Mostrando postagens com marcador EUA. Mostrar todas as postagens
Mostrando postagens com marcador EUA. Mostrar todas as postagens

domingo, 25 de março de 2007

Casa Branca 2008: cobertura universal à assistência médica

A disputa presidencial americana no próximo ano terá como tema, assistência médica, mais especificamente a ampliação da cobertura restrita atual para o atendimento universal. Essa questão candente foi discutida com os candidatos potenciais à Casa Branca, mas somente os democratas compareceram. Todos concordam que é um imperativo do momento atual americano, mas poucos explicitam que haverá aumento de impostos. Essa questão é tão importante, que governos estaduais estão se adiantando à legislação federal. Hillary Clinton é que mais pode falar, afinal foi destroçada há doze anos quando no governo de seu marido tentou abordar o tema. Abaixo, trecho da reportagem do The New York Times.
LAS VEGAS, March 24 — Seven Democratic candidates for president promised Saturday to guarantee health insurance for all, but they disagreed over how to pay for it and how fast it could be achieved.
Senator Barack Obama of Illinois said Saturday that he would develop a plan that would provide health care insurance for all by January 2013.
Senator Hillary Rodham Clinton of New York assailed the health insurance industry and said she would prohibit insurers from denying coverage or charging much higher premiums to people with medical problems. John Edwards, the former senator from North Carolina, offered the most detailed plan for universal coverage, saying he would raise taxes to help pay the cost, which he estimated at $90 billion to $120 billion a year. Senator Barack Obama of Illinois appeared less conversant with the details of health policy and sometimes found himself on the defensive, trying to explain why he had yet to offer a detailed plan to cover all Americans. “The most important challenge is to build a political consensus around the need to solve this problem,” Mr. Obama said. Gov. Bill Richardson of New Mexico offered a potpourri of ideas to achieve universal coverage, including tax credits to help people buy insurance and an option to let people ages 55 to 64 buy coverage through Medicare. To help pay for his proposals, Mr. Richardson said, he would “get out of Iraq” and redirect money from the military to health care. The candidates spoke at a forum on health care at the University of Nevada, Las Vegas, sponsored by the Service Employees International Union and the Center for American Progress Action Fund, a liberal advocacy group. Sponsors of the forum said they had also invited Republican candidates, but none attended. Health care is emerging as a top issue in the 2008 presidential race, as businesses join consumers in demanding action to curb costs and cover the uninsured.
Nevada has gained new prominence in the political calendar. It will provide an early test of voter sentiment in a Sunbelt state with a large Hispanic population, and the results here could help create momentum for a Democratic candidate going into New Hampshire. Nevada Democrats are scheduled to hold presidential caucuses on Jan. 19 next year, five days after the Iowa caucuses and three days before the first-in-the-nation primary in New Hampshire.
Mrs. Clinton said she hoped to make health care “the No. 1 voting issue in the 2008 election.” Her remarks were reminiscent of a speech she gave to the service employees union in May 1993, when she attacked “price gouging, cost shifting and unconscionable profiteering” in health care and the insurance industry. On Saturday, she said that the failure of her proposal for universal coverage in 1994 made her more determined to achieve the goal now. “It also makes me understand what we are up against,” Mrs. Clinton said. “We have to modernize and reform the way we deliver health care. But we have to change the way we finance it. That’s going to mean taking money away from people who make out really well right now.” Mrs. Clinton complained that “insurance companies make money by spending a lot of money, and employing a lot of people, to avoid insuring you, and then if you’re insured, they try to avoid paying for the health care you receive.”
To deal with such problems, Mrs. Clinton said,
“we could require that every insurance company had to insure everybody, with no exclusion for pre-existing conditions.”

terça-feira, 13 de março de 2007

Genérico, não necessariamente o mais barato.

