I wouldn't mind my insurance company giving me guidance on how much various places would cost. But their hideous web app can barely manage "Which doctors are covered by this plan."
It's not how much it costs you, it's how much it costs them.
Because of the way co-insurance works, that's related.
I wouldn't mind my insurance company giving me guidance on how much various places would cost. But their hideous web app can barely manage "Which doctors are covered by this plan."
It's not how much it costs you, it's how much it costs them.
Because of the way co-insurance works, that's related.
Not necessarily. In this case, it was not.
Yea, if the deal was "Hey, go to Bob's discount X-ray and we'll waive/reduce your copay" that'd at least be something.
I actually get prices from my insurance company....after the fact. Geez thanks!
i blindly picked a doctor and he damn near killed me
There isn't much other way of doing it, unless you happen to know a lot of sick people to get recs. And since most people who want a new doctor will be moving to a new town, they aren't going to have much in the way of resources that way.
i blindly picked a doctor and he damn near killed me
There isn't much other way of doing it, unless you happen to know a lot of sick people to get recs. And since most people who want a new doctor will be moving to a new town, they aren't going to have much in the way of resources that way.
That's the way I did it--granted, I had the luxury of not being sick (and admittedly, when I do get sick...it doesn't warrant going to the doctor), so it was a matter of asking people where they got their physicals (which is how I have my current doctor).
Why are we talking about HMO's in the past tense? As far as I can tell, every plan on the NYC health exchange is an HMO. In practice this means there are a huge amount of "gotchas" where you have to grill everyone you come into contact with about whether they and their tests are in or out of network. And then confirm with your healthcare company that this is true.
Then Kaiser isn't a classic HMO. Kaiser will literally NEVER refer you to a non Kaiser doctor unless Kaiser doesn't have a doctor that does the thing you need. And if they do, they will pay for it. Kaiser facilities all say "Kaiser" on the outside, clear as day, and take your Kaiser card (and only your Kaiser Card) to prove eligibility. If you don't have a Kaiser card, then you can't use their facilities other than the emergency room. There is then no billing or forms to sign. You just pay a $25 flat fee, and your prescription copay at the pharmacy.
Now Kaiser does offer some shitty plans which don't behave like this, but the 'proper' kaiser plan you can get means you just wander in to a Kaiser hospital, wave your Kaiser card about and say...
"I'm sick, give me da medicine!"
and they will pretty much figure it out why you eat shitty hospital food and browse the internet. No more brainpower or stress from you required. Need an MRI? Sure, no problem, lets wheel on downstairs and have one. How about a fancy biopsy. Off to the lab it goes! How much did it cost, I don't give a monkeys! Sorry sir, you need to spend an extra night here. Sounds good to me, I'll enjoy my free night in this very noisy comfort inn.
That fee varies by your plan. I know plenty of people with Kaiser through their employers and depending on the employer plan it can be $15/25/50, etc. Other benefits can vary as well, ER can be 50/visit or 500 depending, etc. Generally this is tied to how many people your employer is covering, big 10k person bureaucracy is getting better rates than tiny 20 person engineering firm.
The pricing is still all up front, so you should know how much an office visit/ER visit/whatever will cost, but the variety in copay can really add up. I fuck up my hip playing soccer and need to go to PT 3/week at $15, that's $45, which won't even cover a single visit for my buddy on the $50 plan. As costs add up you end up less likely to use on the higher plans which of course means less preventative care, etc.
Point being just saying someone has kaiser doesn't mean they're still not getting pinched.
Wow, I wish my PT was only $15 a session. All the decent PTs for the problem I have are out-of-network, and guess what all NY State of Health plans don't cover?
Why are we talking about HMO's in the past tense? As far as I can tell, every plan on the NYC health exchange is an HMO. In practice this means there are a huge amount of "gotchas" where you have to grill everyone you come into contact with about whether they and their tests are in or out of network. And then confirm with your healthcare company that this is true.
Then Kaiser isn't a classic HMO. Kaiser will literally NEVER refer you to a non Kaiser doctor unless Kaiser doesn't have a doctor that does the thing you need. And if they do, they will pay for it. Kaiser facilities all say "Kaiser" on the outside, clear as day, and take your Kaiser card (and only your Kaiser Card) to prove eligibility. If you don't have a Kaiser card, then you can't use their facilities other than the emergency room. There is then no billing or forms to sign. You just pay a $25 flat fee, and your prescription copay at the pharmacy.
Now Kaiser does offer some shitty plans which don't behave like this, but the 'proper' kaiser plan you can get means you just wander in to a Kaiser hospital, wave your Kaiser card about and say...
"I'm sick, give me da medicine!"
and they will pretty much figure it out why you eat shitty hospital food and browse the internet. No more brainpower or stress from you required. Need an MRI? Sure, no problem, lets wheel on downstairs and have one. How about a fancy biopsy. Off to the lab it goes! How much did it cost, I don't give a monkeys! Sorry sir, you need to spend an extra night here. Sounds good to me, I'll enjoy my free night in this very noisy comfort inn.
