for everyone's benefit and good health.
Aug 15, 2009 7:21:00 PM
Anonymous Anonymous said...
In reading the original article it occurred to me that the execs were a combo of insurance and pharmaceutical people. Seemingly the issue was defined to mean insurance execs. It seems incredible to me that people will spend upward of $500.00 on a night out and complain of a $20.00 co-pay for the doctor. Considering that by the numbers presented, the average doctor makes $149,000.00, by obama's logic, he's a pauper. Furthermore, why be a doctor when you could make tons of money being a semi-literate mostly culturally depraved athlete, entertainer, or politician.
Aug 18, 2009 1:04:00 PM
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Thursday, August 23, 2007
CEO Compensation: Who Said Health Care is in a Financial Crisis?
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Those of you who are struggling to pay for your generic medicines or wondering why the doctor is charging you a $5.00 co-pay, give some thought to these facts about how our health care dollars are allocated. At the end of this post, there is a list of 23 health companies I found on Forbes.com, what the CEO was paid in 2005, and the average paid to the CEO in the past five years.
Imagine adding vice presidents, Board of Directors, stock holders and the other 200-300 other companies all cashing in on your health to that total at the bottom.
Based on this, the next time you want to argue with your Primary Care doctor's front desk about a $5.00 co-pay, remember that he makes an average of $149,000.00 per year. On the other hand -- using United Healthcare as an example -- your insurance company paid their CEO -- one man -- $324,000,000 over a recent five year period.
If you are uninsured, try calling any one of these 23 CEOs and see if they will give you free insurance.
BTW: 10% of 14.9 billion is 1.4 billion. If basic insurance costs $8,000/year for a family then taking 10% from just these CEO salaries would insure 35,000 Americans a year for five years. That is a lot of people that can be helped just by 23 men. Looking at the companies as a whole that profit from health care, we can probably pay for every uninsured person in this country for decades to come.
The numbers are numbing, which is why we should do something about this.
* United Health Group
CEO: William W McGuire
2005: 124.8 mil
5-year: 342 mil
* Forest Labs
CEO: Howard Solomon
2005: 92.1 mil
5-year: 295 mil
* Caremark Rx
CEO: Edwin M Crawford
2005: 77.9 mil
5-year: 93.6 mil
* Abbott Lab
CEO: Miles White
2005: 26.2 mil
5-year: 25.8 mil
* Aetna
CEO: John Rowe
2005: 22.1 mil
5-year:57.8 mil
* Amgen
CEO: Kevin Sharer
2005:5.7 mil
5-year:59.5 mil
* Bectin-Dickinson
CEO: Edwin Ludwig
2005: 10 mil
5-year:18 mil
* Boston Scientific
CEO:
2005:38.1 mil
5-year:45 mil
* Cardinal Health
CEO: James Tobin
2005:1.1 mil
5-year:33.5 mil
* Cigna
CEO: H. Edward Hanway
2005:13.3 mil
5-year:62.8 mil
* Genzyme
CEO: Henri Termeer
2005: 19 mil
5-year:60.7 mil
* Humana
CEO: Michael McAllister
2005:2.3 mil
5-year:12.9 mil
* Johnson & Johnson
CEO: William Weldon
2005:6.1 mil
5-year:19.7 mil
* Laboratory Corp America
CEO: Thomas MacMahon
2005:7.9 mil
5-year:41.8 mil
* Eli Lilly
CEO: Sidney Taurel
2005:7.2 mil
5-year:37.9 mil
* McKesson
CEO: John Hammergen
2005: 13.4 mil
5-year:31.2 mil
* Medtronic
CEO: Arthur Collins
2005: 4.7 mil
5-year:39 mil
* Merck Raymond Gilmartin
CEO:
2005: 37.8 mil
5-year:49.6 mil
* PacifiCare Health
CEO: Howard Phanstiel
2005: 3.4 mil
5-year: 8.5 mil
* Pfizer
CEO: Henry McKinnell
2005: 14 mil
5-year: 74 mil
* Well Choice
CEO: Michael Stocker
2005: 3.2 mil
5-year: 10.7 mil
* WellPoint
CEO: Larry Glasscock
2005: 23 mil
5-year: 46.8 mil
* Wyeth
CEO: Robert Essner
2005:6.5 mil
5-year: 28.9 mil
TOTAL 2005: 559.8 mil
TOTAL 5-Year: 14.9 billion
Related Topics:
* Group Pushes Universal Health Care
* Is Health Insurance a Right?
