Health Care Law Stands

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Supreme Court Lets Health Law Largely Stand - NYTimes

The Supreme Court on Thursday largely let stand President Obama’s health care overhaul, in a mixed ruling that court observers were rushing to analyze...

...The decision did significantly restrict one major portion of the law: the expansion of Medicaid, the government health-insurance program for low-income and sick people. The ruling gives states some flexibility not to expand their Medicaid programs, without paying the same financial penalties that the law called for...

The pharmacy saturation ENDS!

I still don't know how this law will affect pharmacists. Anyone care to educate me on this issue?

I hear they are going to start killing old and sick people and forcing women to take oral contraceptives. I guess it'll be less counting for us in the end, I love slapping stickers on teh packs of birth control every sunday

Originally Posted by notafraid87

I still don't know how this law will affect pharmacists. Anyone care to educate me on this issue?

Great healthcare coverage --> more patients --> more prescriptions written --> more prescriptions filled?

Originally Posted by PharmEcon

Great healthcare coverage --> more patients --> more prescriptions written --> more prescriptions filled?

inb4automationandmailorderwillnegateallofthis

Zero copay on preventive services, no lifetime limit, no limit on pre existing condition....sounds good to me.

and the government helps pay for those who can't afford it (within certain limits, anyway)

More scripts....more work....more jobs?

Originally Posted by rxlea

More scripts....more work....more jobs?

Bring on the $30k sign on bonuses and the alaskan million dollar contracts!!!

As I recall, the act makes it hard for insurance companies to raise rates. I think the increased number of people covered will increase revenues but I also seem them trying to cut costs associated with taking on the sickly that were previously uncovered. With the cap on increase of premiums, I think reimbursements to healthcare providers could be severely cut. This could make current health care go from bad to worse in terms of quality. I sometimes half jokingly think that the act was put in place to drive down the quality in healthcare to a point (due to reimbursements) that it was shown that health insurance needs to be a publicly owned single payer system. Admittedly, I haven't had time to read very much on any of this though. My speculations and apprehensions are based only off of hearing things on NPR.

Originally Posted by gotdrugs

inb4automationandmailorderwillnegateallofthis

Yes it is true that automation will receive some benefits from this law. Yet, they still need more pharmacists to manage medications for additional 32 million people. I think the spirit of the new law is to reduce cost of insurance and healthcare cost overall. And pharmacists can do this by doing MTM. I know this because I work in insurance company and do MTM everyday. A lot of time, we deny to pay for new medications prescribed by physician which are more expensive and show equal efficacy. So, pharmacists definitely have the knowledge necessary to do this.

Now, even if you disagree with me on this, on the other hand, i still think the mail order pharmacies still need to open new facilities and hire more technicians and pharmacists to operate. This leads to more demand for us who want to work in mail order.

Insurance companies will be taking a hit, correct? So that could lead to decreased pharmacy reimbursement for our services. Increase in number of prescriptions for a decreased reimbursement would mean more work for pharmacy just to break even. Also, from what I understand Medicaid will be expanded. We will have more Medicaid patients filling rx's which give us crappy reimbursements as well. I would love it if pharmacies hired more staff to deal with the increased demand, but with lower reimbursements, would they? Or would we just essentially have to stick it out? Ugh. Seems like this could be good or bad for us... time will tell.

Hate to be a debbie downer but most of the new people added to the healthcare system are mostly not as sick as the ones already in it (process of adverse selection) and will probably need less medications. If anything, this might be a temporary boost but the problem still remains.. The number of pharmacy schools in this country is too damn high!!

Lol... more patients... more scripts... more jobs.... lol. More like more scripts... less dispensing fees.... lower salary... and higher taxes.

High Court’s Health-Law Ruling a Boon for Pharmacies, Benefit Managers

http://blogs.wsj.com/health/2012/06/...s/?mod=WSJBlog

Originally Posted by joetrisman

Bring on the $30k sign on bonuses and the alaskan million dollar contracts!!!

As I recall, the act makes it hard for insurance companies to raise rates. I think the increased number of people covered will increase revenues but I also seem them trying to cut costs associated with taking on the sickly that were previously uncovered. With the cap on increase of premiums, I think reimbursements to healthcare providers could be severely cut. This could make current health care go from bad to worse in terms of quality. I sometimes half jokingly think that the act was put in place to drive down the quality in healthcare to a point (due to reimbursements) that it was shown that health insurance needs to be a publicly owned single payer system. Admittedly, I haven't had time to read very much on any of this though. My speculations and apprehensions are based only off of hearing things on NPR.

lol that's right! Prime real estate outside of anchorage!

