This is by definition an improvement over what America has, so I welcome it. That doesn't change the fact it's an umbrella in a hurricane, so it's really not that interesting.
Socializing the whole thing is significantly better. Remember America already has socialized medicine for 40% of the population. It is long past time to up that to 100%.
As a Canadian I highly disagree. And anecdotally many health care providers from Canada agree with my take. People frequently die, or get sicker, as they wait their turn in months long queues or lack of supply due to government quotas.
There is nothing stopping the government from substituting lower-quality, less effective procedures when their MBAs come in an consult about how to reduce costs.
My father fell off a ladder and had a pretty severe head injury, and had both an MRI and a CT scan within a half hour, at no cost. Yes, lower-priority conditions may have to wait, but it's also by definition because they're lower priority - and they'll have to wait in America too.
The idea that the Canadian healthcare system is somehow leaving people to wait and die in a way the American system is not, is a falsehood propagated by major American insurers and their lobbying group AHIP. Here's a Cigna executive apologizing for doing just that. [1]
[1] https://www.npr.org/2020/06/27/884307565/after-pushing-lies-...
There are often months long waits for here too, try getting a dermatology appointment, we just also have the privilege of paying for it out of pocket as preventative skin care checks are not actually classified as preventative medicine so it counts towards your deductible meaning you have to pay the first $2000.
This also happens in the US. Plus, if you do happen to get care you can go bankrupt!
>when their MBAs come in an consult about how to reduce costs.
The US is far far past this point already.
> their MBAs come in an consult about how to reduce costs
You don’t think the big health insurance companies in the US do the same thing?
This results in often legitimate procedures being denied. But make no mistake, the care providers billing insurance are just as likely or more likely to try to grab money in any way possible.
I was once involved in a company that would place laboratories and other diagnostic machinery in physician's offices. They would always be very interested in what the insurance reimburses and how many patients they can run it on. There would always be some gimmick like Oh, homocystine we can run on every patient for $5 and be reimbursed $30, and then you would see that ran on every single patient they could to make that money. Eventually insurers would have to shut it down. High sensitivity CRP was another one until medicare locked it to being run once in a patient's lifetime.
I've personally found this particularly common and suspect within the Dental industry.
https://health.sunnybrook.ca/navigator/too-many-dental-x-ray...
The shitty ones, maybe. I know many physicians who acknowledge that unnecessary tests lead to unnecessary interventions, which is proven to reduce quality of life and decrease outcomes.
(Maybe not the practitioner directly, the providing organization)
In theory, free market healthcare should improve alignment.
Insurance companies pay procedures and make money when people are less sick. Hospitals make money when they perform procedures. Insurance companies are therefore incentivised to only pay procedures from competent hospitals, the ones that won’t result in more follow-up costs.
The problem is, of course, it’s not a free market - neither on the hospital side (prices are not public) nor on the insurance side (it’s much more affordable through employment)
This is true of prisons (you can't exactly have private prisons compete for your business). Of fire departments (I'm not going to call for quotes while my house burns down). Of police departments.
If it's not a free market, it should be socialized, imo.
It's not as simple as that. Insurers are regulated. They can't keep any more than 20% of the money they collect. It sets up an incentive for them to collect and spend more money.
Do you think that part of the reason that America is so attractive to pharmaceutical innovation is because of the obscene profits that can be made in the prescription space that is not only allowed by our laws, but encouraged by our politicians?
If we were to socialize our pharmaceutical sector, which would involve putting caps on pricing, do you think this would make innovation into treatment which involves huge upfront costs in research a non-starter?
Would neutering the profit motive and corporate greed in our pharmaceutical sectors revert our pharma studies back to university programs and corporate tax write offs/good will programs and the occasional government budget surplus when they've decided to not funnel it towards another uneccessary war?
An extreme case of this (in some places) is the internet provider. If they know they're the only ones they can basically charge much more than if you were living in an area with healthy competition. What're you gonna do, not use the net?
Most people aren't medical doctors, and most aren't gonna gamble with their health. It's a transaction where one side has way more information, less to loose, and therefore more power. Hopefully they use that power for good.
Healthcare privacy laws make it extremely difficult to evaluate the value proposition of care providers. You can't just, like, look up a list of their previous patients' medical histories.
I think your entire premise is flawed here. Businesses make money by providing services that people want / need.
It's not a flawed premise. It just doesn't occur 100% of the time. It tends to occur in industries with poor competition (mono/oligo-polies)
US per capita health expenditure: $11000USD (#1).
I don't know what the 'left' is doing there but it seems very efficient.
Maybe this is me "weaponising" the NHS but you're going to have to provide a bit more evidence if you're making such a bold claim.