Technorati Tags: health care, health care reform, CEO compensation, health insurance
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Posted by: Doctor K at 3:45 PM
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35 Comments:
Anonymous Anonymous said...
The problem is that medicine is rooted in capitalism (as is everything else). Without getting into long discussions relating to the that thread topic, universal healthcare plan (such as Canada's) would considerably equate to socialism (on the way to communism - and we all know how that works). The problem with the capitalism based system is high costs/prices, but there are numerous medical advances made every day. When Canadian citizens are stricken with cancer, do you really think they get in line at the local cancer center? If they can afford it, they come to New York to be treated at Sloan-Kettering. Now, I know that many of you reading this who just so happen to have Hillary bumper stickers on your Audi A6, are beginning to tune me out; my argument is not for or against a universal healthcare plan - but simply to make a point that money is the root of all (evil or otherwise). The currents systems is costly for those who are or aren't insured, but the advances in medicine are there. Were the current advanced trends in open heart surgery, total knee replacements, infertility treatments, cancer treatments, bloodless surgery, etc. etc. etc created in Canada? How about China? How about any other socialist country? If the United States went to socialized medicine years ago, several of the advances that are so costly today wouldn't even exist yet, so where is the loss? Sure, I think it is wrong for some nit wit pharmaceutical sales rep with a high school GED to make $200,000/year to wine and dine Doctors to get them to prescribe specific medications. Is is so wrong for pharmaceutical companies to charge for their research? For every new drug created, there have been huge costs put into the research and development of such drugs, not to mention the same costs for those drugs researched that never pan out. Without the capitalism model in which greed is (unfortunately) the driving factor, what is the incentive for the creation of world class drug products? Sure, the CEO's can make a bit less, how can you force that? If you think the drugs cost too much, don't buy them. But you NEED them???? - well then I guess you have to pay the price. If the pharmaceutical companies never created the drug in the first place, you still wouldn't have it - as far as I am concerned, the drugs that they develop and possess are intellectual property for them to market and sell as they see fit. Is is morally right? - than depends. I hope they can sleep at night; if not, they should lower their drug prices to make them more affordable. Otherwise, keep making advances.....
As far as insurance CEO's - they are the ultimate scum - but they are still in business for a reason: People keep buying their product (or lack thereof). We need a few moral based individuals to start insurance companies and do the RIGHT THING. The answer is not FREE HEALTCARE - as nothing is ever ever ever ever ever ever free. The middle class will be taxed to pay for everyone's healthcare. Instead of my paycheck showing xxxxxxx to taxes and xxxx to healthcare, it will read xxxxxxxxxxxxxxxxxxxxxxx to taxes and ____ to healthcare. what is the difference, other than the reduction in medical advances and longer waits at the doctor? Insurance reform is the key. We need a few moral based individuals with $$$ (of course) to start insurance companies that are not profit based. Sure, they should make one million dollars per year, but not 400 million over 5 years. This would initiate some competition (another factor of capitalism) and force the current companies to drastically reduce their costs (and useless baggage staff - further reducing costs) and health insurance would be more affordable.
Many people seem to blame doctors; why don't they charge less? why can't they see me for free? why do I have to pay a copay? WAAAaahhhh!!! People don't realize that doctors invest a great deal of time and money just to be called "doctor". They should have a nice house and drive a BMW 730i, regardless of their patient's social status. They have put a great deal of time and money into their education. What would help is if the government appoint representatives to negotiate pricing for the uninsured as insurance companies do. If a doctor bills $300 for a visit and the insurance company pays $90, that is because of pre-negotiated pricing and contracts. I agree that an uninsured person should not be held to the full $300 when my insurance company would have paid $90 for the same result.
And as fr as copays are concerned, I have no problem with them. They serve a very good purpose: They keep people from going to the doctor needlessly. If there were not any copays, people would go to the doctor for a simple headache. Copays exist to invoke some though as to whether or not it is necessary to go to the doctor.
Aug 26, 2007 7:07:00 PM
Anonymous Doctor K said...
The above post hits the nail on the head on the issue between the negotiated price a physician accepts and a "retail" fee. There is little in between.
I disagree with the insurance company compensation because they ae generally not regulated as they should be. There are no laws dictating a definition of minimum coverage. In fact, if the law would l=simply state that all insurers and HMO's must give, as a minimum the same package as Medicare which has no restrictions on who you can see and no precertification or clinical carriers that may the the entire solution after all.
Doctor K.