That fee varies by your plan. I know plenty of people with Kaiser through their employers and depending on the employer plan it can be $15/25/50, etc. Other benefits can vary as well, ER can be 50/visit or 500 depending, etc. Generally this is tied to how many people your employer is covering, big 10k person bureaucracy is getting better rates than tiny 20 person engineering firm.
The pricing is still all up front, so you should know how much an office visit/ER visit/whatever will cost, but the variety in copay can really add up. I fuck up my hip playing soccer and need to go to PT 3/week at $15, that's $45, which won't even cover a single visit for my buddy on the $50 plan. As costs add up you end up less likely to use on the higher plans which of course means less preventative care, etc.
Point being just saying someone has kaiser doesn't mean they're still not getting pinched.
Yes, clearly American healthcare is VERY difficult to transition to completely not shit, but, that "Multiple minor visits adds up!" problem is going to bite you on any plan, as might say, "You need to take these 25 different prescriptions every day for 6 months. Refill them every week"
But those costs tend to be the sort of things which add up to highly predictable annoyance level costs. "Urg, I will owe Kaiser $1000 this quarter". Not, "What's this bill for 3 million dollars honey?"
Upfront pricing and no surprises is a benefit so MASSIVE I can't understand why anyone would choose "Not Kaiser".
Why are we talking about HMO's in the past tense? As far as I can tell, every plan on the NYC health exchange is an HMO. In practice this means there are a huge amount of "gotchas" where you have to grill everyone you come into contact with about whether they and their tests are in or out of network. And then confirm with your healthcare company that this is true.
Then Kaiser isn't a classic HMO. Kaiser will literally NEVER refer you to a non Kaiser doctor unless Kaiser doesn't have a doctor that does the thing you need. And if they do, they will pay for it. Kaiser facilities all say "Kaiser" on the outside, clear as day, and take your Kaiser card (and only your Kaiser Card) to prove eligibility. If you don't have a Kaiser card, then you can't use their facilities other than the emergency room. There is then no billing or forms to sign. You just pay a $25 flat fee, and your prescription copay at the pharmacy.
Now Kaiser does offer some shitty plans which don't behave like this, but the 'proper' kaiser plan you can get means you just wander in to a Kaiser hospital, wave your Kaiser card about and say...
"I'm sick, give me da medicine!"
and they will pretty much figure it out why you eat shitty hospital food and browse the internet. No more brainpower or stress from you required. Need an MRI? Sure, no problem, lets wheel on downstairs and have one. How about a fancy biopsy. Off to the lab it goes! How much did it cost, I don't give a monkeys! Sorry sir, you need to spend an extra night here. Sounds good to me, I'll enjoy my free night in this very noisy comfort inn.
That fee varies by your plan. I know plenty of people with Kaiser through their employers and depending on the employer plan it can be $15/25/50, etc. Other benefits can vary as well, ER can be 50/visit or 500 depending, etc. Generally this is tied to how many people your employer is covering, big 10k person bureaucracy is getting better rates than tiny 20 person engineering firm.
The pricing is still all up front, so you should know how much an office visit/ER visit/whatever will cost, but the variety in copay can really add up. I fuck up my hip playing soccer and need to go to PT 3/week at $15, that's $45, which won't even cover a single visit for my buddy on the $50 plan. As costs add up you end up less likely to use on the higher plans which of course means less preventative care, etc.
Point being just saying someone has kaiser doesn't mean they're still not getting pinched.
Yes, clearly American healthcare is VERY difficult to transition to completely not shit, but, that "Multiple minor visits adds up!" problem is going to bite you on any plan, as might say, "You need to take these 25 different prescriptions every day for 6 months. Refill them every week"
But those costs tend to be the sort of things which add up to highly predictable annoyance level costs. "Urg, I will owe Kaiser $1000 this quarter". Not, "What's this bill for 3 million dollars honey?"
Upfront pricing and no surprises is a benefit so MASSIVE I can't understand why anyone would choose "Not Kaiser".
Oh for sure, in my case I'm moving to an area where kaiser isn't offered by the employer. There's one general office in town but otherwise you have to truck it to Portland for anything else, so I get why kaiser isn't offered.
I don't know the reach of the local network that is covered by my employer, but my options are coverage via an 80/20 PPO or an HMO style where everything is upfront costs, and yeah, given the option not sure why anyone would go 80/20. Pretty much anytime anyone in my extended family has been on an 80/20 style plan and a big health cost has come up they've been fucked hard covering that 20%, no thanks.
Lower drug prices for older people
On the campaign trail, Mr. Trump embraced allowing Medicare to negotiate the price of the drugs it buys for older people, an issue traditionally supported by Democrats but long opposed by Republicans — and the powerful drug industry.
