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Insurance copays are higher than the cost of the drug about 25% of the time
- aceon48 8y agoI wonder what % of people now believe the US medical system is the scam that it is. Utterly dishonest pricing.
- doctorless 8y agoDo pharmacists have to take the Hippocratic Oath? How is not telling your customers that the insurance copay is higher than cash not harmful?
- astura 8y agoThey have gag clauses that prevent them from doing so Why Your Pharmacist Can’t Tell You That $20 Prescription Could Cost Only $8: https://www.nytimes.com/2018/02/24/us/politics/pharmacy-benefit-managers-gag-clauses.html https://www.nytimes.com/2018/02/24/us/politics/pharmacy-bene...
- alphabettsy 8y agoThere are articles such as this: https://www.pharmacytimes.com/contributor/douglas-jennings-pharmd-fccp-faha/2016/06/when-should-patients-pay-cash-for-prescriptions https://www.pharmacytimes.com/contributor/douglas-jennings-p... , suggesting that some contracts forbid pharmacies from mentioning a cash option to patients. Which should be illegal.
- ilaksh 8y agoThe pharmacists are beholden to the large companies that control their paychecks.
- gnicholas 8y agoEven doctors don't have an obligation to serve the patient's financial interest. I used to work for a Chicago-based company, and they offered Blue Cross / Blue Shield of Illinois. In California, where I live, these are two separate insurers. The doctor's office got to choose which run to my treatments through. After finding that they were doing it in a way that was advantageous to them and disadvantageous to me, I asked a friend who works in medical ethics and billing whether doctors have a duty to serve the client's best financial interest. I was surprised the answer was no because lawyers (my former career) certainly are required to do so.
- dominotw 8y agodepends on the deal. Copay might be higher in one case but it will discount other cases. So overall it might be higher for this patient for but for everyone in total its cheaper.
- maxxxxx 8y agoIt's just mindboggling that pricing in medical is so opaque. Mandating transparent pricing should be the number one reform everybody should be able to agree with.
- maxerickson 8y agoIt would be massively politically unpopular as it would tear the mask off of Medicare and Medicaid.
- maxxxxx 8y agoWhat mask?
- maxerickson 8y agoThey get praised for being financially efficient but it isn't really clear that they pay the costs of the services they mandate.
- maxxxxx 8y agoWell then let's clear that up and see if what you say is true.
- maxerickson 8y agoSure, good idea. But we circle back to my original point, politicians have no interest in doing that.
- h4b4n3r0 8y ago>> everybody should be able to agree with We’ll see about that in the next couple of years. This was one of the more prominent campaign promises by Trump, and the dude has a habit of actually following through on that, whether you like it or not.
- 8y ago
- brd 8y agoI have a doctor friend who's made it a habit to recommend that patients use GoodRx anytime they go to pick up prescriptions. Doctors can only be so involved in the pharmacy side of the transaction and a lot of pharmacists aren't able to intervene. It's sad that it requires a 3rd party app to help people not get screwed over by the current US medical system.
- TheAceOfHearts 8y agoYou don't need a third-party app to use GoodRx. I use it regularly, and you can just have em email or text you the discount info. When you go to the pharmacist, you hand em the printout or phone, and they type it in. I'd definitely suggest people at least compare prices with em before going to pick up their medicine. Another suggestion, at least for California: always ask for paper prescriptions! Fuck digital prescriptions. With a paper prescription you can go to any pharmacy you want and have it filled (i.e. shop around and find the cheapest)! But with a digital prescription you can't have it transferred to another pharmacy without calling up the doctor, which is completely fucked up. It's especially frustrating when your regular pharmacy is out of your prescription and your refill day happens to land on the weekend. Now you have to wait 2 days for your refill. One situation I've had happen occasionally is that I'll miss my regular pharmacy's closing hours because I was busy, so I'll just drive to my nearest 24-hour pharmacy to have my prescription filled; you can't do that with digital prescriptions! I've literally saved hundreds of dollars, just by shopping around a bit. And heck, it's not as if driving an extra half a mile is such a big deal, especially when it can end up saving you a few hundred dollars. I'll also note that sometimes even within the same franchise prices can vary greatly, so it's often worth going a little bit further. I think pharmacists are allowed to point out services like GoodRx, but it might be frowned upon, I'm not sure. At least in my case, I found out about their services thanks to a pharmacist: I was refilling a prescription, and the pharmacist walked out of their sealed off area, pulled me to the side and told me to look up this "GoodRx" thing.
