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Private insurers are too fragmented and small to negotiate a reasonable price for treatment. They lack the leverage that something like a national single-payer
by omegaworks 10y ago
Private insurers are too fragmented and small to negotiate a reasonable price for treatment. They lack the leverage that something like a national single-payer system would have.
- replicatorblog 10y agoThe largest insurer in the US covers more people than the NHS. The second and third largest insurers rival other continental health services.
- omegaworks 10y agoPlease offer an alternative rationale for why they aren't as effective. I'm trying to understand why US healthcare is so broken.
- refurb 10y agoIt's easy. The UK can say "no" to paying for certain drugs. They take some political flak for it, but overall they've been able to keep spending down. Even mention not paying for something in the US and holy hell happens. Even Medicare and Medicaid can't say no for the most part. If American's want cheaper healthcare they are going to have to get used to having less of it and not get all the fancy new technology right away.
- woofyman 10y agoInsurance companies only pay for what they consider usual and customary.
- omegaworks 10y ago>It's easy. No, clearly it's not. I work for a startup that's delivering health services. Insurance companies have a very high bar for what they cover. They are very conservative about covering new therapies. There's a lot of snake oil in medicine (acupuncture, homeopathy) and they don't want to pay for what doesn't keep their members healthy.
- refurb 10y agoIt's not easy to execute, but it's easy to figure out one of the key drivers of increased costs in the US. Compare drug coverage in the US vs. Canada or the UK. New drugs are often covered immediately post-FDA approval in the US. Heck, look at Exondys 51 for Duchenne's. The FDA barely approved it and pretty much every US insurer is paying for it. That doesn't happen in other countries. A great example is the diabetes drug called Jardiance. It has better efficacy than older drugs and every US insurer covers it. It's not covered in many Canadian provinces.
- gozur88 10y agoIf by that you mean they can't dictate the price of drugs, sure. But that has more to do with not being an arm of the state than being "fragmented and small".
- omegaworks 10y agoThe CHS and NHS are able to negotiate drug prices even though they can't coerce US companies with force.
- gozur88 10y ago"You give us this price or we don't use your drug" isn't coercion?
- omegaworks 10y agoThe drug company can walk away from the negotiation. Either party can say no. That's the difference between coercion and negotiation.
- gozur88 10y agoThe difference is governments don't have competition. If you play hardball with a drug company in the US, one of the reasons they can walk away is there are other insurance companys to which they can sell their drugs. And insurance companies can't throw drug company officers in jail.
- omegaworks 10y ago> The difference is governments don't have competition. There are many governments in the world. If one government plays hardball with a drug company, drug company can go find a different government, or negotiate with private insurers in that same country. Yes, private insurers exist even in countries that provide basic healthcare to all their citizens. [0] > And insurance companies can't throw drug company officers in jail. Show me where this has happened. This scaremongering and black-ops has nothing to do with the practice of negotiating price. There are many people that wish Martin Shkreli went to jail for gouging AIDS patients, but that's not happening. 0. http://thehealthcareblog.com/blog/2012/01/16/the-awkward-world-of-private-insurance-in-the-uk/ http://thehealthcareblog.com/blog/2012/01/16/the-awkward-wor...