Persuade other countries to pay more
One key proposal would involve pressuring other countries to raise their prices for prescription medicines. Drug prices in the United States are the highest in the world; many countries with centralized health care systems have successfully negotiated lower prices from pharmaceutical companies.
Require drug ads to include the price
Prescription drug commercials are ubiquitous. But what if those ads had to disclose the drug’s price? That is something the Trump administration says it wants to explore.
Ban ‘gag clauses’ for pharmacists
Some contracts between pharmacies and pharmacy benefit managers prohibit pharmacists from telling patients when a drug they need would be cheaper if they paid in cash, rather than using their insurance.
“This is a total rip-off, and we are ending it,” Mr. Trump said in his speech on Friday. The administration’s written proposal is more vague, saying that it “may” prohibit these gag clauses in plans for Part D, the Medicare drug program.
End the patent games
Trump said on Friday he would rein in this game-playing, saying “our patent system will reward innovation, but it will not be used as a shield to protect unfair monopolies.”
Some of the most theoretical ideas also have the potential to be the most disruptive.
One is to upend the existing rebate system, in which drug companies pay rebates, or discounts, off the list price to insurers and employers. But those rebates are often considered trade secrets, and pharmacy-benefit managers pocket a portion of the rebate for themselves, creating what many have described as perverse incentives that keep drug prices rising.
The Trump administration has said it is examining whether it should consider rebates to be a form of illegal kickback, a change that would likely require congressional action.
From those, the one less likely to happen is the one about making other countries pay more, but the rest is possible. And of course, many of these proposals are kinda missing the meat, since it was only a speech.
Also feels like a fig leaf to the insurance companies to help people justify those rising premium prices when they see the price of drug x is a bajillion dollars (before formulary pricing discounts your insurer negotiated.)
I kinda disagree, when people see the x bajillion dollar prices they are going to go against the pharma companies. See the backlash against Martin Shkreli.
'Other countries should pay more so we pay less' isn't even one of those 'stupid arguments that sounds right as long as you don't think about it' statements. It's just very dumb.
EDIT:
Lower drug prices for older people
On the campaign trail, Mr. Trump embraced allowing Medicare to negotiate the price of the drugs it buys for older people, an issue traditionally supported by Democrats but long opposed by Republicans — and the powerful drug industry.
This came up on the campaign trail, but I believe his speech yesterday didn't even mention negotiating drug prices for seniors on medicare
End the patent games
Trump said on Friday he would rein in this game-playing, saying “our patent system will reward innovation, but it will not be used as a shield to protect unfair monopolies.”
WHAT DOES THIS MEAN? THESE TWO WORD SALAD STATEMENTS AREN'T EVEN RELATED
Also feels like a fig leaf to the insurance companies to help people justify those rising premium prices when they see the price of drug x is a bajillion dollars (before formulary pricing discounts your insurer negotiated.)
I kinda disagree, when people see the x bajillion dollar prices they are going to go against the pharma companies. See the backlash against Martin Shkreli.
The drug he raised the price on still has its high price though. Shkreli may be in prison but nothing actually changed.
+8
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FencingsaxIt is difficult to get a man to understand, when his salary depends upon his not understandingGNU Terry PratchettRegistered Userregular
Also feels like a fig leaf to the insurance companies to help people justify those rising premium prices when they see the price of drug x is a bajillion dollars (before formulary pricing discounts your insurer negotiated.)
I kinda disagree, when people see the x bajillion dollar prices they are going to go against the pharma companies. See the backlash against Martin Shkreli.
The drug he raised the price on still has its high price though. Shkreli may be in prison but nothing actually changed.
I believe it went down, but not to the original price.
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Magus`The fun has been DOUBLED!Registered Userregular
'Other countries should pay more so we pay less' isn't even one of those 'stupid arguments that sounds right as long as you don't think about it' statements. It's just very dumb.
EDIT:
Lower drug prices for older people
On the campaign trail, Mr. Trump embraced allowing Medicare to negotiate the price of the drugs it buys for older people, an issue traditionally supported by Democrats but long opposed by Republicans — and the powerful drug industry.
This came up on the campaign trail, but I believe his speech yesterday didn't even mention negotiating drug prices for seniors on medicare
End the patent games
Trump said on Friday he would rein in this game-playing, saying “our patent system will reward innovation, but it will not be used as a shield to protect unfair monopolies.”
WHAT DOES THIS MEAN? THESE TWO WORD SALAD STATEMENTS AREN'T EVEN RELATED
I assume he means people will feel safe to work on new things knowing their ideas will be protected while also saying that companies can't use them to.. well, uh.. maybe he meant copyright for the second one? My brain hurts.
Or did you mean the difference between his drug statements and the patent one? Cause I have no idea then.
