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Mark Cuban's Cost Plus Drugs

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Re: Mark Cuban's Cost Plus Drugs

#181

Post by maerF0x0 »

dragonwriter wrote: post #177
maerF0x0 wrote: post #176

Earlier quoted context omitted.

https://fee.org/articles/america-outperforms-canada-in-surge... Saying America spends more is pretty weak claim because Americans are fatter, more often shot, face worse natural disasters (hurricanes, earth quakes)... Of course they spend more. There are hundreds of variables why healthcare per capital would be cheaper in Canada from CoL to quality of doctors (the ones that remain are ones who cannot compete in the h…

> Saying America spends more is pretty weak claim because Americans are fatter, more often shot, face worse natural disasters (hurricanes, earth quakes)... Of course they spend more. “Fatter“ and “more often shot” are at least in part due to choices about the focus and distribution of physical and mental health care, not independent factors (in fact, the political faction most defensive of the ways in which the US sy…

I actually do agree that part of the gun violence equation is mental health care. That doesn't mean socialized mental health care is the best solution to healthcare needs. Simply that having a society which does not value mental healthcare at all is suboptimal.

Re: Mark Cuban's Cost Plus Drugs

#182

Post by maerF0x0 »

arcticbull wrote: post #180
maerF0x0 wrote: post #176

Earlier quoted context omitted.

https://fee.org/articles/america-outperforms-canada-in-surge... Saying America spends more is pretty weak claim because Americans are fatter, more often shot, face worse natural disasters (hurricanes, earth quakes)... Of course they spend more. There are hundreds of variables why healthcare per capital would be cheaper in Canada from CoL to quality of doctors (the ones that remain are ones who cannot compete in the h…

Actually my opinions are data driven.

You cannot apply data without values. If I told you X people die every year from Y, it would be your values that suggest if we should do anything about it.

X could be lots or little, Y could be Covid or the death penalty. Data tells you nothing about the justice of a situation.

Re: Mark Cuban's Cost Plus Drugs

#183

Post by spywaregorilla »

treis wrote: post #150
spywaregorilla wrote: post #88

Earlier quoted context omitted.

Was there someone around previously who could take my order and give me the drugs at those prices? I'm not convinced this is true. I'm not familiar with GoodRx but they appear to be a coupon aggregator which is not the same thing

Depending on the drug, yes. Walmart & Amazon have cheap generics and so do many regional grocery stores.

> Depending on the drug

That seems like the value prop though. The cases where it's not, and the alternatives are absurdly expensive. People seem to be focusing on the median case where it's marginally more expensive or cheaper

Re: Mark Cuban's Cost Plus Drugs

#184

Post by DanBC »

an9n wrote: post #57
arcticbull wrote: post #48

As always the issue with privatized social services is that the goal is to make money, not to provide a service so the incentives are fundamentally misaligned. For-profit care providers make money when the fail to provide care. When they fail to cover procedures. When they can substitute lower-quality or less effective goods and services. When they can sell you catastrophic cover with deductibles and co-pays too high…

Let's hope you make a better fist of it than the UK - the NHS is currently unreformable to any significant degree, due to it being weaponised by the left.

When you consider the massive reforms carried out by Lansley (a Conservative health minister. These reforms caused huge problems, didn't particularly work, were widely misunderstood even by his own party, and are now being rolled back) and now the Hunt/Hancock/Javid reforms to ICSs it's just plain wrong to say "the NHS can't be reformed".

Re: Mark Cuban's Cost Plus Drugs

#185

Post by DanBC »

an9n wrote: post #157
pc86 wrote: post #105

Earlier quoted context omitted.

Don't get me wrong, I think claiming the NHS has been "weaponized by the left" is idiotic, but I don't see how PC expenditures support or refute that point?

I got this terminology straight from the horse's mouth: https://www.theguardian.com/politics/2015/jan/12/labour-refu... 'Labour has defended the way it is campaigning on the NHS – but once again refused to confirm that Ed Miliband told the BBC that he wanted to “weaponise” the NHS in the election campaign.' 'The spokesman said: “I am not going to talk about words used in private conversations. They should not be shar…

Bit weird of you to use that NHS Providers site. Chris is here talking about the Conservative party making misleading claims:

> So here is a challenge to politicians who say they support the NHS. Be clear and straight about the numbers – for example, don’t double count what’s already been announced and don’t confuse five and one year commitments to boost a headline number. Acknowledge the scale of the funding needed to deliver services to meet our growing needs, and to rebuild our NHS, making it fit for the 21st century. That means looking beyond hospitals, important though they are, to other parts of the service which have suffered similar neglect, for which patients are today paying the price.

That "double counting" means that the amount of money being invested is less than claimed; the numbers of new staff being trained & recruited or retained is less than claimed; the numbers of new hospitals being built is less than claimed; etc.

