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The Middle Men: Drug Prices and the (No Spoilers) Mueller Report


It. It's Tuesday, April ninth. Welcome to skim this. We're breaking down the most complex stories of the day and giving you the context on why they matter today, we're talking about prescription drug prices and these guys called pharmacy benefit managers. They were in the hot seat today in congress. We'll explain how their rebates impact millions of patients across the country, then attorney general William Barr, testified before congress for the poorest time since he got the mullahs report, no spoilers, but we'll tell you what he said about the behind the scenes stuff. And finally, you think your taxes are a bit of a drama try being Megan Markle, we're here to make your Tuesday smarter. Let's skim this. Today's episode is brought to you by calm, the number one health app that helps you reduce your anxiety and stress plus improve your sleep. The big story today is about prescription drugs and about how and why the price of medications has gone through the roof Americans pay more per year for prescription drugs than any other developed country in the world and the costs keep rising today. The Senate finance committee hauled in executives from five big companies called pharmacy benefit managers. These are companies. You might have heard of like CVS, hell and Optum Rx part of United health insurance company, big drug companies and more and more members of congress on both sides of the aisle are blaming these pharmacy benefit managers or P B M's for drugs being so expensive. Senator Ron Wyden. Oregon says the PPM's were supposed to help consumers get a fair shake from big pharma what they actually are or middlemen who were raking in these profits while the drug prices soar into the stratosphere today. Five of them. Those pharmacy benefit managers said no surprise. It's not our fault. Prices are so high we're really here to help. So that's confusing. Why are these guys being blamed for high drug prices and not the prescription drug companies who make and sell the drugs who are these PPM 's that's what we're gonna talk about today. What are what role do they play in the high cost of prescription drugs? And how does what they do affect people in real life. So PBS are very powerful middleman in the healthcare industry. They got big back in two thousand and six when prescription drug coverage became a part of Medicare suddenly a huge portion of the population had prescription coverage through their insurance. So these PPM's came in to negotiate with pharmaceutical companies on behalf of Medicare. But also for private insurance companies basically ensures tell PB 'em something like find me the best deal on let's say insulin. And then the PBS go to all the drug companies to see which one will give the ensure the biggest discount on insulin. Technically, they call it a rebate. The word rebate is a key point here. This is where the role of PBS comes into play drunk companies wanna make money so instead of actually giving a rebate they Jack up. What's known as the list price, basically the sticker price, and then they offered the PB M'S a rebate, aka a discount. It's like if best buy and target and Costco, all tripled prices on flat screen TV's at the beginning of November. So that on black Friday, the sales prices would look amazing. That's what's going on here except not with TV's and headphones. It's about medicine. Lifesaving drugs like insulin or just meds that help with quality of life. For example, arthritis back in two thousand twelve a yearly prescription of the arth rightous struck Humira used to cost nineteen thousand dollars. Now. It's twice that. So jacking up prices is an issue. We'll get more into that in just a sec. But the other problem with the PB EMS is the way that they get paid. For many their commission isn't based on the final prices that they negotiate it's based on the discount that they negotiated which means the higher the jacked up price, the bigger that discount, the more the pharmacy benefit managers make. So they have no incentive to bring the list price down. And this is a bipartisan issue. The Trump administration has proposed a way to fix this problem. Cut out the middleman at least when it comes to people on Medicare and some Medicaid plans and make it sue drug manufacturers give these discounts directly to the patients. Some experts say this could make things better for consumers and set a new standard for the industry. But some in the industry say it can make things worse by weakening, the PBS who say they're negotiating for consumers. Because like we said that's their argument. They're getting good deals for their clients the insurance companies and their clients people with their insurance, but here's the catch. There's a ripple effect for everyone else around twenty eight million Americans who don't have health insurance or drug coverage and a lot of people who have high deductibles or who pay co-insurance when they're sick. They're paying that full jacked up list price for medicine if they can afford to which when it comes to life saving medicine like insulin for diabetics can mean a matter of life or death. So what's the skin? On a global level. The US is starting to look outside for prescription drugs. Some states are looking at options that would allow them to buy cheaper drugs from places like Canada on a national level. Some of these are taking the hint and trying to set limits on how much people are paying for things like insulin. Getting these costs down is a bipartisan concern, but this is also playing out as Republicans at the state level are fighting to get the Affordable Care Act overturned the required insurance companies to offer prescription drug coverage. If that happens more people will be impacted by these games for the time being Republicans in congress and President Trump say, they'll leave the ACA alone at least until after the twenty twenty elections