'Other countries should pay more so we pay less' isn't even one of those 'stupid arguments that sounds right as long as you don't think about it' statements. It's just very dumb.
Exceedingly so.
Note, he doesn't want to institute tariffs, he just wants other countries to pay more. Not for any other reason, than to hope that the Pharma companies will be magnanimous and drop the cost of pharmaceuticals to Americans. Because that's how the free market works, obviously. Companies have a certain profit margin that they can't exceed. Moron.
And there's NOTHING stopping the US from negotiating similar prices on pharmaceuticals, other than recalcitrance of the lawmakers (in the pocket of Big Pharma) that put rules in place to stop it from happening. But don't want to blame THEM.
Just gives Trump the capacity to blame "the other". If Europe/Canada/Australia/etc don't concede to pay more for no real reason (which I can't see them doing), then it can be made to be THEIR fault that drug companies aren't lowering prices.
It's just so mindnumbingly stupid, I'm not surprised it came out of this administration.
'Other countries should pay more so we pay less' isn't even one of those 'stupid arguments that sounds right as long as you don't think about it' statements. It's just very dumb.
Exceedingly so.
Note, he doesn't want to institute tariffs, he just wants other countries to pay more. Not for any other reason, than to hope that the Pharma companies will be magnanimous and drop the cost of pharmaceuticals to Americans. Because that's how the free market works, obviously. Companies have a certain profit margin that they can't exceed. Moron.
And there's NOTHING stopping the US from negotiating similar prices on pharmaceuticals, other than recalcitrance of the lawmakers (in the pocket of Big Pharma) that put rules in place to stop it from happening. But don't want to blame THEM.
Just gives Trump the capacity to blame "the other". If Europe/Canada/Australia/etc don't concede to pay more for no real reason (which I can't see them doing), then it can be made to be THEIR fault that drug companies aren't lowering prices.
It's just so mindnumbingly stupid, I'm not surprised it came out of this administration.
It's a standard US talking point: assumes that developed countries are doing better than the US because they somehow exploit the US rather than because they have left-wing policies.
It makes it easier to dismiss the very policies that would help. For example, negotiating with drug companies and having one (or a few) powerful buyers.
Drugs shouldn't be advertised on tv, but forcing drug companies to say "costs $hundreds per dose" will limit their desire to advertise a lot of medications. It's actually a pretty good suggestion, which means I will be shocked if it goes anywhere.
Forcing other countries to pay more to cover up our failed system is pure, distilled American jingoism at it's finest though, so I expect that to be Trumps main push. The pharma companies are probably salivating at that idea, too. America's legacy: Crab-bucketting the world.
Drugs shouldn't be advertised on tv, but forcing drug companies to say "costs $hundreds per dose" will limit their desire to advertise a lot of medications. It's actually a pretty good suggestion, which means I will be shocked if it goes anywhere.
Forcing other countries to pay more to cover up our failed system is pure, distilled American jingoism at it's finest though, so I expect that to be Trumps main push. The pharma companies are probably salivating at that idea, too. America's legacy: Crab-bucketting the world.
'Other countries should pay more so we pay less' isn't even one of those 'stupid arguments that sounds right as long as you don't think about it' statements. It's just very dumb.
EDIT:
Lower drug prices for older people
On the campaign trail, Mr. Trump embraced allowing Medicare to negotiate the price of the drugs it buys for older people, an issue traditionally supported by Democrats but long opposed by Republicans — and the powerful drug industry.
This came up on the campaign trail, but I believe his speech yesterday didn't even mention negotiating drug prices for seniors on medicare
End the patent games
Trump said on Friday he would rein in this game-playing, saying “our patent system will reward innovation, but it will not be used as a shield to protect unfair monopolies.”
WHAT DOES THIS MEAN? THESE TWO WORD SALAD STATEMENTS AREN'T EVEN RELATED
I assume he means people will feel safe to work on new things knowing their ideas will be protected while also saying that companies can't use them to.. well, uh.. maybe he meant copyright for the second one? My brain hurts.
Or did you mean the difference between his drug statements and the patent one? Cause I have no idea then.
I mean trump is a terrible orator, but that snippet seemed pretty straight forward to me. He wants to weaken patents, either in terms of longevity or application.
He’s basically saying that patents are supposed to encourage innovation (by giving the company/scientist who spends big money on R&D a way of ensuring they can profit from their work/spending) but they have gotten out of hand and are allowing drug companies to act like monopolies (price gouging, anti competition policies, etc...).
"The world is a mess, and I just need to rule it" - Dr Horrible
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Magus`The fun has been DOUBLED!Registered Userregular
edited May 2018
I'll be honest, I get confused between copyright, trademark and patent. They all seen very same-y.
If we allowed (re-)importation of drugs it would presumably result in other countries paying more and us less. Our current laws allow drug companies to charge a very high delta between countries.
