posted
So*, Matthew had this ear infection a few weeks ago. Took amoxicillin, finished his dose, didn't complain about more pain.
Went to the doc yesterday for followup, seems his eardrum burst but the pus never drained because it's too thick (doc showed me, it's yellow and icky) .
Doc puts him on oral antibiotic and ear drops. Not too worried when I go to pick them up;we have insurance and the amox was only about $2.50 for us.
Our co-pay was $98!!! OMG! What is the point of insurance if the working poor have to take money out of savings or put off needed purchases when their kid gets an EAR INFECTION! (in this case, Brian is putting off shoes for himself; it's summer, he doesn't need the soles to be waterproof).
Posts: 2711 | Registered: Mar 2004
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posted
No, if we'd paid full price it would have been almost $300!!! (I asked, I was so shocked when I saw the price) Which I think is utterly insane!
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posted
I also think sometimes doctors don't pay any attention to the price of prescriptions...and often there is an alternative that would work just as well.
posted
If you specifically ask your doctor or better yet, your pharmacist, they will tell you if there are any generics to be bought.
As for the price of drugs, tells drug companies to stop spending billions upon billions on advertising and the price will drop dramatically.
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quote:As for the price of drugs, tells drug companies to stop spending billions upon billions on advertising and the price will drop dramatically.
Why do you think drug companies do advertise to consumers? I mean, we can't go buy the drug without a doctor's prescription so what's the point?
They do it because it works. Because if you get your brand name out there and the public remembers it they'll ask their doctor about it, and in many cases the doctor will prescribe it. So, advertising helps you sell more.
Selling more and selling it fast is very important to your drug company because they only have a finite amount of time to grab as much market share as possible before the patent is up and the generic industry comes in and devastates their sales.
Advertising helps push the trend lines up, and that makes investors happy. So the drug company makes more. Stopping advertising means that either the drug company will just accept the fall in market share, or have to make up the lack by more aggressive marketing techniques directly to the physician. But see, in today's climate that's more and more difficult. Doctors see many patients and have such a quick turnover time they can't afford to take too much time out of their day to talk to a drug rep. And if you think drug companies spend a lot of money on Direct to consumer advertising, what do you think it costs to staff a sales force trained to pitch to physicians?
If tomorrow Congress made it illegal for drug companies to directly advertise prescription drugs to the public, I would not be surprised if prices rose instead of fell.
Posts: 14428 | Registered: Aug 2001
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2. Well, maybe I'm a little that stupid, I knew that but I worded my statement wrong. I meant RAISE the tax on them to make up for the difference. They aren't really losing money, it's just redirected.
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posted
Uh, the amount of the tax on the drug companies would approximately equal the increase in the price of drugs which would approximately equal the amount the government was contributing to help buy drugs.
Net gain for consumers: zero (approximately)
The increase in drug prices would be somewhat less than the tax in reality because market demand and supply are not linear functions; however, the amount the government contributed would also be lessened by the administrative overhead of the drug aid, so they'd still be in the same general ballpark.
Posts: 15770 | Registered: Dec 2001
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posted
The only way it would be a mildly effective thing for consumers is if the subsidy was only available to people who couldn't afford it (including the price increase due to the tax) and didn't extend very far into those that were part of the consumer surplus for the drug purchases.
That would enable more people to buy drugs than already could.
Better, though, at least under our current system, to offer a tax break to companies which provide assistance to low income people to purchase drugs.
Hmmm, I wonder what the best way to do it would be under a simplified tax code (assuming one wished to target benefits).
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posted
One major drug company just this week announced a voluntary year-long moratorium on direct-to-consumer ads for prescription drugs. Was it Bayer? I have to go to work, no time for googling.
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quote:Originally posted by Lyrhawn: So basically...give up and suffer?
Like fugu said, there are other ways. The drug industry is the most profitable in the country--various methods could be used to lower their profits and force lower prices.
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posted
I don't see any need to lower their profits; my tax break example wouldn't do that, for instance, but would lead to drugs being affordable to many poor people.
Posts: 15770 | Registered: Dec 2001
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posted
The whole American system of healthcare is a mess. Don't you think we have gotten to the point where the rights to "Life, Liberty, and the Pursuit of Happiness" would include the right to access to healthcare for all citizens?
It is a right in the rest of the world's developed countries (and a bunch of the under-developed, as well).
