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Universal Health Care
#31
On a more serious note: The cost of drugs for members is a big expense in our HMO. To try to control costs, we have a drug formulary, divided into class a, b , c drugs. The A drugs can be prescribed willy nilly, They are the tried and true and include generics. Class b are more expensive and second line drugs. To prescribe these, a list of indications has to be met, sometimes including failure on cheaper drugs, (if appropriate). More restrictions on class c. To go outside the formulary requires a major effort and is considered on a case by case basis. Even so, drugs remain a major, major expense.

The VA which provides drugs at low or no cost has a formulary of about 1200 drugs versus the 4500 drugs in most hospital formularies. The VA will not offer a drug that has been on the market less than 3-4 years.
It successfully controls cost.

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#32
Lee, you touch lightly on a real source of our medical insurance woes, IMHO, the unions. Your little viagra example is indicative on how it has gotten out of control. Not to worry through, if by some chance some sort of universal coverage does happen, I'll bet within 5 years a major union will have found a way for their members to receive "better".

David

Ninole Resident
Ninole Resident
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