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Drugmakers raise US prices on 350 medicines despite pressure

reuters.com

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Re: Drugmakers raise US prices on 350 medicines despite pressure

#121

Post by nradov »

fuckinpuppers wrote: post #98
Workaccount2 wrote: post #19

Earlier quoted context omitted.

Last year I needed to get blood work done, some of which may or may not be covered. It took me two weeks, dozens of phone calls, and multiple "escalations" to learn what would be covered and what the price would be if it wasn't Totally insane. The kicker is that after all that, the price I was billed wasn't even the price I was given (thankfully it was less though).

That’s what is insane. I called my insurance to ask if some tests were covered since preventative care is 100% covered. They couldn’t answer if cholesterol test would count. How is that not automatically classified as preventative? It’s one of the most basic metrics. So they want me to get the doctor to give me the ICD code and the diagnosis code. Or something. Two different codes. They’ve added so much bureaucracy a…

I think you might be confused by the terminology. Under the ACA (Obamacare) there are a limited set of preventive health services that are covered at no cost to the patient. These are a subset of all preventive care services that meet strict criteria for effectiveness. Cholesterol screening may or may not be included based on your age and diagnosed conditions.

https://www.healthcare.gov/preventive-care-adults/

Re: Drugmakers raise US prices on 350 medicines despite pressure

#122

Post by beAbU »

olyjohn wrote: post #55
Workaccount2 wrote: post #19

Earlier quoted context omitted.

Last year I needed to get blood work done, some of which may or may not be covered. It took me two weeks, dozens of phone calls, and multiple "escalations" to learn what would be covered and what the price would be if it wasn't Totally insane. The kicker is that after all that, the price I was billed wasn't even the price I was given (thankfully it was less though).

I just had some bloodwork done, myself. My provider accidentally billed insurance, which had lapsed due to being laid off. I got my "Explanation of benefits" and it was $1000 billed to them, but I was given a $500 "discount." So I only owed $500... Cash cost was $50. Makes no goddamn sense. Also I went in for a colonoscopy and an endoscopy. Insurance was billed for $14000. I got statements from 4 different doctors, a…

This uncertainty of what things cost would kill me. It must be terrible!

We had a baby 2 weeks ago, which included 4 nights in the hospital before and after the birth, a surprise c-section, various specialists, follow ups, consultants and blood tests.

Our total outlay so far is about €30 for the parking at the hospital every day.

We have insurance, but we did not use it for the baby. I need to see a dermatologist next week. Cost will be €300, which I can claim back from my insurance afterwards. I just punch the doctor's name into my insurance portal, and they list the procedures and the amounts I'm covered for each.

If I asked my GP to refer me to a public dermatologist, I would have waited longer for an appt, but I would have only had to worry about parking at the hospital, everything else would be free.

Re: Drugmakers raise US prices on 350 medicines despite pressure

#123

Post by thrance »

vjvjvjvjghv wrote: post #4

"Rome said the companies seem to be maximizing prices while negotiating discounts behind the scenes with health and drug insurers and then setting yet another price for direct-to-consumer cash-pay sales." This describes the biggest problem in US healthcare. No clear and consistent pricing. If we had a real market, you would get a prescription and then go to the seller with the lowest price. And everybody would get th…

And when you get a broken leg you'd go shop around, comparing prices and looking up reviews? You can't have a "real" healthcare market. It is inelastic, people will always pay whatever is asked of them. It requires massive investments, naturally consolidating into a few large actors that are then easily able to join in a cartel, lobby the State for regulatory capture, etc. Price gouging and profiteering are just the end game of a free market functioning normally.

Re: Drugmakers raise US prices on 350 medicines despite pressure

#124

Post by [deleted] »

beAbU wrote: post #122
olyjohn wrote: post #55

Earlier quoted context omitted.

