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CVS Is Said to Agree to Buy Aetna

nytimes.com

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Re: CVS Is Said to Agree to Buy Aetna

#111

Post by psergeant »

just1nn wrote: post #103
jrnichols wrote: post #76

Earlier quoted context omitted.

> treated for rashes or flus by nurses I sometimes think that's one of the things that's kept health care so expensive. Nursing salaries aren't cheap. A lot of the home health and basic clinic stuff could be handled by an LPN/LVN or even a Paramedic in many cases. Not everything needs an RN. There are plenty of available telemedicine options to put a provider in touch with a higher level of care if necessary.

"Professional Extenders" are everywhere, and it hasn't caused anything to become cheaper. If you show up at an urgent care, just expect that you will be treated by a LPN and a PA or a NP. A Family Practice physician's salary is about comparable to a Sr. Engineer at many tech companies (~160k), and they can have significant malpractice insurance overhead and insane hours. A PA or NP still makes 6 figures, so the "savi…

> “Professional Extenders" are everywhere, and it hasn't caused anything to become cheaper.

This needs the caveat of “to American consumers”. The NHS seem to be heavily moving in that direction, and I suspect “cheaper” is no small part of that

Re: CVS Is Said to Agree to Buy Aetna

#112

Post by ropeladder »

chimeracoder wrote: post #88
Flammy wrote: post #66

Earlier quoted context omitted.

How would that not significantly harm the pharmaceutical companies? Don't they make a decent percentage of their revenue off of brands which are currently price protected via these tariffs?

> How would that not significantly harm the pharmaceutical companies? Don't they make a decent percentage of their revenue off of brands which are currently price protected via these tariffs? As lostapathy explained below, US prices are currently high because that's where pharmaceutical companies are capturing their profits. In fact, even European pharmaceutical companies make most of their revenue from sales in the…

"the US funds over 50% of R&D for the entire world"

Not sure exactly what numbers you're basing that on, but I believe a significant portion of that research (especially basic level stuff) is government funded, which is not a good argument for allowing pharma companies to keep prices high.

Re: CVS Is Said to Agree to Buy Aetna

#113

Post by JshWright »

jrnichols wrote: post #76
allenz wrote: post #67

I see this as a move towards providing cheap basic medical care. This is timely now that it's possible that the individual mandate will be repealed. Millions of uninsured people could be treated for rashes or flus by nurses at CVS cheaper and faster than at doctor's offices. More competition in healthcare could be a good thing--many say it's bloated and overpriced. The risk is that poor people get basic care while ri…

> treated for rashes or flus by nurses I sometimes think that's one of the things that's kept health care so expensive. Nursing salaries aren't cheap. A lot of the home health and basic clinic stuff could be handled by an LPN/LVN or even a Paramedic in many cases. Not everything needs an RN. There are plenty of available telemedicine options to put a provider in touch with a higher level of care if necessary.

'Even' a paramedic?

While we might cost about the same, our scope of practice is a lot broader than an LPN's...

Nursing unions and trade groups are generally very opposed to the 'paramedic practicioner' or 'community paramedicine' model.

Re: CVS Is Said to Agree to Buy Aetna

#114

Post by ropeladder »

The only real upside I see here is that, the more vertically and horizontally concentrated the private sector gets, the more absurd most arguments for privatized, profit-driven healthcare appear.

Basically every other developed country has shown that the government can do as good of a job at half the cost. Socialize it all.

Re: CVS Is Said to Agree to Buy Aetna

#115

Post by pcurve »

briandear wrote: post #65
dd36 wrote: post #64

Earlier quoted context omitted.

Don’t the walking dead already pick up prescriptions there? I share your concern. Maybe they could service people out of Tesla Semis in the parking lot? Only half joking.

Why do we still have to pick prescriptions up? We have pizza delivery — why not for medicines? Order your drugs with an app and it shows up at your door.

cvs caremark and express scripts already send out billions of scripts via mail every year. Mostly maintenance medications, of course.

Re: CVS Is Said to Agree to Buy Aetna

#116

Post by libertyEQ »

just1nn wrote: post #97
allenz wrote: post #89

Earlier quoted context omitted.

