American Healthcare continues to go backward

In case anyone doesn’t recognize it, this is Trump taking the first step in the complete government takeover of healthcare. It will be interesting to see how the Democrats oppose it.

So we might get socialized medicine out of all of this?

On one hand, if it lowers healthcare costs by cutting out the middle man (i.e. private insurance, all the non medical costs of medicine) Id be cool with it. On the other I don't trust the administration at all in their ability to deliver something that will be beneficial to everyone.

I'm not sure what to think about that.
 
So we might get socialized medicine out of all of this?

On one hand, if it lowers healthcare costs by cutting out the middle man (i.e. private insurance, all the non medical costs of medicine) Id be cool with it. On the other I don't trust the administration at all in their ability to deliver something that will be beneficial to everyone.

I'm not sure what to think about that.
I’m not sure I would call it “socialized”, at least not yet. Because the idea here is that people are going to simply pay out of pocket but pay a lot less. The next step would be to set up government primary care clinics where people pay out of pocket but pay a lot less. If you add up the craploads we pay in premiums it wouldn’t be difficult to do. The VA actually has a pretty good model in place.
 
I’m not sure I would call it “socialized”, at least not yet. Because the idea here is that people are going to simply pay out of pocket but pay a lot less. The next step would be to set up government primary care clinics where people pay out of pocket but pay a lot less. If you add up the craploads we pay in premiums it wouldn’t be difficult to do. The VA actually has a pretty good model in place.

Government run would be socialist. If we pay less Im good with whatever. As incompetent as this administration is though I don't see that happening.
 
Government run would be socialist. If we pay less Im good with whatever. As incompetent as this administration is though I don't see that happening.
My concern is that my profession is already being crushed by PBMs. Bypassing them with a government website could be a death blow. And what do people do if they have a problem? Who do they call?
 
I’m not sure I would call it “socialized”, at least not yet. Because the idea here is that people are going to simply pay out of pocket but pay a lot less. The next step would be to set up government primary care clinics where people pay out of pocket but pay a lot less. If you add up the craploads we pay in premiums it wouldn’t be difficult to do. The VA actually has a pretty good model in place.
Whether it is socialism or not is certainly up for debate.

What isn't up for debate is that if any democratic president had made such a proposal, the Republicans would be screaming SOCIALISM from the top of their lungs. But, since this came from orangemanRX, they will talk about how great it is.

Lest we forget.......

Screenshot 2025-09-30 at 11.03.53 AM.png
 
Government run would be socialist. If we pay less Im good with whatever. As incompetent as this administration is though I don't see that happening.

Here is the thing, Mark Cuban already has this model running in a capitalist way. The role of government here should be to facilitate having drug companies offer medications to be sold in a profitable but affordable way to the market that is already in place. At least, that is what they would do if they were still conservative and did not simply sell out their soul to every idea to come from an aging orange man.
 
My concern is that my profession is already being crushed by PBMs. Bypassing them with a government website could be a death blow. And what do people do if they have a problem? Who do they call?

Yep. If Trump really wanted to get a handle on drug prices:
1. The government would get rid of PBMs
2. They would force companies to sell medications at prices that are seen in other similar nations or suffer heavy taxation to cover the astounding costs
3. Let pharmacies do their job and charge a reasonable rate on prescriptions for their beneficial services.
4. Prevent insurance companies from forcing pharmacies to use insurance costing to patients who prefer to pay themselves.
 
Yep. If Trump really wanted to get a handle on drug prices:
1. The government would get rid of PBMs
2. They would force companies to sell medications at prices that are seen in other similar nations or suffer heavy taxation to cover the astounding costs
3. Let pharmacies do their job and charge a reasonable rate on prescriptions for their beneficial services.
4. Prevent insurance companies from forcing pharmacies to use insurance costing to patients who prefer to pay themselves.
PBMs provide no clinical benefit. Meanwhile, adverse drug effects cost us between $70 and 120 billion per year and no one is monitoring for them. Take the money from the PBMs and give it to the pharmacists to monitor for ADEs.
 
What is a PBM and why is it bad? I Googled what it was and it looks like some sort of middle man who just takes and cut. What else is there about them?
 
What is a PBM and why is it bad? I Googled what it was and it looks like some sort of middle man who just takes and cut. What else is there about them?
Pharmacy benefit manager. It’s like a second insurance company that specifically pays for prescriptions.

Walgreens owns the largest PBM in the country, OptumRx. If you really want to know everything about PBMs there is a series in the Columbus Dispatch. Look for the name Antonio Ciaccia. I worked with him on an Ohio Pharmacists Association task force on PBMs and it all made it into the Columbus Dispatch.

 
Walgreens owns the largest PBM in the country, OptumRx. I
Walgreen's isn't quite evil enough. UNH owns OptumRX and OptumHealth which is now the largest employer of physicians in the US. WBA did partner with the devil, but doesn't own.
 
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