Trump and 340b

[sloh]

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thoughts?



“Instead of opaque pricing spreads, there would be documentation showing how much in discounts was generated and where the money ultimately flowed.

Sunlight is a powerful disinfectant. That is precisely why the hospital lobby recoiled.

If 340B savings are truly being used to expand care for low-income patients, reduce out-of-pocket costs and support essential services, then transparency should be welcomed. Instead, we’ve seen lawsuits, coordinated messaging campaigns and dire warnings about supposed catastrophic consequences.

A Maine district court has temporarily enjoined the pilot, with a judge suggesting that the Department of Health and Human Services did not adequately consider impacts on safety net providers and calling the initiative “hastily assembled.”

 

[Mandelin Rain]

Everything has become a scam. 340B is no different. Abruptly ending the program would definitely restrict access though. There would be a wave of closures.

Anything to not force pharma to lower their drug prices, I guess.

 

[drowsy12]

kind of sad (more than kind of) that everyone knows basically everything in modern American society is a total scam and yet we have nothing we can do about it.

 

[ramsesthenice]

thoughts?



“Instead of opaque pricing spreads, there would be documentation showing how much in discounts was generated and where the money ultimately flowed.

Sunlight is a powerful disinfectant. That is precisely why the hospital lobby recoiled.

If 340B savings are truly being used to expand care for low-income patients, reduce out-of-pocket costs and support essential services, then transparency should be welcomed. Instead, we’ve seen lawsuits, coordinated messaging campaigns and dire warnings about supposed catastrophic consequences.

A Maine district court has temporarily enjoined the pilot, with a judge suggesting that the Department of Health and Human Services did not adequately consider impacts on safety net providers and calling the initiative “hastily assembled.”

I feel like I've seen this movie before. Sounds good on paper. But these folks all have PhDs in "creative financing" and this particular administration has a track record of coming up with tough sounding corporate laws that have little to no teeth or too many loopholes. I'm not holding my breath it ends up being as meaningful as it sounds.

 

[communitydoc13]

No doubt 340B has been abused. It has expanded well beyond the scope intended or probably even imagined at conception. That said, I do not want further consolidation. I have no problem with a 340B revision that disincentivizes consolidation and attempts to preserve access. Agree that transparency in pricing is critically important. (Trump admin was right about this in the first term). In fact, I believe financial transparency is critically important down to the personal level...I advocate for public access to all tax returns, including the presidents.

kind of sad (more than kind of) that everyone knows basically everything in modern American society is a total scam and yet we have nothing we can do about it.

The scam is the point. It's the money...period. The money in lobbying and the money in direct political contributions (thank you citizens united).

We are in aggregate a culture defined by competitiveness, by wealth accumulation personally and corporate growth collectively...not service, not innovation that is not immediately monetizable, certainly not integrity.

So, you either create an administrative structure (rules) that corporate entities and people will feel obligated to game (and will periodically require revision), or (as per this administration) you diminish regulations and establish a series of exceptions based on personal interactions, executive preference and overt graft. You punish entities based on cultural alignment with the executive (see specific university sanctions, lawfare against law firms, suits against media and DOD decoupling from actually good universities).

The idea of 340B revision is good...the fact that it may have the legs to happen is strictly a function of the fact that non-profits, the civil service and academics are the cultural enemy of Project 2025.

The bigger picture is can we view our federal government as being a good faith partner at all at this point (I would argue that it really has been such, in aggregate, in the past). That we get the meds we are prescribed, that there has been relatively good quality control, that the integration of academic and corporate research has brought us so many remarkable therapeutics, that there are fairly rigorous standards for human subjects research, and that medicine has become increasingly evidence based is...remarkable. And regarding 340B... its conception was rational, as it is in disparities across our population that our health outcomes become poor in aggregate, not in the efficacy of our system when paid for.

We (the PMCs) are the target of this cultural moment. We have been imperfect and at times infuriating (see academic costs and administrative overhead in healthcare). But I'll stand by a professional and relatively politically independent government of experts as well as an over emphasis on credentialism over what it is being replaced by.

 

[Mandelin Rain]

The bigger picture is can we view our federal government as being a good faith partner at all at this point

 

[Mandelin Rain]

Can the AMA just buy like 250 million of his cryptocurrency or something?