#CareTalk Podcast – Reimportation Scares Canada

#CareTalk Podcast – Reimportation Scares Canada


– Hey John, you know what this is? – Funny money? – This is the coupon that Canadians use to get their vile of insulin. I went shopping, got you
a couple of items also. – But you still can’t buy your
insulin from Canada, David. (upbeat jazz music) – Welcome to Caretalk, your monthly home for incisive debate about
healthcare, business and policy. I’m David Williams, president
of Health Business Group. – And I’m John Driscol,
the CEO of CareCentrix, we’re mostly monthly. – John, it’s nice to see you again. You usually take a long vacation, you didn’t really get a
fantastic tan this time, though. Now John, speaking of not
getting a tan, Canada. The Canadians are worried– – They’re in lather – The Americans are going to come up and grab all the drugs
out of their pharmacies and bring them back, are they paranoid or are they right? – They should be. Look, they sensibly
negotiate with big pharma, to get a fair price, we don’t, our prices are six to 10 times as high. Why shouldn’t we go across the boarder and buy those drugs,
that for the most part were manufactured here and priced here, then discounted by Canada, I don’t think the American consumer should be denied the
ability to get a fair price. – Well, John we diss the
Canadian health care system at every opportunity and
then say, you know what, we can’t solve our own
problems of drug pricing, so we’ll let the Canadians do it. I think what the Canadians
are going to do, John, is they’re going to solve it by copying our example and building a wall on the southern boarder of Canada and keep the drug migrants
out, we’re troublemakers. – If they build the walls
as effectively as we do, we can still go and buy those drugs. So David, what do you think
of the authorized generic. – Well John, I’m a big
believer in authority, so the idea an authorized generic, I think is a damn good idea. – So what is an authorized generic? – Let me explain it to you, John. So lets say you have a big pharma company like Merck or Pfizer, their hard-earned dollars coming to– – Hard earned big, fat margin. – Their development money
has already been spent, and they’re selling the
drug and the patent ends. Now, when it ends, they’re
going to have a cheap, generic competitor come in. – The monopoly patent that they’ve had. – The patent. It’s not a monopoly patent, a patent. – Okay. – And when it’s going to end, they’re going to have a
cheap, generic competitor come into the market and
trash the price, right. – Give a fair price, yup. – So what they do is, they
have an authorized generic. They say, “I’m going to put
a generic on the market. “Myself, and not only
that, I don’t have to pay “the PBM’s, their rebates for that, which “they don’t deserve anyway,
and I don’t have to give “Medicaid as big a rebate
that they don’t deserve.” And plus, people see a generic
and they see a generic, and they assume it’s cheaper, and if they think that. – But you’re misleading. They whole notion of
the authorized generic is simply a way for the
monopoly big pharma company, that’s already made
plenty of money during its monopoly period, to make it seem like, by using the word generic. It’s like saying there’s discount when there isn’t one for drugs. Look, if the average American
person who’s on chronic meds, one out of three, or one
out of four people cannot afford the drugs they’re prescribed for life-sustaining purposes. Prices are too high. The use of the notion
of a generic, authorized or not by big pharma with the same brand, misleads the public, it’s
typically priced a lot higher. It should stop. – Fine, John, you can have
the unauthorized product. Go for it. Now listen– – Works just fine. – Okay, now John, I know
you’re not big reader, so I doubt you saw the New
England Journal of Medicine– – Might have missed it. – Yeah, it’s got kind of
some long words in it. And they wrote a perspective
about accountable care organizations, and
they said that using skilled nursing facilities,
that is nursing homes as piggy banks. – What is an accountable
care organization? – So, an accountable care organization, the idea is to try to
reduce the costs and improve the quality of care by giving
the provider organization the responsibility for the
entire chain of a patient. So, John, what do you
think about this idea about using the SNF’s, as they call these skilled nursing
facilities, as a piggy bank for savings for the
ACO’s, what is that about? – I don’t get hung up
with the individual words. Look, ACO’s were designed
by the federal government to try to force hospitals
and doctors to manage populations and risk a little bit better. So, typically they’re
built around hospitals. Those hospitals sensibly squeeze the supply chain of nursing
homes, which is the amount of days folks would