I'm not sure about the quality of care going down though. CMS has specific standards to meet meaningful use. In order to get reimbursements, practitioners will have to meet these standards, which also include EMR.

I think EMR and the push for preventive services could increase quality.

I've said for a long time that the health care system needs to transition to prevention focused care rather than treatment focused.

Guess we shall wait and see.

I really like the no copay for preventive services, though.

So putting more people on medicaid and erasing the doughnut hole is a good thing? All this means is taxes are going to go up DRAMATICALLY within the next 5-10 years, which Obama promised would not happen....how else will the state and feds pay for meds? reimbursments are already getting rediculous. Not to mention the crisis in european countries that hospitals are owed millions of dollars the the fed gov ran insurance cannot pay back. Oh and its unconstitutional to force people to be insured, but if your not insured we will tax the crap out of you.....right....

Dont get me wrong, there are some great things with this health bill and many things that need to be fixed in our current system, some of which have been mentioned above....but at what cost? Well its at your cost and my cost.

Originally Posted by UConn101

High Court’s Health-Law Ruling a Boon for Pharmacy Benefit Managers

fixed that for you

Script volume will increase, but it's likely that reimbursements will continue to fall. Where does this money come from to provide insurance to these millions of previously uninsured? If you say you're going to cover something, but need to save money, the only way to accomplish both is to pay less.

more volume, less reimbursement = same revenue as we have now, but working harder for it

Originally Posted by rxlea

I really like the no copay for preventive services, though.

That should include a gym membership on all insurance plans. Doesn't get more preventative than exercise.

Oh, and my contacts and glasses too. It'll prevent car accidents, and trauma centers/ burn units are expensive to run.

Originally Posted by Ackj

That should include a gym membership on all insurance plans. Doesn't get more preventative than exercise.

Oh, and my contacts and glasses too. It'll prevent car accidents, and trauma centers/ burn units are expensive to run.

Quit being dramatic.

Originally Posted by Ackj

fixed that for you

Script volume will increase, but it's likely that reimbursements will continue to fall. Where does this money come from to provide insurance to these millions of previously uninsured? If you say you're going to cover something, but need to save money, the only way to accomplish both is to pay less.

more volume, less reimbursement = same revenue as we have now, but working harder for it

You can't work any harder when you already work the hardest. Therefore, additional patients to your pharmacy force your employer to hire more technicians and/or pharmacists, or the worse case they will replace you with a better pharmacist who can handle more than you.

Another interesting thing is that more volume is not always equivalent to less reimbursement. It maybe true that the reimbursement will decrease a bit or even to the lowest point it can get, but the number of additional patients is more likely to balance out or even improves the profit. It will be tough to current employed pharmacists, but it can give the rest of people who are unemployed a better chance to land a job.

What's going to happen when doctors stop accepting Medicare and Medicaid? Your "insurance" is useless if a doctor refuses to bill it.

Originally Posted by BenJammin

What's going to happen when doctors stop accepting Medicare and Medicaid? Your "insurance" is useless if a doctor refuses to bill it.

Doctors would run out of business too with $500k in student loan. Patients will go to nurses, Pa, or pharmacists for help.

Originally Posted by BenJammin

What's going to happen when doctors stop accepting Medicare and Medicaid? Your "insurance" is useless if a doctor refuses to bill it.

They won't stop taking it. Some might.and some already don't take insurance at all (some psychiatrists, for example).

Medicaid/care ensures there are patients to be seen.

Originally Posted by 5minutes

Doctors would run out of business too with $500k in student loan. Patients will go to nurses, Pa, or pharmacists for help.

Eh? Nurses not fully trained as docs, PAs need docs for final verdict, and pharmacists...well, they don't diagnose.

And I don't necessarily think reimbursements would be THAT low to force all docs in private practice to shut down and be employed in hospitals. Specialists will take a huge hit, no question, but I've heard that the new law favors primary care physicians. Correct me if I'm wrong.