I agree that CVS wants to stave off Amazon and mail order pharmacies. But a buyout is an expensive way to secure a fraction of the market. Buying Aetna makes it easier to expand the new Minute Clinic business model. CVS no longer has to worry about getting paid less than a hospital for treating a cough or fever. Aetna could even charge zero copay for nurse visits. It's more competition in the "basic healthcare" space…

The "Caremark/CVS" insurance that I have for prescriptions allows me to go to Target/CVS for covered medications, but I also have the option to mail-order (from them, of course). I also have Aetna Health Insurance just by chance (we have a choice of 3 companies @work). Amazon is going to buy drugs in major bulk (Walmart, or Mail-order-pharmacy style), and likely will charge low "dispensing fees" (because robots will…

>Amazon is going to buy drugs in major bulk (Walmart, or Mail-order-pharmacy style)

All pharmacies, electronic and brick-and-mortar, go through one of 3 wholesalers: Cardinal, AmerisourceBergen, or Mckesson. It's, "which retailer can drive distribution?"

Re: CVS Is Said to Agree to Buy Aetna

#117

Post by throwaway13337 »

ropeladder wrote: post #114

The only real upside I see here is that, the more vertically and horizontally concentrated the private sector gets, the more absurd most arguments for privatized, profit-driven healthcare appear. Basically every other developed country has shown that the government can do as good of a job at half the cost. Socialize it all.

I agree in spirit but I'd also point out that our public spending on health care is already at about the same costs as western counties with socialized medicine. [1]

Our tax dollars are already paying out as much as other countries do but their citizens get a lot more for their money.

The solution to lowering the cost of medicine in the US has not a single solution but lies at every level of the system.

[1] https://www.oecd.org/health/health-systems/Focus-Health-Spen... - it's the second chart.

Re: CVS Is Said to Agree to Buy Aetna

#118

Post by chimeracoder »

ropeladder wrote: post #112
chimeracoder wrote: post #88

Earlier quoted context omitted.

> How would that not significantly harm the pharmaceutical companies? Don't they make a decent percentage of their revenue off of brands which are currently price protected via these tariffs? As lostapathy explained below, US prices are currently high because that's where pharmaceutical companies are capturing their profits. In fact, even European pharmaceutical companies make most of their revenue from sales in the…

"the US funds over 50% of R&D for the entire world" Not sure exactly what numbers you're basing that on, but I believe a significant portion of that research (especially basic level stuff) is government funded, which is not a good argument for allowing pharma companies to keep prices high.

> Not sure exactly what numbers you're basing that on, but I believe a significant portion of that research (especially basic level stuff) is government funded, which is not a good argument for allowing pharma companies to keep prices high.

Nope, government funding is tracked separately.

Re: CVS Is Said to Agree to Buy Aetna

#119

Post by guelo »

allenz wrote: post #67

I see this as a move towards providing cheap basic medical care. This is timely now that it's possible that the individual mandate will be repealed. Millions of uninsured people could be treated for rashes or flus by nurses at CVS cheaper and faster than at doctor's offices. More competition in healthcare could be a good thing--many say it's bloated and overpriced. The risk is that poor people get basic care while ri…

There's no reason to believe that a return to pre-ACA will make the market behave differently than it did pre-ACA.

Re: CVS Is Said to Agree to Buy Aetna

#120

Post by chimeracoder »

jonas21 wrote: post #100
chimeracoder wrote: post #90

Earlier quoted context omitted.

> Yes. If consumers and/or pharmacies in the US could easily and reliably source cheaper brand-name drugs from international markets where price ceilings are in effect, it would ruin many drug companies, especially smaller ones. Those price ceilings only exist because of the artificial trade barrier between the US and those other countries. Without that trade barrier, pharmaceutical companies would charge roughly equ…

The companies would be fine, but it would probably severely limit the availability of life-saving drugs in poorer countries. One can argue that on the whole, that's a worse outcome.

> The companies would be fine, but it would probably severely limit the availability of life-saving drugs in poorer countries. One can argue that on the whole, that's a worse outcome.

Not really - countries like China and India don't recognize US (or European) pharmaceutical patents to begin with, so they're not bound to purchasing brand-name drugs from the original manufacturer.

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