- hirsin 8y agoGoodRx /is/ the third party app. The point is that US consumers shouldn't need to worry that their medical insurance is duping them.
- h4b4n3r0 8y agoYep. I take blood pressure medication. Cost without insurance: $5.70/mo. Cost with insurance: $10 co/pay. I know this because my insurance lapsed once for a month. Same exact pills, same manufacturer even.
- crivabene 8y agoI am on the same exact medication. I live in Italy. My 90-day supply is 15 euro (5 euro per box), but the government covers most of it through the healthcare system, so I end up paying 3 euro (1 euro per box).
- dev_dull 8y agoAnd you could probably get it even cheaper if you ordered them from a pharmacy in India.
- jarfil 8y agoExcept they'd probably get stopped by customs.
- walshemj 8y agoand might be counterfeit
- HarryHirsch 8y agoAnyone who thinks the FDA should be abolished should read the Warning Letter of the Week and reconsider: http://chemjobber.blogspot.com/search/label/warning%20letter%20of%20the%20week http://chemjobber.blogspot.com/search/label/warning%20letter...
- reaperducer 8y agoOur investigator documented that you have an employee food preparation area within your drug manufacturing area with no separation between open manufacturing equipment, cooking utensils, and personal-use items. The practices observed at your facility, which was observed open to the outdoors, increase the likelihood of your drug products becoming contaminated.
- HarryHirsch 8y ago
- dev_dull 8y agoAnother example of how distorted prices are in this market. Price discovery is nearly impossible. Some places can't even tell you how much a drug cost without insurance because they don't even know!
- wtvanhest 8y agoPrice transparency would dramatically reduce the cost of healthcare in the US. It is an essential step that we must take before 'fixing' healthcare.
- howard941 8y agoAnecdata warning . Took paper Rx to a very large chain that has a one word name beginning with a W and was told they wouldn't quote the cost of the prescription without scanning the Rx. And destroying it so I couldn't take it anywhere else.
- briandear 8y agoThat right there should be an anti-trust case. I am big on the free market, but that whole concept hinges on transparency in pricing.
- freedomben 8y agoOften times they take the script and put their sticker on it before even checking if it's in stock. I have had this happen numerous times. I then go to another pharmacy because the first was out of stock (and my time is worth nothing, so of course I can drive all over town and stand in line for 20 to 40 minutes at each place) and get interrogated by the pharmacy tech, "did you take this somewhere else to fill!!???" Because apparently only a criminal would fill a controlled substance. And with the DEA artificially limiting production, it's very normal for the first three pharmacies to be completely out of stock.
- conanbatt 8y agoYes, price discovery is impossible. The core way to solve it would be to detach healthcare from employers. This way insurance companies would have to compete to provide measurable price benefits to their patients. Even Bernie sanders with his single-payer platform includes separating healthcare from employer, its the most clear-cut change to do, but also a hugely disruptive one.
- tialaramex 8y agoUnder the NHS most patients pay a "prescription charge" which is intended to encourage patients not to seek prescription meds when they needn't do anything. (Several big categories like pregnant women are exempt from charges, and if you use lots of medicine you can "prepay" a fixed fee of about £100 each year to stop getting charged regardless) The charge is more than some cheap OTC medicine you might get prescribed, e.g. hay fever tablets are pennies per box and the charge is almost £10. But pharmacists are required to tell you if you could just buy it yourself for less - they collect the charge so they have the opportunity to point this out whereas your doctor needn't know if you pay or not. Logically the charge must also be bigger than the price for some of the cheapest prescription-only medicine and there's no way to avoid paying extra in the UK as far as I know in this case.
