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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%

#21

Post by jsheard »

acchow wrote: post #19
porcoda wrote: 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

Even if that's true for the actual pharmas, how are insurance companies like UHC innovating? They're just middlemen.

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

#22

Post by throwway120385 »

BugsJustFindMe wrote: post #13
throwway120385 wrote: post #10

Earlier quoted context omitted.

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.

I'd be fine with a 20-50% markup on MSRP to cover billing and administration costs but when the insurer owns the pharmacy they can "negotiate" whatever rate they want and you have to pay it. I don't see it directly in the article, but I suspect they do the same thing with cancer drugs as with IVF drugs and require you to go through their pharmacy for insurance coverage. Insurance plans often have lifetime maximums, and when they set their own prices and collect money from themselves for the medication they sell you they can basically dictate how much actual coverage you get versus someone paying cash. And because you chose "bill insurance" when you ordered the medication, you're now on the hook for whatever additional cost there was versus the cash price. And also they won't tell you what the cost is until after the medication has already shipped.

So it's at least plausible that they're abusing their position as the company that owns the pharmacy and the insurance plan to charge you a lot of money and provide very little coverage and also to gouge you at the very end of your coverage, because that's exactly what they did to my partner and I.

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

#23

Post by daveguy »

acchow wrote: post #19
porcoda wrote: 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

Profit motives for medical / biotech research, yes. What innovations have insurance companies made in the last 100 years besides to squeeze out more profit?

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

#24

Post by jampekka »

BugsJustFindMe wrote: post #4

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…

There are many models used in different jurisdictions. Typically it's a government body for negotiation, assessment and sometimes price caps.

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

#25

Post by bb88 »

acchow wrote: post #19
porcoda wrote: 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

Profit motive can also drive profiteering.

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

#26

Post by brightball »

porcoda wrote: 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…

Does anybody defend them?

I’ve been on the selection side as an employer and several others will probably echo what I’m about to say.

Virtually every insurance provider is going up 15-20% / year to the point that it’s completely unsustainable. United was quoted to me as almost 20% lower than current rate for our provider (before they are about to go up 20%).

On premium alone they will save some people close to $500 / month for what is…”on paper” the same coverage.

I’ve read all of the same stuff about United that everybody else has but the finances put employers in a very difficult position.

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

#27

Post by prettyStandard »

jsheard wrote: post #21
acchow wrote: post #19

Earlier quoted context omitted.

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

Even if that's true for the actual pharmas, how are insurance companies like UHC innovating? They're just middlemen.

They prevent unnecessary treatments! /s

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

#28

Post by landryraccoon »

BugsJustFindMe wrote: post #4

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…

I take issue with the claim that in order to say something is too expensive that you must be able to precisely propose an alternative price.

I have no idea what the correct margin for essential cancer drugs is. I don’t think it should be a 10x markup. Intuitively, it seems that there’s something wrong with price gouging dying cancer patients. If you have an argument why my intuition is wrong, please share it.

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

#29

Post by bogwog »

acchow wrote: post #19
porcoda wrote: 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

Competition is what drives innovation. There are many ways to chase profits without innovating.
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