Earlier quoted context omitted.
My information is from 10-K filings with SEC, and my statement is referring to net profit margins, which are what they are. Unless there is massive fraud going on, managed care organizations are not earning massive profits. If their PBM divisions are, then they are simply subsidizing the insurance division, but it would make no difference to people. The total expense for premium plus out of pocket expenses would not…
One big element is that a lot of large companies and non-profits run their insurance programs as self-insured. They pay the direct costs of the medical care of their insureds, and keep the annual premiums the entire employee-base pays. The "insurance companies" are paid a percentage of the total revenue/claims as an administration fee, so they have incentives to push the overall amounts paid up, not down. Self-insuri…
Biohackers take aim at big pharma’s stranglehold on insulin
271–280 of 392 posts
Re: Biohackers take aim at big pharma’s stranglehold on insulin
#272Why not allow patients to buy generic insulin from overseas (from India for example) ? If I could just you know, ask a friend of mine to fly to India and bring a monthly supply of cheap India made generic of Humalog, that would be great, right? and if insurance company kicks in a few bucks for me, that would drive down the cost of care for insurance company as well
The whole reason it’s cheap is the vast majority of the cost is shouldered by the west. If you were able to execute this arbitrage (and you should be able to but can’t legally) you would quickly find prices would lower slightly in the west and rise dramatically elsewhere.
It’s all profiteering. By preventing price discovery they make a boatload of profit even after writing down the losses on “foreign aid”.
Re: Biohackers take aim at big pharma’s stranglehold on insulin
#273Earlier quoted context omitted.
I don't know about this place mentioned in the article, but there's a similar orginazation at https://cheapinsulin.org/ that you can look into.
TFA blames "big pharma's stranglehold" for high insulin prices, but interestingly the cheapinsulin.org explanation [1] seems to be much more about "big insurance", with pharma companies basically forced to kow-tow if they want their products to be covered. [1] https://cheapinsulin.org/high-insulin-prices
Re: Biohackers take aim at big pharma’s stranglehold on insulin
#274I simply don't understand the healthcare system in the US. Its meant to be a free market, yet insulin costs a ridiculous amount. However Opioids and synthetic opioids are cheap as chips. To put it into context, In the UK the NHS buy Insulin at you can see the prices here: https://bnf.nice.org.uk/medicinal-forms/insulin.html They come from the same companies and are produced to the same standard. How can a bureaucrati…
Most of the 'socialist' countries don't pay for R&D on drugs; US consumers do. They pay a marginal price based on production cost, but almost none of the fixed price investments in efficacy, safety studies etc.
The US system in no way resembles a functioning market. It's a byzantine spider web of regulatory capture, patent abuse, bad incentives and inertia.
Re: Biohackers take aim at big pharma’s stranglehold on insulin
#275Earlier quoted context omitted.
Ok, I guess that's the core of our disagreement. I do believe that "X prevents Y" means " causes Y". Thanks for the discussion.
To me, it's the difference between "is a requirement for" and "is the cause of". - People drive cars. - Cars are car jacked. - If people did not drive cars, carjackings could not happen. - People driving cars is a requirement for carjackings. - People driving cars is not a cause of carjackings. I understand that it is possible and truthful to argue that people driving cars is a cause of carjackings; it's just not my…
Re: Biohackers take aim at big pharma’s stranglehold on insulin
#276Can someone explain in layman's terms why there is no competition on this market? As insulin is so cheap to produce, why can't I just get my own product approved and sell it?
There are crazy patents throughout the entirety of the insulin production pipeline. Some of these being extremely absurd such as patenting the pH of a buffer for specific protocols! I volunteer for the Open Insulin Foundation on/off when not too focused on my research project and it's basically how can we come up with a roadmap to making this decentralized insulin without violating any existing patents. An added laye…
Re: Biohackers take aim at big pharma’s stranglehold on insulin
#277Re: Biohackers take aim at big pharma’s stranglehold on insulin
#278Earlier quoted context omitted.
Every drug company gives away their drugs for free to people who can't afford it in the US. It's sad that not enough people take advantage of patient assistance programs.
I'm curious, but what does "can't pay" mean? Does it mean the drug cost 100%+ of your income? 10% of your income?