- yipeedipee 8y agoJust thought I would mention in Scotland with NHS Scotland we pay no prescriptions charges.
- toomuchtodo 8y agoDefend your public services and safety nets at all costs; vultures await an apathetic electorate.
- oliwarner 8y agoI think we're 15 years too late to recognise this. We've been pushing healthcare budgets down and into private hands (PFI, tendered provision contracts) for at least that long. And while it's demonstrably failed, we keep pushing that way. We have too many politicians with too many fingers in too many pies telling too many lies about the "dream" that is American healthcare.
- toomuchtodo 8y agoPoliticians that can’t be reasoned with can be replaced. Run for office. Failing that, support candidates that support your views. Democracy exists as a function of effort.
- jwr 8y agoSomething is very wrong with the whole medical insurance system in the US. Having recently been exposed to it, I keep discovering new surprises and being shocked regularly. What I found most bizarre is that Americans who are "temporarily" in the US (e.g. expats, visiting) can get health insurance with better terms and at about 1/10th the price of what residents are offered. Someone is being had, I'd say.
- MrMorden 8y agoThat could be because for the really expensive stuff they'll pay for you to be transported back to your home country, where your primary insurance will treat you.
- nraynaud 8y agoI am a foreigner in the US, and I am not eligible to health insurance at home anymore, there is a residence condition.
- jwr 8y agoNo, that is not the type of insurance I was writing about. To take an example, take a look at Patriot America Plus from https://www.visitorscoverage.com/visitor-health-insurance/plans/ https://www.visitorscoverage.com/visitor-health-insurance/pl... It does include the acute onset of pre-existing conditions, $250 total yearly deductible, 100% percent in-network coverage. But it is not available to US residents, only for short term (up to two years) stays.
- IncRnd 8y agoFrom Patriot on that page, "Cannot accept an address in Maryland (MD)."
- kalleboo 8y ago> The Patriot America Plus Plan is available for any non-US Resident , visiting the USA for a short period of time > Pre-existing conditions are not covered by Patriot America Plus Plan It requires you to already have insurance somewhere else, and they expect you to go home for anything chronic (expensive). It sounds exactly the same as any travel insurance you can get in your home country (and is included in many fancy credit cards) You said "expats" before, but ex-pat implies residency in the US. Tourists/business travelers are a whole other ballgame. They're just protecting against not getting hit by a car when they're at their week-long conference. They're all limited in scope of their costs by their visitor's visa duration (typically 90 days)
- Spooky23 8y agoI think the telmisartan story is cherry picked to tell the story the author wanted to tell. I’m on that drug, and have a good health plan that charges the lesser of copay or actual cost for drugs. That drug was going generic two years ago, and it took the generic manufactures awhile to ramp up. The generic drug cost more than the name brand version for a few months and was constrained — the pharmacies my my area had difficulty doing a 90 day fill. It ultimately didn’t drop to super cheap status until they were approved to sell it in a normal pill bottle — previously it was sold in blister pack form.
- crb002 8y agoSave some by paying out of pocket? You can still use it as a healthcare expense come tax time.
- briandear 8y agoHealth expenses only matter if they exceed 7.5% of your income for a given year. Using flex accounts though, that would give you a big tax win. Flex and HSAs are really the only way to really get tax savings on health since the standard deduction was doubled in the Trump tax plan.
