Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Fed Up with Drug Companies, Hospitals Decide to Start Their Own

nytimes.com

Post reply on HN
Print view View original

111–120 of 244 posts

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#111

Post by nkrumm »

shykes wrote: post #86

This article makes it seem like drug companies alone are responsible for predatory pricing in US healthcare, with hospitals being somehow on the consumer's side of the issue. In reality US hospitals are just as guilty of predatory behavior. If they do achieve lower costs through a new generics company, I do not trust them one bit to pass on the savings to patients. Why would they?

Even if they do not directly pass this on to patients, cheaper generics will benefit patients in terms of their availability. I recently was involved in a case where a flucytosine (an old, generic anti-fungal) was considered for a patient, but the cost of treatment was $7,000 (as an outpatient) and therefore not considered (despite this being the best option). For an interesting analysis of this, see [1].

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4885648/

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#112

Post by maxxxxx »

telchar wrote: post #108
sbov wrote: post #68

Earlier quoted context omitted.

It's not only that. Our local hospitals can't give us prices for procedures that other places can. We tried price shopping an hsg test because we had to out of pocket it. Hospitals took hours on the phone and multiple call backs. Other places could give us a quote in minutes. We chose a hospital based on price. The morning of the procedure they told us it doesn't include everything. But they said we were wrong and ou…

It's frustrating. Neither the hospital nor the insurer typically has sufficient information to give you an answer. It's even worse when your information like age or diagnosis history factors into it.

Somehow they can figure it out after the procedure. They could easily give you the cost for each billing code upfront but they choose to hide the information from the patient;

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#113

Post by siquick »

shykes wrote: post #86

This article makes it seem like drug companies alone are responsible for predatory pricing in US healthcare, with hospitals being somehow on the consumer's side of the issue. In reality US hospitals are just as guilty of predatory behavior. If they do achieve lower costs through a new generics company, I do not trust them one bit to pass on the savings to patients. Why would they?

> If they do achieve lower costs through a new generics company, I do not trust them one bit to pass on the savings to patients. Why would they?

As a non-American (UK and Australia citizen) it bewilders me that this is considered a possibility.

Why are hospitals doing the opposite to offering the best care possible to all citizens? Are they for-profit in the US?

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#114

Post by intopieces »

shykes wrote: post #86

This article makes it seem like drug companies alone are responsible for predatory pricing in US healthcare, with hospitals being somehow on the consumer's side of the issue. In reality US hospitals are just as guilty of predatory behavior. If they do achieve lower costs through a new generics company, I do not trust them one bit to pass on the savings to patients. Why would they?

For one, a significant number of of hospitals are non profit. Excess earnings must be invested into hospital itself in the form of capital improvements and additional staff. Controlling costs is a way of reducing their own need to spend this excess money.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#115

Post by dragonwriter »

u801e wrote: post #105
vkou wrote: post #35

Earlier quoted context omitted.

Your car is unlikely to experience life-threatening complications with a nearly unbounded upper cost while it's being fixed. Your body is. A routine surgery can absolutely turn into a hundred-thousand-dollar nightmare. Never mind that a mechanic has a much better understanding of a car, then a doctor does of a human body.

> Your car is unlikely to experience life-threatening complications with a nearly unbounded upper cost while it's being fixed. If you bring your car in for repair and tell them that you need to have the car's brake rotors and pads replaced, the shop can tell you that the parts will cost X and the labor will be Y hours at Z cost per hour and give you a relatively accurate estimate. They may later tell you that there w…

> Why can't that be the same case if I go to get a chest X-ray with posterior-antierior and lateral views? If you have the CPT code(s) and the insurance information, it should not be difficult or time consuming to get the cost estimate.

It is both difficult and time consuming [0], and, moreover, often distant from the provider, because medical billing is quite often outsourced.

[0] Perhaps not in the median case, but there are plenty of complex cases, which is one of the reasons this is outsourced.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#116

Post by usefulcat »

mirimir wrote: post #82
Clubber wrote: post #72

Earlier quoted context omitted.

I they seem to be explicitly targeting generics, so R&D doesn't come into play. It's really just find someone who can build a known compound and press it into a pill. This has the potential to be massively disruptive.

