I work in health insurance administration. I can confirm health insurance companies are bullshit.
S.C.A.M.
It’s designed to not make sense.
Recently had to buy Paxlovid. Pharmacy: “it is expensive and your insurance doesn’t cover it. Will be $1500.” Me: “I don’t know.” Pharmacy: “Wait. If you go to the Pfizer website you can get a coupon.” Me: “ok” (Looks up website and gets coupon on my phone. Paxcess Patient Support Program.) Pharmacy: “let me check now. Oh, free!”
Please make it all make sense.
I had the exact same experience.
Your lucky your pharmacy tech recommended the manufacturer coupon. My wife was the only one at her pharmacy that did that
Are the other people she works with actually evil or what? I can’t imagine not begging everyone who came in with a Paxlovid prescription to do that.
Likely one of those things where if you use it too much you lose it.
Meanwhile over in Europe - went to the doctor in spring as a cough didn’t go away for ages. As suspected nothing he could do much - irritated throat, and just at the time when cold season was giving way for allergy season. So he prescribed some nose spray - and asked if he should also add some antihistamine to the prescription to save me a few eur (didn’t check, but it probably is single digits. That stuff is cheap)
Yeah I have terrible allergies and went to a new doctor, he couldn’t do much but I mentioned I use an over the counter nasal spray for $40. He’s like oh, let me write you a prescription and now I get a prescription one for free in Canada. Too bad my allergy pills aren’t covered though but those are still an affordable price at least.
Shit when I have coughs that go too long I just keep coughing.
As a hospice worker, please don’t let stuff like that go unaddressed if at all possible.
Oh trust me the doctors don’t care. Went to the doctor twice already and got sent off after marking me down for general anxiety and possible sleep apnea.
We got a shitty version of Republican healthcare reform, and Republicans and moderates refuse to admit we need anything more.
Republicans want to tear it down
And “moderates” say asking for more is somehow worse than being a Republican.
Shits not getting better till will finally get neoliberal.politicians out of the Dem party and back where they came from: the Republican party.
I don’t know why people act like they don’t understand opening the “left party” up to “fiscally conservative moderates” just concentrates all the crazy in the Republican party and depresses turnout from the right.
If you’re trying to stop facism, we’re taking the wrong path.
If you’re trying to make sure the wealthy always win tho, yeah, this makes sense. But the fascists are going to keep winning half the time.
When they could be winning 0% of the time if we just gave Dem voters candidates they want. Because any “moderate” voters that go R, are statistically insignificant.
They’re just loud and insist they’re always right. Theyre Karen’s.
And we need to go back to just ignoring them.
God you have to stop writing one sentence per paragraph.
Shit is so unreadable.
All it does is take up space.
Why do they not want other people to have their basic needs met?
I guess because it’s not profitable?
The more desperate someone is, the less they’re able to plan ahead and evaluate options.
They’re focused on the short term and only plan to avoid short term negatives.
The people who get irrationally upset when you ask for more out of the Dem party are great examples of that. They’re so stressed and afraid that everything becomes a binary choice of two options that can’t be I fluenced in any way
It’s basic psychology and why Republicans went from Nixon resigning because he knew voters wouldn’t tolerate his illegal actions to modern day trumpets.
The same thing will happen to the Dem party if we walk down the same path as the Republican party.
And thats what the rich want.
Its why WB bought CNN, their board members flat out said it.
Refusing to vote (or making a worthless vote) isn’t the way forward.
Ideally the Republicans are relegated to the trash bin and the Dem party splits into two, the Squad/Bernie party and the Clinton/Pelosi party.
It makes labor more expensive because people will be less desperate for wages.
What in the sam hell are you trying to communicate with this word salad?
But if you want to talk politics and healthcare, there’s one party that’s made any real effort at improvement in the last 2 decades, and it’s the Democrats. The Republicans try to gut the system at every opportunity.
There are plenty of Democrats in Congress that would like to continue to improve healthcare, but the Dems don’t have the numbers - particularly in the House - to pass further reform.
There are plenty of Democrats in Congress that would like to continue to improve healthcare, but the Dems don’t have the numbers - particularly in the House - to pass further reform.
So you’re saying therenis both “plenty” but also “not enough”?
That doesn’t make logical sense to me…
I’m saying not everyone Dem in office really wants to fix healthcare, as evident as there seems to always be just enough against progress to stop progress.