Originally Posted by notafraid87

Eh? Nurses not fully trained as docs, PAs need docs for final verdict, and pharmacists...well, they don't diagnose.

And I don't necessarily think reimbursements would be THAT low to force all docs in private practice to shut down and be employed in hospitals. Specialists will take a huge hit, no question, but I've heard that the new law favors primary care physicians. Correct me if I'm wrong.

Yeah, but where do the patients go with "all" the doctors refuse insurance? I find benjamin's question funny.

Originally Posted by rxlea

Quit being dramatic.

No drama, just a request so that I can reap some of the benefit that I'll be paying for. Throw the dog a bone. What is there for preventative medicine to improve my health? I'm fully immunized, and I don't have any modifiable risk factors to speak of. Plenty of insurance plans cover gym memberships, and I think that's a great idea. But maybe if my taxes go up significantly, the gym membership might not fit in the budget, so I won't exercise anymore. My grocery budget will slim down too, so I won't buy expensive produce, that'll get switched to sugary salty processed foods. I'll admit, it's unlikely that my taxes are getting hiked that much to make those changes, and I probably would make cuts somewhere else instead, but why not encourage me to keep up the good work?

Originally Posted by 5minutes

Yeah, but where do the patients go with "all" the doctors refuse insurance? I find benjamin's question funny.

Like what Walgreens thought they would to to express scripts. Except not "all" refused, and then they were left out in the cold. Similarly, I doubt that many docs would refuse insurance. Most of them are really in medicine for the right reasons and not worrying about their reimbursements. New grads with high debt will be less able to do that, of course, but it would have to be extreme to get to the point that docs would be turning away patients en masse.

Originally Posted by Ackj

No drama, just a request so that I can reap some of the benefit that I'll be paying for. Throw the dog a bone. What is there for preventative medicine to improve my health? I'm fully immunized, and I don't have any modifiable risk factors to speak of. Plenty of insurance plans cover gym memberships, and I think that's a great idea. But maybe if my taxes go up significantly, the gym membership might not fit in the budget, so I won't exercise anymore. My grocery budget will slim down too, so I won't buy expensive produce, that'll get switched to sugary salty processed foods. I'll admit, it's unlikely that my taxes are getting hiked that much to make those changes, and I probably would make cuts somewhere else instead, but why not encourage me to keep up the good work?

Keep up the good work.

Veggies are cheap btw people just don't like to eat them. And some people legitimately don't have access to them.

I know some employers do provide gym memberships or have a gym but most of those are larger corporations/institutions.

Lower wage workers probably won't have that luxury. But at least they can obtain health insurance and go to a yearly checkup without a copay.

Anyone can guess and predict and some predictions will be better than others. However, I really believe we won't know until 5-10 years down the road.

Originally Posted by Ackj

fixed that for you

Script volume will increase, but it's likely that reimbursements will continue to fall. Where does this money come from to provide insurance to these millions of previously uninsured? If you say you're going to cover something, but need to save money, the only way to accomplish both is to pay less.

more volume, less reimbursement = same revenue as we have now, but working harder for it

This new healthcare plan will suck. It just means more work for much less pay. The jobs will not increase since the money is decreasing. Obama sucks. The end.

Originally Posted by PharmEcon

Great healthcare coverage --> more patients --> more prescriptions written --> more prescriptions filled?

--->>>with less staffing and help then you have now because the reimbursemnet will be so ****ty---------->>>pharmacist jumpng off buildings

Well if you are a lazy ass then Obama is good. He is good at giving away free stuff to everyone that doesn't want to get a job and work for themselves. I guess if you are one of those people you will love Obama.

Yeah for the PBM's!!!!!! The rest of you are screwed!

Oh and a yeah for mailorder!!!! Now the rest of you are screwed.

Originally Posted by rxlea

Zero copay on preventive services, no lifetime limit, no limit on pre existing condition....sounds good to me.

and the government helps pay for those who can't afford it (within certain limits, anyway)

More scripts....more work....more jobs?

Thereis an error here...mark out government and replace with taxpayer and while you at it put your name in parenthesis after taxpayer because in the end thats who is paying for it.

Originally Posted by rxlea

lol that's right! Prime real estate outside of anchorage!

I'm not sure about the quality of care going down though. CMS has specific standards to meet meaningful use. In order to get reimbursements, practitioners will have to meet these standards, which also include EMR.