Aug 28, 2007 9:07:00 AM
Anonymous Anonymous said...
For those who think healthcare is a privilage take a look at these CEO numbers. Whatever privilage it was has been taken away by these ridiculuous salaries. It is like Jon Q. Public is getting the scraps off the table from these companies after they steal as much money as they can from the healthcare system.
I think if there is anyone out there who is having trouble getting healthcare, why don't you write one of these CEO's a letter a see if they will pay the few hundred a year to get you coverage or will they buy yet another jet to fly them to go skiing.
Aug 29, 2007 10:13:00 AM
Anonymous Fried Liver said...
Would I rather have a system that encourages me to be fat and sedentary, and when I need open heart surgery for my clogged arteries, I get the best top notched care while others die outside the emergency room? Or would I like to have a system enables me to take responsibility for living healthy and avoid that surgery?
Now the average Canadian probably goes to the cancer center in Canada. The rich Canadian come to the U.S. Some Americans goes to the average cancer center and some of them get now treatment.
I didn't realize Canada was communist.
Where I live, there is one company that manages power. I need power to run my computer and telvision and to take a hot bath. There are no competing companies for power and so this particular power company has a monopoly. It could charge 10 times as much and I would probably still pay for power because I like to take a hot bath. I wonder why no one protests this situation as a communist way of life. One power company-where's the capitalism in that.
With our overweight, sedentary society and our polluted world, we have created a need for open heart surgery, total knee replacements, infertility treatments, cancer treatments.
If money is the root of all evil, I would rather see everyone with basic health care spending all that money on preventable diseases.
I don't drive an Audi A6. I ride a bicycle.
Aug 29, 2007 8:07:00 PM
Anonymous Fried Liver said...
Also, a good business plan for a pharmaceutical to develop medications that treat diseases instead of cure them. Why get rid of all your customers.
Aug 29, 2007 9:40:00 PM
Anonymous Anonymous said...
Fried Liver,
I going to take a leap and assume that you didn't like my post.
I will tell you this; I am in excellent physical condition and will never need open heart surgery due to obesity. I will probably need a total knee replacement some time in my life, but again not a result of obesity or pollutants (this would be a result of traumatic injury). All this, and yes, I currently pay a great deal for healthcare coverage for me, my wife, and my children. The system is flawed, but I pay enough for other people through welfare and social security - I don't need to pay more for their health coverage, also (which would result in me still needing supplemental coverage).
I get randomly drug tested as a condition of my employment - think of it a pre-requisite for the honor of paying taxes. Then there are those who sit on their ass and collect off the system which my taxes support; do they get drug tested before they pick up their bi-weekly check? No. (And this is not a rant against welfare - The welfare system is necessary to help people get on their feet or get through unfortunate circumstances - BUT IT IS ABUSED BY MANY). Would recipients of "universal healtcare" be drug tested and denied if their "illness" was a result of illicit drug usage. I would have to say no, and I don't want to hear that it is an illness either....it becomes an illness after a very distinct choice. I grew up with nothing, received no financial aid for college, no free passes, rides, etc. I worked to get where I am and have a serious problem taking from my 2 children to FURTHER support those with 5 or 10 who can't afford it on their own, but scrape up enough for a pack or too of cigarettes every day. I would like to have 4 or 5 children, but a logical and responsible choice was to have 2 children because I am not sure that I can properly provide for additional children they way a responsible parent should. I would like for everyone to have health coverage, but my point is that nothing is free. The concept of a universal healtcare is too often referred to as FREE Healthcare (free for them........because they are not paying for it). I agree that we should focus on prevention rather than waiting to treat an illness, but that doesn't work with alcohol and nicotine abuse; how will it work with healthcare? I learned that cigarettes were bad when I was in the first grade, as did everyone else my age. Yet, many still chose to smoke. As I grew older, I learned that big macs were bad, yet many still chose them as a primary staple to their diet. This prevention that you speak of is taught in school and elsewhere - people make their own choice. We do not need another government funded project paid for by the middle class. Why should I have to pay more for their bad choices? The thought aggravates me just as hearing someone sue Phillip-Morris for their throat cancer (and I am against smoking, by the way). How does one voluntarily breathe smoke into their lungs (after paying to do this) and somehow be surprised when they find out that it was killing them - people die in house fires from smoke....duh! Then it is somehow somebody else's fault. My increased tax dollars should pay for their treatment, too? In addition, what about the esteemed individuals who work, but off the books (i.e. - no work records, no paid taxes, etc.)? They get on the "free healthcare" gray train also? They are obviously able bodied as they do work, but somehow don't contribute because they do not pay their share of taxes. You can't cut them out because it would no longer be FREE, umm, errr, I mean universal. I know of numerous individuals who work "off the books" and thus have extra income (from saving taxes) for their boat and other amenities which myself and most other tax payers do not have. I should pay for their healthcare?
