Opinion: CVS Health President Larry Merlo Says U.S. Healthcare Outdated
I tend to agree with Larry Merlo, but not for the same reasons… Our healthcare is “controlled” by the insurance industry and because in 1945 the 79th Congress gave the insurance industry an EXEMPTION from the Sherman Antitrust Act with the McCarran Ferguson Act
https://en.wikipedia.org/wiki/McCarran–Ferguson_Act At the time, it was a valid necessity so that the insurance industry could share actuarial data so that better cost estimates could be determined using a much larger population database.
Like all good things, you give a industry a “inch” and they will take a “mile”. Today when the sharing of actuarial databases are no longer needed, the insurance industry has expanded this exemption into many areas that was not initially intended .. or even a potential issue – nor existed – back in 1945.
Under the CVS HEALTH UMBRELLA, CVS has a Prescription Benefit Manager (PBM) and Silver Scripts (Part D Insurance) both are licensed as insurance companies and enjoy the exemption of Sherman and they are trying to acquire Aetna Insurance with some 40 million beneficiaries .
When the PBM first appeared on the scene (1969-1970) they claimed that they “negotiated” reimbursements with Pharmacies… their “negotiations” involved with here is what we are going to pay you “take it or leave it”. Back then 70%-80% of pharmacies were independents and if more than one pharmacy tried to “negotiate” what was offered.. the DOJ sent our warning letters that the pharmacies were involved in “price fixing” and the DOJ would take them to court.
Now, entities like CVS, can dictate the profit margins of the pharmacies competing with its 10,000 community pharmacies. They can – as they do with Silver Scripts – charge pts higher copay if the pts don’t get their Rxs filled at one of their “preferred pharmacies” .. except … all of their preferred pharmacies are CVS pharmacies, or they can MANDATE that the pt have all their prescriptions filled via a CVS owned mail order facility.
With CVS trying to acquire Aetna, will those Aetna beneficiaries be required to go to a CVS Minute Clinic ( “nurse in a box”) or get charged a larger copay or deductible if they don’t and if they get a Rx from their visit at the Minute Clinic… they will be required – or have a financial inducement – to get any Rxs filled at the CVS pharmacy.
How far is CVS from acquiring a hospital system with a vast community physician practice network and the pt has any part of a CVS service… their will be a financial inducement to exclusively use other CVS services.
So does Mr Merlo reference that our healthcare is outdated… because… many pts still have a personal freedom of choice of where – and from whom – they receive their care ?
Unfortunately, the insurance industry has one of the largest “pot of money” to fund lobbying activity and it will probably take hell freezing over before the McCarren Ferguson Act is repealed and as long as it remains on the books… people, like Mr Merlo, will try every trick in the book to gain control over who provides you healthcare services.. It won’t matter if you like or believe that the person you are dictated to see… is likeable or even fully competent.
Filed under: General Problems
I had use them a long time ago to.And yes for years they were filling my pain medication. One day I walked in to get my medication, hand to God, the pharmacist told me a policeman had just came in and told him not to fill anymore Opioid prescriptions’ I looked at the jerk and just laughed at him and asked for my prescription. They are the worst
I know that maybe 10 yrs(?) ago I started to see everything in pharmacy had CVS “markings” on it. At what point does the”Conglomerate ” become the “ATT” from back when,and the government decided they were “to big” and broke them up? People better wake up and start using an alternative pharmacy. That is of course if CVS didn’t get their grubby hands into their insurance and have no choice but to use them.
WOW
CVS is the worst. They are Liars and don’t give a crap about their patients, their only purpose is to collect and make as much money as
Possible while screwing as many people as possible.
When this whole fake opioid crisis first began I had my scripts, at least 10, filled every month at CVS. I am a CPP and never had any problem w/my meds with them for 10yrs. Suddenly, they were out of stock, I
Called each day and each day they lied to me. Since I only took my
Pain meds when I couldn’t take the pain any more I was luck enough to have some left so I didn’t get sick while I waited for my pills.
Finally, after (2) weeks I realized I was being lied to along with several
Other chronic pain patients. We voiced our anger considering we were all long time Patients and than found other pharmacy’s.
I won’t even buy a pack of gum from that organization.