- linsomniac 8y agoMy experience is that it's more like 90% of the time. My "lessons learned" is: Talk to your pharmacist and see what options they have for cash payment and discount cards like GoodRx. It takes them a couple minutes to compare to your insurance, but for me it's cutting the cost of my prescriptions by around half. My insurance has a $10 copay, but limits me to getting 30 day supplies. Currently they are moving to require you to get refills through them by mail, which would be fine except I'm skeptical that it would cost me significantly more. I have 3 prescriptions, which with the monthly copay would add up to $90 a quarter. Using the "GoodRx" or other "discount card", those 3 prescriptions with a 90 day supply end up costing me around $40 a quarter. The meds for my family's recent set of illnesses were cheaper with the GoodRx than the copay, but just barely.
- ars 8y agoWant to do something about it? https://www.gormanhealthgroup.com/blog/trump-administration-alarms-pbms-with-first-drug-pricing-initiative/ https://www.gormanhealthgroup.com/blog/trump-administration-... Take action and write, tell them you oppose the PBM's and want drug kickbacks removed from the safe harbor exception! This is what you are up against: https://www.pcmanet.org/wp-content/uploads/2018/07/PCMA-comments-on-Blueprint-RFI-July-16-2018.pdf https://www.pcmanet.org/wp-content/uploads/2018/07/PCMA-comm... Oh, they sound very convincing with great charts and data and bullet points. But they are very very wrong, they are looking out ONLY for themself! I can't find where to comment, and I think the comment period might be closed, but doesn't matter write anyway. Encourage the Trump administration to do it and get rid of kickbacks!
- dawhizkid 8y agoNot sure how widely known or common this is for medications but I take PrEP (Truvada) and the maker has a free "co-pay" card on their website that basically covers $4800/year in copayments (well above the $50/month I would ever pay). I'm sure there's some shady big pharma economics behind why these exist in the first place, but at the very least I'm getting a very expensive drug for free.
- amaccuish 8y agoWe're about to get Truvada free on the NHS here in the UK and I'm interested on going on it. Have you had any side effects?
- dawhizkid 8y agoNo side effects, no.
- bradleyjg 8y ago> I'm sure there's some shady big pharma economics behind why these exist in the first place The co-pay is designed to make you share in the pain of the sky-high costs the drug manufacturer charges the insurance company. This has two benefits—1) you are only going to get it if you really need it 2) maybe you’ll lobby your congressperson to rein in monopolist pricing. By giving you a coupon there’s no pain sharing and those benefits are lost. Sure you’ll pay higher premiums, either directly or in reduced wage gains, but that’s defuse and indirect, so far less likely to drive behavior.
- dawhizkid 8y agoMakes sense
- zdragnar 8y agoBiologic drugs are grown, not manufactured. Mine should be around 4k / dose; insurance won't cover it, so the drug company only charges me I think a $25 copay. Fwiw, the insurance would have covered older alternatives, but the potential side effects on those are worse than the cure.
- ghaff 8y agoI'm not sure I understand this article. I take a few drugs the cost of which is less than the co-pay and I pay that lesser amount when I pick up my prescription from a major US pharmacy chain. They have my health insurance info and would charge the co-pay if the amount were more. But they don't because the retail price is less.
- sitkack 8y agoI have routinely had to pay the $20 minimum for generics that cost $5 retail. So I paid $15 over retail for using my health insurance.
- dv_dt 8y agoI am skeptical of claims that the US heathcare system could be fixed solely by better consumer medical information. But this is one area where consumers can often save money - just by asking their pharmicist when they go to fill a prescription to run the cost both under insurance vs cash pay. One wonders what value health system administrators are providing when such a high percentage of negotiated drug plans result in higher prices than cash prices.
- wallace_f 8y ago>One wonders what value health insurance administrators are providing Good question. This was also discussed last week on HN[1]. Since 1970, the number of doctors is up 150%, in line with pop. growth, while healthcare administrators up by 3200%. 1-https://news.ycombinator.com/item?id=17756845 https://news.ycombinator.com/item?id=17756845
- csomar 8y agoNot from the US. But how in God sake does this make any possible sense? I mean if the insurance doesn't want to insure a certain medication, then you just pay it for yourself (provided they explain why; or that your contract said so). But how could it be possible that you pay more?