BTW, I never stated Canada was communist......you made that leap. I merely mentioned Canada, China, and "other socialist countries" in the same sentence.
As far as you power situation, that sounds similar to Con-Ed in New York City. I grew up in long Island where there was Lilco, which was a similar monopoly. The isue was that they were awarded the monopoly for installing the power lines, etc. throughout the entire area (which I would assume would be rather costly). If they never did this, there would be no electricity to pay a high cost for in the first place. If the high cost is a problem, move to an area where you can chose your electric supplier.
My issue with the current healthcare system is that insurance companies provide NOTHING. The get paid a great deal of money to do nothing but cash their checks and negotiate prices. They provide no real product or service - they merely pay out claims when they have to. It is wrong for the executive to make as much as they do when there is no true service.
Aug 30, 2007 12:22:00 AM
Anonymous Anonymous said...
I almost forgot about your pharmaceutical comment. As far as treating versus curing, you are absolutely correct. Maybe the government could also come up with a better plan. Here is an idea: Once a drug is created (after millions of dollars have been invested), the government should immediately make it generically available so there is no profit for the creator of that drug. That should motivate pharmaceutical companies to create some rather useful products.
Maybe instead we should stop spending so much money trying to figure out if water was present on Mars 89786363839056390 billion years ago and use that money to create of few useful drugs that would be competition for the existing companies to reasonable price their products. The government should also have it's own health insurance fund (similar to worker's compensation) in which individual can pay for coverage at a cheaper rate than the other companies listed by Dr. K. That would also force some competition.
Aug 30, 2007 12:37:00 AM
Anonymous Anonymous said...
can anyone tell me what the name of pills that don't have a name or number on it. the pills are red in color and are the shape of M&M's.
Aug 31, 2007 1:53:00 AM
Blogger WebMD Blog Admin said...
To anonymous at 10:53 PM:
That sounds like a question for a pharmacist to answer after looking at it, but you're welcome to try browsing our Drug Database to see if you can find the information there.
Aug 31, 2007 12:16:00 PM
Anonymous Fried Liver said...
"But John R. Seffrin, the chief executive of the cancer society, which is based here, said his organization had concluded that advances in prevention and research would have little lasting impact if Americans could not afford cancer screening and treatment."
Although there are individuals that need expensive treatment even though they live a healthy lifestyle doesn't negate the fact that an unhealthy lifestyle contributes to millions of wasted health care dollars. Maybe we could get this obesity thing under control and give all the money saved to the CEOs of the insurance companies.
"Why should I have to pay more for their bad choices?"
Obviously not a person of compassion. It's so easy to demonize someone who needs help so you don't have to help them. When I crash my bike, will you leave me on the side of the road for my "bad choice". Maybe we should deny health coverage for those who have accidents. No knee replacement for you. And lets go further, let blame all illness and injury on inferior genetic material and a weak soul. Why should I pay? I am a superior human speciman with strong moral values.
Aug 31, 2007 1:27:00 PM
Anonymous amyjh said...
To the initial anonymous poster on this subject:
Thank you for your post. I hold the same position on insurance reform and you stated it better than I ever could have.
Sep 1, 2007 3:01:00 PM
Anonymous Doctor K said...
The issue of CEO compensation is not a debate between capitalism and socialism. It is a comment on extreme greed of corporations that market insurance products and medicines we probably don't need and pay-off (read as "lobby") Congress to keep them bassically unregulated.
The pharmaceuticals and insurance companies have a free ride at the expense of the consumer. The compensation profiles are outragously greedy BECAUSE these companies deny care and produce many inferior drug products.
Doctor K.
Sep 1, 2007 8:35:00 PM
Anonymous Anonymous said...
US medical research isn't completely capitalistic anymore than growing corn is. The National Institutes of Health are funded through the US budget (meaning by US taxpayers0. Besides, aren't pharmaceutical companies allowed large research & development writeoffs, probably for inflated figures? Hope to see more on these topics. Meanwhile, thanks to the author for putting us on alert to the shocking, disproportionate figures for CEO compensation.
