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Why is insurance charging anyone for drugs? Shouldn't the pharmacy/doctor/hospital charge the patient and the insurance company pay some percentage of the cost
by kenjackson 2y ago
Why is insurance charging anyone for drugs? Shouldn't the pharmacy/doctor/hospital charge the patient and the insurance company pay some percentage of the cost (maybe negotiating the price of the drugs downward)? It seems we've overcomplicated a system that should be much simpler.
- legitster 2y agoThe report is misleading. What is being alleged here is that PBMs overpriced over the generics. So it's like if Coca-Cola set the price of their can at $50, and NoName at $0.50. So you be are being "overcharged" at the grocery store when you buy the Coke and not the NoName. It's not actually clear from the report that the PBMs actually profited from overcharging. Furthermore, if the doctor prescribes a name brand drug, it's not always the prerogative of the PBM to switch the prescription on behalf of the customer.
- kenjackson 2y agoThank you. That makes sense. Why are you being downvoted? I'd love if someone could say why they're downvoting you, because it seems like you addressed my question -- unless you just fabricated an answer -- but it would be nice if they said that.
- boroboro4 2y agoBecause in reality PBM and insurance company owned by the same corporation, in this case: UnitedHealthcare, UnitedHealthcare Insurance, Optum. This makes it possible for PBM & instance work out any price they want, loophole cap on profit for insurances required by law (15%), and bring cost of healthcare up. Pure fraud it is.