Como os consumidores brasileiros já aprenderam, em vários momentos o preço do genérico se aproxima ou mesmo supera o do equivalente de marca. Agora, esse fenômeno foi detectado nos EUA, onde a venda de genéricos está crescendo muito nos últimos dois anos. Abaixo, trecho de reportagem do The Wall Street Journal.
Why Generic Doesn't Always Mean Cheap
Zocor Case Shows DrugstoresMay Offer Only Small SavingsOver Brand-Name Drug Prices
By SARAH RUBENSTEINMarch 13, 2007; Page D1
The great promise of cheap generic drugs is taking a bumpy road to arrival.
Case in point: Zocor, one of the most commonly prescribed pills in the U.S., which lost patent protection last June. Multitudes of patients have switched to generic versions of the cholesterol-lowering drug, lured by lower insurance co-payments or the promise of a significant price drop for those who pay out-of-pocket.
As predicted, the price that many insurers pay for generic Zocor has dropped dramatically. But the price that pharmacies charge patients who pay cash remains high in many locations, with wide variations by vendor. At online pharmacy walgreens.com, for instance, the price for 30 tablets of a 20-milligram dose of
Merck & Co.'s Zocor is $149.99, compared with $89.99 for simvastatin, the generic version. And last week, the same dose of simvastatin cost $108.99 at CVS's Web site, compared with $154.99 for Zocor. After a call from a reporter, CVS said it would drop its simvastatin price to $79.99, as part of an "ongoing price analysis."
At a time when policy makers are searching for ways to cut health-care costs, generic drugs are often viewed as one of the most straightforward solutions. But as the situation with generic Zocor illustrates, prices can vary wildly, and may not be nearly as cheap as expected. Generics of a number of other notable drugs that came off patent recently -- including the antidepressant Zoloft, the antibiotic Zithromax and allergy drug Flonase -- have also so far failed to deliver big savings in many cases.
"We're not seeing that sharp a drop-off" in price among generic drugs that have come out in the past couple of years, says Jim Yocum, executive vice president of DestinationRx Inc., a Los Angeles pharmacy data and software company. "We're just not seeing it."
To be sure, even for the uninsured, generics still typically cost less than their branded counterparts. And at big clubs such as
Costco Wholesale and Sam's Club, out-of-pocket prices for generics do generally plummet. Simvastatin costs $6.97 for 30 pills of the 20-milligram dose at a Sam's Club for which the company provided price information.
But just how far -- and how fast -- generic prices fall depends on a number of factors. Among them:
how many generics makers sell the drug; how much competitive pressure pharmacies feel; whether there is another alternative, such as a different generic in the same class of drugs; and whether a particular generics maker gets an initial exclusivity period. By law, the first generics maker to challenge a patent on a branded drug and prevail wins six months of exclusive sales.
For the more than 46 million Americans without health insurance -- plus perhaps millions more whose insurance plans don't cover drugs -- the lesson is to shop carefully. Some pharmacies list prices online, and certain Web sites will compare prices from a number of competitors. If your pharmacy doesn't list prices, a few phone calls to some competitors can mean big savings. If you're willing to travel, try pharmacies that aren't very close to each other and are less likely to react directly to each other's prices.
The growing variety of outlets for prescription drugs -- with wholesalers and online vendors joining the chains and mom-and-pops -- brings a range of business models that affect how generics are priced. At sellers where drugs are a significant driver of revenues, prices may remain high. Sometimes, as with generic Zocor, prices stay high even after a six-month exclusivity period ends, when additional generics makers start fueling supply.
Stores say they regularly review prices. At drugstore.com, generic simvastatin until recently had been at $125 for the common 30-tablet dose, compared with $135.99 for Zocor, even after the six-month exclusivity period ended in late December. After a reporter called to inquire about the price, drugstore.com on Friday dropped simvastatin to $27.99, which the company said was part of a regular review. Zocor now costs $139.99. On walgreens.com, simvastatin's price hadn't fallen after the six-month period's end. After a reporter inquired about it in late February, it dropped to $89.99 from $129.99. A spokeswoman said the price had already been under review.

sábado, 3 de março de 2007

Assistência médica nos EUA: cobertura universal cada vez mais próxima

The New York Times e CBS divulgaram pesquisa sobre a assistência médica nos Estados Unidos. A maioria apoia um plano governamental que amplie a cobertura e, para isso se concretizar está disposta a pagar mais impostos. Obviamente, eleitores republicanos são contra, mas não conseguem interferir no resultado porque estão mais divididos que os democratas e, os independentes estão com os democratas. O resultado está no site do NYT http://www.nytimes.com.
A diferença com o Brasil é que temos cobertura universal, mas ninguém quer pagar por isso, somente exigir mais, mais e mais. Em hospital público exige-se até direito a estacionamento.

quinta-feira, 15 de fevereiro de 2007

Projeto no Congresso americano para barrar "discriminação genética".

O Congresso americano avança para impedir que testes genéticos sejam utilizados por empregadores e por empresas de seguro. Se aprovado será um exemplo bom para os demais países. Ao que consta, há locais com teste para doenças como a coréia de Huntington.
Abaixo, trecho de reportagem do The Wall Street Journal.
Genetic-Discrimination BanNears Congressional Approval
By JANE ZHANGFebruary 15, 2007; Page A11
WASHINGTON -- A bill barring discrimination by employers and insurers based on genetic information is moving swiftly through Congress, drawing praise from privacy advocates and objections from business groups that the measure is too broad.
The legislation would be the first federal law prohibiting health insurers from denying coverage or charging higher premiums based solely on genetic information. It also would forbid employers from using the information to make hiring, firing and other job-placement decisions.

sexta-feira, 19 de janeiro de 2007

Um gráfico interessante...

Adivinhe que fenômeno representa o gráfico ao lado? Se, você respondeu o número de americanos com seguro-saúde garantido pelo empregador, acertou. O pico foi de 65% em 2000. Esses dados foram divulgados na edição de hoje do The Wall Street Journal. Ontem, o governador da Pennsilvania lançou o projeto de cobertura ampla aos moradores do Estado. Isso depois de Massachusetts, Vermont, Maine e California. Abaixo, trecho da reportagem do WSJ. Note que Mitt Rommey, ex-governador de Massachusetts é candidatíssimo a Presidente pelos republicanos. Há grande chance da cobertura universal ser a grande questão das próximas eleições, se a retirada do Iraque já tiver sido efetivada, obviamente.
Then there's raw partisan politics. Democrats believe they have the political wind at their backs and that one reason they do is public anxiety about health care. Republicans feel a need to respond, and often look for approaches that rely less on government and more on market forces.
At the same time, some proponents of free trade seek ways to ease workers' anxieties about globalization so they might be less hostile to it. Recent initiatives at the state level reflect the public pressure for some kind of governmental action -- and at the same time increase the pressure for some federal action.
"Legislators and governors are feeling pressure from small businesses," says Katherine Swartz, a professor at the Harvard School of Public Health. She has another idea for dealing with the problem: government-subsidized reinsurance pools that might make it more affordable for employers to offer insurance.
Ms. Swartz says that "nobody believes anything is going to come out of Washington. States are more willing to say let's try something." Flush state budgets help. A survey by the Kaiser Family Foundation found that one-third of states, 17 in all, increased access to health coverage in 2006, often to low-income children. F