Sep 7, 2007 5:13:00 PM
Anonymous Anonymous said...
gbtlwamI've worked in healthcare both as hands on and in billing and receivables. I am well aware of the strange goings on between Healthcare Provider Companies (not doctors) and the various insurances that pay the bills. Bill a service at $100.00, insurance says I'll pay $50.00 and you can bill the patient for $30.00. Now, if you are a patient without insurance do you think there is any savings for you? Maybe, but it will depend on the doctor and the company he works for. Some places do offer a nice discount for upfront payments. Basically, there is no problem with healthcare; only the fact that the majority of it is now run as big (really big) business. I've heard of more than one doctor who has had to declare bankruptcy or decide to just leave healthcare completely. Strange things happened to me when I turned 65; I signed up for an advantage plan with Part D coverage. The first time I went to get my blood pressure pill, it was $13.00 more than what I had been paying when I was self pay and eligible for the pharmecutical discount from the pill maker. I also needed ostomy supplies (have used them for over 24 years) and could not find a DME on the vendor list that handled them. Since this is not something you can wait on, I made out of pocket purchases until I finally found out how to get my supplies through a mail order company and now the insurance company is balking at reimbursing me but I am planning on being a very squeaky wheel because they did not even contract with this company until months after I had made my first purchase and the customer service never advised me for even longer.
Sep 7, 2007 8:05:00 PM
Anonymous Anonymous said...
I believe that it was in one of the "Non Sequitur" cartoons that a disgusting blob on the floor was identified as "...just a bloated CEO."
That pretty well describes America's CEO's: bloated.
Sep 7, 2007 9:32:00 PM
Anonymous Anonymous said...
This is hysterical. Blaming health care cost on 23 individuals; spoken like true socialist. Pull your head out and look around at the world. The US is the most SUCCESSFUL country in the world when it comes to standard of living. Go ask citizens in Canada, Cuba, Sweden, etc... which system they would prefer; the majority will select the United States. This article is a joke - do some serious research next time before spouting your uneducated thoughts across the blogosphere.
Sep 7, 2007 10:06:00 PM
Anonymous Anonymous said...
A universal health care system such as Canada's will lead to socialism and then to communism? What moronic nonsense! So the President, the VP, all members of the cabinet in Washington D.C., all members of Congress, the top judiciary, and all other top federal and local government officials and their families, as well as the entire military, are all "socialists" and "communists" because they get free health care? How about all these exorbitantly-paid CEOs who have their health insurance paid by their corporations? Citizens of Canada and Sweden, where there is free and universal health care, prefer U.S. treatment? Ha! Says who? Not according to public opinion polls, in which Canadians say they would not change their health care system for any other in the entire world. And how about the 50 million Americans who have no health insurance? Do they prefer our health care system to Canada's? What good are your "advances in medicine" to them? The U.S. has the "highest living standards in the world"? Says who? Not according to the IMF, the World Bank, and the OECD. Using currency exchange rates for their calculations, these U.S.-dominated institutions do not rate us even among the world's top 10. And the U.N., using purchasing power parity (PPP) instead, does not rate us even among the world's top 20. Also according to U.N. data, the U.S. was ranked 17th in the world in life expectancy (expected life span) in 2006--behind not just Canada and Sweden, but behind even Cuba. True, the U.S. is still number 1 in health-care per-capita expenditures, but we all know where most of that money goes--into the deep pockets of the 40,000+ private health-insurance corporations, especially their CEOs and other top administrators, doctors, nurses and other health providers. "Medicine is rooted in capitalism (as is everything else)"? What baloney! Are national security and defense, police protection, fire departments, primary and secondary education, etc. also "rooted in capitalism"? Why should public health be rooted in an economic system based on greed and private profit? Just watch Michael Moore's movie "Sicko". You might finally learn something
Sep 9, 2007 3:08:00 PM
Anonymous Doctor K said...
I always find it humorous how bringing out facts lead some people to one conclusion and others to another.
In answer to the pseudo-patriot who seemed to think that this blog-post blamed all of healthcare on CEO compensation of insurance and pharma execs then please take your head out of the sand. The post simply states a simple fact: companies that deny healthcare claims on a regular basis such as United Healthcare, continue to reimburse their executive out of proportion to any known formula except perception on Wall Street.
This country is great NOT because we are wealthy annd NOT because we have capitalism but because we always question those in authority and call our representative to task to correct a wrong. A high standard of living does not give Congress or Wall Street unresatricted license to act. The free market is free because of the freedom of intellectual ideas.