spend in nursing homes. But, I gotta tell ya,
my 85-year-old mother does not want to spend any
more time in a nursing home than she needs to, and I think
that’s true of most people. So, attacking the system
for saving money and getting people directly
at home, that’s nuts. We should be sending more people home, and at CareCentrix,
that’s what we focus on, and perhaps, the way
it’s being squeezed today is to reduce days in
nursing homes, but soon, it’ll be days in the hospital. It’s a good thing that people
shouldn’t be criticizing. You should be ashamed. – I’m ashamed of myself,
John, you’re exactly right. But I’ll tell you what, I think
that they should do a better job of having a continuum of
care, as opposed to having hospitals fighting with nursing homes fighting with home
care, fighting with your 85-year-old mother, which I would not recommend to anybody. – So, David, you saw this
US Preventive Task Force recommendation that
everyone should be screened for illicit drugs– – I read all that stuff
now, of course I do. – You look a little agitated
about this recommendation that every doctor should
have a conversation about, and being screening their patients, their adult patients,
for illicit drug use. Why does that get under your skin? – It just does, John, I’ll tell you why. When I go into my primary care physcician to have my annual
checkup, right, instead of talking to me, she’s just
writing on the computer, she’s like a hamster on
habitrail, she has to screen me for this, she
has to ask me about that, did I wear my bicycle
helmet, am I depressed– – Well… – Yeah, you know, I’m
riled up because I have to listen to all this nonsense,
and they want to hear am I using illicit drugs. They’re going to say,
“Do you use cannabis?” – Slow down. – Guess what’s now
sale-able in Massachusetts, it’s legal, okay cannabis. 85% of the people who
are adults who are using illicit drugs are using cannabis. I don’t want to waste my doctor’s time asking a stupid question. – Illicit drug use is a
huge and growing problem. 20% of all adults are using illicit drugs, of those, perhaps only
20% are super dangerous, but I guarantee some people
are abusing cannabis. I think in the privacy
of that conversation with your doctor, you shouldn’t
be afraid of the facts, you shouldn’t be afraid of the truth. I think the doctors need
more of that information, I think it’s a great recommendation, but if we’re going to fight over that, I think it might be time
for the lightning round. – That’s good, John, because
I don’t want any untruths that could be struck
down by that lightning. – John, a Montana man was recently charged $500,000– – Nuts. – For dialysis treatment. Should he have paid his bill? – No, no, no! There’s a whole game that’s being played of in and out of network
that the major providers charge patients and it’s
usually hidden my insurance. Don’t pay it. That bill was 97 times the
cost the fresenius would be reimbursed on a per-session basis for dialysis under Medicare. Don’t pay crazy bills. – John, the crazy thing there is, I bet if they charge $50,000 or $75,000, the guy would’ve actually
sucked it up and paid it. – Unfair. – So David, climate change is clearly a healthcare issue, right? – John, I guess if you’re
only tool is a hammer, everything looks like a nail. And, no, climate change is
an environmental issue, John. Okay? Not everything
is a healthcare issue. – Environment affects people’s health. David, low-level ozone
is a direct function of the heating of the earth,
the fires that are coming up, and the erosion and pollutants
that naturally happen in the air, and you see
it in emphysema rates. You’re wrong. – So, Al Gore, the used
to call him Mr. Ozone, you’d be Mr. Ozone Junior. – John, I understand
that somebody manipulated that Novartis data on
gene therapy for that 2-million dollar drug, what do you think the punishment should be for them? – Well, I think they were
fired, they were moved out of the organization. I thought it was odd that
it was a little bit slow, but I think the punishment
of bing fired is appropriate. What do you think? – I think they should have
their own gene edited. – So, David, some say Tom Brady’s too old to play in the NFL. – John, with a coach like
Belichick and the type of pass protection that he has, I think he’s going to be just fine, although, yes, I think everybody’s too old
to play in the NFL, John, because it’s too darn dangerous. What do you think? – Look for the Patriots in the Super Bowl. – Well that’s it for
another edition of Caretalk. I’m David Williams, President
of Health Business Group. – And I’m John Driscol,
CEO of CareCentrix, thanks for watching. Hey there, listeners, want more Caretalk? There’s more to be had
in our other episodes, so be sure to look for those and subscribe to Caretalk on
your favorite service.

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