In the future, be up-front with your doctor about the limits of your prescription coverage and budget. Ask the Doc to not only phone the Rx to the pharmacy, but also to ask the pharmacist how much it will cost. If it is a hardship, ask if there is something else that could be prescribed, or if there are drug samples that you can have.
And a Refuah Shleimah (speedy, complete recovery) to Matthew and his bum ear.
posted
The other thing is that drug company money goes into research for medications that bring very little profit because they aren't used that often, but the drugs are hugely important...cancer, HIV, parkinson's...all the stuff that aren't as clear cut as an antibiotic, etc.
I understand the struggle to pay for medication. I'm on daily medications that full price would cost upwards of $900 a month. With copays, I still pay $140 a month. I can't ever go without insurance. Ever. Because if I do, I lose coverage of my lifelong illness that requires those medications. I'd be screwed.
Yet we need drug companies to do that research that brings them so little profit. It saves lives.
Posts: 14745 | Registered: Dec 1999
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posted
Actually, drug companies stay in business because they come up with new drugs. When it comes down to it, research would hopefully (if they had any sense) be the last thing to go if prices were to be lowered on drugs. Huge personal salaries of top officers would be the logical first cut, but I don't know what it would take for that to happen.
Posts: 21182 | Registered: Sep 2004
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"The whole American system of healthcare is a mess. Don't you think we have gotten to the point where the rights to "Life, Liberty, and the Pursuit of Happiness" would include the right to access to healthcare for all citizens?"
I actually disagree with that. I think Americans have the right to pursue good health, but I don't think that means tax-payers should have to fork over cash every time a hypochondriac thinks they're sick. Or a smoker gets lung cancer. Or someone obese has a heart attack.
I think America should do more to make healthy foods available to the poor. I think the county health departments should go back to being primary care providers. I think there are reasonable steps we can and should take that are far short of government healthcare for everyone for any reason.
Posts: 2283 | Registered: Dec 2003
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posted
My son has a co-pay prescription coverage, which is good. His medication is $230 a month (one prescription!) but with the co-pay, we only have to pay $30. Of course, that's because we pay nearly $300 a month for his coverage.
My coverage is Medicare and Medigap, for which I pay about $150 a month, but there is no prescription coverage. So, there are medications that my docs think might work, but are too expensive for me to even bother trying. And Bush's plan for prescriptions wouldn't help me at all. It sucks, really.
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posted
Let's not forget that many drug companies do have programs that give medication free or at reduced cost to those that can demonstrate a real financial need. Granted, it doesn't help everyone, but it does help some of the most needy.
When I worked for a company that had a prescription drug for kids with cystic fibrosis, we had a program whereby we gave away free vitamins and meal supplements to anyone on our prescription. CF kids need lots of supplemental nutrition because they don't digest food well. Usually vitamins and meal supplements aren't covered by insurance so it was a huge out of pocket expense for many families. One of my jobs was designing and maintaining the database that kept track of the program information - we shipped everything out every month, the families didn't even need to pay for shipping.
While our requirement was that they be on our prescription, we did have situations whereby we would send stuff to a family that wasn't on our meds, if our drug didn't work for that child for some reason, and they had a real need. Every pharmaceutical company I know of has a benevolence program, which does similar things.
Posts: 14428 | Registered: Aug 2001
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posted
AvidReader, what about the folks that become ill through no perceived (by the greater masses) fault of their own?
Half a century ago, I'd be in an institution with my illnesses.
Instead, the medications I take allow me to be a productive member of society. When I'm stable, unless I TOLD you I had an illness more troublesome than ADHD, you wouldn't know. Without medication, you would certainly know.
What would be more beneficial for society? People who contribute as other members, including pay taxes, or people who are so ill that they continue to be a drain and not part of a productive society?
It's all fun and games until someone who was healthy, exercised, ate well, didn't smoke or drink or do illegal drugs, comes down with cancer. Try as we might, we can't predict if a major illness will hit someone. Sure, there are factors that can contribute to the possiblility, such as smoking or drinking or what have you, but in reality, we still don't know. And if you don't have insurance when it hits, then you aren't just medically screwed, you're financially screwed for life unless you have to have gobs of money squirreled away.
Posts: 14745 | Registered: Dec 1999
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The main points of a tax break program to support drugs for low income people would be to shore up particularly expensive drugs for particularly disadvantaged people.