The healthcare debate is healthier for this country than any healthcare solution. The fact that the country as a whole has a high standard of living has no meaning for a large percentage living under the poverty line.
For profit insurance plans are copunterproductive to healthcare. For profit pharmaceuticals are not. Insurance companies produce no product. There is no reason why the insurance companies need to even be in business. If they went away, no product of substance would be lost. It is not socialism to have a two-tiered medical system of basic insurance supplied by the government on a sliding scale of payment and opting out for private plans.
Dr. K.
Sep 10, 2007 1:57:00 AM
Blogger anonymous said...
And they say drug costs are high because it is costly to develop drugs but it appears they are high because the money made on drugs goes into the CEO's pockets. Plus,
most of these CEO's probably don't know how to develop drugs.
The same is true with insurance companies. It would make you believe that it is better to line the pockets of one person then to save a life.
Most likely, an individual who was self-employed and carried out business as the big businesses do in health care would be in prison for conducting business the way they do.
Oct 5, 2007 9:30:00 PM
Anonymous Anonymous said...
Anonymous:according to me,most of the doctors around the world have forgotten the Hippocrate's Oath and it has become the HIPOCRISY OATH..
After, a malpractice, and you come out with pain from their cabinets, or hospitals:their weapon is "but, it is in your mind, you are deppressed, you need a shrink.....etc"
Oh, and the medication inserts don't write all the side effects that you can get by swallowing it,plastering it, sticking needles....
Well, I have an idea that I will not share with any of you......because this battle, I want to win.
Jun 23, 2008 2:05:00 PM
Anonymous Anonymous said...
Dear Dr K,
I read your article on Hip Resurfacing and would have to say you have NOT done your research. The Hip Resurfacing Manufacturer you refer to is using a product with 10 years of clinical success, with survival ship of 97-98% after 8 years. It was just recently introduced to the United States, but has experienced tremendous success for over a decade around the world. As for the fracture rates of 1-2%, it is favorable to the increased dislocation rates and revision rates of a total hip. Maybe you should do a little more research before you run your mouth.
My only question is what total hip manufacturer pays your mortgage these days???
Aug 2, 2008 1:47:00 AM
Anonymous Anonymous said...
"universal healthcare plan (such as Canada's) would considerably equate to socialism (on the way to communism - and we all know how that works)."
very well, for every first world country but the united states?
Most medical advances are made through public funding, and then sold to private firms. The profit motive is not responsible for our scientific breakthroughs, evil nasty dirty socialism is.
Sep 30, 2008 7:54:00 PM
Anonymous Anonymous said...
I'll tell you what. The next time you go to the grocery store, just go ahead and send me the bill and I'll pay it for you.
Exactly how cost conscious are you going to be with your purchases? And what would you expect to happen to food prices?
Nov 22, 2008 12:31:00 AM
Anonymous Anonymous said...
i'm a united health care user that has been told by the pharmacy that i have to use mail order. i finaly found a drug that works for my cronic headaches but i can't a mail order i trust. i never done this before i dont know who to trust with my info. i'm going to be layed off in a month from job with ins.(furniture) i dont kown who to go with.
Dec 6, 2008 9:03:00 PM
Anonymous Anonymous said...
"I'll tell you what. The next time you go to the grocery store, just go ahead and send me the bill and I'll pay it for you.
Exactly how cost conscious are you going to be with your purchases? And what would you expect to happen to food prices?"
In regard to the above comment... You are forgetting that greed is a factor in this on the side of the Health Care Corp. Execs. The set up whole departments to deny claims so that they can have more big screen tvs, executive homes for their lavish parties, etc... They are the ones laughing all the way to the bank with the Healthcare business in the last 20 years or so. So that analogy does not compute. Free market in health care means the ones with the power takes all the eggs.
Apr 1, 2009 3:54:00 AM
Anonymous Anonymous said...
Thank you Doctor for posting this article. I had known CEO's make extraordinary fees, and had a fair idea (that wasn't too off the mark) for average doctor salaries, but hadn't put the numbers together to show what a frightening mess this is (although I knew it was) Your article added more clarity to the health care crisis.
And to the socialist phobes..OYe. There is no amount of common sense that these folks would ever accept. Some people have to be dragged into the future kicking and screaming.
FYI, pharmaceutical CEO's pay themselves MUCH more than they spend on research and development. And their ad campaigns absorb sometimes up to three times more than they invest in R&D.