- Arcsech 8y agoThe costs are not made clear to the consumer. Usually how it works in the US is you give your insurance information to the pharmacy, then then the pharmacy tells you how much you have to pay. You may be told what portion the insurance paid, but that’s a portion of a cost the insurance company negotiated. You aren’t told what it would have cost if the insurance was never involved.
- willio58 8y agoIt’s explained in the article. PBMs are responsible for the raised prices. Which, by the way, is absurd to me as an American. I think at this point most Americans agree there are major flaws in our system, it’s just a disagreement about how to fix it.
- deleted 8y ago[deleted]
- reaperducer 8y agoyou just pay it for yourself That used to be the way it worked. You'd go to the doctor and he'd charge you, say, $35 for a basic exam, and you'd pay in cash. Since health insurance became widespread, now doctors charge crazy amounts. My doctor charges something like $210 for a basic exam, or $185 for the "negotiated rate" to the insurance company. I saw on television once that the reason we're in this mess has to do with WWII. With so many working-age people fighting overseas, finding workers was hard for companies, so they started raising wages. The government was afraid of war + inflation, so it put limits on pay raises. So, instead, big companies started offering health care benefits. And thus, an industry was born. At least that's what I remember from the TV. I can't cite the show or channel, but I do watch a lot of PBS and virtually zero YouTube.
- cascom 8y agoI had this experience with imaging (MRI), cost 10% more with insurance than without. I asked a friend in the healthcare industry about this - they said that since insurance companies negotiate all the services at once - the insurance company is trying to lower the total cost for the whole insured pool, this often means that they will marginally overpay for high margin services in order to get big discounts for the really costly things. The hospital makes more gross margin, and the insurance company lowers it’s total spend. The offshoot is that individual people may bear the brunt of this grand bargain... No idea if it’s true, but had a ring of truth to it...
- tantalor 8y agoSounds like price fixing; a crime
- fipple 8y agoPrice fixing is a crime only when coordinated among multiple suppliers.
- ipython 8y agoA crime is only what legislature declares is a crime... One would consider why it is the law for a mechanic to give you a written estimate for work to your vehicle, and be required to call you before exceeding by a notional amount- yet, a hospital can legally withhold all cost information from you and yet you’re responsible for the bill in full after the service.
- Gibbon1 8y agoMy refrain. If a mechanic conducted business like a hospital they'd have their business license pulled and the owner would go to jail.
- matwood 8y ago> I had this experience with imaging (MRI), cost 10% more with insurance than without. Depending on where you went it could have been much more than 10%. Non-emergency imaging is definitely one of those things you ask about other locations and if they have cash pricing. When I needed an MRI if I was to use my insurance it was going to be ~$1000 because of high deductible plan. A different place took payment at the time and it was $350. According to the doctor who wanted me to get the MRI, hospitals are far and away the most expensive places to get one.
- aviv 8y agoI have many friends and family members that frequently complain about the high cost of their health care and insurance premiums. Yet most of them are leading unhealthy lifestyles, a mix of bad diets, smoking, sedentary lifestyle, etc. There seems to be a big disconnect in their head between how they live their lives and how much it affects their health spending. Sure, it would be nice if pharmaceutical drugs cost less, and if copays were cheaper. But it would be much better to not need either of those to begin with.
