Make it make sense.
The price was bullshit to begin with. The cream probably sells over the counter for about $2.50 in most other countries, so OP still ended up paying 10x the price.
People tweeting stuff. We allow tweets from anyone.
RULES:
Make it make sense.
The price was bullshit to begin with. The cream probably sells over the counter for about $2.50 in most other countries, so OP still ended up paying 10x the price.
Its a tax scheme.
The pharmacy claims this medication is worth $275, insurance covers $40, and then they get as much as they can out of the patient while claiming the rest as a loss they can write off on their taxes.
US healthcare is stupid.
You should really be replacing ~~stupid~~ with "evil"
That's fucking evil and the cunts should be held accountable for their evil
But yous won't cos you're pussies
I’d say US healthcare is toxic, and behaves despicably toward those in its care. It’s also inefficient and often counterproductive.
All of this is a result of stupidity and evil, coming both from outside the industry, as well as perpetually generated by the already-ill structure of the industry.
It warps the minds of those who join it, as customers, providers, and regulators. We’re all like software devs loyal to the terrible architecture of a bad codebase due to having to adapt to it to get anything done.
Fucked up systems fuck people up.
It looks like the pharmacies do not get the tax write offs, if any. It’s the drug manufacturers who get to double dip by charging insurers for whatever they’re willing to cover, and then write off the rest causing tax payers to foot the bill.
Regardless, I agree with the article that there needs to be legislation that both bans these type of “shell game” programs, and capping the price of medications. And for what it’s worth, I don’t care if that means companies don’t make as much money. They’ll still make money, and the drugs do not actually cost that much to make.
Yeah, it makes sense if you think of it like Skyrim Horse Armour except with life saving drugs. They'll take as much money from you as they think they can get away with.
Yup. This price is at least partially distorted by the fact that she can’t just go buy the cream without getting a prescription first. That means tight control over distribution, meaning huge barriers to entry and being forced to play ball with this insurance system when someone does enter.
There’s no way for the market to create that simple channel from this medicine to those who need it at the natural market price which is quite low.
All these elements that aren’t naturally required, but are required by law to be part of the deal, cause the price to get weird.
Recently had to buy Paxlovid. Pharmacy: “it is expensive and your insurance doesn’t cover it. Will be $1500.” Me: “I don’t know.” Pharmacy: “Wait. If you go to the Pfizer website you can get a coupon.” Me: “ok” (Looks up website and gets coupon on my phone. Paxcess Patient Support Program.) Pharmacy: “let me check now. Oh, free!”
Please make it all make sense.
Your lucky your pharmacy tech recommended the manufacturer coupon. My wife was the only one at her pharmacy that did that
Are the other people she works with actually evil or what? I can’t imagine not begging everyone who came in with a Paxlovid prescription to do that.
Meanwhile over in Europe - went to the doctor in spring as a cough didn't go away for ages. As suspected nothing he could do much - irritated throat, and just at the time when cold season was giving way for allergy season. So he prescribed some nose spray - and asked if he should also add some antihistamine to the prescription to save me a few eur (didn't check, but it probably is single digits. That stuff is cheap)
The only thing crazier to me than American healthcare is how many of my fellow Canadians keep pushing for us to have this bullshit, too.
It's not just Canada - there are people in countries with far better Healthcare Systems that the US, including with National Health Services, who want a US style one.
However this isn't "man on the street" kind of people, these are the kind who think that if Healthcare costs went from 7% of GDP to 14%, they themselves would be able to capture a significant proportion of those extra 7% - so "investors", financiers and the kind of politicians bought with money from ultra-rich Americans (like the money that Steve Bannon came to Europe with a couple of years ago very overtly to strengthen the far right).
My own country now has an ultra-neoliberal part that popped-up from nowhere some year ago after Steve Gannon brought that money to Europe, with the most glitzy marketing and the most expensive political pamphlets of all parties, and who, in a country with an actual National Health System, were the only party that wanted it fully privatised, though they stopped being open about it when they found out people were overwhelmingly against it. This party's ideology has zero local ideas or basis and is wholesale imported from the America's hardest neolibs (think Financiers and Tech Bros) and yet it got itself up to 7% of the vote in about 5 years.
I have a medicine that is $1650 with insurance, copay is $60. Or, rung without insurance and the discount card, it's $0.
Medicine pricing is utterly a scam.
Yeah dude I have dry eyes. A 3-month supply of my eye drops is $2700 out of pocket, but there's this magical card that makes it zero. WTF.
It's actually a pretty clever scheme by drug companies to foist the cost of medicine development AND supplying uninsured people onto insurance companies (and from there, the cost is passed on to people with insurance). I just don't understand how it's legal, or why the insurance companies - who are supposed to have such great collective bargaining power - accept this status quo.
I have noticed that it only seems to happen with very expensive, very recently developed drugs which are not yet part of the insurance companies recommended therapies, and they typically require a prior authorization (special approval based on the doctor stating there is a medical necessity for this, and only this, drug).
Exactly this. The only annoying part is that it then doesn't count toward your deductable and out of pocket maximum. It's crazy how nominally $1k+ medicines become like $30 when you pay without insurance.
you did not save any money for the insurance because that discount is negotiated. they don't actually pay the $40. They contract with the drug supplier to raise their "full" price and then discount it for the insurance customers so they look like the insurance is providing value.
