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Message
re: How Do We Fix American Healthcare?
Posted on 8/18/19 at 6:49 pm to RTM4
Posted on 8/18/19 at 6:49 pm to RTM4
quote:
We can't.
It is broken beyond repair without a free market, competitive system.
No reason to pay thousands of dollars for sutures are minor infections. It has gotten out of hand and cannot be fixed.
And it will eventually lead us to single payer.
Posted on 8/18/19 at 6:58 pm to ToesOnTheNose213
quote:or it's 1/10th of that in Canada and less in Mexico. Same drug. Same manufacturer. In some cases, same packaging. But a ten-fold price difference. US insulin prices have skyrocketed over the past few years.
"Okay! The price is $700 per."
Why?
Because they could.
Opaque pricing enables gouging. It is ridiculous.
Posted on 8/18/19 at 7:20 pm to NC_Tigah
quote:I have been home for a few years now and I know this stuff changes daily. But when I was in administration, I think we had a good handle on costs, cost to charge ratio, cost reports, large group purchasing, etc. We surely had waste but we stayed ahead of the game. Things have changed and thankfully, I was gone before ObamaCare. But, what you say about the complexity of the whole issue drives home my point that the general consumer can't make two cents out of healthcare pricing. I am all about transparency but the healthcare consumer is the least informed of all industries. You can't kick a tire and pick your hospital based on some arbitrary price list that means nothing to even the back office people that work in the billing office. Someone codes the procedures, someone punches in the codes and out spits a bill. Insurance gets in from there, whoever that might be.
In many (perhaps most) cases, hospital administrations are breathtakingly uninformed as to costs, potential cost savings, and purchasing impacts. A transactionally opaque, anticompetitive pricing environment enables operational incompetence. Often no one, from top to bottom, has a clue as to costs.
Posted on 8/18/19 at 7:47 pm to ToesOnTheNose213
quote:
"I need insulin to live."
"Okay! The price is $700 per."
"I can't afford that, and I'll die without it."
"What are you talking about? I just told you the cost up front. The Healthcare system works!"
"'K...I can get it at the place across the street for $525.
Bye."
Posted on 8/18/19 at 7:50 pm to NC_Tigah
quote:
or it's 1/10th of that in Canada and less in Mexico. Same drug. Same manufacturer. In some cases, same packaging. But a ten-fold price difference. US insulin prices have skyrocketed over the past few years.
I started this post thinking that tenfold was an exaggeration, so I decided to check out pricing online to see what came up:
Of the most popular basal insulins:
Basaglar: CA: $153/5 pens. In US $250/5 pens
Lantus:
$153 in CA (5 pens) while $286 for the same 5 pens here
Levemir:
$210 vs $462
Tresiba:
$158 vs $608
Toujeo:
$200 vs $308
All above prices are in USD. I've admittedly not looked deep into other particular suppliers but prices seem to be somewhat similar at a few other sites.
It looks like the US is, at face value, more expensive. From somewhere between 40-400%
If you look here, though, you'll see that Sanofi will accept $99/m for a monthly supply of your insulin up to 10 vials/pens per month, which would be cheaper than even the Canadian price advertised for Lantus.
This is all information readily accessible online, but it is far from intuitive. Doctors of write a prescription, and if the patient doesn't complain about the cost, they move on. If patients ask, it is often fairly easy to find a workaround that works for all involved. Being a smart consumer and talking about prices with your physician goes a long way if it interests you or the prices are out of your comfort zone. There are times that nothing can be done, but more often than not there's a workable solution.
And if you want just a good place to start, GoodRx + manufacturer's websites are the best two places to go to look for coupons.
Posted on 8/18/19 at 8:07 pm to Hopeful Doc
quote:
It looks like the US is, at face value, more expensive. From somewhere between 40-400%
Which countries have the cost of R&D + the years long FDA process worked into the cost?
Posted on 8/18/19 at 8:10 pm to dawgfan24348
It's real simple. Establish and enforce the following laws.
1. Open access
2. No price fixing
1. Open access
2. No price fixing
Posted on 8/18/19 at 8:13 pm to Dale51
quote:None. We pay; they benefit. I am sure some drugs are developed overseas but I doubt any companies doing the development have the onerous rules and regs of the FDA.
Which countries have the cost of R&D + the years long FDA process worked into the cost?
Posted on 8/18/19 at 9:03 pm to Hopeful Doc
quote:You shouldn't. I'm not prone to exaggeration.
I started this post thinking that tenfold was an exaggeration
quote:But the larger point is there is no reason for a significant differential between Canada and the US at all.
Israel, Italy, Germany, Greece, Taiwan and Canada -- all countries where she's bought insulin for her 13-year-old daughter at a fraction of the price in the U.S., even with health insurance. She's part of a group of people with diabetes and their parents who regularly caravan 5 hours each way from St. Paul, MN, to buy the life-saving medicine in Canada.
On a trip across the border this spring, six of them spent $1,265 on insulin supplies that would have cost them $12,400 back home.
"We saved over $11,000 by going to Canada," says Greenseid.
LINK
Posted on 8/18/19 at 9:17 pm to Hopeful Doc
quote:
But the current system definitely sucks. But the hospitals aren't totally to blame. They're working within the convoluted rules written for them to operate within
I agree somewhat. And I do understand that hospitals are operating on thin margins (but that’s partially because there’s never not a construction crane over the hospital). And I do understand that they have loss leaders. An insurance company I worked for had a major computer company as a client and the hospitals in that company’s headquarters’ area had a flat rate of $350 or something ridiculous for a carpal tunnel procedure. Because the insurance company could.
Posted on 8/18/19 at 10:29 pm to NC_Tigah
quote:
But the larger point is there is no reason for a significant differential between Canada and the US at all.
I do not work for Sanofi or receive any money from them. But if your stuff isn’t covered, and you’re privately insured, $100/m beats anything else you’ll find. Their products are at least as good as any competitor as far as I’m concerned.
If you’re on Medicaid, something is covered, and the formulary in LA is readily available online.
What really blows is coverage for Medicare patients without secondary coverage or an rx plan. They get more or less screwed. There are still decent prices on plenty of passable insulin (and essentially any other class of medicine you could need), but it may not be the one that you’re used to using.
Even still, I’ve got some good friends practicing in Canada and a handful that came here and never went back. I’d much rather receive treatment here than there. And I’d much rather be a physician here than there, for what its worth.
Posted on 8/18/19 at 10:36 pm to Hopeful Doc
quote:
Even still, I’ve got some good friends practicing in Canada and a handful that came here and never went back. I’d much rather receive treatment here than there. And I’d much rather be a physician here than there, for what its worth
The majority of people that have lived under both systems for any extended period of time and have used them come to the same conclusion. I have 22 year in each give or take - as much as I high have frustration here - easy call - here every time.
Not a fan of my 1700 a month premium but that is another story for another time
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