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I think the conversation around health care costs in the US should start here. 30% of spending is on hospital care, and 20% is on physician and clinical care ou

I think the conversation around health care costs in the US should start here. 30% of spending is on hospital care, and 20% is on physician and clinical care outside the hospital. Increasingly hospital-led health systems own outpatient clinics, so their bargaining power is massive. Groups like Sutter, Ascension, HCA control significant swaths of this 50% chunk of US health spend with monopolies or near monopolies in some regions, and can push insurance companies Yet the conversation is focused on drug pricing, which represents 10% of US healthcare spend. If we brought our per capita drug spend down to OECD averages it would basically result in flat year over year growth for just one year, and then things would go back to normal. I work in biotech (and know egregious stuff happens) but am also starting a company aimed at tackling the issue mentioned above for full disclosure, but I think the data are pretty supportive of those positions

refurb 8y ago
Your comment about hospital system negotiation is really important. A good example of the crazy costs hospitals pass onto insurers are drug costs. If a patient goes to their physician for say Rituxan, the doc gets paid a 4.3% mark-up on what they pay for the drug, plus the infusion fee. At a hospital? They mark-up the drug by 100%+, and often get a 340B discount so they can profit wildly.[1] Hospitals have been acquiring physician practices at an astonishing rate, which means costs go up when the service offered doesn't change at all. And your comment about local monopolies is very true. If your a hospital system in a rural location (only game in town). You can bend insurers over with your fees. [1]http://www.drugchannels.net/2016/04/new-data-how-outrageous-hospital.html http://www.drugchannels.net/2016/04/new-data-how-outrageous-...
- aaavl2821 8y ago
  Medicare part b drug pricing / economics is such an unfortunate part of our healthcare system. Fortunately there aren't too many drugs under that payment system but it creates a whole lot of weird incentives for those that are. There's a great investigational video on price of part b cancer drugs but I can't seem to find it, I think it was done at MSKCC or elsewhere in NYC

refurb 8y ago

Your comment about hospital system negotiation is really important. A good example of the crazy costs hospitals pass onto insurers are drug costs. If a patient goes to their physician for say Rituxan, the doc gets paid a 4.3% mark-up on what they pay for the drug, plus the infusion fee. At a hospital? They mark-up the drug by 100%+, and often get a 340B discount so they can profit wildly.[1] Hospitals have been acquiring physician practices at an astonishing rate, which means costs go up when the service offered doesn't change at all. And your comment about local monopolies is very true. If your a hospital system in a rural location (only game in town). You can bend insurers over with your fees. [1]http://www.drugchannels.net/2016/04/new-data-how-outrageous-hospital.html http://www.drugchannels.net/2016/04/new-data-how-outrageous-...

aaavl2821 8y ago
Medicare part b drug pricing / economics is such an unfortunate part of our healthcare system. Fortunately there aren't too many drugs under that payment system but it creates a whole lot of weird incentives for those that are. There's a great investigational video on price of part b cancer drugs but I can't seem to find it, I think it was done at MSKCC or elsewhere in NYC