because it's clear that access to healthcare is going to be a big issue for voters. On the other side of Capitol Hill today attorney general William bar finally spilled some tea on the mullahs report. That's next. Stress and anxiety can make you feel exhausted all day, but when it's time to go to bed it can feel impossible to fall asleep. Calm the number one health app can help their premium subscription includes guided meditations, relaxing sounds and sleep stories to help you get shot. I right now skim this listeners get twenty five percent off a calm premium subscription at com dot com slash skim. Get unlimited access to all of coms content today at com dot com slash skim. Get calm and stop stressing. Attorney general William bar was on Capitol Hill today to present his budget to a house appropriations subcommittee and to chat about stuff like the opioid epidemic immigration judges and counterintelligence. But of course, the general we could not hold this hearing. Without mentioning the elephant in the room. And I'm not referring to my colleagues on the other side. That elephant congressman Jose Serrano is talking about is special counsel Robert Muller's three hundred or so page report about Russian interference in the two thousand sixteen election and the Trump campaign it's on bard's desk. He sent a four page skim to congressional leaders last month his summary. Yes. Russia tried to influence the two thousand sixteen election. No, the Trump campaign did not collude with Russia. And no, President Trump did not obstruct Justice. But that last one he said is not actually according to Muller, it's bar and his deputy AG. Rod Rosenstein interpretation of the report that's been a big bone of contention. Today was the first time bar spoken about it to congress since he wrote that appropriations committee chair Nita Lowey said his cliff notes did not do it for her. All we have this your four page summary, which seems to cherry pick from the report to draw the most favored. Conclusion possible for the president. So what answers did he give today? I bar said he's going to release the mother report in the next week. So everyone can read Muller's conclusions. But and this is a big, but he said there are going to be reductions he wrote this in the letter before, but he laid it out again, he's going to take out any information that came from grand juries, anything that could reveal intelligence sources or methods information that could interfere with ongoing prosecutions and anything that implicates the privacy of people who weren't charged in the investigation all of that will be crossed out here's bar, but I am relying on my own discretion to make as much public as I can. But it won't all be blacked out far says he's going to color code the redaction. So lawmakers will know which information we can't see is from grand jury. And which information we can't see has to do with another prosecution bars working with a special counsel's office on that. Coating so that'll be a fun art project. Apparently, the attorney general and the special counsel have been hanging out for a while Barr. Says that his deputies had been overseeing the special counsel. So they had an inkling about what was going to be in the report, and then a few weeks before Muller handed over his report Barr says they met to talk about the report when it came out Barr says he asked Muller if you wanted to read the summary letter before he sent it out. But that Muller didn't it. Other than all that. There were no real Muller reports spoilers bar is scheduled to testify about the full report. Once it's out, which is like we said supposed to happen within the next week. What else is happening within the next week you finishing your taxes? We've got a story to make you feel better about your tax burden up next. Tax day is less than a week away. But that's not just a headache for normal people. Even the British royals are stressed out by the IRS this year, especially mother to be Megan Markle, the retired American actress became a British duchess less than a year ago, but she's still a US citizen. As a US citizen Margot has to pay taxes. And that means she has to report big bucks in foreign Bank accounts and assets over two hundred thousand dollars and gifts from foreigners like the ones. She got from the Queen for her wedding Markle will have to declare all of that. And her shared income with her husband Prince, Harry the royals are notoriously private about their money. Now for the first time they could be scrutinized by the IRS. And it's not just Megan Harry. There could come at any minute newborn. We'll also have to pay because it will be a US citizen by birth. So until Megan's baby gives up its US citizenship a silver rattle. A pretty pony for your birthday a trust fund. Get ready to cough up those receipts wanna make sure your taxes. Don't give you a headache out the skims guy to all things taxes at the skim dot com slash skim money taxes. Before we go today. We've got a fun fact coming to you from the North Pole. Today is the North Pole marathon that's twenty six point two miles in extreme subzero temperatures in one of the most remote places in the world. They're actually running on a huge sheet of floating ice. So technically on water not exactly our idea of a great Tuesday out. But for the last seventeen years people have traveled from all over the world just to take part. This isn't the kind of race you decide to do on a bed. The entry fee is over eighteen thousand dollars, which includes round trip flights from Norway to the North Pole camp, a place to stay medical support. That's important and the chance to stand at the exact geographic North Pole. If you're still wondering how extreme the races? Here's one of the FAQ's on the website. Will there be a threat from polar bears? And that's all for skin this. Thanks for joining us tonight. And we hope you'll catch us again tomorrow, be sure to hit subscribe. 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