Let’s Make Prescriptions Less Costly

by Jeannine English, AARP President, AARP The Magazine, June/July 2015
This summer, Medicare celebrates its 50th birthday, a grand achievement for older Americans and their families. This great program brings health security to more than 54 million Americans, mainly those who are 65 or older.

The golden anniversary is a natural time to consider how to keep Medicare strong for the next 50 years, and I want to spotlight a longtime AARP policy recommendation: giving the secretary of Health and Human Services the authority to negotiate prices for prescription drugs covered by Medicare.

Americans pay a lot more for prescription drugs than people do in other advanced countries. Yet, unlike private insurance plans, Medicare is not allowed to negotiate with drug companies to lower prices.

Let me give you an example. In 2013, a highly regarded new drug for hepatitis C named Sovaldi was introduced in this country. U.S. retail price: $1,000 per pill. In most cases, the treatment requires 84 pills, for a total of $84,000.

But if you negotiate, the cost goes down. The U.S. Department of Veterans Affairs, which is not bound by Medicare’s rules, was able to negotiate a Sovaldi price of $543 per pill ($45,612 for the regimen, about half the Medicare price). Germany negotiated a price of about $66,000; the United Kingdom negotiated a price of around $57,000.

harmaceutical companies say that their prices reflect costly investments in research and development. But why is there so much wiggle room? Why must they spend so much on marketing?

Prices for medications push up health care costs and consistently exceed inflation. While Americans with prescription drug coverage do not pay the full amount, the high prices are ultimately passed on to taxpayers and health care consumers.

AARP is fighting for commonsense measures to keep Medicare strong for future generations. Negotiating prices for prescription drugs could potentially save billions of dollars.

If you agree, please call your senators and ask them to cosponsor S.31, the Medicare Prescription Drug Price Negotiation Act of 2015.

Jeannine English is the President of AARP.


The Plight of the Disabled Graduate

by Mikhail Zinshteyn
The shift from high school to college, or from higher education to the workforce, is harrowing enough, but for the 6 million students diagnosed with a disability, the stakes are higher and the transition is all the more challenging.

That’s the big takeaway from Diplomas Count, Education Week’s annual spotlight on trends in high-school completion. This year’s package includes nearly 20 articles, student profiles, and data tools that dissect the major themes concerning students with disabilities as they consider what’s next after high school.

From weaker support systems on college campuses and workplaces, to pervasive misunderstandings about their specific needs, students with disabilities are often playing catch-up with the rest of the population. While improvements are underway to foster a more accommodating environment for those with disabilities like dyslexia or visual impairment, more can and should be done.

But some states stand out above others in their efforts to smooth the entry into higher education or the labor force for a student with a disability, serving as a model for others to put in place the programs and personnel experts say are needed.

To be clear, the nation has made major strides in providing an education for students requiring specialized support. As recently as the early 1970s, just one-fifth of students with disabilities were enrolled in public schools. Today, some 82 percent of students considered disabled are “mainstreamed,” Education Week notes, meaning they spend a substantial amount of instructional time in classrooms with students without disabilities. Still, while the national high school graduation rate exceeded 80 percent in 2013, students with disabilities completed high school at a rate of 62 percent. The graduation rates vary by states: Mississippi and Nevada graduated less than 30 percent of their students with disabilities in 2013; Arkansas, Pennsylvania, and Texas graduated at least 75 percent of their disabled student population that year.

But even the higher graduation rates should be treated with caution. In a radio interview, Christina Samuels, the lead writer of this year’s Diplomas Count, said “How you define even a regular diploma for students with disabilities varies by state.” According to Samuels, in some states the graduation requirements are up to the “team of parents and teachers who develop a student’s individual education plan. You can take easier tests, [or] you can take no tests, you don’t have to take the same type of math or the same depth of math.” Troubling to her are not only are the lack of uniform standards but that sometimes students don’t even realize their diplomas were earned using an easier rubric.

Meanwhile, some of the rules that are in place to ensure students with disabilities are prepared to handle the rigors of life after high school are seldom enforced by states. One article in the Education Week package notes that federal law calls on schools to develop with students self-advocacy plans, which focus on their strengths, preferences, and interests. The article’s author, Sarah Sparks, writes, however, that a “2004 federal longitudinal study found only 3 percent of students with disabilities in general education classrooms were specifically trained to speak and plan for themselves.”

Once students with disabilities leave high school, the federal provisions meant to improve their chances of a secure livelihood change as well. The federal Individuals with Disabilities Education Act no longer applies to students once they graduate. And the federal laws for working adults or college students (Americans with Disabilities Act and Section 504 of the Rehabilitation Act) ask less of colleges and employers than the education law does of public schools. Schools that receive IDEA funds could do more, however, the U.S. Department of Education warned last year as it toughened its conditions for receiving a slice of the roughly $12 billion special-education program.

Samuels said in some ways it may be easier for a student with a visual impairment to secure the assistance she would need because her disability is more apparent than for a student with attention deficit disorder or an emotional disability.

“What we’re asking of students with disabilities is to really know themselves and to know what kinds of things they might need,” Samuels said. “If they think they can achieve the goals that they have set out for themselves, seeking out the extra assistance that might be available in that college atmosphere, that’s great, but there also needs to be an understanding of ‘yeah, maybe I do need to have my professors know that I’m going to need certain accommodations.’”