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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%

#311

Post by nradov »

ceejayoz wrote: post #309
nradov wrote: post #264

Earlier quoted context omitted.

Health care now has significant price transparency, although there are still some major gaps and it can be challenging to shop for the best option. Many consumers are still unaware of the tools available. https://www.cms.gov/priorities/key-initiatives/healthplan-pr... https://www.cms.gov/priorities/key-initiatives/hospital-pric...

Good luck trying to make sense of it. https://www.dolthub.com/blog/2023-03-23-illusion-of-transpar... > Humana published their MRFs across 11,000,000 different files, then rate-limited how fast you could download them HN discussion: https://news.ycombinator.com/item?id=35347647

Your missing the point. No one expects consumers to download the MRFs. Humana plan members can just log in to their web portal to search for the treatment they need and see prices across all the local network providers.

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

#312

Post by ceejayoz »

nradov wrote: post #311
ceejayoz wrote: post #309

Earlier quoted context omitted.

Good luck trying to make sense of it. https://www.dolthub.com/blog/2023-03-23-illusion-of-transpar... > Humana published their MRFs across 11,000,000 different files, then rate-limited how fast you could download them HN discussion: https://news.ycombinator.com/item?id=35347647

Your missing the point. No one expects consumers to download the MRFs. Humana plan members can just log in to their web portal to search for the treatment they need and see prices across all the local network providers.

> Humana plan members can just log in to their web portal to search for the treatment they need and see prices across all the local network providers.

Maybe. The article also asserts their data, where available, is often also wrong. See the section titled "Cross checking with hospital data".

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

#313

Post by ceejayoz »

gruez wrote: post #244
ceejayoz wrote: post #233

Earlier quoted context omitted.

> Young voters were far more split: 41% found the killer's actions acceptable, while 40% found them unacceptable, per the poll. About 24% found them "somewhat acceptable" and 17% "completely acceptable." That's a big number of people.

"greater public" =/= "Young voters"

My point is that an entire generation of voters sees it as about a 50/50 split. That's shockingly high.

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

#314

Post by nradov »

markdown wrote: post #179
bloppe wrote: post #145

Earlier quoted context omitted.

I'm going to go ahead and defend them because private insurance is actually far from the most broken thing about US healthcare, yet they seem to shoulder all the blame. Average health insurance profit margin in US is ~3%. That's not a greedy profit margin. It's the health care that's expensive, not the insurance. Health care is much more expensive in the US than in similar countries. I'm not an expert on why, but the…

The only reason healthcare is so expensive is because a dysfunctional insurance industry exists.

There are actually many reasons and the commercial insurance industry, while in serious need of reform, is hardly the most significant reason for high costs.

https://www.sensible-med.com/p/the-entire-healthcare-system-...

https://www.bloomsbury.com/us/price-we-pay-9781635575910/

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

#315

Post by NickC25 »

shpongled wrote: post #62
NickC25 wrote: post #42

Earlier quoted context omitted.

A lot of that research is primarily done in university labs, mind you. On the taxpayer dime. Somehow the research escapes a lab and Pfizer manages to put some stupid name on it and reaps billions in profit.

It requires billions of dollars and a decade+ to translate academic research into a clinical outcome. Most academic research is not reproducible or robust enough to even be replicated outside of the lab that performed it - and this will only be discovered after spending millions of dollars of private funding.

I get that completely - and you're completely correct: most research isn't ready for clinical trials let alone commercial distribution. And even then, only a small amount of reproduce-able work matures into a finalized product. Yes, there needs to be financial incentives for the private sector to find promising work, and funding the next steps once it escapes the University ecosystem. I'm all for that. But as a society we need to be clear about where the initial funding comes from, and who those are who pay for that first round of funding are.

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

#316

Post by SilasX »

tptacek wrote: post #279
inferiorhuman wrote: post #277

Earlier quoted context omitted.

Does that include the artificially bloated cost of care (compared to e.g. Medicare), the costs of Medicare Part D fraud, and the costs of having care denied and delayed (2–3x the claim denial rate of Medicare) or just the premiums? Last time we did this song and dance you doubled down on incorrect assumptions about how Medicare functions. So, no, it's not likely I'll come to the same conclusions as you.

Go ahead and do it any way you'd like, show your work, and I think you're going to reach the same conclusion about how silly this is.

Yes, it is pretty silly to think American healthcare would no longer be a global laughingstock if surprise bills of $5000 were replaced with surprise bills of $4700.

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

#317

Post by NickC25 »

nozzlegear wrote: post #114
amelius wrote: post #91

Earlier quoted context omitted.