And the other top 20 health care countries most certainly do not secretly wish to have our system. In fact, when health care discussions grow heated someone will often say, "do you want a system like the US" and it stops the debate in their tracks as they all laugh. (See Fred Friendly's Reinventing Health Care) NO nations are jealous of our health care system. Sorry, just not so.
And some with money get their health care elsewhere in the world as well. It's the nature of the rich, the globe is their shopping mall, including health care.
Apr 25, 2009 8:42:00 AM
Blogger Lee said...
This is a disgrace.
Jun 19, 2009 1:35:00 AM
Blogger Jesse said...
An answer to Anonymous. You had a great post, however I wanted to point out one thing. I do agree with you that any pharmaceutical company has the right to make a profit on their product. But R&D are only part of the equation to their prices. One of the big ones that you ignore is Marketing. You mention that the high school educated rep can make $200K by "selling" the drug to doctors. And of course we've all seen those drug commercials on TV, periodicals, etc. I still don't understand why prescription only drugs need to be marketed to the masses, especially when the list of unintended effects of the drug is longer than my arm. Doctors should do their due diligence on the available drugs on their own. They shouldn't be "sold" on them.
Anyway, all of this marketing, a lot of which is unnecessary is a major component of what makes drug prices so high.
Jun 26, 2009 2:05:00 PM
Blogger Andrew said...
With regard to the marketing of prescription drugs, I find the amount of money spent on direct-to-consumer marketing one of the most disturbing trends of all. As a medical student, I know that I'm going to face patients who demand a certain drug that they don't need, just because they saw an ad on TV. And I also know that, if I refuse to prescribe it, many of them will just look for some other doctor who will. In effect, Big Pharma makes an end run around even the requirement of prescriptions, in order to sell people unnecessary and often dangerous drugs.
Jul 1, 2009 8:31:00 AM
Anonymous Kit Burns said...
I suggest that you change an item in the text so that the salary differences you are pointing out are clearer. Please indicate the Primary Care doctor's salary at "$149,000" instead of "$149,000.00".
It is considerably clearer to the reader as the extra ".00" is not needed; the camparison when you see the "0's" is stark as it really is. Thanks.
Jul 5, 2009 9:22:00 AM
Anonymous Anonymous said...
My late mother-in-law was "covered" under UnitedHealthcare and when she needed it she was discharged before the tests to find the problem, cancer in her kidney, because UnitedHealthcare called Harris Methodist in Ft. Worth to send her home because she had reached her "cap" in late September 2008. She died December 30th, 2008.
Between her discharge and her death, approximately 90 days, she was given the normal runaround and made to pay up through 2008. In early December she was rushed to the hospital and finally it was discovered that her kidney needed to be removed but by December she was too weak to survive the surgery.
It's nice to know that decent people suffer and die so that people like William W McGuire can earn $342M over 5 years by denying payment to their customers. The stack of unpaid medical bills of over $25,000 from my late mother-in-law, along with this information, as well as the recent Washington Post article about the billions big insurance forced their consumers to pay as heard by the Senate Commerce Committee, and the $1 million a day spent by Congressional lobbyists I just get all warm and fuzzy inside.
Before her death my mother-in-law stood in line for 4-hours to vote for "change" in tremendous pain. This was one of her last acts before entering a hospital she'd never leave, alive, and she did it so that no one else would have to suffer as she suffered. Not only was she dying but she was financially ruined, especially if she lived, because we know that 62% of bankruptcies in America are health care related and 80% of those are middle class with insurance "coverage", on top of the increasing pile of United's unpaid bills, the system doesn't move fast enough to get aid to people who are too young to retire and disability is too slow to avoid maxing out credit cards to live on being out of work for 6 months.
What a shame that thanks to lobbyists her suffering and the efforts of others will probably go in vain thanks to people like Sen. Max Baucus (D-MT), Sen. Chuck Grassley (R-IA) and others especially in the Senate Finance Committee where 350 of their former colleagues and staffers are back as lobbyists for the health care industries.
America ranks behind "Third world" countries in life expectancy (down from 11th to 42nd over past two decades), infant mortality (37th) and a host of other indicators to determine the quality of our health care system so where this is concerned America is not #1. However, America is #1 on what we spend on health care and the number of bankruptcies as a result of health care.
What a shame.
Jul 10, 2009 9:33:00 AM
Blogger Tighe said...
