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Why is coupon clipping for food (without which you starve and die) not a problem? One of the biggest problems with healthcare today is a lack of price transpar

by bhupy 6y ago

Why is coupon clipping for food (without which you starve and die) not a problem? One of the biggest problems with healthcare today is a lack of price transparency, and GoodRx appears to offer that. Most healthcare systems in the world operate on price transparency, and as long as that's the case, there should always be a need for the services GoodRx offers.

arcticbull 6y ago
> Why is coupon clipping for food (without which you starve and die) not a problem? The government already does an awful lot to make food affordable in the US, including subsidizing corn to well below the cost of production via continuous re-authorization of the Farm Bill. Then there's food banks, and SNAP. Both of which should be expanded. The government does absolutely nothing to make drugs affordable. At all. > Most healthcare systems in the world operate on price transparency, and as long as that's the case, there should always be a need for the services GoodRx offers. Most healthcare systems in the world operate by having the government form a bulk buying organization and negotiating the price of drugs down to a fraction of what Americans are forced to pay even in places without socialized prescription drug coverage. The reason drugs in Canada are cheap is because the provinces negotiate the prices, not because they socialize the costs. There is very limited socialized prescription drug coverage in Canada. So when the government permitted re-importation of drugs from Canada, they basically refused to negotiate themselves and wanted to instead rely on Canadian provinces to negotiate on their behalf. Nutty. One way of solving this would be to have Medicare negotiate the price of all drugs in the US. [edit] There's lots of comprehensive solutions, and none of them involve coupon clipping.
- bhupy 6y ago
  > Well, thanks to the government, there's socialized food for those in need, in the form of food banks and SNAP. Yes. Why can't we have the same for prescription drugs? > Most healthcare systems in the world operate by having the government form a bulk buying organization and negotiating the price of drugs down to a fraction of what Americans are forced to pay even in places without socialized prescription drug coverage. This isn't true. Switzerland operates on an entirely private insurance model. Ditto the Netherlands. Singapore (which enjoys the lowest per capita health expenditures and some of the best outcomes) is almost entirely driven by transparent pricing and regulations. Germany uses public-private hybrid model. In France, the NHI operates on a reimbursement model, where you still buy drugs at a pharmacy and shop around by price. The Canadian model is great, but it's not nearly as efficient as Singapore's. > One way of solving this would be to have Medicare negotiate the price of all drugs in the US. It's not the only way, you can also just institute price controls. Monopsony negotiation is in-effect the same thing. (addressing your edit) > The government already does an awful lot to make food affordable in the US, including subsidizing corn to well below the cost of production via continuous re-authorization of the Farm Bill. > The government does absolutely nothing to make drugs affordable. At all. Yes, all of what you said is correct there, and yet you still have a world where you shop for food on the basis of transparent pricing and sometimes even take advantage of coupons. Just like regulations and welfare co-exist with market pricing with food, so too can it exist with prescription drugs. Even in a world where the government offers direct subsidies on drugs, there is a place for GoodRx and its model. > [edit] There's lots of comprehensive solutions, and none of them involve coupon clipping. But that's just not true. GoodRx would, for example, do very well in Singapore, Switzerland, the Netherlands, and Germany. https://www.wbur.org/onpoint/2019/06/24/us-health-care-drugs-insurance-germany https://www.wbur.org/onpoint/2019/06/24/us-health-care-drugs...
  - deleted 6y ago
    [deleted]
  - arcticbull 6y ago
    > Switzerland operates on an entirely private insurance model. Switzerland probably isn't a good example, they're the second most expensive healthcare system in the world, right after America.
    - bhupy 6y ago
      Switzerland also enjoys some of the best health outcomes, though. Unlike America, Switzerland has the highest average life expectancy, the lowest infant mortality, some of the best cancer outcomes, and respiratory illness outcomes. Switzerland is an often used example because they actually get something for what they pay, unlike America. https://www.rd.com/article/switzerland-worlds-best-healthcare-system/ https://www.rd.com/article/switzerland-worlds-best-healthcar... The US pays more for less. Switzerland pays more for more. Canada pays less for adequate. Singapore, however, earns the distinction of paying less for more: https://www.bloomberg.com/graphics/infographics/most-efficient-health-care-around-the-world.html https://www.bloomberg.com/graphics/infographics/most-efficie...