I just had some bloodwork done, myself. My provider accidentally billed insurance, which had lapsed due to being laid off. I got my "Explanation of benefits" and it was $1000 billed to them, but I was given a $500 "discount." So I only owed $500... Cash cost was $50. Makes no goddamn sense. Also I went in for a colonoscopy and an endoscopy. Insurance was billed for $14000. I got statements from 4 different doctors, a…

This uncertainty of what things cost would kill me. It must be terrible! We had a baby 2 weeks ago, which included 4 nights in the hospital before and after the birth, a surprise c-section, various specialists, follow ups, consultants and blood tests. Our total outlay so far is about €30 for the parking at the hospital every day. We have insurance, but we did not use it for the baby. I need to see a dermatologist nex…

[deleted]

Re: Drugmakers raise US prices on 350 medicines despite pressure

#125

Post by collingreen »

tzs wrote: post #110
Analemma_ wrote: post #14

Earlier quoted context omitted.

Mate, this Supreme Court ruled that the President is immune to prosecution and de facto outside and above the law. I’m honestly not sure what to tell you if you’re still hoping for rule-of-law decisions to come out of it.

The 14th Amendment says all people born or naturalized in the US and subject to its jurisdiction are citizens. If someone is immune to prosecution and de facto outside and above the law, I wonder if a case could be made that they are not subject to US jurisdiction, and that invalidates prior citizenship by birth or naturalization.

I sure hope not. We don't need any help weakening citizens' protections from the government.

Re: Drugmakers raise US prices on 350 medicines despite pressure

#126

Post by lotsofpulp »

anthuswilliams wrote: post #119
lotsofpulp wrote: post #111

Earlier quoted context omitted.

> Contrast this with a no-rebate world with cheaper/more transparent pricing. Fewer patients would hit their out of pocket maximum. And premiums would go up. Every insurer has to get their premium approved by every state’s insurance regulator, and every state’s insurance regulator is not going to allow them to have more than a few percent of profit. > They can use the rebates they get from the providers to subsidize…

> And premiums would go up. Yes. As I wrote above, insurers compete on premiums, and they do do so by using rebates to subsidize those premiums by spreading patients' deductibles across the insured population. As far as profits go, I can't speak to regulatory issues since they will vary by state, but in any case the same critique would apply if insurers are pocketing a fixed percentage of a larger amount. Re your sec…

> but the central point is that people who have to USE their insurance (i.e. sick people) subsidize the premiums of people who don't (healthy people), and this critique applies regardless of age.

You’re losing me here. This claim is categorically false. You cannot consider only the deductible when calculating who subsidizes who.

The only way to calculate it is premiums + deductible + out of pocket maximum = total healthcare costs. And the subsidy via premium is so large that it negates effects of a deductible and out of pocket maximum.

Note that all plans have to be actuarially equivalent, regardless of what deductible you choose. The actuaries have to account for rebates and other pricing strategies when ensuring actuarial equivalence, so that the ratio of what the plan pays versus what you pay meets the required ratio for that metal level.

https://www.healthcare.gov/choose-a-plan/plans-categories/

Since your health is not a factor in pricing your insurance, it has to be that people less likely to need healthcare pay for the people likely to need healthcare.

It is the same as if the government forbade auto insurers from using moving violations history, or life insurers from using health measures, or home insurers from using flood maps.

Re: Drugmakers raise US prices on 350 medicines despite pressure

#127

Post by metadope »

tzs wrote: post #108
metadope wrote: post #93

Earlier quoted context omitted.

Someone once proposed a National Sales Tax. I think it was suggested that we could eliminate personal income taxes if we imposed a federal sales tax on all purchases. Liberals vehemently opposed the idea, calling it 'regressive', meaning it would be socially backwards, but the idea held appeal as a simple and fair way of "taxing everyone equally". For some reason, a majority of public opinion leaned left on this part…

> Liberals vehemently opposed the idea, calling it 'regressive', meaning it would be socially backwards, but the idea held appeal as a simple and fair way of "taxing everyone equally" I'm not sure what you mean by "socially backwards". "Regressive" and "progressive" are terms of art in tax law and theory. A tax is regressive if people with less income pay a higher percentage of their income toward that tax than do pe…

Yes, that was very much my point, and thank you for making it clearer than I did. I confess to having attempted to couch the term (in single quotes) in order to lessen its potential to trigger reactionary righteousness.