And that logically it’s a safe assumption there’s even more that would oppose progress if they had to, they just don’t want to publicly oppose it unless they’re forced to.
So we basically have two choices.
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Be reactive and keep assuming every Dem supports the party platform until they personally pull a Joe Manchin
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Be proactive and make sure the people on our team our really on our team before we have to rely on them. So that when we have the House, Senate, and presidency we can accomplish stuff.
But if you want to talk politics and healthcare, there’s one party that’s made any real effort at improvement in the last 2 decades, and it’s the Democrats.
And they got a more conservative version of Mitt Romney’s plan passed…
And have spent over a decade opposi g we improve it up to at least where the Republican presidential candidate was 16 years ago…
That’s not enough dawg
Voters want more, they deserve more. So why not give voters a candidate that agrees so that we can easily prevent fascists from getting elected?
I don’t see any downsides to the Dem party running Dem politicians that agree with Dem voters.
I agree with all you’re saying. Obama’s Romneycare was also a huge gift to the insurance companies.
Yeah, we didn’t get healthcare, we got a penalty for not being able to afford insurance…
I get people being excited for any progress back then, I was too.
But it’s 16 years later and now we want from both parties presenting plans to improving it, to one party trying to burn it down and one insisting asking for progress is worse than burning it down…
People just treat it like a team sport now. If you’re not praising their pick, it means you picked the other team.
Meanwhile I’m just out here advocating for the fundamentals.
Like, what did happen to the picks and roll?
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GoodRX is my favorite shitty bandaid for this feature of a capitalist health care plan.
Make it make sense.
The price was bullshit to begin with. The cream probably sells over the counter for about $2.50 in most other countries, so OP still ended up paying 10x the price.
Yup. This price is at least partially distorted by the fact that she can’t just go buy the cream without getting a prescription first. That means tight control over distribution, meaning huge barriers to entry and being forced to play ball with this insurance system when someone does enter.
There’s no way for the market to create that simple channel from this medicine to those who need it at the natural market price which is quite low.
All these elements that aren’t naturally required, but are required by law to be part of the deal, cause the price to get weird.
Sort of like hospital bills now. My wife went to the E.R. 2 months ago. They billed the insurance $4K. The insurance said nope and paid $220. We paid $40.
Yeah, it makes sense if you think of it like Skyrim Horse Armour except with life saving drugs. They’ll take as much money from you as they think they can get away with.
Its a tax scheme.
The pharmacy claims this medication is worth $275, insurance covers $40, and then they get as much as they can out of the patient while claiming the rest as a loss they can write off on their taxes.
US healthcare is stupid.
You should really be replacing
stupidwith “evil”That’s fucking evil and the cunts should be held accountable for their evil
But yous won’t cos you’re pussies
Nope. It’s consequential. They need to raise their shareholder value in any way that’s legal, even if it’s not morally right. If they won’t do that, they’d get into trouble. For corporations tax loopholes are there to be exploited.
Making those loopholes illegal is what will fix this. Then you can call it good craftsmanship by politicians. Right now you can barley call it shoddy.
I’d say US healthcare is toxic, and behaves despicably toward those in its care. It’s also inefficient and often counterproductive.
All of this is a result of stupidity and evil, coming both from outside the industry, as well as perpetually generated by the already-ill structure of the industry.
It warps the minds of those who join it, as customers, providers, and regulators. We’re all like software devs loyal to the terrible architecture of a bad codebase due to having to adapt to it to get anything done.
Fucked up systems fuck people up.
It looks like the pharmacies do not get the tax write offs, if any. It’s the drug manufacturers who get to double dip by charging insurers for whatever they’re willing to cover, and then write off the rest causing tax payers to foot the bill.
Regardless, I agree with the article that there needs to be legislation that both bans these type of “shell game” programs, and capping the price of medications. And for what it’s worth, I don’t care if that means companies don’t make as much money. They’ll still make money, and the drugs do not actually cost that much to make.
It’s also a scheme for the pharmacies to get as much as they can from the insurance companies.
You misspelled tax ‘scam’…
It’s not the pharmacies that set the prices. At least, not really. The pharmacy pays near the listed “cash-price” for the drug from the wholesaler, who buys from the manufacturer, so the pharmacy can’t really afford to charge much less than they do for many drugs.
