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posted by martyb on Saturday August 03 2019, @01:44AM   Printer-friendly
from the there-should-be-an-app-for-that dept.

Fountain Valley resident Jennifer Moore makes a really good point.

"When you take your car to the mechanic, they give you a written estimate before they touch it," she told me.

"So why is it that when you go to the hospital, you have no idea how much something will cost until the bill arrives?"

Moreover, why are prices so completely different from one healthcare provider to another?

And why is it that when patients try to find out in advance how much something will cost, they're treated like unwelcome guests rather than equal partners in their own treatment?

[...] The near-total lack of transparency in healthcare pricing is a key reason we have the highest costs in the world — roughly twice what people in other developed countries pay.

Simply put, drugmakers, hospitals, labs and other medical providers face no accountability for their frequently obscene charges because it's often impossible for patients to know how badly they're being ripped off.

[...] Moore's insurer, Cigna, was charged $2,758 by the medical center for the two ultrasounds. However, Cigna gets a contractual discount of just over $1,000 because it's, well, Cigna. All insurers cut such sweetheart deals with medical providers.

That lowered the bill to $1,739. Cigna paid $500. That left a balance of $1,239, for which Mika was entirely responsible because she hadn't met her $1,250 deductible for the year.

Moore quickly ascertained online that the average cost for a pair of ultrasounds is about $500 — meaning the medical center's original $2,758 charge represented a more than 400% markup.

Cigna's lower contractual charge of $1,739 still meant the bill had been marked up more than 200%.

And the $1,239 Mika had to pay was more than twice the national average.

Wait, it gets even worse.

Moore said that after working her way through various levels of customer service in the medical center's billing department, she learned that the cash price for the two ultrasounds was $521.

https://www.latimes.com/business/story/2019-07-29/column-could-our-healthcare-system-be-any-dumber


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  • (Score: 0) by Anonymous Coward on Saturday August 03 2019, @09:25AM (4 children)

    by Anonymous Coward on Saturday August 03 2019, @09:25AM (#875051)

    Just wait until you have an actual medical issue to pay for. Being hit for thousands for something you thought you were covered for really sucks.

    I did a calculation for the 'insurance' I have. I would need to have several very nasty problems happen in one year to break even. Break even mind you.

    Completely and utterly useless.

  • (Score: 1, Informative) by Anonymous Coward on Saturday August 03 2019, @12:59PM (3 children)

    by Anonymous Coward on Saturday August 03 2019, @12:59PM (#875093)

    My friend is diabetic and found out his new insurance (he became a federal employee) won't even cover insulin. Totally worthless mandatory waste of money.

    • (Score: 0) by Anonymous Coward on Sunday August 04 2019, @07:57AM (2 children)

      by Anonymous Coward on Sunday August 04 2019, @07:57AM (#875419)

      https://www.washingtonpost.com/news/magazine/wp/2019/01/07/feature/insulin-is-a-lifesaving-drug-but-it-has-become-intolerably-expensive-and-the-consequences-can-be-tragic/?noredirect=on [washingtonpost.com]

      His mother helped him look for a health plan on the marketplace set up by the Affordable Care Act, but his options were expensive. To keep going to the same doctors, she says, he was looking at paying about $450 monthly, in addition to a high deductible of more than $7,000, which would mean months of paying out-of-pocket for most of his medical care. He opted to go without insurance, forgoing that expense to focus on paying for his insulin and supplies until he could find a better option.

      What Alec soon learned was just how much his insulin would end up costing: more than $1,000 a month. The price of insulin — once modest — has skyrocketed in recent years, making the lifesaving medication a significant, even burdensome, expense, especially for the uninsured and underinsured. The costs are so heavy that they have driven some patients to ration their supplies of the drug in a dangerous gamble with life-threatening consequences.

      At the time Alec discussed skipping insurance coverage, he told his mother, “It can’t be that bad.” Within a month of going off her policy, he would be dead.

      Insulin, in its various manufactured forms, has been used to treat diabetes for almost a century, since Canadian researchers isolated the hormone in a lab in 1921. Before their discovery, what we now know as Type 1 diabetes was fatal. Even after being put on starvation diets, patients often lived no more than a few years. The researchers who transformed diabetes treatment won the Nobel Prize, and they sold their patent to the University of Toronto for a total of $3. “Above all, these were discoverers who were trying to do a great humanitarian thing, and they hoped their discovery was a kind of gift to humanity,” historian Michael Bliss told The Washington Post in 2016.

      Soon, though, insulin became a commercial enterprise. By 1923, the American pharmaceutical company Eli Lilly was manufacturing enough insulin for diabetics across North America.

      The 1990s saw the advent of insulin analogs, synthetic drugs made to better mimic the body’s own insulin production.

      In the past decade alone, U.S. insulin list prices have tripled, according to an analysis of data from IBM Watson Health. In 1996, when Eli Lilly debuted its Humalog brand of insulin, the list price of a 10-milliliter vial was $21. The price of the same vial is now $275.

      The global insulin market is dominated by three companies: Eli Lilly, the French company Sanofi and the Danish firm Novo Nordisk. All three have raised list prices to similar levels. According to IBM Watson Health data, Sanofi’s popular insulin brand Lantus was $35 a vial when it was introduced in 2001; it’s now $270. Novo Nordisk’s Novolog was priced at $40 in 2001, and as of July 2018, it’s $289.

      a father from Maine told senators that a 90-day prescription for just one of his son’s insulins would cost him $1,489.46. That’s with his high-deductible insurance. He testified that he has taken to buying the same three-month supply from a Canadian pharmacy for about $300 plus $50 in shipping.

      • (Score: 0) by Anonymous Coward on Sunday August 04 2019, @04:07PM

        by Anonymous Coward on Sunday August 04 2019, @04:07PM (#875540)

        What's this bullshit about "keeping the same doctor"? Apparently you can't afford him, so move in. How much would have Obamacare cost for basic care and prescription coverage?

      • (Score: 0) by Anonymous Coward on Monday August 05 2019, @01:07PM

        by Anonymous Coward on Monday August 05 2019, @01:07PM (#875915)

        tl;dr The system is broken