By "socially backwards" I meant to allude to a reversal of social evolution. If you start with the premise that we evolve as a society (and as individuals, cells in our grand aggregate organism), then you might see an increased tax burden on the poor as moving backwards, de-evolving, regressing.

I apologise for obscuring my meaning, stepping so lightly through (what I perceive to be) the minefield of HN's perpetual potential political polarization (and for here, now, my abuse of alliteration) that I danced over the point I was trying to make.

A blanket tariff policy is effectively a national sales tax which is regressive (and bad, taxation without representation is bad, bass ackwards orange man bad).

Re: Drugmakers raise US prices on 350 medicines despite pressure

#128

Post by acdha »

mmooss wrote: post #105
acdha wrote: post #40

Earlier quoted context omitted.

There are a lot of bad health outcomes built into our society, yes, but by the time people are confronted with the health impacts of cars, agriculture subsidies, for-profit healthcare, etc. it is likely that drugs will be necessary to treat the very real, immediate problems which any given patient has. Reversing the subsidies for things like car-dependency would positively benefit millions of people but it’s a genera…

I agree about the significance of those large-scale changes; still ... > Reversing the subsidies for things like car-dependency would positively benefit millions of people but it’s a generational change, not something most individuals can do. Individuals frequently can chose to not use a car, of course. Still, it's not realistic for everyone or all the time, especially in a society built for automobile use. > by the…

> Individuals frequently can chose to not use a car, of course

To some extent, yes, but my point was that it’s not realistic for many people because we treat walkable neighborhoods like luxuries. If you wake up in your 40s with a bad back and cardio problems because you live in a suburb and drive everywhere, you can’t roll back the clock and build sidewalks, legalize density, or run decent transit and on average don’t have the money to move somewhere dramatically better.

I think a growing number of people, especially younger ones, realize this is unsustainable but it took generations to get here and it’ll take a while to change trajectories, too. If gas prices had stayed high in the seventies that might have gone differently but a huge percentage of American neighborhoods are designed to minimize physical activity and that’s often enforced by law.

Re: Drugmakers raise US prices on 350 medicines despite pressure

#129

Post by anthuswilliams »

lotsofpulp wrote: post #126
anthuswilliams wrote: post #119

Earlier quoted context omitted.

> And premiums would go up. Yes. As I wrote above, insurers compete on premiums, and they do do so by using rebates to subsidize those premiums by spreading patients' deductibles across the insured population. As far as profits go, I can't speak to regulatory issues since they will vary by state, but in any case the same critique would apply if insurers are pocketing a fixed percentage of a larger amount. Re your sec…

> but the central point is that people who have to USE their insurance (i.e. sick people) subsidize the premiums of people who don't (healthy people), and this critique applies regardless of age. You’re losing me here. This claim is categorically false. You cannot consider only the deductible when calculating who subsidizes who. The only way to calculate it is premiums + deductible + out of pocket maximum = total hea…

The claim about who subsidizes who was always hyperbole, I'll grant you that. I included the statement to make the point that this is the phenomenon people are referring to when they make that statement.

I happen to think there is validity to the statement if you control for other actuarial factors. But if you don't think that makes sense as a lens through which to look at the problem, I won't quibble, even though I disagree. We're also only talking about drug prices here, which is a small portion of overall healthcare spending.

In any case, the central point, that insurers benefit from higher prices, still stands.

Re: Drugmakers raise US prices on 350 medicines despite pressure

#130

Post by KumaBear »

dfxm12 wrote: post #12
KumaBear wrote: post #6

Earlier quoted context omitted.

Why does the US consumer of said medications subsidize many other countries who have access to the same medications for a fraction of the US sticker price?

Lots of reasons. One of them is that other countries negotiate deals country wide and can get bulk discounts. The US does this with the VA and Medicare, and people using those services generally pay less than the rest of Americans. In the end, it is largely a policy choice, as having a single payer could get better negotiated deals on drugs. https://www.healthsystemtracker.org/brief/how-medicare-negot...

Thanks for adding this information and yes this is exactly the point I was trying to make. Nationalized systems have better outcomes when they control the supply, demand, and pricing. If that doesn’t work manufacture it ourselves at a discount.
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