Lawmakers want to know why Hepatitis C drug costs $84,000

[mp170.6]

They do, that's why they bill insurance x amount over because it will get paid. They also know the generics and I've been prescribed many of them or had a doctor look it up before prescribing.

 

You're making an excuse for negligence much how many did for all the parties involved in mortgage meltdown. Everybody knows everything or as much as they want to know. If the system allows people to take advantage of it, people will.

 

I have to disagree on that one.  No doctor I've ever been to knows the cheapest medication and I always ask about it.  All they know is generics are cheaper.  Sometimes I've gone in knowing the cost of drugs and when I tell the doc, he/she often laughs and asks if I'm serious? 

 

The pharmacy at Costco gave me a master list of all the drugs they sell with generic and name brand prices.  I gave the list to one of my doctors about six months ago.  On my last visit, I noticed she had laminated the list and it was hanging in the hallway, so maybe there is hope. 

[Brandon]

You're dismissing making money for ignorance. It's the reason they have Prozac or Cialis pens in the lobby when you sign in or why you see the big pharm reps there with their totes and pushing the product......it's about money.

 

I'm new to healthcare, so I'm going to act like a know-it-all, but I work on this side or deal with it while living with someone in the industry that deals with prescriptions, doctors, diagnosis, etc. When you are sick doctors assign you a known drug that should work for your symptoms. After a drug hits the market it gets a generic and doctors know this or are given the info, at worst their PA's know, but generics don't make the money big pharm does....and most of these guys have big pharm in their portfolio anyway.

 

I can't speak for every doctor, some are old school/stuck in their ways and only prescribe certain drugs while some I meet aren't big pill pushers. Some put up those laminated lists for their PA's and interns. I'm also sure some doctors don't care and just push what the reps bring in and just like the mortgage industry when all the big banks had account execs visit brokerages and push their exotic or new loan program and sell it to the offices, same thing.

 

If a doctor is prescribing drugs, they (generally) know about the drug from side effects to how it reacts which also includes generics as they are released by the FDA. Asking the doctor in training next to me, it's generally up to the consumer to ask for the generic or if it's available.

[Spirit]

Slow your roll everyone.  Obamacare's got this. 

[Vegas Halo Fan]

My concern is that if the courts ever require this treatment for inmates, it's an absolute budget buster for us. Our medication budget would more than double overnight. Right now we are using protocols, so that only the ones who are symptomatic and/or have high viral counts get the actual medication.

Edited June 22, 2014 by Vegas Halo Fan

[HaloFan85]

I don't have an issue with insurance companies, they just facilitate claims. The problem is we have a system where doctors and hospitals can take advantage and charge $23 for a ****ing band-aid.

 

I actually don't even understand Halofan's post, a lot of industries are multi-billion industries.

I suffered a severe cut to the back of my arm about 5 years ago, and aside from all the other charges (stitches, etc.), I was charged $20 for 1 bandage roll and $60 for 3 gauze pads ($20 per).  The next day, I got a box of 5 bandage rolls and a box of 25 gauze pads for about $25 from Walgreens.

 

Pricewise for the same amount of items:

 

Walgreens - $25

ER - $600

 

Something is definitely wrong with that.

[Blarg]

Looks like your math, $60 + $20 = $80, not $600.

[Brandon]

That's the broken part of healthcare, it's not close to being affordable and allows for this make up your own price shit like rich dudes do with taxes and write offs.

 

I was in a serious car accident a few years ago and got the breakdown to give to my insurance. Everything from the ambulance (if I was conscious I would have greatly denied getting in) to x-rays, shots, bandages.....everything was just egregious. One of my business partners is from the equipment sales side and I get that the machines and tools are expensive and that the doctors education is also expensive and time laden, but the mark up isn't in line.

 

But hey, if someone was going to pay me back regardless of the invoice I send out, why not? 

[nate]

A couple years ago my wife was having some really bad headaches.  They got bad enough that she went to the doctor.  The Dr. referred her to Huntington Memorial in Pasadena for a CAT scan.  To be clear she wasn't at the hospital for a diagnosis, just a CAT scan that would be sent to our regular Dr.  We were there for less than two hours.