The way to fix the US system is for the health insurance market to be regulated like the auto insurance market, i.e., break up the state monopolies. Then for our employers to give us the money they're paying on our behalf. Then we could shop for a health insurance plan like auto insurance. Within a couple of years, the market would start sorting out the costs.
But no. We'll get socialized medicine. And it will look much like our disastrous Veterans Health Administration.
Good will and brand alone isn't sufficient to build a medical system on.
This keeps showing up but it's total bullshit. Cuban wants to take 15% of the transaction for running a web site and processing payment. They're not manufacturing drugs. They're not buying drugs. They're not shipping drugs. They're not doing anything at all besides taking your order and giving it to someone to do all those things. It's not a charity. It's a profitable business and a very profitable one at that.
Oh yeah, and the prices aren't lower than what you can get using GoodRX.
In reality I'd expect that 15% to be necessary if they want the company to survive after some years. There are tons of not so visible overheads and costs, and it (apparently) has taken a billionaire to be able to start such a company (disclaimer: I have no idea what GoodRx is).
If I could generate the amount of free advertising Cuban's getting I would.
Enter insurance companies. They don't want to pay $1,000 for a $50 drug so they negotiate. But there's too many insurance companies for them to have good leverage and efficiencies in negotiation.
Enter Pharmacy Benefits Managers. They get hired by insurance companies to negotiate with drug companies and pharmacies. Thus the buying power is pooled and they only have to pay people to negotiate one time.
GoodRX is like the last category. Except that instead of getting paid by insurance companies they sell user data and collect some fees from pharmacies and drug manufacturers.
You need <drug> in <area>
They search pharmacy prices in <area> for <drug> + <generic versions of drug>
You get back a list of where it is cheapest to have <drug> fulfilled by a pharmacy in <area>
I clicked on the medication's link (just for lookup), and it took me to a page which listed Manufacturing, 15% Markup, Pharmacy Labor and in a circled blue box: "* additional cost at checkout Shipping $5.00".
The original point is that if you include that cost, then their prices for many drugs are no longer the cheapest.
On GoodRx I see the same drug at a local grocery store for $6.84, (Costco is $8.49) and online pharmacies like geniusRx are $4.50 (s/h unknown). My health insurance through a local pharmacy would cost $14.38
I don't like all the advertising on costplus about how they're saving you like $490 out of $500 on Rx, because everyone else is doing that to. There is literally nothing new here. My local grocery store beat his price by 10%+. But as long as you know that the "pricing reduction" is total bunk and not a competitive advantage and just an explanation of the current state of the industry that EVERYONE is doing, then it's one more option that could be the lowest for you.
In my case, it didn't help me.
In other words, I don't think Cuban puts his name on all businesses he's involved in like this, but for this case specifically it seems fairly obvious that using his name furthers their message.
That said I have to assume Cuban is also getting a PR benefit here.
When you say the prices were about even with what you pay at costco is that comparison with or without healthcare insurance paying part of it?
If your insurance paid part of it and its comparable then Cubans pharmacy is a win for those without healthcare insurance.
I still think this is a great service regardless.
But are you taking into account how much a month you are paying into that insurance when comparing the two?
If CostPlus is coming close to what you are getting your prescription for with a paid into insurance plan, than I would call that a win for those without insurance.
Might be worth looking at lowering my own insurance coverage to one that might not be that great for prescription, as long as costplus and costco type places come close to after insurance priced meds.
It's an easy way to karma-farm on HN.
Sometimes? The medical industrial complex's MO is to squeeze as many people (in the USA) as they can for every penny they have. The American sheeple have been duped to vote against their own best interest (a single-payer system). We don't have the best medical care in the world and we pay at least 10x for it.
> Why are your prices so cheap?
Not native English, but that is not English right?
Edit; guess my school English told me that is wrong ;
- prices are low
- this medicine is cheap
So learned something ;) thanks
It just sounds weird to me, because I think I was thought this is wrong a long time ago in school.
EDIT: As an American, "Why is it so cheap?", and any variant, is completely normal.
That seems different ; ‘it’ refers to the goods, not ‘price’.
Didn’t know it was common, like said, not native english.
ooooh okay that is really neat
How do I get the drugs? order it from our pharmacy.
Wat?
Instead of:
Pharma co -> Distribution -> Pharmacy -> You
It's:
Pharma co -> Cost Plus -> You.
Cost plus is still a pharmacy by definition.
"We work with Truepill pharmacy, our trusted fulfillment partner to fill your prescriptions. Truepill has a team of accredited pharmacists who will ensure your medication is safe and delivered to your doorstep on time."
Oh, and guess who owns most of TruePill???
Hint - https://www.optumventures.com/portfolio
There is very little new in the PBM/Pharmacy world from what I've seen, just more layers of redirection and subterfuge :)
> Everything is an advertisement, and some of it is clearly marked as such.