I think EMR and the push for preventive services could increase quality.

I've said for a long time that the health care system needs to transition to prevention focused care rather than treatment focused.

Guess we shall wait and see.

I really like the no copay for preventive services, though.

I meant a drop in quality due to even less accessibility to health care providers due to the volume providers must do with decreased reimbursements. I avoid going to the doctor like the plague as it is as I always feel ripped off for going. I dig the preventive focus. In the long run, this could be a huge money saver if everyone gets on board for primary prevention.

Originally Posted by MountainPharmD

Yeah for the PBM's!!!!!! The rest of you are screwed!

Oh and a yeah for mailorder!!!! Now the rest of you are screwed.

I have absolutely no interest in PBMs or managed care (and yet I'm getting a MBA ) . However, turns out a neighbor I just met yesterday out of the blue is waist deep with the pharmacy portion of a major local pbm. She was hounding me to come work for them or do a residency after school. Sometimes you wonder if fate is knocking at your door or if its just coincidence.

Not so fast.... we don't know what this will do to our fields.

It may be a less reimbursement, less pay for you guys type thing OR it could be that WAGS will just squeeze more scripts through your shift and still pay you the same. We just don't know.

We will have to see.

Originally Posted by SHC1984

Well if you are a lazy ass then Obama is good. He is good at giving away free stuff to everyone that doesn't want to get a job and work for themselves. I guess if you are one of those people you will love Obama.

Is your rich preceptor feeding you that line of crap.

I'm happy to see my taxes go up if it means more people will have health care access. It sure beats raising taxes so we can torture and kill more "enemy combatants"'around the globe

Originally Posted by MountainPharmD

Yeah for the PBM's!!!!!! The rest of you are screwed!

Oh and a yeah for mailorder!!!! Now the rest of you are screwed.

Wow those two are my FAVORITE in pharmacy! LOL...I would love to have either job upon graduation...too bad its 1000000000 graduates to 100 jobs.

Originally Posted by joetrisman

I have absolutely no interest in PBMs or managed care (and yet I'm getting a MBA ) . However, turns out a neighbor I just met yesterday out of the blue is waist deep with the pharmacy portion of a major local pbm. She was hounding me to come work for them or do a residency after school. Sometimes you wonder if fate is knocking at your door or if its just coincidence.

How can anyone NOT love PBM? My first rotation was at a PBM place and my preceptor has the MOST RELAXING job in the history of the world.

For god sakes she comes to work whenever she wants to and leaves whenever she wants to...she told me she can work from home if she decides to.

She told me to take off 4 out of the 5 Fridays I was there too cuz she never works weekends and hardly ever work on Fridays. LOL...

Managed care is the BEST job ever.

Originally Posted by SHC1984

Well if you are a lazy ass then Obama is good. He is good at giving away free stuff to everyone that doesn't want to get a job and work for themselves. I guess if you are one of those people you will love Obama.

Yeah!!! I'd much rather give my money to the super rich and to the oil companies than those darn poor people.

Originally Posted by npage148

Is your rich preceptor feeding you that line of crap.

Eh.. Sounds more like Fox News.

Originally Posted by SHC1984

Well if you are a lazy ass then Obama is good. He is good at giving away free stuff to everyone that doesn't want to get a job and work for themselves. I guess if you are one of those people you will love Obama.

Oh boy.

Originally Posted by SHC1984

How can anyone NOT love PBM? My first rotation was at a PBM place and my preceptor has the MOST RELAXING job in the history of the world.

For god sakes she comes to work whenever she wants to and leaves whenever she wants to...she told me she can work from home if she decides to.

She told me to take off 4 out of the 5 Fridays I was there too cuz she never works weekends and hardly ever work on Fridays. LOL...

Managed care is the BEST job ever.

I ID. I find it fascinating and exciting. Everything else I could do (well except onco ) but it would just be a job at that point. I find ID to be something I'm passionate about and work would be fun sans the bureaucracy, etc.

Originally Posted by npage148

Is your rich preceptor feeding you that line of crap.

I'm happy to see my taxes go up if it means more people will have health care access. It sure beats raising taxes so we can torture and kill more "enemy combatants"'around the globe

I agree I don't like taxes going to war. However, I still think paying for YOUR own healthcare should be YOUR OWN responsbility. Just like wiping YOUR OWN ass should also be your own responsbility.

