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UnitedHealth's Effort to Deny Coverage for a Patient's Care (2023)

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Re: UnitedHealth's Effort to Deny Coverage for a Patient's Care (2023)

#2
Horrifying. But also horrifying that treatment costs so much. Supposedly we have to let drug companies charge extravagant prices because it costs so much to discover new treatments, but there has to be a great deal of inefficiency there. Are we getting a 99% solution for $X when we could be getting a 95% solution for $X/10?

Re: UnitedHealth's Effort to Deny Coverage for a Patient's Care (2023)

#3

Horrifying. But also horrifying that treatment costs so much. Supposedly we have to let drug companies charge extravagant prices because it costs so much to discover new treatments, but there has to be a great deal of inefficiency there. Are we getting a 99% solution for $X when we could be getting a 95% solution for $X/10?

> Supposedly we have to let drug companies charge extravagant prices because it costs so much to discover new treatments

Big pharma disinformation? Perhaps most new treatment research is government funded (and by governments of other countries).

Re: UnitedHealth's Effort to Deny Coverage for a Patient's Care (2023)

#4

Horrifying. But also horrifying that treatment costs so much. Supposedly we have to let drug companies charge extravagant prices because it costs so much to discover new treatments, but there has to be a great deal of inefficiency there. Are we getting a 99% solution for $X when we could be getting a 95% solution for $X/10?

The inefficiency is that for many pharmaceutical companies in the US, their marketing budget is much higher than (~10X) the R&D budget.

Re: UnitedHealth's Effort to Deny Coverage for a Patient's Care (2023)

#5

Horrifying. But also horrifying that treatment costs so much. Supposedly we have to let drug companies charge extravagant prices because it costs so much to discover new treatments, but there has to be a great deal of inefficiency there. Are we getting a 99% solution for $X when we could be getting a 95% solution for $X/10?

We have to let drug companies charge extravagant prices because of otherwise medical care costs would not be so high.

Companies providing medical Care have to spend 80% of their costs on actual medical care, not marketing and executive compensation.

The only way to make the 20% that really matter to the decision makers larger is to make the medical costs larger.

It is one reason people on United healthcare get $100 gift card to see their primary care provider each year.

It's also the reason why there's no real pressure to reduce drug costs.

Re: UnitedHealth's Effort to Deny Coverage for a Patient's Care (2023)

#9

Horrifying. But also horrifying that treatment costs so much. Supposedly we have to let drug companies charge extravagant prices because it costs so much to discover new treatments, but there has to be a great deal of inefficiency there. Are we getting a 99% solution for $X when we could be getting a 95% solution for $X/10?

We have to let drug companies charge extravagant prices because of otherwise medical care costs would not be so high. Companies providing medical Care have to spend 80% of their costs on actual medical care, not marketing and executive compensation. The only way to make the 20% that really matter to the decision makers larger is to make the medical costs larger. It is one reason people on United healthcare get $100 g…

>Companies providing medical Care have to spend 80% of their costs on actual medical care, not marketing and executive compensation.

That requirement was imposed on insurers in response to already-exorbitant medical costs. It does create a perverse incentive, but it cannot be the root cause of the issue.

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