Posts: 15770 | Registered: Dec 2001
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posted
romanylass, that is shocking. Do you have to be on that particular insurance? Poor Matthew! I wish him a safe and speedy recovery.
Andrew and I pay a lot for our plan, but my metformin is only $10 a month and the most I've ever paid for an antibiotic is $30. Even my clomid was only $120. We figure that the high monthly cost of our plan is still less than the prescriptions would be.
Another thing to consider when complaining about prescription drugs - the US is carrying countries who have socialized medicine. Pharmacuetical [sp?] companies know that those countries have a certain budget for drugs, so their prices are fixed. Therefore, they make their major profits in the US, where they can charge whatever they want. Andrew wrote a paper on it last year and it was pretty surprising. It would be pretty bad for those socialized medicine countries if the US were to adopt the same program.
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posted
*nods* Yep. When I left the company we were seriously considering shutting down foreign distribution to several countries because it was costing us money to sell there rather than making us money.
Also, don't forget the US has the stringest regulatory requirements in the world, it costs a ton to stay in FDA compliance but that regulation is what makes our drug supply so safe.
And I wanted to point out that mack has some good points. Antibiotics are usually very cheap, when my kids get an ear infection usually the cost of the amoxicillin is less than my drug copay. Drugs that are very common, can be made in large quantities, and have a long shelf life are much, much cheaper than the drugs that treat rare diseases. Sometimes you have drugs you actually lose money on, but pharmaceutical companies still supply them because to take them off the market and say "It's just not profitable enough" is not an option when you have a lifesaving drug.
[ June 17, 2005, 11:16 AM: Message edited by: Belle ]
Posts: 14428 | Registered: Aug 2001
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Mrs. M, what were Andrew's main sourses for that paper? Because everything I've ever seen has said that that just isn't true. It isn't FDA compliance, and it isn't subsidizing medicine, US prices are that high because the market will bear the prices. That's how the free market works, after all.
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I still would like to see a breakdown of what a company like Pfizer actually spends per department. I've looked at the company annual reports that are available for free online, but it doesn't break it down the way I'd like to see it.
For example, how much do they spend on advertising vs. R&D? How much does regulatory compliance cost? How much goes into legal liability to protect against law suits, or to defend them? How many drugs do they spend millions on in R&D and yet never make it to market? What about drugs that do make it to market, and then get pulled several years later and tie the company up in legal fights for years, like we're seeing with Baycol now?
Posts: 14428 | Registered: Aug 2001
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quote: Do you have to be on that particular insurance?
Yes, it's all Brian's work offers. And we make just a little too much to put them on state plan.
tante, I will ask the doc next time. I can still count on one hands the scrips I've had filled for all three kids, so it took me by surprise.
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Though, it is important to note that the AARP doesn't try to be an unbiased source. I think it is an important organization...but like most lobbying groups...they have their biases that come out in their publications
Posts: 1901 | Registered: May 2004
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posted
Well, I have seen some interesting things in the pharmacy.. such as children's scripts for fluoride... the insurance co-pay is $10.00 for 30 tablets, but won't allow you more than 30 tablets at a time for your kids. If you don't put it through the insurance, the same fluoride tablets cost $9.99 for 100 of them! So don't forget that the insurance companies also mark up the co-pays on some meds. There is also the drug lobby to consider. The hundreds of thousands of dollars spent each year paying politicians to prevent bills/laws that would cause them to lose $$. But think of this, if all the lawmakers in Washington D.C. had to pay for their own insurance plans and co-pays, instead of having it funded by taxpayer money, if they had to go a year paying for their own and their families meds, Dr visits, etc.... do you really think that they would be so reluctant to do something real about the problem? For some reason, I doubt they would let the situation continue as it is now. Just something to think about. Posts: 325 | Registered: Aug 2002
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posted
mack, it's a good question. It's also not one I've got an answer to.
I still maintain government healthcare is going to cause more problems than it solves. I'd like to see America advocating smaller changes first instead of a 180 on the foundation of how we do business.
Some places in Europe and Canada are thinking about having a two layered system. The government provides the services they do now for free with the long waits, but people can choose to pay for faster service. I suppose that's one idea since people who can't afford the good service still get something, but how much of the problem does it end up solving? The rich still get better care and the poor still die waiting for operations.