'Other countries should pay more so we pay less' isn't even one of those 'stupid arguments that sounds right as long as you don't think about it' statements. It's just very dumb.
EDIT:
Lower drug prices for older people
On the campaign trail, Mr. Trump embraced allowing Medicare to negotiate the price of the drugs it buys for older people, an issue traditionally supported by Democrats but long opposed by Republicans — and the powerful drug industry.
This came up on the campaign trail, but I believe his speech yesterday didn't even mention negotiating drug prices for seniors on medicare
End the patent games
Trump said on Friday he would rein in this game-playing, saying “our patent system will reward innovation, but it will not be used as a shield to protect unfair monopolies.”
WHAT DOES THIS MEAN? THESE TWO WORD SALAD STATEMENTS AREN'T EVEN RELATED
I assume he means people will feel safe to work on new things knowing their ideas will be protected while also saying that companies can't use them to.. well, uh.. maybe he meant copyright for the second one? My brain hurts.
Or did you mean the difference between his drug statements and the patent one? Cause I have no idea then.
I mean trump is a terrible orator, but that snippet seemed pretty straight forward to me. He wants to weaken patents, either in terms of longevity or application.
He’s basically saying that patents are supposed to encourage innovation (by giving the company/scientist who spends big money on R&D a way of ensuring they can profit from their work/spending) but they have gotten out of hand and are allowing drug companies to act like monopolies (price gouging, anti competition policies, etc...).
I don't disagree, but there's no way that gets through the Senate.
I guess we know what the "consulting" money from Novartis was for. He dropped the one heterodox thing from his campaign that also was the one thing that might actually work. Having Medicare negotiate drug prices broadly.
But I'm sure if Canada starts spending more on pills that money'll go straight to my pocket rather than yacht purchases.
I guess we know what the "consulting" money from Novartis was for. He dropped the one heterodox thing from his campaign that also was the one thing that might actually work. Having Medicare negotiate drug prices broadly.
But I'm sure if Canada starts spending more on pills that money'll go straight to my pocket rather than yacht purchases.
Today I learned that Medicare can't negotiate drug prices (I'm not an American, to be fair).
This is literally the most ridiculous thing I've read this year.
I guess we know what the "consulting" money from Novartis was for. He dropped the one heterodox thing from his campaign that also was the one thing that might actually work. Having Medicare negotiate drug prices broadly.
But I'm sure if Canada starts spending more on pills that money'll go straight to my pocket rather than yacht purchases.
Today I learned that Medicare can't negotiate drug prices (I'm not an American, to be fair).
This is literally the most ridiculous thing I've read this year.
Yeah it's especially crazy since other agencies, like Veterans Affairs, negotiates EVERYTHING regarding their healthcare, to keep costs down. So we have the model to show that it would work.
If we allowed (re-)importation of drugs it would presumably result in other countries paying more and us less. Our current laws allow drug companies to charge a very high delta between countries.
No, it would not. Other countries pay less because they negotiate price and usually have a single (or a few) powerful buyers, with a very strong negotiating position.
The reason the US pay more is that you have set things up so that the drugs companies get to charge whatever they want.
Patients are in no position to negotiate, and insurance companies don't care that much, and don't have the negotiating capacity of a government.
You can say that again. As someone who splits their time between the US and Australia, the prominence of pharmaceutical commercials on American television is insane.
"Ask your doctor about Obscenea, to see if it's right for you.". No, in Australia we trust the doctors to prescribe the medication we need, not the medication we are told we want.
As a result, there are very few prescription drugs advertised. Meaning we don't also have to hear the horror list of side effects every third advert. Again, we trust our doctors to explain things when they're prescribed.
Big Pharma is a blight. "Marketing" masquerading as "choice". Like anyone not in the industry has any f'n clue what they're choosing.
You can say that again. As someone who splits their time between the US and Australia, the prominence of pharmaceutical commercials on American television is insane.
"Ask your doctor about Obscenea, to see if it's right for you.". No, in Australia we trust the doctors to prescribe the medication we need, not the medication we are told we want.
As a result, there are very few prescription drugs advertised. Meaning we don't also have to hear the horror list of side effects every third advert. Again, we trust our doctors to explain things when they're prescribed.
Big Pharma is a blight. "Marketing" masquerading as "choice". Like anyone not in the industry has any f'n clue what they're choosing.
And if you dont have Faith in your doctor to have up to date knowledge or act in your best interest.. find another doctor. Because the only thing worse than telling you doctor you want the drug that you saw on TV, is him giving it to you for the same reason.
You can say that again. As someone who splits their time between the US and Australia, the prominence of pharmaceutical commercials on American television is insane.
"Ask your doctor about Obscenea, to see if it's right for you.". No, in Australia we trust the doctors to prescribe the medication we need, not the medication we are told we want.