This. Insurance is incentivised to make everything as expensive as possible.
https://pluralistic.net/2024/06/13/a-punch-in-the-guts/
TLDR deregulating medicine has been a disaster. Monopolistic hospitals, ridiculous drug IP laws, and medical price middlemen with bad incentives make the US medical system the most expensive in the imperial core countries with the worst outcomes.
My insurer bought my pharmacy, and my FSA provider bought my clinic. My wife's wellbeing is one acquisition or merger away from being fully at the whim of a single corporation in which every single component continues to fail to talk to another, and is fully disincentivized to do so.
It's not a "healthcare system". It's a "health insurance system". And like all insurance systems, it's designed to make money for the insurance companies. It functions quite well in that respect.
Many countries in the world actually have health care systems, but the US does not.
It's insane to me that healthcare looks like this in the US, I mean I live in an objectively weaker economy and my healthcare is vastly better in terms of cost, availability and has no hard ties to employment.
That is crazy messed up. My gut feel is that it's again down to the corporate shareholder problem, where infinite growth is demanded. It's defies belief that this hasn't been fixed, and really makes me think that overall we may be losing the war of greed vs humanity.
My gut feel is that it's again down to the corporate shareholder problem, where infinite growth is demanded. It's defies belief that this hasn't been fixed, and really makes me think that overall we're losing the war of greed vs humanity overall.
It's also maintained as a tool to punish labor for stepping out of line. Look at recent labor disputes in the States. The first thing that is done by the company is to shut off healthcare access.
I had a guy argue with me once that US is better than other countries because we have choice in health insurance and I said most people have healthcare tied to their employer who chooses what options they have and this dude argued we ultimately have the choice because we choose where to work.
I work in health insurance administration. I can confirm health insurance companies are bullshit.
GoodRx or something like it was used. Welcome to the man in the middle scam that makes people think they're getting a good deal when in reality, they pay for insurance but insurance makes it so costly to use their insurance that people have to pay for it out of pocket or with an HSA but can't apply the cost to their annual deductible. This is a win win for insurance companies and patients get screwed. I hate the US healthcare system so much from spending time interacting with it from the perspective of work and personally.
The fact that the US is the only major industrialized nation without some from of a universal healthcare system is supremely fucked up...
Do those of you in the US understand that this is literally only a thing in the US?
Most of us do but unfortunately only about half of us are under the impression that other systems are better and more sustainable. Entrenched financial interests run our government and a large portion of those entrenched interests made their fortunes from this medical system
Eczema medication costs a few cents to produce, you can get it for a few bucks in almost every country, but the patents in the US and the weakened regulatory system due to corporate pharmaceutical lobbying means that the patent holders can charge whatever they want and until healthcare reform occurs or unless a specific law is passed, like with insulin, US shoppers will keep paying literally any price the patent holders and their subsidiaries pull from the top of their heads and write down on your bill.
Because half the country votes for a party that explicitly says this is a good way to run things, and the other half votes for a party that says it isn't great, but we shouldn't really do anything meaningful about it.
Until there is mass "you are all assholes and we demand a more representative electoral system" demonstrations, nothing will change.
Readers may note that this applies to basically every problem in the US right now
The US healthcare system isn’t broken. It’s functioning exactly as it’s intended to function: as a way to extract the maximum amount of money from the US public.
It's crazy how we call health insurance, insurance. All it does is slightly discount the bill. It doesn't insure anything.
We got a shitty version of Republican healthcare reform, and Republicans and moderates refuse to admit we need anything more.
Republicans want to tear it down
And "moderates" say asking for more is somehow worse than being a Republican.
Shits not getting better till will finally get neoliberal.politicians out of the Dem party and back where they came from: the Republican party.
I don't know why people act like they don't understand opening the "left party" up to "fiscally conservative moderates" just concentrates all the crazy in the Republican party and depresses turnout from the right.
If you're trying to stop facism, we're taking the wrong path.
If you're trying to make sure the wealthy always win tho, yeah, this makes sense. But the fascists are going to keep winning half the time.
When they could be winning 0% of the time if we just gave Dem voters candidates they want. Because any "moderate" voters that go R, are statistically insignificant.
They're just loud and insist they're always right. Theyre Karen's.
And we need to go back to just ignoring them.
What in the sam hell are you trying to communicate with this word salad?
But if you want to talk politics and healthcare, there's one party that's made any real effort at improvement in the last 2 decades, and it's the Democrats. The Republicans try to gut the system at every opportunity.
There are plenty of Democrats in Congress that would like to continue to improve healthcare, but the Dems don't have the numbers - particularly in the House - to pass further reform.
GoodRX is my favorite shitty bandaid for this feature of a capitalist health care plan.
The free market works for a lot of stuff. It does not work for healthcare.
It doesn't work for anything that's a necessity. If I have no choice but to buy it, I can never put any pressure on the market or shitty corporations.
US healthcare is extortion.
I live in Australia and suffered an A.V. malformation in my brain and almost died. I was flown to a major hospital in the city for emergency brain surgery and spent 3 months in recovery. The whole thing cost me exactly $0.
America really screwed over it's own people, huh?
Last time I looked at a dark web drug site I saw them selling fucking anxiety and bipolar drugs, at really good rates too but you had to buy in bulk
That's the goal. The insurance company wants your premiums while keeping the out of pocket so high you find another way to pay, so they don't have to cough up a dime.