The United States of America accounts for only 5% of the world’s population, yet as a nation, we devour over 50% of the world’s pharmaceutical medication and around 80% of the world’s prescription narcotics (American Addict). The increasing demand for prescription medication in America has evoked a national health crisis in which the government and big business benefit at the expense of the American public. (II) The enacting of Medicare Part D in 2006 only helped to fuel America’s hunger for prescription medication. In 2003, President George W. Bush announced and signed the Medicare Prescription Drug, Improvement, and Modernization Act (also known as the Medicare Modernization Act, or MMA) on December 8th. The roughly $400 billion dollar measure was marketed to the American public as something that will provide care for the millions of senior citizens who, at the time, were struggling to afford prescription medication. This was the largest development of Medicare since 1965, which is when the program was initially created, and gave hope to those wishing for positive medical reform. According to title XI of the “Medicare Prescription Drug, Improvement, and Modernization Act of 2003”, the most significant change will be the affordability of prescription drugs by implementing the importation of drugs from Canada, along with necessary safety measures, in order to lessen the cost (United States Congress, 832). For those who were in retirement homes and lacked a steady income, the affordability of drugs was often a deciding factor in the decision to seek medical attention and the idea that those individuals ceased to live simply because they lacked the funds tugged at the heartstrings of many Americans. Although the Medicare Moderniza... ... middle of paper ... ...pecially with the use of DTC advertising, to such a wide range of afflictions greatly increased their consumer base, but one of them proved to be deadly. In 1999, four years after Lilly sent study results to the U.S. Food and Drug Administration showing Zyprexa didn’t alleviate dementia symptoms in older patients, it began marketing the drug to those very people, according to documents unsealed in insurer suits against the company for overpayment.(Applbaum, 248). Soon after it began to be used in those suffering from dementia, there were studies produces that showed an increase in death rate among elderly patients taking Zyprexa. In January of 2009, Eli Lilly and Company, who produced the drug, ended up settling the lawsuit and agreed to pay $1.415 billion which was one of the biggest corporate settlements in the history of pharmaceutical companies (Applbaum, 237).
Prescription and pharmaceutical drug abuse is beginning to expand as a social issue within the United States because of the variety of drugs, their growing availability, and the social acceptance and peer pressure to uses them. Many in the workforce are suffering and failing at getting better due to the desperation driving their addiction.
In order to take advantage of this demand, five billion dollars is spent by the pharmaceutical industry on marketing each year. This marketing, usually in the form of advertisements, often distorts facts and makes the necessity for drug treatment seem greater.... ... middle of paper ... ... Washington, D.C.:
In 2006, prescription drug coverage, Medicare Part D became available under Medicare for the first time. In 40 years of history, this program is the most significant change in government health care, offering the potential for improved access to required medications for millions of Americans (Improving the Medicare Part D Program for the Most Vulnerable Beneficiaries, n.d.). The
Medicare is a social policy many of our seniors look to for their stability when they reach 65
On the typical day, over 90 people will die at the hand of opioid abuse in America alone (National). In fact, as of 2014, nearly 2 million Americans were dependent and abusing opioids. The Opioid Crisis has affected America and its citizens in various ways, including health policy, health care, and the life in populous areas. Due to the mass dependence and mortality, the crisis has become an issue that must be resolved in all aspects.
The question, however, is whether or not such drug coverage is a worthwhile project to undertake. Is the problem indeed serious enough to call for the type of reform that the candidates are proposing? Medicare is already a very costly program to keep up, and adding prescription-drug coverage would increase these costs even more. In order to fund this project, there will need to be a tax hike. Should taxpayers subsidize this prescription-drug benefit? Is there a good reason why this redistribution should take place? What are the benefits and costs of this proposal? These and other questions will be addressed in this paper as we examine the following topics: the need for senior citizens to have prescription-drug coverage, the political rhetoric involved with this issue, the projected shortfall in the budget of the Medicare program, and who really would benefit if a prescription-drug benefit was added to Medicare.
Managed care dominates health care in the United States. It is any health care delivery system that combines the functions of health insurance and the actual delivery of care, where costs and utilization of services are controlled by methods such as gatekeeping, case management, and utilization review. Different types of managed care plans came into development by three major factors. These factors include choice of providers, different ways of arranging the delivery of services, and payment and risk sharing. Types of managed care organizations include Health Maintenance Organizations (HMOs) which consist of five common models that differ according to how the HMO is related to the participating physicians, Preferred Provider Organizations (PPOs), Exclusive Provider Organizations (EPO), and Point of Service Plans (POS). `The information management system in a managed care organization is determined by the structure of the organization' (Peden,1998, p.90). The goal of a managed care system is to provide subscribers and dependants with needed health care services at the lowest possible cost. Certain managed care plans also focus on prevention by trying to keep members healthy.
