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  • waghorsedoodoo waghorsedoodoo Mar 26, 2010 9:55 AM Flag

    Derailment of the Gravy Train

    How long do you think it will take before pressure to lower Medicare reimbursements steps up to the plate? It looks like lots more people will swell the Medicare ranks as Baby Boomers start to retire and Obamacare reaches out to another 30 or 40 million presently uninsureds.

    There is ZERO chance that the current, fat Medicare reimbursement rates will be left alone for any sustained period of time. What has started with Medicaid under pressure from State legislatures wrestling with mounting deficits will inevitably migrate to the Medicare arena.

    Will Medicare reimbursement pressure occur sooner... or later.

    I know what I think.


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    • so since wal-mart wouldn't open again til about 10 am saturday, do you just end up letting your kid cry their self to sleep that night?

      or do you go to walgreens, get the rx, buy the sour patch kids for your 'sooner to be healthy than if you took them to walmart in the morning' child because you are happy that they won't be crying all night and don't have to wait until the morning?

    • Is that a Mail order rebate,

      I see walgreens has a history in Mail order, than the profit margins on scripts and patient satifaction are a slam dunk.


    • Oh, Right after the kid gets the candy the clinic can also test for diabetes on their way out.
      Perhaps a free Blood glucose monitor
      with their purchase.

    • Bringing A 2 year old peadiatric patient into a pharmacy store clinic to be treaded for a ear infection.

      For your information Pediatrics is a very specialized form of medicine, and NO PHARMACY BASED clinic in their right mind would attempt this.

    • Ok RB, so what do you do when its Friday night and your 2-year old has an ear infection (he has a fever of 100 and is crying because his ear hurts). Do you take him to the emergency room, wait two hours and pay $500? Do you wait out the weekend, holding him at night because he is in too much pain to sleep and schedule an appointment for monday afternoon, taking the day off work? Maybe you take him to an after-hours clinic if there is one near by and wait in a crowded waiting room for three hours with people who look like death warmed over, hoping you both don't catch something, to see a frazzled nurse practitioner (I expect most doctor's offices to look like this soon as well under the new health care system)?

      It would be wonderful if we were all members of Congress with a physician on call 24-7, but sadly that's not the case.

      Also, please note, I'm not trying to disparage nurse practitioners with the comparison to Jiffy Lube. It just is that I'd rather have a doctor for really complicated things, which is similar to rebuilding an engine, but a nurse practitioner would be perfectly suitable for more routine things, which in a car would be like getting the oil changed.

    • Embarrassingly BAD! If I were Yank I would scrap my computer immediately until the urge to try and post "humor" subsided and then I would leave it unplugged!


    • You make me laugh..

    • You forgot to add the Private insurance carriers also.. This cost reduction pathway has been on the wall for over 10 years..
      This is where both Exec's at Walmark and CVS fell short of reading the signs and how/where Express scripts entered into the picture.
      Reimbursment rates for Rx's are going to come down, that I would bet on, the Question going forward is how do you impact the cost of treating a disease.
      A MD friend called it "Name that tune" and the less beats.... the lower the costs.

      Drugs are commodities,but the cost structure of treating a disease can be impacted by the team treating the patent and the data matrix they use by Managing patient care.

      Caremark had a leg up on this platfoam,
      CVS and Walgreens still have no Clue execpt what a patient is worth or what drug interactions can occur.

      Exprees Scripts made its plan early and got into the major hospitals and collected data as to disease management and cost controll.

      Ex. Scripts short fall is they don't have Community based pharmacy's, A big plus on MD. order changes, as well as direct communication with the patient.

      Should any of these Pharmacy company's in this sector, seek out the right employee's they may see profitability come back.
      As for the store based Clinic's what a lame idear.. by people who never had any experience in the heathcare market.