4 ms·

This looks like a case study of what is wrong with the US healthcare system. There isn't much discussion of why it's expensive in the US specifically. In other

by omh 7y ago

This looks like a case study of what is wrong with the US healthcare system. There isn't much discussion of why it's expensive in the US specifically. In other countries insulin prices haven't risen in the same way and are still affordable. So why is the price gouging only happening in the US? As a T1 diabetic in the UK, where the wonderful NHS covers all of my insulin costs, this is one reason why I'd never be able to move to or work in the US.

ataturk 7y ago
How much is your overall tax rate? Do you even know? The "wonderful" NHS is fucking over somebody so you can have your cheap whatever. There's no free lunch.
dx7tnt 7y ago
And a great reason for why you wouldn't want to.
adventured 7y ago
It's because the US healthcare system is a nightmare combination of extreme government control & regulation, and corporatism. They socialize the cost and privatize the profit, to the benefit of a small percentage of the population that works in those fields or invests into them. It's a very large, regressive wealth transfer. You can only do that with the intentional, direct assistance of the governments (federal + state governments) as enablers that protect the healthcare cartels and worker guilds.
coldpie 7y ago
> As a T1 diabetic in the UK, where the wonderful NHS covers all of my insulin costs, this is one reason why I'd never be able to move to or work in the US. I'm a T1 Diabetic in the US and I consider myself very lucky to work in software. I have good insurance, so my medication only costs me about $200 per month. That's just an additional cost I have to pay to be alive, on top of all the other stuff everyone else has to pay for, too. If I had a lower paying job, or a job with less good health insurance, I can see how I'd be priced out of living.
- chadcmulligan 7y ago
  I'm sorry but I find that horrifying. I'm in Australia, my brothers recently diagnosed as a T1 diabetic, he's currently taking a career break to spend time with his family and get his health and medication all sorted out. Thats all fine here because the costs are reasonable, I see these reports form the US and can't help but wonder when it will get here, most 'innovations' do, fortunately the US health system doesn't seem to be getting a foot hold here. It seems to me, as an observer, that the health system along with the cost of education have been set up to produce a slave class, I could be wrong but its definitely something that I fight to keep out of here. Five years or so ago I was regarded as a socialist, but with how things are going, most people I speak to no longer argue about it, so it seems the battle is being won here. I find it hard to understand how there aren't marches in the street over there about this.
  - coldpie 7y ago
    It's bad, but it's not all that bad. Most jobs, such as mine, provide health insurance that makes costs at least manageable, if not reasonable. I live a happy and comfortable life, despite the $200 monthly tithe to the CEOs of the insurance and pharmaceutical companies. And there is progress being made. The ACA passed under Obama was a very significant step forward, and public perception is shifting in favor of more government involvement in healthcare[1]. As with most things, the problem is money in politics and media. Republicans resist any attempt to slow the accumulation of money into the hands of the ultra-wealthy, and also own the most popular news channels, so they've convinced a significant chunk of the population that making the wealthy wealthier will somehow help them. A good chunk of Democrats are also paid to oppose changes to the current healthcare regime. But there's a growing number of Democrats actively campaigning for single-payer and other sane systems, and support among voters for single-payer is also growing[2]. There's hope. The situation isn't so bad that violence is the answer, yet. [1] https://www.pewresearch.org/fact-tank/2018/10/03/most-continue-to-say-ensuring-health-care-coverage-is-governments-responsibility/ https://www.pewresearch.org/fact-tank/2018/10/03/most-contin... [2] https://thehill.com/policy/healthcare/339247-poll-support-grows-for-single-payer-healthcare https://thehill.com/policy/healthcare/339247-poll-support-gr...