If we're essentially looking at a choice between everyone getting substandard care and some people getting better care, why make a multi-billion dollar overhaul to the system? Why not let people with no insurance go to the county health department and see a doctor for anything? Given the precedents, socialized healthcare just doesn't make a lot of sense.
Posts: 2283 | Registered: Dec 2003
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Avid: because the evidence is, it will save trillions in the long run. At least, that's the case in pretty much every country with socialized medicine, their costs per person are significantly less for a higher overall standard of care with significantly better satisfaction from the average citizen. I think a much better question is, why don't we want that?!
And I don't find the precedent argument particularly persuasive; socialized healthcare is a new thing pretty much everywhere, the very idea of socialized anything didn't exist until pretty recently in the grand scheme of things. However, lots and lots of countries have managed to adopt it.
Posts: 15770 | Registered: Dec 2001
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posted
What about the fact that the people working end up subsidising healthcare for everyone in the nation? The baby boomers are getting ready to retire and not contribute full time taxes to the system. How can it possibly end up saving us money?
Posts: 2283 | Registered: Dec 2003
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Under our current system we're paying for their healthcare anyways, we're just doing it in a hideously inefficient manner. We don't have privatized healthcare right now, we have boon fiefs of population subgroups generously provided to insurance companies.
The inefficiencies come in because we have literally thousands of companies duplicating the same basic infrastructures over and over again, and not only that, dedicating large amounts of funds in many cases to preventing the breakage of arcane rules designed to make them the most money (mainly related to which doctors one can see and the like).
I think there are likely better ways of doing socialized or semi-socialized healthcare than what other countries have, but a system would have to try pretty darn hard to be worse than our current one.
Yes, baby boomer retirement will put a strain on the system. But its going to do that on any system, and it doesn't really matter. If we think it is right that american citizens enjoy a basic level of healthcare, then we find a way to fund that basic level of healthcare. While I'm not suggesting we bankrupt ourselves doing it, we're in no danger of that; healthcare's expensive, but not that expensive. If we only think its right for american citizens to have that basic level of healthcare when we can pay for it with pocket change, then we don't really think its important.
Of course populations aren't uniformly spread out, and it would be better if we had, oh, say, bothered saving in times of plenty for times of need (but of course that's called "overtaxing" instead of prudent finances -- if we always return a surplus and never save any, of course public benefits will have major problems), but that's no excuse not to create a better system, preferably one that will be prepared for the next time it happens instead of everyone suffering through it.
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posted
Oh, not only that, but all that infrastructure dedicated to determining if someone has a "preexisting condition", determining the exact nature of what caused the injury due to bizarre insurance details, et cetera, will basically be gone.
Posts: 15770 | Registered: Dec 2001
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posted
:shrug: Personally, I don't see why insurance companies shouldn't be allowed to turn a profit like any other business. We need electricity, too, but that doesn't stop the power company from turning mad profit.
Florida Power discovered a while back that they were paying Blue Cross and Blue Shield more each year for insurance than their employees actually spent on healthcare. So FP kept BCBS on to handle the paperwork and began to pay for the healthcare themselves.
A lot of big companies did that and would like to stop since it's expesive. They want the governement to do it for them. I don't see any reason to let big businesses who can afford it off the hook and move the burden directly to the taxpayers under the guise of helping the poor when it doesn't sound like the poor are going to get much better service anyway.
Personally, I feel like a lot of talk about socializing healthcare is a scam. I'm skeptical about the whole idea. I'd like to start with much smaller changes that don't involve corporate welfare.
Posts: 2283 | Registered: Dec 2003
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posted
Avid, another thing is that many of the uninsured ARE working. But they're stuck working jobs that don't provide insurance at all. Everything about it blows.
I figure, if I'm paying taxes, I'd like to get something out of 'em that's tangible. Because I always MUST have continuous healthcare, I can't ever let any insurance lapse. If I do, no insurance company will ever have to cover my condition again, because it's pre-existing. This means I don't have a lot of freedom in terms of my career. The only reason I can persue my own business in photography now is because my husband has a full time job that provides benefits (starting in August). Extending coverage from my full time job costs over $500 a month. My RENT is $600 a month. There's just something wrong with that number. And after that $500 a month, I still have a $100 per year deductible for medication, $10, $25, and $40 copays for medications. $10 PCP visits, $20 specialist visits (if I'm referred to one).
