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.
Nope. It’s consequential. They need to raise their shareholder value in any way that’s legal, even if it’s not morally right. If they won’t do that, they’d get into trouble. For corporations tax loopholes are there to be exploited.
Making those loopholes illegal is what will fix this. Then you can call it good craftsmanship by politicians. Right now you can barley call it shoddy.
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.
It’s not the pharmacies that set the prices. At least, not really. The pharmacy pays near the listed “cash-price” for the drug from the wholesaler, who buys from the manufacturer, so the pharmacy can’t really afford to charge much less than they do for many drugs.
And the price the patient sees after insurance is decided based on the insurance or pharmacy benefit manager who deals with prescription benefits for the insurance.
Pharmacies are also contractually prevented from charging less to a cash-paying patient than what they charge to the insurance companies, so you start getting weirdness with coupon cards to work around that.
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)
As a hospice worker, please don’t let stuff like that go unaddressed if at all possible.
Yeah I have terrible allergies and went to a new doctor, he couldn’t do much but I mentioned I use an over the counter nasal spray for $40. He’s like oh, let me write you a prescription and now I get a prescription one for free in Canada. Too bad my allergy pills aren’t covered though but those are still an affordable price at least.
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.
Even if a semi-private healthcare system means the rich get better care, the money generated will improve the free system vs what we have now. So overall everyone gets better care although some people get BETTER better care
- this is the argument *
This is exactly NOT what will happen.
I’m assuming that was your intention OP, but just in case:
What will happen is private sector clinics/practices/ect will be able to pay more than public, because they can charge whatever they want, so all the talented nurses/doctors ect will vacate the public sector for private, leaving public understaffed and underfunded even more than it is now. Then some shit government will point at the anemic public system they let suffer and say “it doesn’t make sense to keep this thing alive” and take it out back and shoot it. Then we turn into the states.
The rich get better care (which they can already get with a quick plane ticket if they can’t wait) everyone else gets $300 cream.
It’s f-ing ridiculous that anyone believes for profit healthcare would (note I believe they COULD, they just are designed not to) provide better care than a unified public service that wasn’t being slowly chipped away to make room for profiteering.
Our Healthcare system isn’t properly funded and managed for our growing population. Covid burst the bulkheads and is used as an excuse to push for private government funded clinics as “more access to healthcare is better”. Why don’t we save some money and just open more public clinics is never on our politicians agenda.
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).
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).
Hey now. You forgot that research for 99% of novel drugs discovered this century was funded in at least equal portions by public grants (paid for via taxes). So, the drug companies are really triple-dipping there.
If you just need to hydrate your eyes, chances are your drops are just salted water
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.