- arenaninja 8y agoI do wonder if insurance paying for everything under the sun is part of the issue. I remember hearing talk of medicine for some chronic conditions being available over the counter (migraines, diabetes, asthma, etc.). The way I see it, my car insurance only covers a limited number of issues. Unfortunately, health insurance has historically come on the wrong side of things (e.g.: pre-existing conditions BS)
- lotsofpulp 8y agoHealth insurance in the US isn’t insurance. It’s a scheme to try and spread around the costs of providing healthcare to everyone, and everyone tries to pass the buck to those with the least power in the system. Large employers with young, healthy office workers win, and poorer taxpayers who don’t have health insurance or independent contractors who have very little power lose. The people who have nothing get medical care, but it’s not ideal, but they don’t have anything to pay with either. So try not to be in the middle - the ones with enough assets to take, but not enough to defend against having them taken (e.g. not being part of a group that can negotiate out of it). God forbid we actually come out and say we, as a country, want to support each other. A large portion of our fellow citizens would rather play this game of hot potato, but don’t have the balls to turn poor people away from the emergency room and tell them to die.
- ddingus 8y ago>God forbid we actually come out and say we, as a country, want to support each other. A large portion of our fellow citizens would rather play this game of hot potato, but don’t have the balls to turn poor people away from the emergency room and tell them to die. This. If we can't actually commit to taking care of our own, just who are we as a nation?
- scarface74 8y agoHealth insurance in the US isn’t insurance. It’s a scheme to try and spread around the costs of providing healthcare to everyone That by definition is insurance.... https://www.investopedia.com/terms/i/insurance.asp https://www.investopedia.com/terms/i/insurance.asp
- samstave 8y agoWatch "drug Short" on the "Dirty Money" series on Netflix. It pretty enraging, and you are likely already familiar with the story, Valeant Pharma and Martin Skrelli.... https://www.netflix.com/watch/80149535?trackId=14170289&tctx=0%2C2%2Ca534ce77-e4b4-4d8c-9077-4da1a44b8a0e-77260350%2C331d9787-d92a-4dfc-b506-3eb056dd1503_30039662X3XX1534727957227%2C331d9787-d92a-4dfc-b506-3eb056dd1503_ROOT https://www.netflix.com/watch/80149535?trackId=14170289&tctx...
- mamon 8y ago...and the other 75% of the time pharmaceutical companies simply factor in the insurance payments into the drug price raising it to unreasonable level.
- drawkbox 8y agoHealth pricing is a weird fixed pricing with all sides in insurance companies, medical suppliers and doctors holding the cards to get the highest prices within the gamed rules with the consumer left out in the cold and each bill a random output that is rarely known beforehand. Part of the problem is healthcare provided through work that skews pricing for large companies over individuals/small/medium businesses and entrepreneurs. If we can't get healthcare removed from employers and have both a private and public option based on Medicare for all. We AT LEAST need legislation to bring in CLEAR pricing for insurance cost and non-insurance rates, similar to the CFPB mortgage Loan Estimate and Closing Disclosure that show all pricing clearly in one sheet of paper both the estimate and the final mortgage. What other product do we buy that the price is not known until after the product/service is rendered? At least some idea of an estimate is even hard to get as each part of the medical pricing matrix scam (insurance companies, medical services/suppliers, doctors, pharmaceuticals) try to keep pricing shrouded to stick it to people wherever they can. The consumer healthcare experience is horrible in the US healthcare system and employers being the insurance companies main customers is a major part of this problem but pricing can be helped with clear regulations and needs to be now.
- analog31 8y agoIn my view, understanding the flow of money in the health care system will be impossible until the system is wholly owned by the government. This may be the primary reason why health care in most civilized countries costs half of what it does here. Until then, everybody who's gouging us accuses everybody else of being the ones who are gouging us.
- ohazi 8y agoWhat would happen if we suddenly made opaque pricing illegal? If anyone sells anything to anyone, they'd be required to publicly disclose the price. Having thought about it for all of thirty seconds, I can't see any downsides. Can anyone convince me otherwise?
- therealdrag0 8y agoNot necessarily a downside, but in some industries I think most people don't care that much if different customers get different prices. Like B2B, often the sales people feel out and negotiate a customer to see how high they can sell a product/service for. And that can actually be nice for small companies. They are probably getting subsidized by larger companies to some extent. I know the company I work for has negotiated very aggressively on some of our infrastructure pieces (metrics, config-management, db etc), where there was no way we could afford the sticker price. EDIT: OTOH making opaque prices illegal, wouldn't bar negotiation.