goldcd 7y ago
It was touched on - there's the "official list price" (which has gone up) and the "price actually paid by large providers" (which has gone down). My best guess is that the price rises were to bring in some immediate profits in the short term ("this quarter isn't looking good") and them these were shortly followed by the compensating discount you have to give to your pissed off customer. Problem was that nobody gave a toss about the profit margin on the lone guy paying $1000 a month (or $1300 a month) at retail.
1123581321 7y ago
The reason is that there is demand for the newest drugs and insurance will pay for it. In the US, doctors quickly switched patients from vials to pens, from Lantus to Tresiba, etc. The price goes up because insurance/PBMs negotiate large discounts. Most full-blown diabetics have two insulin prescriptions and after insurance pay $50-100/mo in out-of-pocket costs, so the increases are hidden from them—hence the need for articles like this one.
treis 7y ago
>In other countries insulin prices haven't risen in the same way and are still affordable. So why is the price gouging only happening in the US? The price hasn't really risen in the US either. Or at least not as much as the article implies. The list price has gone up but the corresponding discount given to insurance companies via PBM has gone up about the same. For most people it doesn't make a difference because they buy through insurance. For people like in TFA they get screwed because they have to pay list price. Theoretically, the number of people in that situation should be 0 post Obama care but obviously there are cracks. Unfortunately, the guy in the the articld fell through a crack. Mostly because he didn't realiZe that buying through insurance would save him a bunch of money. Or maybe he was at the wrong pharmacy to get a huge manufacturer discount.
- ubertakter 7y ago
  And this is a good illustration of how the system is completely fucked up. No part of what you wrote is sane (I'm not implying anything about you, just the system). The corporations have gamed the system where it's now normal to suggest that you are responsible for determining and getting discounts, in this instance that it was on the subject of the article to figure out the system, the system that was supposed to be helping him. Being in an employee-owned company, I'm very aware of how much the company pays for insurance. It never goes down, it always goes up. The company has to switch to plans where employees pay larger and larger deductibles, just to keep the insurance cost increases down in the 10% per year range. Usually the reason costs go up is because we "use it too much", people need to use generic drugs, etc. Of course, it's hard to determine actual costs in such a convoluted system, but orders of magnitude cost increases for medicines obviously plays a significant role.
  - treis 7y ago
    > The corporations have gamed the system where it's now normal to suggest that you are responsible for determining and getting discounts It's not really that difficult. You just buy insurance or get on Medicare/Medicaid and you get the discounts. That's not to say that the system hasn't been grossly perverted. Just that the hoops aren't difficult to jump through for pretty much everyone.
makomk 7y ago
It's worth noting that this isn't about the type of insulin either - the NHS generally prescribes the new, fancy insulin analogues to type 1 diabetics as their first choice because they provide actual clinical benefits, despite this article's claim that they're a giant con that only exists to line the pharmaceutical industry's pockets. In particular, Lantus used to be the recommened long-acting insulin of choice for new patients until they switched to something even newer a few years back.