Even generics need FDA approval. Manufacturers must demonstrate therapeutic equivalence.

And in order to get that approval, you will likely need a sample of the product that you intend to demonstrate equivalence to. Good luck getting that sample from the maker of the incumbent product who has nothing to gain and much to lose if your product were to get approved.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#117

Post by kevin_thibedeau »

siquick wrote: post #113
shykes wrote: post #86

This article makes it seem like drug companies alone are responsible for predatory pricing in US healthcare, with hospitals being somehow on the consumer's side of the issue. In reality US hospitals are just as guilty of predatory behavior. If they do achieve lower costs through a new generics company, I do not trust them one bit to pass on the savings to patients. Why would they?

> If they do achieve lower costs through a new generics company, I do not trust them one bit to pass on the savings to patients. Why would they? As a non-American (UK and Australia citizen) it bewilders me that this is considered a possibility. Why are hospitals doing the opposite to offering the best care possible to all citizens? Are they for-profit in the US?

1) Properly healing people reduces your customer base. 2) Yes (with some exceptions).

The other aggravating factor is that most mutual insurance companies have also converted to a for profit model that reinforces the incestuous coupling between pharma and medical providers. There is no voice left who has an interest in lowering costs.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#118

Post by Gustomaximus »

icantdrive55 wrote: post #95
shykes wrote: post #86

This article makes it seem like drug companies alone are responsible for predatory pricing in US healthcare, with hospitals being somehow on the consumer's side of the issue. In reality US hospitals are just as guilty of predatory behavior. If they do achieve lower costs through a new generics company, I do not trust them one bit to pass on the savings to patients. Why would they?

Never forget being charged 14.99 for one Acetaminophen while in a hospital, and this was years ago. My father had good insurance. He went in for a spider bite. He needed to stay the night. I arrived and he thanked me for Teddy Bear, and flowers. I told him I didn't send you anything. He said, "Well someone did?" Weeks later he called me up, and said the gift shop on the hospital send the gift, and charged the Insuran…

One of the best rules for US hospitals (other than universal care) would be for all hospitals to publish prices annually and charge one set price, be it a walk in patient or large union.

This should be a reasonable rule if people want to keep capitalist system healthcare. Its not stopping them competing, only applying a transparent and level playing field to the market.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#119

Post by thatcat »

ekianjo wrote: post #55
TillE wrote: post #32

Earlier quoted context omitted.

From that perspective, does any country have their own publicly owned pharmaceutical manufacturer? It's the kind of thing the NHS should do, since they control most other aspects of health care, but I don't think they do. There's so little benefit to competition with generics, you may as well have that vertical integration to at least provide what hospitals need.

Country-owned means of production have usually not fared well vs competitive forces in the past. And it could be considered as unfair competition: a state-owned manufacturer could basically have a blank check from the government for any kind of investment and would not have to worry at all about profitability. It sounds very nice as a thought exercise, but economical incentives are very tightly linked with productivi…

The problem is anti-competitave behavior though, right? The pharmacutical market is highly consolidated. Trying to rely on some startup to successfully compete in a highly consolidated market that requires a lot of capital and specialized labor isn't going to work, only the government can compete at that level so they should - especially when it is so clearly in the public's best interest for everyone to have access to the services provided by the market.

>Country-owned means of production have usually not fared well vs competitive forces in the past

Currently in the exact markets being discussed ISP markets are in a similar situation. If you look at municipal broadband providers, they has fared very well - providing better service (fiber) for lower costs while protecting the public interest by opting in to net neutrality. Outside of ideological concerns it's hard for me to the problem with the government intervening in stagnant markets by competing directly.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#120

Post by mirimir »

brucephillips wrote: post #106
mirimir wrote: post #102

Earlier quoted context omitted.

Well, some of us blame the whole thing. Why shouldn't healthcare be a government service? Why is that less appropriate than police and military? Or roads?

The same reason any industry benefits from being privatized: to incentive innovation. The antibiotics revolution would never have happened, at least not in America, had there not been a profit incentive. The other services you listed are less dependent on innovation.

OK, I get the dogma.

But reality is more complicated.

See https://www.pharmaceutical-journal.com/news-and-analysis/fea...

Post reply on HN