On December 8, 2003, President Bush signed into law the Medicare Prescription Drug Improvement and Modernization Act of 2003 (Pub. L. 108-173). This landmark legislation provides seniors and individuals with disabilities with a prescription drug benefit, more choices, and better benefits under Medicare. It produced the largest overhaul of Medicare in the public health program's 38-year history. The MMA was signed by President George W. Bush on December 8, 2003, after passing in Congress by a close margin. One month later, the ten-year cost estimate was boosted to $534 billion, up more than $100 billion over the figure presented by the Bush administration during Congressional debate. The inaccurate figure helped secure support from fiscally conservative Republicans. It was reported that an administration official, Thomas A. Scully, had concealed the higher estimate and threatened to fire Medicare Chief Actuary Richard Foster if he revealed it. By early 2005, the White House Budget had increased the 10-year estimate to $1.2 trillion.
Medicare Part D Drug benefit is also known as Medicare Rx. “On January 1, 2006 Medicare initiated the Medicare Part D Prescription Drug Benefit, authorized by Congress under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, known as “MMA”” (Medicareadvocacy.org). Medicare Part D enables Medicare beneficiaries to purchase outpatient medications at retail, home infusion, mail order and long-term care pharmacies.
The two major components of Medicare, the Hospital Insurance Program (Part A of Medicare) and the supplementary Medical Insurance program (Part B) may be exhausted by the year 2025, another sad fact of the Medicare situation at hand (“Medicare’s Future”). The burden brought about by the unfair dealings of HMO’s is having an adverse affect on the Medicare system. With the incredibly large burden brought about by the large amount of patients that Medicare is handed, it is becoming increasingly difficult to fund the system in the way that is necessary for it to function effectively. Most elderly people over the age of 65 are eligible for Medicare, but for a quite disturbing reason they are not able to reap the benefits of the taxes they have paid. Medicare is a national health plan covering 40 mi...
Collectively, the Department of Health and Human Services and the Department of Justice work to reduce healthcare fraud and investigate dishonest providers and suppliers. The Health Care Fraud Prevention and Enforcement Action Team recouped almost 3 billion in fraud, this year alone. Also, aggressive strategies exist to eliminate Medicare prescription fraud. Patients abusing or selling painkillers received by visiting several doctors and obtaining multiple prescriptions costs Medicare millions annually. Fraud affects everyone, preventing it requires government officials and citizens diligently working together.
Medicare and Medicaid are two of the United States largest broken systems, which must sustain themselves in order to provide care to their beneficiaries. Both Medicare and Medicaid are funding by a joint effort between the federal government and the local state government. If and when these governments choose to cut funding or reduce spending, Medicare and Medicaid take the biggest hit. Most people see these two benefits as one in the same, two benefits the government takes out of their pay check to help fund health care. While the government does deduct a sum from paychecks everywhere, Medicare and Medicaid are very two very different programs.
Medicare is a national social insurance program, run by the U.S. federal government since 1966 that promises health insurance for Americans aged 65 and older and younger people with disabilities. Being the nation’s single largest health insurance program, covering a large population for a wide range of health services, Medicare's funding is a fundamental part of it sustainability. Medicare is comprised of several different parts, serving different purposes, some of which require separate funding. In general, people at the age of 65 and older who have been legal residents of the United States for at least 5 years are eligible for Medicare. Same is true with people that have disabilities under 65, if they receive Social Security Disability Insurance benefits. Medicare involves four parts: Part A is hospital insurance. Part B is additional medical insurance, that Part A doesn't cover. Part C health plans, also mostly known as Medicare Advantage, are another way for original Medicare beneficiaries to receive their Part A, B and D benefits. Medicare Part D covers many prescription drugs, some of which are covered by Part B. Medicare is a major operation, not only needing adequate administering but the necessary allocated funds to keep this massive system afloat.
The case under analysis, Eli Lilly & Company, will be covering the positives and negatives with regards to the business situation and strategy of Eli Lilly. One of the major pharmaceutical and health care companies in its industry, Lilly focused its efforts on the areas of "drug research, development, and marketed to the following areas: neuroscience, endocrinology, oncology, cardiovascular disease, and women's health." Having made a strong comeback in the 1990's due to its remarkably successful antidepressant Prozac, was now facing a potential loss in profits with its patent soon to expire. The problem was not only the soon to expire patent on Prozac, but the fact that Prozac accounted for as much as 30% of total revenue was the reality Eli Lilly now faced. (Pearce & Robinson, 34-1)
Roughly 2.8 trillion dollars is spent currently on health care in the United States (Kliff, 2014). In 2013, the United States spent almost 50 percent more than the next highest health care spender, France (The Commonwealth Fund, 2016). Many experts agree health care costs consumes a significant portion of economic output as well as increased premium costs. Several factors are contributing to cost escalation such as defensive medicine, increase in the elderly population, and growth of technology (Shi & Singh, 2016). The United States is considered to have mostly a private health care system, however it spends more money on the public health care system than countries with a completely public health care system. Government funded programs, such as Medicare, play a considerable roll in health care expenditures. It is projected that Medicare expenditures will rise to 9 percent of the GDP by the year 2050 (Shi & Singh, 2016). Further concern arises with drug costs in the United