As a result, there are very few prescription drugs advertised. Meaning we don't also have to hear the horror list of side effects every third advert. Again, we trust our doctors to explain things when they're prescribed.
Big Pharma is a blight. "Marketing" masquerading as "choice". Like anyone not in the industry has any f'n clue what they're choosing.
And if you dont have Faith in your doctor to have up to date knowledge or act in your best interest.. find another doctor. Because the only thing worse than telling you doctor you want the drug that you saw on TV, is him giving it to you for the same reason.
Direct to consumer advertising is such an unequivocal ill with literally no benefit to society that it's hard to think of a more distilled example of how toxic and broken healthcare in the US.
The decision to start on or prescribe a medication should be based on, at least in the abstract ideal, the best available evidence. Marketing does not and cannot do anything but sway decisions away from that best available standard. So we spend hundreds of billions of dollars convincing people and physicians to make worse decisions than they would have otherwise.
It truly is one of the dumbest pillars of our late-stage capitalism health care industry.
Today I learned that Medicare can't negotiate drug prices (I'm not an American, to be fair).
This is literally the most ridiculous thing I've read this year.
It's how the USA manages to have some of the highest public health expenditures in the world, despite huge amounts of the public being unable to afford healthcare.
The focus on the cost of prescriptions makes sense because its the cost people see.
But its 10% of US healthcare costs. If we paid the same as Canada or the UK or wherever your ideal is, our spending would drop like 5%. Its largely a marginal issue in the end
The focus on the cost of prescriptions makes sense because its the cost people see.
But its 10% of US healthcare costs. If we paid the same as Canada or the UK or wherever your ideal is, our spending would drop like 5%. Its largely a marginal issue in the end
Maybe on the macro, but its not a marginal issue for people who have to pay thousands of dollars a month as a stay-the-hell-alive-tax
So prescription prices do need to plummet significantly to match the rest of the world, regardless if its a proverbial drop in the bucket on the macro scale
Today I learned that Medicare can't negotiate drug prices (I'm not an American, to be fair).
This is literally the most ridiculous thing I've read this year.
It's how the USA manages to have some of the highest public health expenditures in the world, despite huge amounts of the public being unable to afford healthcare.
Most of that is Medicare more or less never saying no. Yes in most socialized places you might get denied some sort of care if you're 95 and dying.
in the US we'll spend hundreds of thousands to keep that person alive for a few more months. And in that time you better believe the medical industry will milk Medicare for every dime.
The focus on the cost of prescriptions makes sense because its the cost people see.
But its 10% of US healthcare costs. If we paid the same as Canada or the UK or wherever your ideal is, our spending would drop like 5%. Its largely a marginal issue in the end
Yes, but it's also a savings that costs us nothing to achieve. And over time even a 5% savings compounds to be quite a bit. That is, again, basically just waste because we are hobbling ourselves.
I guess we know what the "consulting" money from Novartis was for. He dropped the one heterodox thing from his campaign that also was the one thing that might actually work. Having Medicare negotiate drug prices broadly.
But I'm sure if Canada starts spending more on pills that money'll go straight to my pocket rather than yacht purchases.
Today I learned that Medicare can't negotiate drug prices (I'm not an American, to be fair).
This is literally the most ridiculous thing I've read this year.
Yeah it's especially crazy since other agencies, like Veterans Affairs, negotiates EVERYTHING regarding their healthcare, to keep costs down. So we have the model to show that it would work.
This works in a pretty funny way when it comes to research. Since Medicare drug prices are static and universal, you know how much they'll cost when budgeting. Price negotiation is so Byzantine and proprietary that at the VA in particular, people just give up and let the hospital (and the taxpayer) eat 100% of the patient care costs even if the research money can pay for it. Finding out prices costs more than paying the price; imagine that.
Marty: The future, it's where you're going? Doc: That's right, twenty five years into the future. I've always dreamed on seeing the future, looking beyond my years, seeing the progress of mankind. I'll also be able to see who wins the next twenty-five world series.
Today I learned that Medicare can't negotiate drug prices (I'm not an American, to be fair).
This is literally the most ridiculous thing I've read this year.
It's how the USA manages to have some of the highest public health expenditures in the world, despite huge amounts of the public being unable to afford healthcare.
Lovely. We already pay more per capita than most socialized medical systems. So we should, in theory, be able to have that level of coverage. While everyone stops paying for insurance. Without tax increases.
That saves each family how much per year on average, again? Oh right, it's already there in the first chart. We could have functional health care while putting a couple thousand dollars per year into the pockets of every american. That this isn't already happening is kind of infuriating.
Today I learned that Medicare can't negotiate drug prices (I'm not an American, to be fair).
This is literally the most ridiculous thing I've read this year.
It's how the USA manages to have some of the highest public health expenditures in the world, despite huge amounts of the public being unable to afford healthcare.