Until medicine becomes a right and not a "for profit" enterprise, we will always have the problem of lack of access to those who cannot afford it. That reads as "Rationing" to me folks. We need a system similar to what veterans have, if we so choose to use it. Citizens and soldiers alike deserve health care, AND sickness care. Perhaps putting a pacemaker in an 80 year old woman (my mom) is not the best use of health dollars now is it? Prescribing lipid lowering drugs for her at age 79 is also foolish. These kinds of waste make those who have needs that medicine will help go unserved. Socialist? What is wrong with taking care of each other anyway. We are a SOCIETY!
Jul 21, 2009 4:02:00 PM
Anonymous Anonymous said...
No one should profit excessively on managing peoples finances or health. We entrust both the financial institutions and the health care industry with our most important assets. I see a similarity in both industries in that greed has replaced ethics. I listen to the justification of the outrageous compensations from the leaders in these industries saying that this is what is needed to recruit and retain top talent. I think that there are plenty of talented individuals willing to work for a fraction of the cost and my common sense says that people willing to work for a reasonable salary is what we really want. People who have a greater sense of entitlement than concern for those they serve are not the people we want caring for our hard earned money or our health.
Jul 28, 2009 7:53:00 PM
Anonymous getreal said...
Anonymous has some good points. There are a few common fallacies in his/her arguments, though:
1) No matter how groundbreaking or advanced, under our present health care system many people who could benefit from such research, procedures, products, or drugs, simply don't have access to them financially. How can we justify keeping our current (inadequate)system, which will just result in more marvelous discoveries and life-saving procedures, but available to fewer and fewer lucky patients who can actually afford them?
3) Increased profits for pharmaceutical/medical research companies and UHC are not mutually exclusive! Rest assured that pharmaceutical companies and their lobbyists will always find many innovative and profitable ways to charge for their research This is a no-brainer.
4) Canadian companies, too, profit from new drug and surgical innovations--the only difference there is that, contrary to here, all of their citizens actually have access to these. No, probably not immediately, and undoubtedly not at the fanciest private hospitals/clinics nor using the priciest specialists. But they do receive the basic and specialized care that they truly need, and do not have to go bankrupt in the process.
5) UHC will stimulate the free market health care system to be more innovative and profitable than ever. Why shouldn't health insurance companies, hospitals, and drug/medical research laboratories have to compete on the free market? Having to cater (finally!) to CONSUMER-DRIVEN preferences, needs, and budgets should actually make them MORE, not less, profitable, especially if the health care focus is much more on preventative care. Yes, health insurance companies will have to spend much more on routine physicals and diagnostic tests than is the case now. Long-term, though, though, their profits should just continue to increase, since they will also not be shelling out millions/billions of dollars on drastic, costly procedures that could have been avoided by earlier diagnosis and an emphasis on prevention and healthier lifestyles. So who loses here? Socialism, schmozialism. Capitalism, free market. Call it what you will. Who cares? Give the American consumer what he needs/wants, at an affordable price, from a wide and well-administered array of government run AND private health insurance plans.
6) As far as I know, NO health insurance company profits are now currently allocated to medical or pharmaceutical research. If I am wrong about this, I am sure that somebody out there will set me straight. So, how is offering UHC going to change this (i.e.,cause research companies to lose money)?
7) The "if you think drugs cost too much, then don't buy them" argument just doesn't hold water. Most patients who are prescribed costly drugs do not CHOOSE to buy/take them, they are actually a life-sustaining measure for them. No industrialized nation today should ever have to put anyone in the position of having to CHOOSE between rent, food, or needed medication. We are too rich and resourceful a country for this to be viewed as acceptable. If EVERYONE is not covered under UHC (medications included), eventually NONE of us will be be adequately covered. Please, this is not rocket science, only common sense.
8) UHC is not "FREE" medical care. Even the most flexible and liberal of government run, or cooperative, health coverage plan/s will always require you to pay SOMETHING towards your medical care.
I agree with Anonymous' comments about co-pays, and many of his other comments as well. But let's get real about some common myths about health care that are pervasive today, and de-bunk them once and for all, for everyone's benefit and good health.
Aug 15, 2009 7:21:00 PM
Anonymous Anonymous said...
In reading the original article it occurred to me that the execs were a combo of insurance and pharmaceutical people. Seemingly the issue was defined to mean insurance execs. It seems incredible to me that people will spend upward of $500.00 on a night out and complain of a $20.00 co-pay for the doctor. Considering that by the numbers presented, the average doctor makes $149,000.00, by obama's logic, he's a pauper. Furthermore, why be a doctor when you could make tons of money being a semi-literate mostly culturally depraved athlete, entertainer, or politician.
Aug 18, 2009 1:04:00 PM
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