4 ms·

Please tell me insurance pays for most of that?

bdcravens 3y ago
Of course :-) Vertex's copay assistance is also very generous, even for those with high income. I have a good developer income, and pay essentially nothing.
- trollian 3y ago
  Not having to deal with insurance & copay shenanigans for my daughter's CF meds is one of the things that keeps me at the large tech company I work at...
- amluto 3y ago
  I personally consider copay assistance to be essentially fraudulent as a concept. The drug company is literally paying the patient to invoke an insurance benefit that kicks a bunch of money to the drug company. I imagine that when an auto body shop pays their customers’ deductibles, it is fraud, legally and ethically.
Aurornis 3y ago
Nobody actually pays those sky-high drug prices themselves. It’s a scheme to extract as much money as possible from insurers. Companies often have programs that provide the drug free of charge (or at a nominal price) to people without insurance. They might also have “copay assistance” programs where they reimburse patients for their copay to bring the out of pocket costs down. The goal is to maximize the amount billed to insurance companies. They’ll go out of their way to reduce the amount billed to the patient directly, because that results in more patients signing up and enabling them to bill more insurance companies. It’s not a good system, but it’s how things work right now. Nobody pays that $100-300K price themselves. Well, we all do through higher insurance costs.
- koolba 3y ago
  > Nobody actually pays those sky-high drug prices themselves. It’s a scheme to extract as much money as possible from insurers. Alternatively, we all pay those sky high prices. It’s baked into our premiums.
  - hackernewds 3y ago
    while employed Premiums = $0. while unemployed, premiums = $3600/year for $0 deductibles for private insurance. would you rather pay 10% of your income in higher taxes like so-called universal healthcare providing countries maintain?
    - viciousvoxel 3y ago
      Yes, personally. Instead of my employer paying for my healthcare (and that being factored into base salary), I would rather receive that money as salary and pay higher taxes. The idea of employers paying for health insurance in the US only came about in the first half of the last century as a way for companies to attract employees without having to raise/compete on salary.
    - verall 3y ago
      Can you give me a link or reference to this incredible $3600/year for $0 deductables insurance? That's cheaper than I pay with my employer covering most of my healthcare. That could be literally lifesaving for friends of mine who currently have to choose between paying about $800/month for insurance with deductables or going without.
      - heavyset_go 3y ago
        One look at the individual market for insurance shows that you will be paying many times the quoted figure if you want insurance that you can actually use, and you will have $8k deductibles and higher out-of-pocket maximums with cheaper insurance.
        verall 3y ago
- masklinn 3y ago
  > It’s a scheme to extract as much money as possible from insurers. [...] The goal is to maximize the amount billed to insurance companies. A big part of the goal is being able to bill a profit, insurers generally require significant drug rebates for coverage. So you triple the sticker price of the drug, offer a 66% drug rebate which the insurer can advertise to their client under the guise of fighting for their access, and they cover your drug at essentially the price you wanted for it in the first place (modulo nonsense like prior authorization, and insurance kickbacks).

Of course :-) Vertex's copay assistance is also very generous, even for those with high income. I have a good developer income, and pay essentially nothing.

trollian 3y ago
Not having to deal with insurance & copay shenanigans for my daughter's CF meds is one of the things that keeps me at the large tech company I work at...
amluto 3y ago
I personally consider copay assistance to be essentially fraudulent as a concept. The drug company is literally paying the patient to invoke an insurance benefit that kicks a bunch of money to the drug company. I imagine that when an auto body shop pays their customers’ deductibles, it is fraud, legally and ethically.

Aurornis 3y ago

Nobody actually pays those sky-high drug prices themselves. It’s a scheme to extract as much money as possible from insurers. Companies often have programs that provide the drug free of charge (or at a nominal price) to people without insurance. They might also have “copay assistance” programs where they reimburse patients for their copay to bring the out of pocket costs down. The goal is to maximize the amount billed to insurance companies. They’ll go out of their way to reduce the amount billed to the patient directly, because that results in more patients signing up and enabling them to bill more insurance companies. It’s not a good system, but it’s how things work right now. Nobody pays that $100-300K price themselves. Well, we all do through higher insurance costs.

koolba 3y ago
> Nobody actually pays those sky-high drug prices themselves. It’s a scheme to extract as much money as possible from insurers. Alternatively, we all pay those sky high prices. It’s baked into our premiums.
- hackernewds 3y ago
  while employed Premiums = $0. while unemployed, premiums = $3600/year for $0 deductibles for private insurance. would you rather pay 10% of your income in higher taxes like so-called universal healthcare providing countries maintain?
  - viciousvoxel 3y ago
    Yes, personally. Instead of my employer paying for my healthcare (and that being factored into base salary), I would rather receive that money as salary and pay higher taxes. The idea of employers paying for health insurance in the US only came about in the first half of the last century as a way for companies to attract employees without having to raise/compete on salary.
  - verall 3y ago
    Can you give me a link or reference to this incredible $3600/year for $0 deductables insurance? That's cheaper than I pay with my employer covering most of my healthcare. That could be literally lifesaving for friends of mine who currently have to choose between paying about $800/month for insurance with deductables or going without.
    - heavyset_go 3y ago
      One look at the individual market for insurance shows that you will be paying many times the quoted figure if you want insurance that you can actually use, and you will have $8k deductibles and higher out-of-pocket maximums with cheaper insurance.
      - verall 3y ago
masklinn 3y ago
> It’s a scheme to extract as much money as possible from insurers. [...] The goal is to maximize the amount billed to insurance companies. A big part of the goal is being able to bill a profit, insurers generally require significant drug rebates for coverage. So you triple the sticker price of the drug, offer a 66% drug rebate which the insurer can advertise to their client under the guise of fighting for their access, and they cover your drug at essentially the price you wanted for it in the first place (modulo nonsense like prior authorization, and insurance kickbacks).