      - timbo1642 6y ago
        > Switzerland also enjoys some of the best health outcomes, though. Unlike America, Switzerland has the highest average life expectancy, the lowest infant mortality, some of the best cancer outcomes, and respiratory illness outcomes. Switzerland is an often used example because they actually get something for what they pay, unlike America. A lot of this has to do with following directions. Tell an obese American to work out, not smoke, take medications properly, etc... and they'll just say "yeah whatever" Our diets are also horrible, most people refuse to exercise, and stress is super high.
- WarOnPrivacy 6y ago
  > there's socialized food for those in need, in the form of food banks and SNAP. No there isn't. That is, the places that tend to have usable, subsidized healthcare for the poor are the same places that tend to have subsidized food for the poor. Likewise for those that don't. Source: Years with freq periods of little/no food (and 5 kids).
  - arcticbull 6y ago
    I agree those programs should be much better. It's also worth considering that the US already spends the least amount on food in the entire world [1] but the most in health care. [1] https://www.ibtimes.com/us-spends-less-food-any-other-country-world-maps-1546945 https://www.ibtimes.com/us-spends-less-food-any-other-countr...
  - timbo1642 6y ago
    > Source: Years with freq periods of little/no food (and 5 kids). Can I ask why 5 kids when you cannot afford them? Lots of people do this and I don't understand the logic
- smnrchrds 6y ago
  > The reason drugs in Canada are cheap is because the provinces negotiate the prices, not because they socialize the costs. This is false. The reason they are cheaper in Canada is that the federal government sets the prices based on average price in a list of comparable countries and forces the manufacturers to follow it. https://www.cbc.ca/news/health/prescription-drug-prices-1.3239317 https://www.cbc.ca/news/health/prescription-drug-prices-1.32...
  - arcticbull 6y ago
    Yes, the government negotiates with the manufacturers, sets the price, and if they don't come to an agreement the drug cannot be sold in Canada. That's in line with what I said. Fine, it may need an overhaul, however, it's dramatically more functional than the literally nothing the US does.
    - smnrchrds 6y ago
      To the best of my knowledge, there is no negotiation. The federal government sets the prices unilaterally and forces the manufacturers to follow it.
      - arcticbull 6y ago
        Sounds like a strong negotiation tactic ;) but point taken.
- timbo1642 6y ago
  > Then there's food banks, and SNAP. Both of which should be expanded. Expanded for what? The goal needs to be to get people off of welfare, not more people on it. Too many people are taking advantage of the system and are lifers that are perfectly capable of working. Many do under the table or cheat in other ways to collect it. Tons of people that have never worked a single day in this country and have come from foreign countries are on it. They are only taking advantage of our country. No one on government benefits should have children until they can AFFORD to have children. The burden shouldn't be on taxpayers because they are irresponsible and are providing a horrible life for their child.
paulcole 6y ago
> Why is coupon clipping for food (without which you starve and die) not a problem? Because most food coupons (Based on my experience in the US) are for “luxury” foods like candy, junk, and snacks. Not fruit, veggies, grains, protein.
- bhupy 6y ago
  That’s not true at all. Most coupons are for any type of grocery at a store, usually promotional in nature for new products or stores. I use coupons for all sorts of basic needs, like free ride share rides (transportation), clothing, groceries (or grocery delivery), etc. I even use promotional pricing to pay less in monthly rent in Brooklyn. Food, clothing, transportation, and shelter are not frivolous expenditures, they are basic necessities. I won’t starve or go homeless without the coupons, but they let me save money every month, which I can use for other stuff like video games or stocks or other activities. This is good for consumers.
  - paulcole 6y ago
    Neat. Sounds like your experience is different than mine. Cool that you said my experience is not true at all though.
    - bhupy 6y ago
      The difference between your description of your experience and mine is that mine is inclusive while yours is exclusive. You are making a claim (a quite bold one at that) that coupons are only used for "luxury" food. While I don't deny that there exists coupons used for luxury food, I am making the inclusive claim that they are also commonly used for ordinary food, based on my own experience. Unlike me, you are attempting to prove a negative — that people do not use coupons for every day basic purchases — based solely on your own experience. The burden of proof for your claim is far greater than the burden of proof for mine.
      - paulcole 6y ago
        Read it again bud. > Because most food coupons (Based on my experience in the US) are for “luxury” foods I didn’t say a thing about how coupons are used. Just what the coupons I see can be used for. Classic HN here. Doubling down on misreading a comment.

