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UnitedHealth overcharged cancer patients for drugs by over 1,000%

fortune.com

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Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%

#11

Earlier quoted context omitted.

They've chosen 90% margin (cost + 1000%). Semicon tool builders (my industry) have margins around 50% (cost + 100%). This is considered high margin manufacturing work. To match United Health's margins we'd need to raise prices by 5x.

I agree, but we can't talk about "over" without talking about where the line is.

I agree as well, just drawing some lines!

Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%

#13

https://archive.ph/cg4we I do not like UnitedHealth, I do not like our existing crop of health insurance executives, and I might even be viscerally glad at some level that the UnitedHealth CEO was killed in a world where justice clearly takes a back seat to greed, but I wish the headline didn't say "overcharged", because there's no established amount of markup that is the correct amount of markup other than what peop…

All I'm going to say is that Optum Specialty Pharmacy is the sole source that UHC will accept for a lot of special drugs. For example UHC offers insurance for IVF including a separate cap for medications, but if you use their insurance you have to order through their subsidiary Optum Specialty Pharmacy and the prices triple or quadruple over MSRP if you buy from OSP using insurance versus if you pay cash. They also w…

I don't want you to give them the benefit of the doubt. I certainly don't think they deserve it. I do think, however, that a conversation about "overcharging" goes nowhere until people talk about exactly where charging ends and overcharging begins.

Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%

#16

https://archive.ph/cg4we I do not like UnitedHealth, I do not like our existing crop of health insurance executives, and I might even be viscerally glad at some level that the UnitedHealth CEO was killed in a world where justice clearly takes a back seat to greed, but I wish the headline didn't say "overcharged", because there's no established amount of markup that is the correct amount of markup other than what peop…

This is exactly it. They are charging that price because that price will be paid, and this maximizes their overall profit. In other similar situations this would spur competition, which would ultimately drive down prices to a reasonable level. But in the healthcare industry competition is often prohibited or made very difficult by law. You can cite the patent system as an example of this, but another horrible one is…

> which should infuriate you

Oh it does!

Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%

#17
post #8

I don’t understand how an insurance company can overcharge consumers. Isn’t their job to pay what pharmacies and hospitals charge? Do insurance companies get money if they approve the overcharged prices? If so how? I thought their revenue was the premiums which are fixed. Is the extra money because people are forced to pay everything after the little the insurance company pays?

UnitedHealth is not an insurance company. They own an insurance company as well as OptumRx, a pharmacy benefit manager, which is described at the very top of this article.

Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%

#18
post #8

I don’t understand how an insurance company can overcharge consumers. Isn’t their job to pay what pharmacies and hospitals charge? Do insurance companies get money if they approve the overcharged prices? If so how? I thought their revenue was the premiums which are fixed. Is the extra money because people are forced to pay everything after the little the insurance company pays?

They're not just the insurance company - they are also the pharmacy manager who sells the drugs to the patient. So there wasn't really anyone to negotiate with - they pick the price they want to sell the drug for and then how much of it they'll cover.

Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%

#19
post #7

Nothing is shocking about the insurance industry anymore since they’ve been pulling this kind of thing for years. To me the most shocking thing is the people who defend them. I understand the drive to make money and build huge businesses: what confuses me is that we treat human health the same as things that don’t directly impact the health of people. It seems to me that there are endless opportunities to get insanel…

How do you respond to people that say the profit motive is what drives innovation, and in the long term we’d rather have better, novel treatments sooner

Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%

#20

https://archive.ph/cg4we I do not like UnitedHealth, I do not like our existing crop of health insurance executives, and I might even be viscerally glad at some level that the UnitedHealth CEO was killed in a world where justice clearly takes a back seat to greed, but I wish the headline didn't say "overcharged", because there's no established amount of markup that is the correct amount of markup other than what peop…

All I'm going to say is that Optum Specialty Pharmacy is the sole source that UHC will accept for a lot of special drugs. For example UHC offers insurance for IVF including a separate cap for medications, but if you use their insurance you have to order through their subsidiary Optum Specialty Pharmacy and the prices triple or quadruple over MSRP if you buy from OSP using insurance versus if you pay cash. They also w…

UHC double-dips because they own Optum even though Optum is "independent". It's fucking disgusting. How they were allowed to buy Optum and didn't have every regulator in the country on the case is beyond me.

I $truggle to think how $omething like thi$ wa$ allowed to happen.

Bastards.

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