UnitedHealth overcharged cancer patients for drugs by over 1,000% • Hacker News Board

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

#91

Post by amelius » Wed, Jan 15, 2025, 9:21 PM UTC

nozzlegear wrote: post #75

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.

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.

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.

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

#92

Post by tredre3 » Wed, Jan 15, 2025, 9:21 PM UTC

baq wrote: post #53

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…

It shows that the US never had a world war on the continent. All the other countries treat health care as a matter of national security. The US’s primary concern is mark to market in pension funds.

> It shows that the US never had a world war on the continent. All the other countries treat health care as a matter of national security.

You seem to be making a weird connection here, but maybe I misunderstand you.

Are you truly suggesting that countries who have socialized health care do so because they've been affected by war on their territory at some point?

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

#93

Post by snailmailstare » Wed, Jan 15, 2025, 9:21 PM UTC

onlyrealcuzzo wrote: post #50

AlienRobot wrote: post #44

Earlier 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.

It seems to me like centralized governments have had a rise that whether impressive or just typical of an average country, was thought to be impossible for them. Couldn't the past performance be down to the absurd costs of data collection and management in the past and the lack of scaling benefit when centralizing gigaflops of secretaries or the costs of doubling a very small number of bytes of information on every household at that time?

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

#94

Post by craigmccaskill » Wed, Jan 15, 2025, 9:22 PM UTC

onlyrealcuzzo wrote: post #79

craigmccaskill wrote: post #66

Earlier quoted context omitted.

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 movi…

But has everything to do with the need to take a closer look at the entire system and how we can do things better.

I feel like focusing on this part of my comment vs. the bum deal part is disingenuous since non-US countries have figured out how to do it for cheaper with better outcomes without the main focus being the up and to the left drive for profit that our current system mandates.

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

#95

Post by croes » Wed, Jan 15, 2025, 9:23 PM UTC

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…

https://en.wikipedia.org/wiki/Price_gouging

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

#96

Post by flatline » Wed, Jan 15, 2025, 9:24 PM UTC

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

We are talking about delivering care, not innovative medical technology. The biggest single target for innovation in care delivery is to get rid of private insurers.

I think the graph at the top of this article really says it all: https://www.economist.com/graphic-detail/2019/05/22/republic...

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

#97

Post by tptacek » Wed, Jan 15, 2025, 9:24 PM UTC

brightball wrote: post #26

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 /…

Sure, I'll defend them, conceptually at least. I think most actors in this system are in some sense corrupt, and I don't think insurers are the most corrupt. Pull up the 2022 National Health Expenditure table, "National Health Expenditures by Type of Expenditure and Program: Calendar Year 2022" and look at combined hospital and physician expenses compared to insurer expenses; it's pretty black-and-white.

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

#98

Post by dylan604 » Wed, Jan 15, 2025, 9:24 PM UTC

tredre3 wrote: post #92

baq wrote: post #53

Earlier quoted context omitted.

It shows that the US never had a world war on the continent. All the other countries treat health care as a matter of national security. The US’s primary concern is mark to market in pension funds.

> It shows that the US never had a world war on the continent. All the other countries treat health care as a matter of national security. You seem to be making a weird connection here, but maybe I misunderstand you. Are you truly suggesting that countries who have socialized health care do so because they've been affected by war on their territory at some point?

It's not just you.

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

#99

Post by deathanatos » Wed, Jan 15, 2025, 9:25 PM UTC

criddell wrote: post #34

jrflowers wrote: post #17

Earlier quoted context omitted.

UnitedHealth is not an insurance company. They own an insurance company as well as OptumRx, a pharmacy benefit manager, which is described at the very top of this article.

Can you explain how discount cards (like GoodRx) work?

I asked that when I first heard about them, and I came to the same conclusion the FTC did, basically: https://www.ftc.gov/news-events/news/press-releases/2023/02/...

Their S-1 also stated,

> In addition, HIPAA, which we believe does not currently apply to most of our business as currently operated

(I should also say that I agree with the implicit message in your comment, too.)

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

#100

Post by hn_throwaway_99 » Wed, Jan 15, 2025, 9:25 PM UTC

I think one of the things that deserves discussion here is the whole concept of pharmacy benefit managers in the first place.

To start, can anyone give some good resources that really explain clearly what the role is that PBMs actually serve, and how the whole system even functions? I've tried to understand in the past but have always thought "Why do you exist???". Like the whole way companies like GoodRX can have a viable business: if I don't use you, my prescription medication is, say, $1000, but if I do use you, it's $60. One of the pharmacies I used to go to even had a keychain with random prescription discount codes on it that the cashier would scan. I.e. I'd go to check out, and the cashier would scan the price and it would come up as $X, then she'd say "Hold on a sec", and scan the discount code on her keychain and then would say "That's better, your price is now $0.1*X".

Like how can any of that possibly make any sense?