And the price the patient sees after insurance is decided based on the insurance or pharmacy benefit manager who deals with prescription benefits for the insurance.
Pharmacies are also contractually prevented from charging less to a cash-paying patient than what they charge to the insurance companies, so you start getting weirdness with coupon cards to work around that.
That’s not how tax write off losses work.
That just sounds like fraud with extra steps.
Eczema medication costs a few cents to produce, you can get it for a few bucks in almost every country, but the patents in the US and the weakened regulatory system due to corporate pharmaceutical lobbying means that the. Patent holders can charge whatever they want and until healthcare reform occurs or unless a specific law is passed, like with insulin, US shoppers will keep paying literally any price the patent holders and their subsidiaries pull from the top of their heads and write down on your bill.
https://pluralistic.net/2024/06/13/a-punch-in-the-guts/
TLDR deregulating medicine has been a disaster. Monopolistic hospitals, ridiculous drug IP laws, and medical price middlemen with bad incentives make the US medical system the most expensive in the imperial core countries with the worst outcomes.
My insurer bought my pharmacy, and my FSA provider bought my clinic. My wife’s wellbeing is one acquisition or merger away from being fully at the whim of a single corporation in which every single component continues to fail to talk to another, and is fully disincentivized to do so.
It’s insane to me that healthcare looks like this in the US, I mean I live in an objectively weaker economy and my healthcare is vastly better in terms of cost, availability and has no hard ties to employment.
That is crazy messed up. My gut feel is that it’s again down to the corporate shareholder problem, where infinite growth is demanded. It’s defies belief that this hasn’t been fixed, and really makes me think that overall we’re losing the war of greed vs humanity overall.
America is not a country that cares for the well-being of its citizens; it is a collection of businesses
I had a guy argue with me once that US is better than other countries because we have choice in health insurance and I said most people have healthcare tied to their employer who chooses what options they have and this dude argued we ultimately have the choice because we choose where to work.
Removed by mod
My gut feel is that it’s again down to the corporate shareholder problem, where infinite growth is demanded. It’s defies belief that this hasn’t been fixed, and really makes me think that overall we’re losing the war of greed vs humanity overall.
It’s also maintained as a tool to punish labor for stepping out of line. Look at recent labor disputes in the States. The first thing that is done by the company is to shut off healthcare access.
You’re absolutely right. Tie health insurance to a job and you get people to never leave.
I don’t even bother with health care because of shit like this. I’m not gonna participate in a fucking guessing game of how much shit should cost. I go to the eye doctor because I have bad vision but that’s it. Even then half the time my insurance refuses to cover my contacts until I called them to argue about it. It’s so infuriating. I’m fortunate to be healthy otherwise. I don’t know how people that need more help deal with it.
A brief history verifies your gut feeling.
Frame Canada
Wendell Potter spent decades scaring Americans. About Canada. He worked for the health insurance industry, and he knew that if Americans understood Canadian-style health care, they might… like it. So he helped deploy an industry playbook for protecting the health insurance agency.
If you have private health insurance (not medicaid/Medicare), and the drug is a brand name or a generic with one manufacturer, then you likely qualify for a rebate card from the manufacturer. This is often in addition to any patient support programs from the manufacturer that involve you sharing your personal financial situation with them.
The pharmacy nor providers usually have time, and certainly not the incentive, to share this information with their patients. If they were concerned with patient care they would, but that’s part of the problem with privatized Healthcare.
It’s called “extortion.”
She probably used GoodRx, which has been known to sell patient data.
I’m not going to argue in favor of them selling user data, but if the savings are that high I think it’s a decent tradeoff as a consumer.
If they got that big of a discount, it may have been a manufacturer’s savings card.
I use it. I did not know thank you.
The basic problem is when the government gets involved in markets, the logic of the market breaks down.
Because we view medicine as “too important to trust to free markets” we have a thick tangle of laws forcing business to happen in specific ways.
You can’t assume the natural set of incentives are shaping the deals, so you can’t assume the natural set of patterns to appear in the deals being struck.
So, that doesn’t make it make sense. But I hope it makes sense of why it doesn’t make sense.
Yes, let’s blame the government for this one despite deregulation and corporate greed and literally for-profit everything causing the absurd costs of everything medical.
GTFO with that libertarian bullshit. You think less government oversight would cause things to be cheaper?