- pasbesoin 8y agoI wonder how much we'd save if we just (say, "economically", for the sake of "civil" speech) whacked all the middlemen. It's like going to the grocery store and wondering how much this "Monopoly" game (just came up in conversation with the clerk at the checkout lane, this evening) is really costing you. Bunch of "marketing" gurus in suits. On top of the "prizes", I'm paying for them and their suit. Bah
- alex_hitchins 8y agoCan someone explin to me how the US prescription process works? As someone in the UK it seems quite alien.
- zifnab06 8y agoIt's always seemed weird to me as well. Let's say you go to the doctor for something like strep throat. You get a prescription for an antibiotic. Doctors offices don't carry drugs, so you take this prescription to a pharmacy to fill it. The pharmacy is a third party that isn't affiliated with the doctor's office. Only doctors can write prescriptions, and as far as I'm aware only pharmacists can fill them. Pharmacists aren't allowed to write prescriptions, even if it's something trivial. On the insurance side, it's a nightmare. The doctor probably charges your insurance $200 for the office visit. Your insurance has a negotiated rate with the doctor's office for $150. You have a coinsurance of 50% if you've met your deductible, so assuming you haven't hit your max out of pocket for the year you pay $75. If you haven't met your deductible (some arbitrary amount you have to pay on top of paying for insurance) you pay $150. If you have hit this max out of pocket number, you'd pay 0. The $50 goes into the void. My employers insurance is something like a $1000 deductible / $5000 max out of pocket / 75% coinsurance. When you get the prescription filled, well, I have no idea how this insane process works. Last time I needed antibiotics the receipt had a "before insurance" amount of $50 with an actual cost to me of $4. I have no idea where the $46 went or what my insurance actually paid.
- alex_hitchins 8y agoIn the UK, I go to a doctor, get the prescription. Some doctors in rural areas have pharmacies joined on but I think the majority don't. I go to the pharmacy, hand in my prescription and pay £8.80 per item (so two boxes of the same drug is £8.80). I pay upfront, so it costs me £104 a year for anything prescribed by an NHS doctor. I see US folks talk about getting half their prescription filled, or seemingly using the same prescription multiple times. We can submit repeat prescriptions (such as I do for BP etc). but the actual prescription 'document' is a one time deal. It's very, very odd to me the way it's set up over there. Especially so that some people fight so hard against change.
- nobrains 8y agoI live in Dubai. I used to get glasses made for AED 100 - AED 200 (USD 27 to USD 54) when I was young, based on what I remember from visits to the opticians with my dad. No insurance. Sometime after that insurance was introduced. Now, as an adult I pay AED 100 - AED 200 (USD 27 - USD 54) [basically the same amount] as 20% co-insurance when getting glasses. Note 1: USD and AED are pegged. Note 2: There has been inflation, but not that much. Tea increased from AED 1 to AED 1.5. Taxi increased from AED 10 to AED 20. Clothes increased 50% perhaps.
- skate22 8y agoSlightly off topic, but you can order glasses (frames and lenses) for under $10 on zennioptical.com Ive ordered my last 3 pairs there, and will never pay $200 for glasses again
- markvdb 8y agoHealthcare and profit don't go together. This is just exhibit n° 31415926535897932384626433. What happens in the software world when you see twentyseven useless levels of abstraction? Exactly the same. You smell a rat. In my ideal world: * Healthcare research funding to come from the public sector and donations only.[0] * Healthcare products can only be sold once the production process is verifiably fully publicly documented. This means independent reproduction by multiple reputable non-profits. * Market based generics manufacturers handle production. Competitors (for profit or non-profit) jump in if pricing gets out of hand. * Healthcare education free to students. * Only non-profit healthcare services allowed. * Compensation for people providing healthcare services is linked to median income. [0] This is not such a big difference as one would think, as more than half of the basic research in the field is actually publicly funded already.