by bhupy 6y ago

arcticbull 6y ago

> Why is coupon clipping for food (without which you starve and die) not a problem? The government already does an awful lot to make food affordable in the US, including subsidizing corn to well below the cost of production via continuous re-authorization of the Farm Bill. Then there's food banks, and SNAP. Both of which should be expanded. The government does absolutely nothing to make drugs affordable. At all. > Most healthcare systems in the world operate on price transparency, and as long as that's the case, there should always be a need for the services GoodRx offers. Most healthcare systems in the world operate by having the government form a bulk buying organization and negotiating the price of drugs down to a fraction of what Americans are forced to pay even in places without socialized prescription drug coverage. The reason drugs in Canada are cheap is because the provinces negotiate the prices, not because they socialize the costs. There is very limited socialized prescription drug coverage in Canada. So when the government permitted re-importation of drugs from Canada, they basically refused to negotiate themselves and wanted to instead rely on Canadian provinces to negotiate on their behalf. Nutty. One way of solving this would be to have Medicare negotiate the price of all drugs in the US. [edit] There's lots of comprehensive solutions, and none of them involve coupon clipping.

bhupy 6y ago
> Well, thanks to the government, there's socialized food for those in need, in the form of food banks and SNAP. Yes. Why can't we have the same for prescription drugs? > Most healthcare systems in the world operate by having the government form a bulk buying organization and negotiating the price of drugs down to a fraction of what Americans are forced to pay even in places without socialized prescription drug coverage. This isn't true. Switzerland operates on an entirely private insurance model. Ditto the Netherlands. Singapore (which enjoys the lowest per capita health expenditures and some of the best outcomes) is almost entirely driven by transparent pricing and regulations. Germany uses public-private hybrid model. In France, the NHI operates on a reimbursement model, where you still buy drugs at a pharmacy and shop around by price. The Canadian model is great, but it's not nearly as efficient as Singapore's. > One way of solving this would be to have Medicare negotiate the price of all drugs in the US. It's not the only way, you can also just institute price controls. Monopsony negotiation is in-effect the same thing. (addressing your edit) > The government already does an awful lot to make food affordable in the US, including subsidizing corn to well below the cost of production via continuous re-authorization of the Farm Bill. > The government does absolutely nothing to make drugs affordable. At all. Yes, all of what you said is correct there, and yet you still have a world where you shop for food on the basis of transparent pricing and sometimes even take advantage of coupons. Just like regulations and welfare co-exist with market pricing with food, so too can it exist with prescription drugs. Even in a world where the government offers direct subsidies on drugs, there is a place for GoodRx and its model. > [edit] There's lots of comprehensive solutions, and none of them involve coupon clipping. But that's just not true. GoodRx would, for example, do very well in Singapore, Switzerland, the Netherlands, and Germany. https://www.wbur.org/onpoint/2019/06/24/us-health-care-drugs-insurance-germany https://www.wbur.org/onpoint/2019/06/24/us-health-care-drugs...
- deleted 6y ago
  [deleted]
- arcticbull 6y ago
  > Switzerland operates on an entirely private insurance model. Switzerland probably isn't a good example, they're the second most expensive healthcare system in the world, right after America.
  - bhupy 6y ago
    Switzerland also enjoys some of the best health outcomes, though. Unlike America, Switzerland has the highest average life expectancy, the lowest infant mortality, some of the best cancer outcomes, and respiratory illness outcomes. Switzerland is an often used example because they actually get something for what they pay, unlike America. https://www.rd.com/article/switzerland-worlds-best-healthcare-system/ https://www.rd.com/article/switzerland-worlds-best-healthcar... The US pays more for less. Switzerland pays more for more. Canada pays less for adequate. Singapore, however, earns the distinction of paying less for more: https://www.bloomberg.com/graphics/infographics/most-efficient-health-care-around-the-world.html https://www.bloomberg.com/graphics/infographics/most-efficie...
    - timbo1642 6y ago
      > Switzerland also enjoys some of the best health outcomes, though. Unlike America, Switzerland has the highest average life expectancy, the lowest infant mortality, some of the best cancer outcomes, and respiratory illness outcomes. Switzerland is an often used example because they actually get something for what they pay, unlike America. A lot of this has to do with following directions. Tell an obese American to work out, not smoke, take medications properly, etc... and they'll just say "yeah whatever" Our diets are also horrible, most people refuse to exercise, and stress is super high.
WarOnPrivacy 6y ago
> there's socialized food for those in need, in the form of food banks and SNAP. No there isn't. That is, the places that tend to have usable, subsidized healthcare for the poor are the same places that tend to have subsidized food for the poor. Likewise for those that don't. Source: Years with freq periods of little/no food (and 5 kids).
- arcticbull 6y ago
  I agree those programs should be much better. It's also worth considering that the US already spends the least amount on food in the entire world [1] but the most in health care. [1] https://www.ibtimes.com/us-spends-less-food-any-other-country-world-maps-1546945 https://www.ibtimes.com/us-spends-less-food-any-other-countr...
- timbo1642 6y ago
  > Source: Years with freq periods of little/no food (and 5 kids). Can I ask why 5 kids when you cannot afford them? Lots of people do this and I don't understand the logic
smnrchrds 6y ago
> The reason drugs in Canada are cheap is because the provinces negotiate the prices, not because they socialize the costs. This is false. The reason they are cheaper in Canada is that the federal government sets the prices based on average price in a list of comparable countries and forces the manufacturers to follow it. https://www.cbc.ca/news/health/prescription-drug-prices-1.3239317 https://www.cbc.ca/news/health/prescription-drug-prices-1.32...
- arcticbull 6y ago
  Yes, the government negotiates with the manufacturers, sets the price, and if they don't come to an agreement the drug cannot be sold in Canada. That's in line with what I said. Fine, it may need an overhaul, however, it's dramatically more functional than the literally nothing the US does.
  - smnrchrds 6y ago
    To the best of my knowledge, there is no negotiation. The federal government sets the prices unilaterally and forces the manufacturers to follow it.
    - arcticbull 6y ago
      Sounds like a strong negotiation tactic ;) but point taken.
timbo1642 6y ago
> Then there's food banks, and SNAP. Both of which should be expanded. Expanded for what? The goal needs to be to get people off of welfare, not more people on it. Too many people are taking advantage of the system and are lifers that are perfectly capable of working. Many do under the table or cheat in other ways to collect it. Tons of people that have never worked a single day in this country and have come from foreign countries are on it. They are only taking advantage of our country. No one on government benefits should have children until they can AFFORD to have children. The burden shouldn't be on taxpayers because they are irresponsible and are providing a horrible life for their child.