So the only contribution of Big Pharma is that they take the risk, collect the funding and do some administrative stuff. It sounds to me like we can get rid of this middle man with some well managed governmental institutions.

> So the only contribution of Big Pharma is that they take the risk That seems to me like the big thing you're kind of glossing over. Like I said, I don't really want to go to the mat for them, but I'm sure there's plenty of risks Big Pharma corps have taken buying up research they thought would pay off and then failed to bring to market. Maybe it'd be better to have governments buying the research and bringing it to…

>and hopefully the taxpayers wouldn't vote in someone who wants to gut whatever arm of the government is responsible for that after enough failed purchases.

Oh, well, that would never happen now would it?

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

#318

Post by dangus »

onlyrealcuzzo wrote: post #89
dangus wrote: post #65

Earlier quoted context omitted.

It is already established fact that Medicare is more efficient than private insurance. https://www.healthaffairs.org/do/10.1377/forefront.20110920....

Assuming that your numbers are correct: You eliminate ~1.2% of total healthcare spending on private insurance profits. Then you eliminate ~37% of ~14% of ~27% total healthcare spending on insurance labor costs = ~1.5%. * Article states medicare is ~37% more efficient. * Insurance companies are required to spend AT LEAST 80% of premiums on actual patient care (~6% of the remaining ~20% are profits - already taken out…

- That literally moves the needle. You don't want your healthcare to cost 2.7% cheaper? If you were buying a TV and Best Buy sold it for $1000 but Costco sold it for $973 you wouldn't buy it from Costco?

- Insurance companies being required to spend at least 80% of premiums on patient care logically incentivizes them to keep patient care costs high, because if costs go down then profit goes down. If your MRI costs $1000 then the insurance company is allowed to make $200 in profit. If your MRI costs $2000 then the insurance company doubles their profit to $400.

- Removing private insurance would give public healthcare far more negotiating power on costs. While there is a limit to profit margins made by insurance companies, there is no limit to the profit margins made by medical suppliers, pharmaceudicals, etc.

- Removing non-paying patients would reduce prices charged by hospitals. Hospitals are essentially sub-prime lenders making loans out where no assets are involved. They have to charge insurance companies more money to cover everyone else who doesn't pay. Moving to healthcare paid for automatically completely removes the issue of unpaid bills, collections, medical bankruptcies (how much do the salaries of bankruptcy courts, judges, lawyers remove from the healthcare system?).

- You're arguing against the established fact that all other countries besides the United States spend less on care. If the United States tried anything else it would be likely to reduce costs.

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

#319

Post by boroboro4 »

kenjackson wrote: post #283
legitster wrote: post #187

Earlier quoted context omitted.

The report is misleading. What is being alleged here is that PBMs overpriced over the generics. So it's like if Coca-Cola set the price of their can at $50, and NoName at $0.50. So you be are being "overcharged" at the grocery store when you buy the Coke and not the NoName. It's not actually clear from the report that the PBMs actually profited from overcharging. Furthermore, if the doctor prescribes a name brand dru…

Thank you. That makes sense. Why are you being downvoted? I'd love if someone could say why they're downvoting you, because it seems like you addressed my question -- unless you just fabricated an answer -- but it would be nice if they said that.

Because in reality PBM and insurance company owned by the same corporation, in this case: UnitedHealthcare, UnitedHealthcare Insurance, Optum. This makes it possible for PBM & instance work out any price they want, loophole cap on profit for insurances required by law (15%), and bring cost of healthcare up. Pure fraud it is.

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

#320

Post by btbuildem »

SpicyLemonZest wrote: post #246
regularization wrote: post #194

Earlier quoted context omitted.

People have wanted health care reform in the US for over a century and it is farther away from ever. This carrot you are waving does not exist, which is why CEO Brian Thompson has filed his last claim denial.

Of course it exists! Most other countries in the world have it. I don't know exactly what the path towards a good healthcare system looks like in the US, but I do know and regret heavily that my uncompromising anti-murder stance will prevent me from endorsing any reform proposal that's associated with Luigi memes. I'm sorry that your frustrations with the healthcare system have driven you to embrace evil and I really…

I think this kind of moral highhorsery is no longer reasonable when facing a malicious adversary that commands multiple orders of magnitude more resources. This is more of an "anything goes" territory, merited by the instinct of self-preservation.

I'd argue that the word "murder" doesn't really apply here -- the thing in a suit that morning was not a human being, it was some kind of a carnivorous ghoul, a biological hybrid of ruthless corporate profit-seeking mandate and what used to be a person long time ago.

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