- arethuza 8y ago"Only non-profit healthcare services allowed." Not sure if this is required - the UK manages to have a socialist health care system (the NHS) for the vast majority and a relatively small private healthcare system for those who want treatments not covered by the NHS, or a nicer room etc. I'm not sure I'd be happy with completely banning access to private healthcare - although I'd prefer it if the NHS was resourced to a level where there really wasn't much need to to go private (which certainly used to be the case).
- ollie87 8y agoThe NHS is a partnership with the private sector any way, because GPs are greedy. All GP practices in the UK are privately run.
- Khaine 8y agoI wouldn't hold the NHS up as a paragon of virtue. I got sick on a recent trip to London and tried to get in to see a GP under the NHS and it was impossible. The clinics near my hotel only accepted same day bookings. I tried calling just after opening hours and the phone was engaged. I managed to get through 15 minutes after the clinic opened and the clinic was booked out for the day and I would have to call back the next day. I tried a number of clinics and they were all booked out. I was lucky that I wasn't that sick and got better. Otherwise, I was looking at an exorbitant fee to see a private doctor. I was shocked, as I always assumed that the NHS was better than the system we have in Australia. I think that there are lots of perverse incentives involved in Medicine and Healthcare. Government intervention is required to balance out these incentives from profit takers and consumers (i.e. smokers, obesity, etc). I'm not sure that any model in the world right now gets the balance right.
- refurb 8y agoMaybe this is a dumb idea, but why not change the laws so medical insurance is more like car insurance - the insurance company works for me? If I get into an accident and it’s the other drivers fault, my insurance goes after them for the money. Would be interesting if once a physician decides to perform services for you, he/she is bound by the insurance you have. If they don’t like it, then they work it out with the insurance company, not you. As a patient, you’d know up front what your responsibility is. Would sure as hell speed things up in terms of physicians and insurance companies figuring shit out.
- turc1656 8y ago"Would be interesting if once a physician decides to perform services for you, he/she is bound by the insurance you have." That's not how the car insurance model works. You have an agreement with your insurance company to provide a certain amount of coverage, irrespective of what has actually happened. If, for example, there is $2,500 of damage, and insurance covers $2,000 of it, the mechanic isn't stuck eating $500. You get billed for that, and rightly so. The mechanic is specifically (and legally) bound to offer the same service/repair at the same price. The mechanic cannot quote you differently for a repair based on the insurance you have and is not bound to any agreement with your insurance company. The mechanic merely accepts the remittance made by the insurance company on your behalf as being towards the total repair cost.
- gumby 8y ago> Would be interesting if once a physician decides to perform services for you, he/she is bound by the insurance you have. Umm, that is how it works. Doctors typically won't prescribe tests or treatments not covered by your insurance.
- stevetodd 8y agoPrices vary also a ton from pharmacy to pharmacy. I recently discovered GoodRx (https://goodrx.com/ https://goodrx.com/), which has been extremely helpful in minimizing prescription costs. * Not affiliated.
- panda888888 8y agoI have so much experience with this, as do thousands of women. Before the ACA was enacted, insurers were allowed to charge copays for birth control pills. I was paying $50/month ($600/year) for something that cost literally pennies for them to manufacture. Generic birth control pills are one of the most common, cheapest medicines out there. I'm glad that the ACA outlawed copays for them.
- swebs 8y ago>I was paying $50/month ($600/year) for something that cost literally pennies for them to manufacture. This applies to the vast majority of drugs. Most of the cost either goes to recouping R&D or funding less profitable drugs.
- panda888888 8y agoTrue. My point is that the most common drugs are often the cheapest, so this 25% number quoted in the article isn't a surprise at all. I actually would have guessed that it would be higher.