High Prescription Drug Usage Is As Bad As High Prescription Drug Costs

According to the headlines in the mainstream media and health news sites pharmaceutical companies are in the hot seat.

It seems everyone is concerned about high prescription drug costs.  But right now I'm more concerned about high prescription drug prescribing and usage.  Why?  It's personal.  While a doctor has never, thankfully, prescribed me drugs, someone very special to me has 14 active prescriptions.  She's just under 50 and has some health issues, but she's hardly in need of 14 different drugs to treat them.  She admits to regularly taking nine (9) of the 14 prescriptions because five (5) of them made her feel ill.

However, recently, she had a serious medical episode that resulted in a trip to the emergency room and a hospital stay.   The emergency room doctor told her that the episode was related to the many prescriptions she was taking--three different ones for cholesterol alone.  The worst part is that all of the doctors she sees regularly and have prescribed her medication are aware of all of the other medications she takes.  Not one of them ever expressed a concern or advised her that taking so many prescriptions could have serious complications and side effects.
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Obamacare Individual Mandate Requires Affordability


I recently asked a group of independent contractors if they could design a health insurance plan, what would it look like. After a long moment without a response, I asked a few more questions.

  • What kind of health plan would you like to have?
  • How would you like to pay for the care you receive?
  • What, if any, information would you like to have before seeking medical care?
Below are the health care plan wants the group articulates:

  • Want a plan that allows you to visit any medical provider
  • Want a health plan without a deductible and coinsurance
  • Want medical care cost estimates
  • Want a health plan I can understand
  • Want to know why health care cost so much
  • Want help paying for health insurance and health care
  • Want an easier way to choose a health plan
  • Want to pay health insurance premiums via tax (like Medicare)
What I learned from this conversation is that it is hard to discuss a subject you don't understand, and people don't understand health insurance and health care plans. What they do understand is that it's a struggle to afford health insurance without the assistance of an employer or government subsidy. They know that health care pricing is hidden from them until it is too late to do something about it. They know that health plan jargon and design is complex and confusing. And they know that the health plan information they receive is not too helpful.

Oh, one more thing that I picked up on talking to this group of ladies in their late 40s to early 50s is that they're afraid and frustrated. They don't know how long they will be able to participate in the current health insurance system. I understand their frustration because no one is offering solutions for people in their situation. Instead they hear government defending how they are helping so many others afford health insurance and health care. They also have to endure the anti-reformist defend the health care status quo.


Government and the health care industry are ignoring the people who are on the hook for paying the most in health insurance premiums and deductibles. Ironically, many of these folks are the biggest supporters of government-led and health care industry supported health care reform. They don't object to paying health insurance premiums and deductibles. However, they do object to paying more in health insurance premiums than their traditionally employed counterparts. They also object to the possibility of having to pay thousands upfront in deductibles.

The government may feel like it has done all it can at the moment by simply increasing access to health insurance. But it has also made buying health insurance mandatory, with a few exceptions. And because of this mandate, access without affordability is an issue firmly in the government's court.

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Depressing Health Care And Retirement Affordability News And Taxes


I’m feeling quite negative at the moment. It’s a strange and unsettling feeling for me. One thing I am feeling especially negative about is the unaffordability of health insurance, health care and retirement, and the government’s Band-Aid approach to addressing these issues. So far this week I’ve read a series of articles that provide examples of how bad things are and how unlikely they are of getting better. These articles spotlight how the private health insurance, health care and retirement saving systems continue to shut the door on any hope of reform.

To its credit, the federal and state governments continue to put forth proposals and pass legislation to abate the affordability crisis. These programs include:

  • Accountable Care Organizations (ACOs)
  • Obamacare
  • Automatic IRA
  • myRA
  • Retirement Savings Contributions Credit (SAVER’s Credit)
  • State IRA programs
But these efforts are still Band-Aids, at a time when we need a massive overhaul of the current systems. And we can start by comprehensively addressing government subsidies that make private sector plans more attractive than public sector solutions.

Rethinking Employment-Based Health And Retirement Plan Tax Incentives

Most workers don't understand the link between the workplace benefits they participate in and the federal tax code. Their employee benefit plan information is littered with terms like pretax, tax-free, tax-deferred and tax-favored, but they would be hard pressed to explain what these terms mean. However, if the link between health and retirement benefits and the tax code was severed, they would immediately figure out that something terrible happened. Their paychecks would be smaller. And they would insist on getting their government tax subsidies back.

Of course workers don't view tax-favored employee benefits as federal government subsidies. They think they are entitled to keep as much of their hard earned money as possible and who cares that only employer-sponsored health and retirement plans receive the subsidy. It's not their fault that not everyone gets it. The tax code is full of provisions that benefit some and not others.
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Obamacare, Open Enrollment and Health Plan Recommendation Tools

It’s November 3, 2105, the third day of open enrollment season for the Affordable Care Act (aka Obamacare). This is the third open enrollment season for the federal health care program. Consequently, every health insurance writer and blogger is trying to prepare an original, standout article on the subject. Many will monitor the site to report any glitches; others will focus on Medicaid expansion and affordability issues. And some of us who actually use the site to purchase health insurance will talk about our experiences comparing and buying health insurance coverage.

I’m part of the last group that purchases individual coverage without any employer or government subsidies. I haven’t chosen a health plan for 2016 yet—I have until January 31, 2016. However, I did start reviewing the various websites that list “Obamacare Plans.” I’ll look at non-Obamacare plans later in the week, which is okay since I don’t receive a subsidy.

I reviewed four (4) websites that allow you to enroll in an Obamacare plan. All four sites provide some type of health plan recommendation tool. You input your zip code, age, gender and smoker status and the tool recommends a health plan. Three of the tools (by, and allow you to estimate your out-of-pocket medical expenses for 2016; uses a built-in estimator that you cannot change.

Confession: was not the first sight I visited to review my 2016 health plan options.

I discovered when I was researching health plan comparison tools for my free eBook—
What Employees Want This Open Enrollment: Health Insurance Plan Recommendations. The site became operational on November 1, just in time for the Obamacare open enrollment season. After inputting my zip code, age, gender, smoker status, estimated health care expenses (which they told me were way below average for a woman my age), I received a plan recommendation. I also had the option of enrolling in the plan on their website, which they claim takes less than five (5) minutes to do. Oh, the tool also allows you to indicate if you are okay with a limited network of health care providers. I am. Continue Reading...