by omh 7y ago

ataturk 7y ago

How much is your overall tax rate? Do you even know? The "wonderful" NHS is fucking over somebody so you can have your cheap whatever. There's no free lunch.

dx7tnt 7y ago

And a great reason for why you wouldn't want to.

adventured 7y ago

It's because the US healthcare system is a nightmare combination of extreme government control & regulation, and corporatism. They socialize the cost and privatize the profit, to the benefit of a small percentage of the population that works in those fields or invests into them. It's a very large, regressive wealth transfer. You can only do that with the intentional, direct assistance of the governments (federal + state governments) as enablers that protect the healthcare cartels and worker guilds.

coldpie 7y ago

> As a T1 diabetic in the UK, where the wonderful NHS covers all of my insulin costs, this is one reason why I'd never be able to move to or work in the US. I'm a T1 Diabetic in the US and I consider myself very lucky to work in software. I have good insurance, so my medication only costs me about $200 per month. That's just an additional cost I have to pay to be alive, on top of all the other stuff everyone else has to pay for, too. If I had a lower paying job, or a job with less good health insurance, I can see how I'd be priced out of living.

chadcmulligan 7y ago
I'm sorry but I find that horrifying. I'm in Australia, my brothers recently diagnosed as a T1 diabetic, he's currently taking a career break to spend time with his family and get his health and medication all sorted out. Thats all fine here because the costs are reasonable, I see these reports form the US and can't help but wonder when it will get here, most 'innovations' do, fortunately the US health system doesn't seem to be getting a foot hold here. It seems to me, as an observer, that the health system along with the cost of education have been set up to produce a slave class, I could be wrong but its definitely something that I fight to keep out of here. Five years or so ago I was regarded as a socialist, but with how things are going, most people I speak to no longer argue about it, so it seems the battle is being won here. I find it hard to understand how there aren't marches in the street over there about this.
- coldpie 7y ago
  It's bad, but it's not all that bad. Most jobs, such as mine, provide health insurance that makes costs at least manageable, if not reasonable. I live a happy and comfortable life, despite the $200 monthly tithe to the CEOs of the insurance and pharmaceutical companies. And there is progress being made. The ACA passed under Obama was a very significant step forward, and public perception is shifting in favor of more government involvement in healthcare[1]. As with most things, the problem is money in politics and media. Republicans resist any attempt to slow the accumulation of money into the hands of the ultra-wealthy, and also own the most popular news channels, so they've convinced a significant chunk of the population that making the wealthy wealthier will somehow help them. A good chunk of Democrats are also paid to oppose changes to the current healthcare regime. But there's a growing number of Democrats actively campaigning for single-payer and other sane systems, and support among voters for single-payer is also growing[2]. There's hope. The situation isn't so bad that violence is the answer, yet. [1] https://www.pewresearch.org/fact-tank/2018/10/03/most-continue-to-say-ensuring-health-care-coverage-is-governments-responsibility/ https://www.pewresearch.org/fact-tank/2018/10/03/most-contin... [2] https://thehill.com/policy/healthcare/339247-poll-support-grows-for-single-payer-healthcare https://thehill.com/policy/healthcare/339247-poll-support-gr...

goldcd 7y ago

It was touched on - there's the "official list price" (which has gone up) and the "price actually paid by large providers" (which has gone down). My best guess is that the price rises were to bring in some immediate profits in the short term ("this quarter isn't looking good") and them these were shortly followed by the compensating discount you have to give to your pissed off customer. Problem was that nobody gave a toss about the profit margin on the lone guy paying $1000 a month (or $1300 a month) at retail.

1123581321 7y ago

The reason is that there is demand for the newest drugs and insurance will pay for it. In the US, doctors quickly switched patients from vials to pens, from Lantus to Tresiba, etc. The price goes up because insurance/PBMs negotiate large discounts. Most full-blown diabetics have two insulin prescriptions and after insurance pay $50-100/mo in out-of-pocket costs, so the increases are hidden from them—hence the need for articles like this one.

treis 7y ago

>In other countries insulin prices haven't risen in the same way and are still affordable. So why is the price gouging only happening in the US? The price hasn't really risen in the US either. Or at least not as much as the article implies. The list price has gone up but the corresponding discount given to insurance companies via PBM has gone up about the same. For most people it doesn't make a difference because they buy through insurance. For people like in TFA they get screwed because they have to pay list price. Theoretically, the number of people in that situation should be 0 post Obama care but obviously there are cracks. Unfortunately, the guy in the the articld fell through a crack. Mostly because he didn't realiZe that buying through insurance would save him a bunch of money. Or maybe he was at the wrong pharmacy to get a huge manufacturer discount.

ubertakter 7y ago
And this is a good illustration of how the system is completely fucked up. No part of what you wrote is sane (I'm not implying anything about you, just the system). The corporations have gamed the system where it's now normal to suggest that you are responsible for determining and getting discounts, in this instance that it was on the subject of the article to figure out the system, the system that was supposed to be helping him. Being in an employee-owned company, I'm very aware of how much the company pays for insurance. It never goes down, it always goes up. The company has to switch to plans where employees pay larger and larger deductibles, just to keep the insurance cost increases down in the 10% per year range. Usually the reason costs go up is because we "use it too much", people need to use generic drugs, etc. Of course, it's hard to determine actual costs in such a convoluted system, but orders of magnitude cost increases for medicines obviously plays a significant role.
- treis 7y ago
  > The corporations have gamed the system where it's now normal to suggest that you are responsible for determining and getting discounts It's not really that difficult. You just buy insurance or get on Medicare/Medicaid and you get the discounts. That's not to say that the system hasn't been grossly perverted. Just that the hoops aren't difficult to jump through for pretty much everyone.

makomk 7y ago

It's worth noting that this isn't about the type of insulin either - the NHS generally prescribes the new, fancy insulin analogues to type 1 diabetics as their first choice because they provide actual clinical benefits, despite this article's claim that they're a giant con that only exists to line the pharmaceutical industry's pockets. In particular, Lantus used to be the recommened long-acting insulin of choice for new patients until they switched to something even newer a few years back.