So, let's say I see my two docs one a month. That's $20. Add in my $125 prescription costs. Then my COBRA. That's $645 a month to keep myself covered. More than I pay for rent. And remember, when I worked fulltime at one of my jobs, I made about $25,000 a year.
$7500 a year for my basic care. Even if I didn't have an illness, it'd be $6000 a year. But that's just my chronic, lifelong illness. What if I'm in a car accident? $150 per ER visit, not including any co-pays I might incur. Get an ear infection? $10 doctor visit, plus $10 antibiotics. No big deal, right?
I take care of myself. I eat right, I exercise, I don't smoke or drink or do any illegal drugs, I'm not overweight. I follow the instructions my doctors give me. I have a couple genetic risk categories, diabetes being one of them. So I take care of that by eating right so I don't GET diabetes.
I'm following all the right steps. I'm doing what I'm supposed to do.
This March I get hit with a sinus infection. Whatever, they happen. I see my doc, I take antibiotics. But to knock this one back, I have to take a z-pack. $25. It doesn't work. Levoquin, $25. Doesn't work. Levoquin again, $25. Nope. And AGAIN, $25. The doctor is stymied, sends me for a CT scan. I don't even want to think of how much THAT would cost if I didn't have insurance. But how could I predict it?
What if someone who has a family who is making $25,000 at an honest day's work that doesn't provide health insurance is hit with something like that? Or an illness that's much, much more expensive than a complicated sinus infection?
Remember how I do all the things I'm supposed to? Symptoms cropped up on me after the sinus infection cleared up (I'm still having headaches, which means I get sent to an ear, nose and throat doctor $20). Symptoms not related to the sinus infection.
Frequent urination. Night sweats. Excessive sweating. Always thirsty. Fatigue.
I finally saw my doctor about them. He's ordered a chest xray, blood tests, urine tests. He said works like lymphoma, tuberculosis, diabetes.
I doubt it's lymphoma or tb. Those are long shots that any doctor has to rule out.
But diabetes? It certainly could be. That's a lifelong illness. I already have ONE. Now I could have TWO!? I did everything I was supposed to. I work. I contribute. I'm a tax paying citizen. I'm lucky enough that I still have insurance.
Lucky.
When it comes to basic health care, it doesn't seem like luck should come into play. Basics include preventative care. We suck up the payments from insuranceless folks visiting ERs. But they have to visit them only when symptoms become that acute. Yet many times, had they had a primary care doc to see, the acute could've been prevented.
We'll all never be financially equal. We don't expect that. But we're all trying in our own way. Even those perceived to be hangers-on to society are still human beings. Seems that part of the pursuit of life would be basic health care.
Posts: 14745 | Registered: Dec 1999
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quote:Because I always MUST have continuous healthcare, I can't ever let any insurance lapse. If I do, no insurance company will ever have to cover my condition again, because it's pre-existing.
quote:HIPAA imposes limits on the extent to which some health plans can exclude coverage for pre-existing conditions. For instance, if you've had "creditable" health insurance for 12 straight months, with no lapse in coverage of 63 days or more, and you switch to a new group health plan, it cannot invoke the pre-existing condition exclusion at all. It must cover your medical problems as soon as you enroll in the plan. (Newborns and adopted children who are covered within 30 days are not subject to the 12-month waiting period.)
Most health coverage is creditable. It includes prior coverage under a group health plan (including a governmental or church plan), health insurance coverage (either group or individual), Medicare, Medicaid, a military-sponsored health care program such as CHAMPUS, a program of the Indian Health Service, a state high-risk pool, the federal Employees Health Benefit Program, a public health plan established or maintained by a state or local government, and a health benefit plan provided for Peace Corps members.
On the other hand, if you don't have that creditable coverage behind you when you enroll in a new group plan, it can refuse to pay for any of your existing medical problems, but only for a maximum of 12 months. Late enrollees in group health plans may have to wait up to 18 months for coverage of pre-existing conditions.
Giving You Credit Where Credit is Due Chances are, if you've already been in a group health plan, you won't have to sit out the full 12-month exclusion period, though. Your new health plan must give you "credit for time served" — the amount of time you were enrolled in your previous plan — and deduct it from the exclusion period. Thus, if you've had 12 or more months of continuous group coverage, you'll have no pre-existing condition waiting period. And if you had prior coverage for eight months, you can be subject to only a four-month exclusion period when you switch jobs.