I am in general in favor of working for yourself and taking care of yourself. You should be responsible for YOU.

News flash: if you have insurance, you are already paying for other people's bad decisions. Not to mention other people's bad luck. I cost my coworkers about 80K when I had cancer and I didn't even have to have chemo. Maybe it was too many diet Cokes or being too close to the microwave. Or maybe I just have crappy genes that made some booboos. It's a long way to fall of that high horse when you realize that even with a good job, you can't afford 80K in medical bills.

Originally Posted by joetrisman

I ID. I find it fascinating and exciting. Everything else I could do (well except onco ) but it would just be a job at that point. I find ID to be something I'm passionate about and work would be fun sans the bureaucracy, etc.

You want to be a clinical ID pharmacist?

I am terrible at ID....its so much memorization!!

I have a very good memory but that class has more memorization than any other class ever....

Just learning the cephalosporins was a pain cuz there was like 5 generations and all the drugs start with a C and the names all look the same to me!!! All those drugs are the same to me...I can NOT memorize them all to save my life and that's just ONE out of 10 million different classes of drugs and bugs to memorize.

Originally Posted by SHC1984

I agree I don't like taxes going to war. However, I still think paying for YOUR own healthcare should be YOUR OWN responsbility. Just like wiping YOUR OWN ass should also be your own responsbility.

I am in general in favor of working for yourself and taking care of yourself. You should be responsible for YOU.

Don't you think it's telling that the US the only developed country that does
not have socialized medicine. The rest of the world voted, Heath care is a right. We were too busy making corporations people to notice.

Originally Posted by spacecowgirl

News flash: if you have insurance, you are already paying for other people's bad decisions. Not to mention other people's bad luck. I cost my coworkers about 80K when I had cancer and I didn't even have to have chemo. Maybe it was too many diet Cokes or being too close to the microwave. Or maybe I just have crappy genes that made some booboos. It's a long way to fall of that high horse when you realize that even with a good job, you can't afford 80K in medical bills.

Me and my classmates were all talking about this just today.

We all agree that if there was just one "national" insurance and everyone pays for it automatically thru their paycheck deductions then that would be the best and most effective.

If EVERYONE's in the USA has to automatically pay $150 a month for this "national" insurance out of their paycheck each month then it would be the best.

That way everyone has insurance and it's affordable. Just go ahead and deduct $100 or $150 out of each month's paycheck for everyone and that should work.

There shouldn't be any exceptions if everyone could contribute a little ($100 a month is very little) then there shouldn't be any problems with being uninsured.

It's also the most fair since everyone is paying the same amount and get the same coverage.

If everyone pays a little, then this country could afford to provide insurance for everyone at $100 a month. This really isn't asking for much at all and this will work the best and save tons of government money in the long run.

Originally Posted by npage148

Don't you think it's telling that the US the only developed country that does
not have socialized medicine. The rest of the world voted, Heath care is a right. We were too busy making corporations people to notice.

Ah, I guess someone has to play the devil's advocate. So here it goes:

are you sure socialized medicine is a good thing? By artificially counteracting the mechanism put in place by natural selection to eliminate unfit genes, we are in effect degrading the overall fitness of the human specie.

Is letting sick people die humane? Of course not. But if we ask a computer what's the most efficient manner to advance the human race, it may very well tell us that we are weakening ourselves and possibly paving the way to our own extinction. Just something to think about.

Originally Posted by xiphoid2010

Ah, I guess someone has to play the devil's advocate. So here it goes:

are you sure socialized medicine is a good thing? By artificially counteracting the mechanism put in place by natural selection to eliminate unfit genes, we are in effect degrading the overall fitness of the human specie.

Is letting sick people die humane? Of course not. But if we ask a computer what's the most efficient manner to advance the human race, it may very well tell us that we are weakening ourselves and possibly paving the way to our own extinction. Just something to think about.

Right. Because we all started out on equal footing and all have the same access.

Originally Posted by SHC1984

I agree I don't like taxes going to war. However, I still think paying for YOUR own healthcare should be YOUR OWN responsbility. Just like wiping YOUR OWN ass should also be your own responsbility.

I am in general in favor of working for yourself and taking care of yourself. You should be responsible for YOU.

Because you've always had a full time job and supported yourself and paid ALL your own bills???