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My friend’s daughter needs an eczema crème and was told the price was $1000 per tube and wasn’t covered under insurance. The price in Canada is around $100. Ye
by blindriver 1y ago
My friend’s daughter needs an eczema crème and was told the price was $1000 per tube and wasn’t covered under insurance.
The price in Canada is around $100. Yes, Big Pharma gouges Americans.
- alephnerd 1y agoThat's your insurance provider that told you no - not "Big Pharma". Which is what TFA points out as well: "The bulk of the rents is captured instead by providers of health-care services such as hospitals and the system’s true money-makers: insurers, pharmacy-benefit managers and other middlemen taking advantage of its opacity. They have higher costs of capital than drugmakers, but they also clear our 10% hurdle much more comfortably (chart 3)"
- tptacek 1y agoBoth are counterparties to negotiations that set price and availability, so it probably doesn't make sense to separate their role.
- Analemma_ 1y agoEveryone is guilty here, because once one sector forms a monopoly, they have monopoly pricing power, and so their counterparty sectors have to form a monopoly as well to keep leverage in negotiations. 50 years ago, there were many more pharma companies, many more insurance companies, and many more hospitals under individual ownership. First the pharma companies consolidated, which give them monopoly pricing power over insurers. So then the insurance companies consolidated to they could negotiate on equal footing, but then they had monopoly pricing power over the hospitals. So then hospitals consolidated so they could negotiate. And now after decades of this, we're right back we're started, except for consumers, who can't consolidate and hence get fucked. The two solutions here are either breaking up all the monopolies at the same time-- pharma, insurance, and hospitals-- so that everyone has market competition again, or letting health care consumers consolidate so they have pricing leverage-- i.e., forming a single-payer health-care system where the government negotiates deals on behalf of a 330+-million payer pool. It does not make sense to either blame or spare one single sector: the pharmas, insurers and hospitals are all guilty, though in a sense all of their hands were forced by their counterparties. It's a coordination problem of exactly the kind government is supposed to solve, hence why government-run health care eventually seems like the only option.
- SJC_Hacker 1y ago> So then hospitals consolidated so they could negotiate. And now after decades of this, we're right back we're started, except for consumers, who can't consolidate and hence get fucked. Consumer consolidation is called voting. Its too bad most consumers have voted in politicians who don't represent their best interests
- thmsths 1y agoI feel like you explained how we got there and our options to fix it perfectly. As you point out we have monopolies (or close to) at every single step. Whatever bandaid people and politician can come up with will quickly be neutralized by these conglomerates, at this point, any half measure is basically useless or has severe tradeoffs.
- potato3732842 1y ago17% of the US GDP is healthcare so that's probably about 20% of the country that will scream bloody murder if you try and touch it in any way that makes it cost the other 80% less.
- FireBeyond 1y agoYou're also neglecting the insurers and PBMs. Health insurers are limited by law as to profit margins. So how to make more money? Raise prices, or signal to providers that you'll pay higher. Because if your incoming premiums have to rise, then that percentage that can be captured as profit rises. But wait... what if you (an insurer) build/buy a middle-man to route prescription money through? That isn't covered by those profit margin constraints. So you can just up the prices of prescriptions and siphon profits that way. Even better, you can do entirely sketchy BS (looking at you, Aetna, but also others): "Sure, you can get your scripts filled at your local pharmacy... but only for <=30 day supplies. We'll reject any script authorization for a supply of 31+ days, like those extremely convenient 90 day refills... unless you use the mail-order pharmacy that is wholly owned by us", thus making people choose between convenience and pricing.
- darth_avocado 1y agoThe more the middle men, the more the cost. It’s not rocket science that big pharma aren’t the only reason why the costs are high. Proof: - I can get plenty of drugs cheaper if I don’t use my insurance - I can get hospital services cheaper if I don’t use my insurance. There have been times where my copay after meeting the deductible and the insurance coverage is higher than my entire out of pocket cost if I don’t use my insurance.
- blindriver 1y agoThe $1000 price is without insurance so what you're saying doesn't apply.
- deadbabe 1y agoSo it should cost $550 in America and $550 in Canada.
- tptacek 1y agoIt depends on your moral system. Equalizing costs across markets almost certainly reduces the number of people who can be served by a medication.
- cpfohl 1y agoI'd be really interested to see these costs averaged (like parent post) but then re-distributed by average income...
- deadbabe 1y agoUm it also increases the number of Americans who can now access those drugs? So whose healthcare is more important to you?
- tptacek 1y agoIt decreases the total number of people with access. Like I said: it depends on your moral system.
- deadbabe 1y agoThe people paying the most in healthcare costs should be getting priority to treatments and medicine don’t you think? Isn’t that fair? If you are getting cheap healthcare because these people are basically subsidizing it for you, and they’re not even getting anything, then you’re the leech. These people laughing at Americans having to go bankrupt to afford $1000 medicine that they only have to pay $10 for in their country: fuck em. How I wish we could distribute the costs evenly…
- tptacek 1y agoDepends on your moral system.
- newyankee 1y agoIssue is more like 'the cure for high prices is high prices' does not seem to work in healthcare
- mrguyorama 1y agoWhich, to anyone who knows even the basic econ ideology that would suggest such a claim, is "duh". You can choose to not repair your car. You cannot choose to not repair your body except in extreme cases. Demand will always be infinite. We don't have the technology to saturate the healthcare market any time soon. Meanwhile, plenty of Americans still insist that they "Don't want to pay for freeloaders" as the current system means hospitals overcharge them to subsidize people with no insurance who come into the emergency room (a much much much more expensive healthcare onramp) and require care. But Americans will fix that shortly. Once hospitals are allowed to just let uninsured people die, you can rest assured that your money will not be used to subsidize poor people. Instead, every excess dime you spend will go right into the profit column of some executive's spreadsheet!
- goobatrooba 1y agoIt is really surreal to see the Americans on here jump to the conclusion that prices should rise everywhere else, rather than that their prices are simply unnecessarily high as there are no proper pricing mechanisms in the US. If you do have that view please show me some evidence that the US prices cross fund other countries rather than just pad shareholders' profits and CEO pay. No, not partisan papers (plenty of US right wing think-tank papers which confuse corporate income with actual R&D) but actual data on research subsidies per capita or a similar comparable unit.