Episode 098: How the 340B Drug Program to Help the Poor Get Medicine Doesn't Work
The Paradocs Podcast with Eric Larson
Release Date: 09/10/2020
Episode 154: Rethinking Vaccine Mandates and the Omicron Variant with Dr. Monica Gandhi
The Paradocs Podcast with Eric Larson
Vaccine mandates, mask mandates, boosters, and variants have been a constant source of debate and controversy with the pandemic. My guest today is Dr. Monica Gandhi, an expert in immunology and infectious disease who runs the HIV clinic at UCSF. She has been a fairly prominent voice in support of the mask and vaccine mandates in her home state of California and city of San Francisco. She returns from her visit in June for SARS-CoV-2 in which she guessed that it wouldn't evade the vaccine or prior infection (spoiler alert: she was right). Do Vaccine Mandates Make Sense? Dr. Gandhi is...
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Episode 153: Crowd Health is Go Fund Me for Health Care on Nitro with CEO Andy Schoonover
The Paradocs Podcast with Eric Larson
What happens when you take Go Fund Me and put it into an ecosystem of likeminded folks who want to build a community to care for each other's health care expenses? You get which draws upon some of the concepts of crowd funding for one time health care expenses within its community. By taking people from all over the country and putting them into a community where there are expectations of caring for others, Crowd Health offers a solution to paying for health care expenses without breaking the bank. Is Crowd Health Insurance? If you've been paying attention to the US health care...
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Episode 152: The COVID Drawdown
The Paradocs Podcast with Eric Larson
Today we are going to discuss the COVID drawdown. Essentially, this is what must inevitably happen for us to return to lives of normalcy where we have typical interactions with others at family gatherings, sporting events, concerts, and business meetings. Unless we are prepared to radically change the way we live our lives and choose isolation (which probably has far greater physical and mental health detriments) then we have to consider how the drawdown occurs and what conditions ned to be present for it to happen. What HaS TO HAPPEN FOR THE DRAWDOWN TO OCCUR? We've talked to...
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Episode 151: Health Care for Those Who Don't Earn High Wages with Dr. David Berg
The Paradocs Podcast with Eric Larson
One of the scariest times for many workers is being presented with a bill for medical services. Even if they have insurance "coverage", the deductible or co-pay might be more than they can afford. For hourly workers in entry level jobs or low skilled positions, medical bankruptcy is a real fear. While barely making ends meet an additional bill for an ER visit or doctor's office stop can send you to collections and destroy your credit. Unfortunately, a lot of Americans are in this exact spot as they earn a living working these low paying jobs but have little medical security even if...
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Episode 150: Make Sure Your Health Insurance Broker is Working for You and not the Insurance Company with David Contorno.
The Paradocs Podcast with Eric Larson
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Episode 149: Is Asymptomatic Spread of SARS-CoV-2 a Thing? with Daniel Halperin, PhD
The Paradocs Podcast with Eric Larson
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Episode 148: Urgent Care as Primary Care with Dr. Juliet Breeze of Next Level Medical
The Paradocs Podcast with Eric Larson
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Episode 147: Has the Pandemic Led to Infants Losing IQ? - with Sean Deoni, PhD
The Paradocs Podcast with Eric Larson
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Episode 146: Explaining COVID in 11 Minutes with Dr. Eric Larson
The Paradocs Podcast with Eric Larson
Imagine yourself in California at a clearing in a large forest. And it’s on fire. There are three groups of people standing before you. A large group is screaming and running around pointing at the fire. They’re yelling that we need to do something, anything we can to stop the fire. Meanwhile, there is another group (not as large) with their backs to the fire. They are mocking and ridiculing the group running around panicking. They tell them to calm down and to stop ordering people around. They insist there isn’t anything wrong at all. Of course, the largest group of people are...
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Episode 145: Surgery without Insurance with Dr. Keith Smith
The Paradocs Podcast with Eric Larson
A lot has happened since we last met with Dr. Keith Smith from the back in 2018. . We also spoke about how the system was rigged to enrich the hospital systems, insurance carriers, and PBMs (what's new right?). So what's happened since then and how has the center done with the pandemic? Is the Surgery Center of Oklahoma Thriving or Just Surviving? Not surprisingly, Dr. Smith says that the center is doing just fine and has increased its market share from other states. Additionally, the international community from Canada is now being allowed to come back into the US for their...
info_outlineToday's discussion begins way back in the early 1990s when Congress was trying to figure out a way to reduce its health care expenses. Sound familiar? Some things never change. And this story is as old as Congress itself as legislators try to solve one problem and end up creating a bigger mess that actually ends up creating far more harm than was occurring with the original. It goes by the rather harmless name of the 340B program.
In the 1990s, Congress recognized the potential problem that pharmaceutical prices imposed on their budget. They also knew that drug companies did not charge the same price to everyone so it seemed logical to mandate that the government - which was the largest purchaser of drugs - receive the lowest possible price. In fact, most companies provided discounted drug prices to in need pharmacies around the country for those in dire financial straits.
However, what this bill did was force the companies to decide to sell all of their medications at the discounted charity prices - which would lead to bankruptcy - or eliminate the charity financing. Naturally, they chose to eliminate the charity leaving the poor without any means to get their medicine.
In two years, Congress attempted to fix this problem by allowing the drug companies to sell their medicines at a discounted price to qualified pharmacies and hospitals under the section 340 B provision. And that leads us to today...
In just the last couple years, the number of hospitals and pharmacies that claim the 340 B provision of charity care has exploded. There is now a majority of facilities claiming the title 340 B which gives them access to deeply discounted drug prices. Despite there being no new expansion of charity work in medicine, these hospitals buy the medicines cheaply and then sell them at their full retail price. Ironically, this occasionally makes drugs much more expensive and inaccessible for those who are poor. But it is a great profit center for the hospitals.
Wayne Winegarden, PhD is a senior fellow at the Pacific Research Institute and expert on the 340 B prescription drug program.show notes
Episode 098: Current Episode
Addressing the Problems of Abuse in the 340B Drug Pricing Program: Dr. Winegarden's white paper discussing the problem of 340B.
Pacific Research Institute: The Institute where Dr. Winegarden is a senior research fellow.
@WayneWinegarden: Wayne Winegarden, PhD's Twitter handle
Episode 094: The End of Safe Harbor for PBMs?
Episode 093: Scriptco Generic drug membership company
Episode 076: A PBM not looking to rip you off with PharmD benefit managers
Episode 043: How PBMs jack up drug prices
Episode 005: What happened to all the medicine?
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