paulcole 6y ago

> Why is coupon clipping for food (without which you starve and die) not a problem? Because most food coupons (Based on my experience in the US) are for “luxury” foods like candy, junk, and snacks. Not fruit, veggies, grains, protein.

bhupy 6y ago
That’s not true at all. Most coupons are for any type of grocery at a store, usually promotional in nature for new products or stores. I use coupons for all sorts of basic needs, like free ride share rides (transportation), clothing, groceries (or grocery delivery), etc. I even use promotional pricing to pay less in monthly rent in Brooklyn. Food, clothing, transportation, and shelter are not frivolous expenditures, they are basic necessities. I won’t starve or go homeless without the coupons, but they let me save money every month, which I can use for other stuff like video games or stocks or other activities. This is good for consumers.
- paulcole 6y ago
  Neat. Sounds like your experience is different than mine. Cool that you said my experience is not true at all though.
  - bhupy 6y ago
    The difference between your description of your experience and mine is that mine is inclusive while yours is exclusive. You are making a claim (a quite bold one at that) that coupons are only used for "luxury" food. While I don't deny that there exists coupons used for luxury food, I am making the inclusive claim that they are also commonly used for ordinary food, based on my own experience. Unlike me, you are attempting to prove a negative — that people do not use coupons for every day basic purchases — based solely on your own experience. The burden of proof for your claim is far greater than the burden of proof for mine.
    - paulcole 6y ago
      Read it again bud. > Because most food coupons (Based on my experience in the US) are for “luxury” foods I didn’t say a thing about how coupons are used. Just what the coupons I see can be used for. Classic HN here. Doubling down on misreading a comment.