I posted the whole explanation, but the bolded part speaks directly to how long pre-existing condition exclusions can last.
It doesn't change your basic premise - coverage gaps would be financially fatal to you. But it's at least a little better than you thought.
Posts: 26071 | Registered: Oct 2003
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posted
There was an article in the paper last week about the teacher's union rejecting an offer by the state for their health insurance to increase in order to offset increased charges. The teacher's union screamed that they couldn't afford to carry more of the burden of their health insurance, it was already unreasonable.
They pay $128 a month for full family coverage that includes drug cards, and the proposed increase was an addition seven dollars a month
I read that, read mack's post, and want to scream.
Posts: 14428 | Registered: Aug 2001
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posted
Dag, thanks. I didn't know about the time-served thing, that's pretty good to know.
Belle, I wonder if those teachers realize what the real numbers are when it comes to insurance and full costs and such.
Posts: 14745 | Registered: Dec 1999
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posted
I don't know. We have great insurance, our family premium is reasonable, and we have a drug card, though our co-pays did go up $10 per prescription last year.
However, every year our insurance cost has gone up, and they increase the same month Wes gets his so-called "cost of living raise" and in the past six years, the raise has been completely offset by the increase in insurance premiums. We've never had a "raise" that really resulted in a raise for us, the insurance increases always were more. If it weren't for the merit raises he also gets, we'd be effectively losing money every year. Unfortunately, the merits are stepped, and once you top out the step you're on (depending on your position) you get nothing more except the cost of living raise. Wes will top out his step in one more year. Then unless he gets promoted and moves to another step, we'll lose money every year.
Posts: 14428 | Registered: Aug 2001
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quote: The whole American system of healthcare is a mess. Don't you think we have gotten to the point where the rights to "Life, Liberty, and the Pursuit of Happiness" would include the right to access to healthcare for all citizens?
This is really the point. The entire system has ballooned to incredibly unreasonable amounts of money.
What is sad is that pharmacies have to listen to all the bickering about drug prices. How much did your doctor charge your health insurance? What about all the surgeries, lab tests, and procedures that are thousands of dollars???
This is just an educated guess, but I am guessing the therapy that your doctor put your son on was a brand-name ear suspension, and a brand-name antiobiotic. All the brand-name ear suspensions retail for well over a hundred dollars alone. This is because they are fluoroquinolones based on drugs like Cipro and Floxin that are also well over a hundred dollars per course. Sadly, we are in an age where pharmaceutical pricing is not based on profit over overhead, but rather alternate therapies.
Why is Prevacid so expensive? Well, because surgery is even MORE expensive...These conversations go on between doctors and drug reps every day in every area of healthcare. But if I had to pay the $40 for every lab test that my doctor ordered, I would want to not see the doctor any more. The WHOLE SYSTEM is this way...
Not only that, but your doctor tried a first line antibiotic that was unsuccessful. What more could they have done???
And how much would you have paid to prevent something like this from happening? Sure that is impossible and just fancy, but I would gladly pay $98 for my child's ruptured eardrum, and much more if I could have prevented the entire condition.
Sorry, but no sympathy from the pharmacist on drug prices today. Posts: 1870 | Registered: Mar 2003
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posted
I don't see any reason they shouldn't be allowed to turn a profit, either. However, the current method for allocating insurance groups isn't capitalist or socialisit, its feudalist.
Also, whether or not health insurance as it exists today should be allowed to exist is a completely different argument. Say we lived in a society with legalized assassination -- does the argument that assassins should be allowed to turn a profit have anything to do with an argument about whether or not its good for society that assassination should be legally practiced?
There's nothing "natural" about the existence of health insurance companies (and thus the profit in them), any more than there's something "natural" about the existence of various trading instruments that exist as part of the vagaries of our financial system. When the potential for an item exists, the item is used for a profit. Health insurance companies have no natural right to offer and make a profit on health insurance.
Given that the tradeoff seems to be, by all the data we have available between the insurance companies existing as they currently do today and a system with lower costs to society, better overall health, and higher overall satisfaction, I see no reason insurance companies as they exist today should be protected at the expense of those things.
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