Lovely. We already pay more per capita than most socialized medical systems. So we should, in theory, be able to have that level of coverage. While everyone stops paying for insurance. Without tax increases.
That saves each family how much per year on average, again? Oh right, it's already there in the first chart. We could have functional health care while putting a couple thousand dollars per year into the pockets of every american. That this isn't already happening is kind of infuriating.
You'd also cut the salary of every doctor and nurse by ~half and fire a whole bunch of office workers. Transition costs are a thing.
Posts
Not necessarily. In this case, it was not.
Yea, if the deal was "Hey, go to Bob's discount X-ray and we'll waive/reduce your copay" that'd at least be something.
I actually get prices from my insurance company....after the fact. Geez thanks!
There isn't much other way of doing it, unless you happen to know a lot of sick people to get recs. And since most people who want a new doctor will be moving to a new town, they aren't going to have much in the way of resources that way.
That's the way I did it--granted, I had the luxury of not being sick (and admittedly, when I do get sick...it doesn't warrant going to the doctor), so it was a matter of asking people where they got their physicals (which is how I have my current doctor).
That fee varies by your plan. I know plenty of people with Kaiser through their employers and depending on the employer plan it can be $15/25/50, etc. Other benefits can vary as well, ER can be 50/visit or 500 depending, etc. Generally this is tied to how many people your employer is covering, big 10k person bureaucracy is getting better rates than tiny 20 person engineering firm.
The pricing is still all up front, so you should know how much an office visit/ER visit/whatever will cost, but the variety in copay can really add up. I fuck up my hip playing soccer and need to go to PT 3/week at $15, that's $45, which won't even cover a single visit for my buddy on the $50 plan. As costs add up you end up less likely to use on the higher plans which of course means less preventative care, etc.
Point being just saying someone has kaiser doesn't mean they're still not getting pinched.
Yes, clearly American healthcare is VERY difficult to transition to completely not shit, but, that "Multiple minor visits adds up!" problem is going to bite you on any plan, as might say, "You need to take these 25 different prescriptions every day for 6 months. Refill them every week"
But those costs tend to be the sort of things which add up to highly predictable annoyance level costs. "Urg, I will owe Kaiser $1000 this quarter". Not, "What's this bill for 3 million dollars honey?"
Upfront pricing and no surprises is a benefit so MASSIVE I can't understand why anyone would choose "Not Kaiser".
Oh for sure, in my case I'm moving to an area where kaiser isn't offered by the employer. There's one general office in town but otherwise you have to truck it to Portland for anything else, so I get why kaiser isn't offered.
I don't know the reach of the local network that is covered by my employer, but my options are coverage via an 80/20 PPO or an HMO style where everything is upfront costs, and yeah, given the option not sure why anyone would go 80/20. Pretty much anytime anyone in my extended family has been on an 80/20 style plan and a big health cost has come up they've been fucked hard covering that 20%, no thanks.
Think that this is the right place, Trump seems to be going against Big Pharma. Made a speech about it and here's a few key points:
From those, the one less likely to happen is the one about making other countries pay more, but the rest is possible. And of course, many of these proposals are kinda missing the meat, since it was only a speech.
I kinda disagree, when people see the x bajillion dollar prices they are going to go against the pharma companies. See the backlash against Martin Shkreli.
EDIT:
This came up on the campaign trail, but I believe his speech yesterday didn't even mention negotiating drug prices for seniors on medicare
WHAT DOES THIS MEAN? THESE TWO WORD SALAD STATEMENTS AREN'T EVEN RELATED
The drug he raised the price on still has its high price though. Shkreli may be in prison but nothing actually changed.
I believe it went down, but not to the original price.
I assume he means people will feel safe to work on new things knowing their ideas will be protected while also saying that companies can't use them to.. well, uh.. maybe he meant copyright for the second one? My brain hurts.
Or did you mean the difference between his drug statements and the patent one? Cause I have no idea then.
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Note, he doesn't want to institute tariffs, he just wants other countries to pay more. Not for any other reason, than to hope that the Pharma companies will be magnanimous and drop the cost of pharmaceuticals to Americans. Because that's how the free market works, obviously. Companies have a certain profit margin that they can't exceed. Moron.
And there's NOTHING stopping the US from negotiating similar prices on pharmaceuticals, other than recalcitrance of the lawmakers (in the pocket of Big Pharma) that put rules in place to stop it from happening. But don't want to blame THEM.
Just gives Trump the capacity to blame "the other". If Europe/Canada/Australia/etc don't concede to pay more for no real reason (which I can't see them doing), then it can be made to be THEIR fault that drug companies aren't lowering prices.
It's just so mindnumbingly stupid, I'm not surprised it came out of this administration.
It's a standard US talking point: assumes that developed countries are doing better than the US because they somehow exploit the US rather than because they have left-wing policies.
It makes it easier to dismiss the very policies that would help. For example, negotiating with drug companies and having one (or a few) powerful buyers.
