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Well, this is going to make for a lot of bad jokes (and probably some pretty funny ones, too). It turns out that Medicare is paying "grossly expensive" prices for penis pumps. Yes, Medicare reimburses for sexual health drugs and devices. It is all part of health, after all. And yes, the Office of Inspector General investigates how much Medicare is paying for penis pumps, which is pretty amusing in and of itself.

But here's the serious side of the story, as it illuminates one of the really big problems that the Affordable Care Act didn't deal with, and that will have to be resolved to make the nation's health care expenditures less insane.

From 2006 through 2011, the investigators found, Medicare paid on average $451 per pump. Medicare beneficiaries were responsible for a $90 co-pay; Medicare put up the remaining $361. That was more than twice what the Department of Veterans Affairs paid per pump: $186. Searching online, the investigators found that consumers could buy similar pumps for even less.

And Medicare paid for a whole lot of these items — more than 473,000 pumps over six years. Had it paid what others paid, the Inspector General’s report concluded, taxpayers could have saved more than $14 million and beneficiaries almost $4 million each year.

Medicare pays more for drugs and devices than the VA because, unlike the VA, it isn't allowed to negotiate prices with drug and device makers. (Note, the Medicare prescription drug law from 2006 prevents Medicare from covering erectile dysfunction drugs like Viagra, because Congress thinks sex is icky.) As this report points out, $14 million in the grand scheme of what Medicare pays out each year is peanuts in the Medicare budget. The salient point here is that the VA is paying about half per device that Medicare is.

The Center for Economic and Policy Research has been arguing for prescription drug price negotiation for some time, and in its latest study estimated that the federal government could save between $230 billion and $541 billion over the next 10 years if it implemented drug negotiation. That was something that President Obama originally proposed in the Affordable Care Act, but in the negotiating process it was dropped, to keep PhRMA onboard.

Every year, progressive members of Congress introduce bills to allow for drug price negotiation, and every year they fail. Maybe a little outrage over having to pay so much for senior citizens' sexytime will help get it done.

Originally posted to Joan McCarter on Fri Feb 07, 2014 at 01:02 PM PST.

Also republished by Daily Kos.

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