 

They billed the insurance $6k.  Almost $4k just for the use of the room we were in while waiting for the CAT scan.  $1500 for the actual CAT scan and $500 for IV fluids (required for the CAT scan).  She never saw a Doctor the entire time she was there, just a nurse that came in and gave her the IV and a technician to wheel her to the CAT scan.

 

One of the most ridiculous things I have ever seen.

[Brandon]

That's the norm.

 

Craziest one I ever saw was some dude crashing a quad in the desert needing to be air lifted, 25k for the helicopter ride.

 

My ambulance ride above was 9k. Most expensive car ride I was ever in....and that was just for the ride, they added on other things used.

 

After that whole experience, I couldn't imagine the people that don't have insurance that get stuck with those bills.

[Tank]

Everyone enjoying their monetized healthcare? 

 

thanks, obama!

[HaloFan85]

Looks like your math, $60 + $20 = $80, not $600.

I was just making a pricing comparison.

 

What cost me $25 at Walgreens would've cost me $600 in the ER.

[mp170.6]

That's the norm.

 

Craziest one I ever saw was some dude crashing a quad in the desert needing to be air lifted, 25k for the helicopter ride.

 

Yeah, my aunt's nephew got bitten by a rattlesnake near Victorville a couple years ago.  I'm pretty sure the helicopter ride to Loma Linda was $20K and his parents are still making monthly payments to the med-evac company. 

[Vegas Halo Fan]

You're dismissing making money for ignorance. It's the reason they have Prozac or Cialis pens in the lobby when you sign in or why you see the big pharm reps there with their totes and pushing the product......it's about money.

 

If you see anything from a drug company in your doctor's office, it has been there for at least three years. New regulations prevent drug companies from handing out anything anymore. I hate it, too, because I didn't have to buy pens, clipboards or paper clip dispensers for years. I still have some of the old stuff, but nothing new is available.

Edited June 23, 2014 by Vegas Halo Fan

[Blarg]

I was just making a pricing comparison.

 

What cost me $25 at Walgreens would've cost me $600 in the ER.

 

You're lucky then. $600 worth of gauze bandages in the ER would have been to cover an amputated arm.

[ABC]

Slow your roll everyone.  Obamacare's got this. 

 

Thanks to the cons obamacare is only a small step in the right direction compared to what it could have been.

[Tank]

$20-25k for a helicopter ride? oh sweet moses. no wonder the system is going broke.

[Spirit]

Thanks to the cons obamacare is only a small step in the right direction compared to what it could have been.

 

I hear ya.  It could have been a lot worse. 

[HaloMagic]

I hear ya. It could have been a lot worse.

That's true. We could have kept the old system.

[nate]

That's true. We could have kept the old system.

 

Yep, then we wouldn't be bankrupting the middle class with health care costs.

[HaloMagic]

Yeah, we'd just be letting poor people die with treatable illnesses. So not really anything bad.

[nate]

Yeah, we'd just be letting poor people die with treatable illnesses. So not really anything bad.

 

Yeah except they still are because they still cant afford it.

 

Also, according to Darwin it actually is the way we continue to succeed as humans.

[Adam]

Yup, insurance companies never lose in the long term.  

 

If they did, there'd be no insurance

[Adam]

BTW - Seems like a piece of cake to avoid contracting Hep C

[Brandon]

$20-25k for a helicopter ride? oh sweet moses. no wonder the system is going broke.

Not the system, people like us. The buck is always passed.

But yeah, look at your print outs of billable items. In just my example they put two strip of tape on some gauze to cover a cut. They charged me $18 for the whole roll of tape. Insurance paid it, but that's the norm.

I know there was fuss because a law was passed that insurance companies could basically pick and choose what they wanted to pay on an invoice (think auto insurance where the rep always tries to payout as little as possible and tell you what shouldn't cost X or why they don't need to pay Y), now imagine they don't want to pay that 6k xray because they think that's egregious, and it is, the doctor is just going to send you the bill of what the insurance company didn't cover.

I don't know if this ever happened or was amended, but it was how things were looking in legislation.

[TobiasFunke]

 

They billed the insurance $6k.  Almost $4k just for the use of the room we were in while waiting for the CAT scan. 

 

One of the most ridiculous things I have ever seen.

 

Did the bill say $4k = "waiting room stay"?

 

That is insane