Forcing other countries to pay more to cover up our failed system is pure, distilled American jingoism at it's finest though, so I expect that to be Trumps main push. The pharma companies are probably salivating at that idea, too. America's legacy: Crab-bucketting the world.
I mean trump is a terrible orator, but that snippet seemed pretty straight forward to me. He wants to weaken patents, either in terms of longevity or application.
He’s basically saying that patents are supposed to encourage innovation (by giving the company/scientist who spends big money on R&D a way of ensuring they can profit from their work/spending) but they have gotten out of hand and are allowing drug companies to act like monopolies (price gouging, anti competition policies, etc...).
Edit: Think I got it.
Trademark - "Got milk?"
Patent - The pasteurization process.
Copyright - Drawing of milk. I guess?
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I don't disagree, but there's no way that gets through the Senate.
But I'm sure if Canada starts spending more on pills that money'll go straight to my pocket rather than yacht purchases.
Today I learned that Medicare can't negotiate drug prices (I'm not an American, to be fair).
This is literally the most ridiculous thing I've read this year.
We literally made it a law that we cannot negotiate.
Yeah it's especially crazy since other agencies, like Veterans Affairs, negotiates EVERYTHING regarding their healthcare, to keep costs down. So we have the model to show that it would work.
No, it would not. Other countries pay less because they negotiate price and usually have a single (or a few) powerful buyers, with a very strong negotiating position.
The reason the US pay more is that you have set things up so that the drugs companies get to charge whatever they want.
Patients are in no position to negotiate, and insurance companies don't care that much, and don't have the negotiating capacity of a government.
Also, advertisements. US TV is different.
You can say that again. As someone who splits their time between the US and Australia, the prominence of pharmaceutical commercials on American television is insane.
"Ask your doctor about Obscenea, to see if it's right for you.". No, in Australia we trust the doctors to prescribe the medication we need, not the medication we are told we want.
As a result, there are very few prescription drugs advertised. Meaning we don't also have to hear the horror list of side effects every third advert. Again, we trust our doctors to explain things when they're prescribed.
Big Pharma is a blight. "Marketing" masquerading as "choice". Like anyone not in the industry has any f'n clue what they're choosing.
And if you dont have Faith in your doctor to have up to date knowledge or act in your best interest.. find another doctor. Because the only thing worse than telling you doctor you want the drug that you saw on TV, is him giving it to you for the same reason.
Direct to consumer advertising is such an unequivocal ill with literally no benefit to society that it's hard to think of a more distilled example of how toxic and broken healthcare in the US.
The decision to start on or prescribe a medication should be based on, at least in the abstract ideal, the best available evidence. Marketing does not and cannot do anything but sway decisions away from that best available standard. So we spend hundreds of billions of dollars convincing people and physicians to make worse decisions than they would have otherwise.
It truly is one of the dumbest pillars of our late-stage capitalism health care industry.
It's how the USA manages to have some of the highest public health expenditures in the world, despite huge amounts of the public being unable to afford healthcare.
But its 10% of US healthcare costs. If we paid the same as Canada or the UK or wherever your ideal is, our spending would drop like 5%. Its largely a marginal issue in the end
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Maybe on the macro, but its not a marginal issue for people who have to pay thousands of dollars a month as a stay-the-hell-alive-tax
So prescription prices do need to plummet significantly to match the rest of the world, regardless if its a proverbial drop in the bucket on the macro scale
Most of that is Medicare more or less never saying no. Yes in most socialized places you might get denied some sort of care if you're 95 and dying.
in the US we'll spend hundreds of thousands to keep that person alive for a few more months. And in that time you better believe the medical industry will milk Medicare for every dime.
Yes, but it's also a savings that costs us nothing to achieve. And over time even a 5% savings compounds to be quite a bit. That is, again, basically just waste because we are hobbling ourselves.
This works in a pretty funny way when it comes to research. Since Medicare drug prices are static and universal, you know how much they'll cost when budgeting. Price negotiation is so Byzantine and proprietary that at the VA in particular, people just give up and let the hospital (and the taxpayer) eat 100% of the patient care costs even if the research money can pay for it. Finding out prices costs more than paying the price; imagine that.
Doc: That's right, twenty five years into the future. I've always dreamed on seeing the future, looking beyond my years, seeing the progress of mankind. I'll also be able to see who wins the next twenty-five world series.
Lovely. We already pay more per capita than most socialized medical systems. So we should, in theory, be able to have that level of coverage. While everyone stops paying for insurance. Without tax increases.
That saves each family how much per year on average, again? Oh right, it's already there in the first chart. We could have functional health care while putting a couple thousand dollars per year into the pockets of every american. That this isn't already happening is kind of infuriating.
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You'd also cut the salary of every doctor and nurse by ~half and fire a whole bunch of office workers. Transition costs are a thing.