Why is my insurer (Aetna) allowed to own the only pharmacy (CVS) it covers? That seems like it should be some kind of violation of antitrust law, no?
UnitedHealth overcharged cancer patients for drugs by over 1,000%
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Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%
#72Earlier quoted context omitted.
I have good news! If you move it to the public sector, you will effectively pay doctors less money for the same work. That's because the way it works currently is that the doctors have to deal with private insurance bureaucracy. By freeing them from this responsibility, they have more time to take care of patients, which should effectively gets you more medical bang for your buck.
You're describing the federal system being massively more efficient - which is theoretically possible - but rarely happens in practice.
The federal system already runs a much more efficient enterprise as evidenced in medicare and medicade since their establishment in the 60s.
Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%
#73Earlier 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.
I guess they have their own labs, you just never learn about their failed experiments.
> failed experiments
Wasn't that what Milla Jovovich was called in to deal with?
Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%
#74I think some critiques of American health insurance are simplistic, but this truly seems very bad. From the report: > "Higher markups can also result in larger internal transfer payments from health plans to affiliated pharmacies, which may allow vertically integrated PBM-pharmacy-insurer entities to retain revenue and profits while formally satisfying the insurers' medical loss ratio ("MLR" ) requirements, but witho…
>In other words. Health insurance firms have capped profits in the US. But in this case one conglomerate can own both an insurer and a PBM, so it can just overcharge consumers for insurance and then launder its profits through the PBM.
Most insightful comment in this thread. THIS is the crux of the issue, and we've allowed the likes of UHC to buy PBMs and other pieces of the supply chain / customer lifecycle because UHC lobbyists claim it would reduce costs across the board and also improve efficiency. Load of absolute bullshit obviously but here we are.
Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%
#75Earlier quoted context omitted.
Profit motives for medical / biotech research, yes. What innovations have insurance companies made in the last 100 years besides to squeeze out more profit?
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.
I'm not trying to go to the mat for Big Pharma, but I'm certain that they do a lot more than slapping a stupid name on the research right at the end of the pipeline. Most universities can't fund sustained, large or diverse clinical trials, for instance; they also can't generally do the long-term post-market research/surveillance once a drug has been released.
Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%
#76[flagged]
Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%
#77Earlier quoted context omitted.
Profit motives for medical / biotech research, yes. What innovations have insurance companies made in the last 100 years besides to squeeze out more profit?
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.
There should be a method + requirement to pay royalties back to public funding for basic research, but pharmaceutical companies really bear 99% of the risk and complexity of bringing a drug to market. It's not all that expensive to find molecules that might do something useful, it's obscenely expensive and risky to prove one does something useful.
Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%
#78Yes, this is an issue!
And, zooming out a little more, free market healthcare is just part of the problem.
We have a system where we’re only treating people once they have a disease, and not working to prevent the disease, so it would be helpful to look at the effects of for-profit companies on making healthy people sicker. Fast food, snacks, alcohol, there are so many industries that are incentivized to succeed by making people sick.
This is the system “working” according to the current rule set.
It’s time to look for a better algorithm than a purely profit maximizing one.
Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%
#79Earlier quoted context omitted.
I don't particularly care if health insurance is public or private. DIRECT health care labor costs (doctor's, nurses, etc) are ~40-60% of TOTAL healthcare spending. Smart people try to figure out ways to make our system better every day. If there was a silver bullet, we'd have already taken it. Health insurance profits are ~1.2% of total health care spending, the cost of running it is approximately ~4% more. It's alw…
Medicare administrative costs are around 2% of total program spending [1] compared to typically >10%. While what you're saying on the surface may be true from the numbers you are comparing, the fact of the matter is that healthcare costs are becoming more and more expensive during a time when many are experiencing a cost of living crisis. The US gets a bum deal on costs and outcomes and while we can argue on which sp…
> While what you're saying on the surface may be true from the numbers you are comparing, the fact of the matter is that healthcare costs are becoming more and more expensive during a time when many are experiencing a cost of living crisis.
Which has almost nothing to do with the amount of profits derived from private health insurance - that's only ~1.2% of spending.
Maybe it used to be ~0.8% - that delta is not moving the needle.
Re: UnitedHealth overcharged cancer patients for drugs by over 1,000%
#80Earlier 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.
I'm not trying to go to the mat for Big Pharma, but I'm certain that they do a lot more than slapping a stupid name on the research right at the end of the pipeline. Most universities can't fund sustained, large or diverse clinical trials, for instance; they also can't generally do the long-term post-market research/surveillance once a drug has been released.
Most pharma companies can't even fund clinical trials. That's why big pharma (Pfizers of the world) are more like holdings companies that buy smaller pharma companies (biotechs) with novel molecules and they big pharma eats the risk of putting the smaller companies' inventions through trials.