Re: Biohackers take aim at big pharma’s stranglehold on insulin
#279My 3 year old daughter was recently diagnosed Type 1. Soon after her diagnosis I discovered a heap of articles about the Open Insulin Foundation. I was even on their website 24 hours ago. However, for the life of me I can't find anything "open" about the Open Insulin Foundation. Could someone please point me in the right direction where I can read anything with more substance than a news article quoting an interview?…
Re: Biohackers take aim at big pharma’s stranglehold on insulin
#280Earlier quoted context omitted.
> Health insurance is a commercial industry. I can't tell whether you're saying "Health insurance in the US is a commercial industry right now" or "there's no such thing as health insurance that is not commercial." The latter statement is not true. Medicare for all would be socialized insurance, as would any single payer plan. There are other kinds of socialized insurance you can find in other countries. The former s…
> Again, you're welcome to lay out your model of how the democrats are responsible. Simple, prior to the ACA I was able to cover my health expenses out of pocket. I’m healthy and literally went to the doctor 3 times in a decade. After being forced by the ACA to buy unneeded and unwanted health insurance, I ended up paying >10k /year for literally nothing. I’ve since paid so much in health insurance that I could have…
Insurance is not something you have because you are ill, it's something you have as a hedge against the probability that you will be ill. Whether you're healthy now has limited bearing on that.
And if you want to be able to have it when you are ill, you need to be willing to contribute to premiums even when you're not. Whether that contribution comes in the form of an explicit premium paid into a risk pool administered by private insurers or in the form of a percentage of your tax dollars paid to a socialized insurance plan (like M4A), that's how insurance works.
From a political standpoint, the individual mandate might have gone down more smoothly if people had been given a choice to opt out of it, in return for agreeing that they could be denied for pre-existing conditions. Democrats at the time made the calculation from a policy/values that too many people wouldn't understand what they were doing and end up shooting themselves in the foot. I used to think that was wrong.
> I ended up paying >10k /year for literally nothing.
> I could have covered my own cancer treatments, out of pocket. I have received nothing for that $100,000+ dollars.
Your numbers don't add up.
Out of pocket costs for a course of cancer treatment usually run well over $100k (and those stats might be for people who do have insurance).
There haven't been many years that the individual mandate was in effect. It went into effect in 2014. Tax for not buying insurance was lowered to zero by 2019. Your yearly premiums would have needed to be not ">$10k" but around $20k for you to have spent $100k in premiums.
And if you didn't want the insurance, it was always legal to simply pay that tax on not having it. How much? Well, for the median income household, that'd be about $700. Much less than You would need to be pulling something north of $500k a year in order for your tax to be $10k. Please, tell us where you worked, and why they were paying you that much while... not offering you insurance?
Or if you were making $500k a year as a business owner / contractor... why you didn't have any accountant or other financial professional giving you better advice? $10k a year in individual premiums is cadillac plan territory, even in expensive metro areas. Generally not what people who are healthy and go to the doctor three times in a decade buy. High-deductible plans with premiums below $300/mo are available to individuals in Los Angeles today. Your individual max required premium shouldn't be more than $3500 a year in 2021 (and in 2014, you could probably get away below $2400/year). Hell, you could cover a family of four in Los Angeles on less than $500/mo in premiums with ACA assistance, for a total cost topping out below $6000/year, so we know that's not what you're talking about (on top of the fact that you spoke in terms of your own health rather than mentioning any family).
Maybe there's some reasonable explanation for why all your numbers are so far outside of credibility here?
> the Democratic Party fought ... M4A
Please. M4A wouldn't even exist as a relevant concept in American political discourse without the Democratic Party. The only reason you know the label at all is because it was advocated in primary contests and by Democrats in congress. Yes, Democrats plural. For an example, read one piece of introduced legislation:
https://www.congress.gov/bill/116th-congress/senate-bill/112...
Notice the list of D Senators as co-sponsors. Notice that it is not short (nearly a third of the caucus at the time). It is profoundly wrong to characterize the Democratic Party as the primary obstacle to something like M4A when it is the only reason why M4A is a potential reality in the US. And saying "I'm no fan of the GOP" doesn't ameliorate that mistake: you can guarantee that the list of Senators sponsoring anything remotely like that bill in the GOP would have a length of 0 (and of course, given when the bill was introduced, only someone who was also ignorant of the composition of the senate at the time could think the primary reason it didn't go anywhere was D efforts).
Also, maybe check your misconceptions about Biden:
https://www.vox.com/21540041/election-2020-joe-biden-health-...
That's him trying to find a way to make medicare for everyone who wants it.