Re: Mark Cuban's Cost Plus Drugs

#186

Post by madmax108 »

treis wrote: post #148
criddell wrote: post #86

Earlier quoted context omitted.

How does GoodRX work?

Part of how the government determines the price it pays for drugs is based on the retail price. That (among other reasons) gives manufacturers incentive to have crazy list prices. A drug that sells for $50 might have a list price of $1,000. Enter insurance companies. They don't want to pay $1,000 for a $50 drug so they negotiate. But there's too many insurance companies for them to have good leverage and efficiencies…

This is such a great, useful explainer (esp. for someone outside the US who don't really know how these systems are set up in the US). Thanks!

Re: Mark Cuban's Cost Plus Drugs

#187

Post by tonyhb »

chevman wrote: post #68
tonyhb wrote: post #15

Earlier quoted context omitted.

They bypass the people who sell drugs to existing pharmacies by operating their own D2C pharmacy themselves. Instead of: Pharma co -> Distribution -> Pharmacy -> You It's: Pharma co -> Cost Plus -> You. Cost plus is still a pharmacy by definition.

From their site: "We work with Truepill pharmacy, our trusted fulfillment partner to fill your prescriptions. Truepill has a team of accredited pharmacists who will ensure your medication is safe and delivered to your doorstep on time." Oh, and guess who owns most of TruePill??? Hint - https://www.optumventures.com/portfolio There is very little new in the PBM/Pharmacy world from what I've seen, just more layers of r…

Yeah, I'm very familiar with Truepill. They're the secret sauce behind many companies: Hims, Nurx, Roman, etc. Truepill is a _dominant_ supplier of drugs to many companies at this point.

Re: Mark Cuban's Cost Plus Drugs

#188

Post by arcticbull »

maerF0x0 wrote: post #182
arcticbull wrote: post #180

Earlier quoted context omitted.

Actually my opinions are data driven.

You cannot apply data without values. If I told you X people die every year from Y, it would be your values that suggest if we should do anything about it. X could be lots or little, Y could be Covid or the death penalty. Data tells you nothing about the justice of a situation.

I don't know man, all the data I see shows the system costs half as much per capita and has similar or better outcomes - and that wait times exist in both countries. So given outcomes are the same or better, the justice level must therefore be roughly the same for half the cost.

You pull out tired narratives like 'care quotas' as though they only exist in one system but not the other. You pull out tired narratives like 'wait times' as though they exist in one system but not the other. I linked you an interview that explains what the industry has been doing to further this narrative, and you didn't read it because again, it doesn't align with your preconceived notions.

What you're telling me is that you don't want to engage on data because the reality on the ground doesn't align with your values and you've been fed a crock.

Re: Mark Cuban's Cost Plus Drugs

#189

Post by rnk »

xyzzyz wrote: post #137
rnk wrote: post #98

Earlier quoted context omitted.

That's incredibly naive. I can already shop for health plans in the us, and it's a shitty result. The rest of the wealthy western world has national health insurance and it works really well. The US is the broken system with declining health of its citizens, even before COVID.

> The rest of the wealthy western world has national health insurance and it works really well. If you talk to people who immigrate to US from those countries with national health insurance, you’ll find that what you claim above is by no means a consensus. For example, I immigrated to US from Poland, and in my opinion, US healthcare is much superior to Polish socialized healthcare, in terms of quality and availabilit…

I'm in the software world in the US. My friends from the UK, Canada, Germany say they strongly preferred their healthcare in their home country. There are scattered things better here (sometimes wait times are less) but mostly it's a stupid waste of time system with enormous effort figuring out and arguing of EOB statements endlessly where you can never know what something costs until the insurance companies and medical providers stop arguing over the details.

Re: Mark Cuban's Cost Plus Drugs

#190

Post by Adrox »

maerF0x0 wrote: post #173
Adrox wrote: post #152

Earlier quoted context omitted.

Exact same thing as Marketing spend. You cannot split the good from the bad. I really cannot understand how you can even think about doing healthcare system for profit. Posting this from a Single-pay country, Germany.

Is Germany single provider too? In my armchair politics I do wonder if single payer, market provider might work. You get the competition of the market, but the tax payer purse. I think technically this is how medicare works but there are a bunch of nuances that make medicare not work (such as negotiation of prices).

I'm not sure if it's matches "single payer". It has mandatory insurance. And you cannot choose most of the things that what you can get covered or not.

I got a "government insurance", which is the most expensive, but also the one with the best cover. There is "private insurances" with cheaper premiums and less cover that are attractive to young people, but it's kind of hard to later in life switch back to the government one.

Most countries in EU have kind of this mixed healthcare, with private, and public ones with the only goal to make sure the private offer competitive enough services... Same thing with hospitals, there is public hospitals, so private ones don't jack up the prices to crazy values...

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