The death of the healthcare market – IOTW Report

The death of the healthcare market

The Grumpy Economist: People really do not need health insurance for regular small expenses, as they do not need car insurance to “pay for” oil changes. And any insurance system relies on an underlying cash market to find what the right prices are. Collision insurance works reasonably well because there is a supply and demand market for auto repair in which people pay their own money and there are competitive suppliers and free entry, offering services along a wide quality-price spectrum.

The underlying cash market has disappeared in health care. If you try to just pay for service, you face the ridiculous sticker prices. Everyone needs to go through some sort of middleman. We have, collectively, fallen for the fallacy that “negotiation” can lower everyone’s price, rather than (try to) lower my price by raising yours. It is widely recognized that catastrophic insurance plus health savings plans are a much better structure than current pay for everything structures. But you can’t do that if people showing up on their own to buy things are faced with fictitious “list prices.”
These thoughts come to mind reading an excellent explanation of the price of insulin posted by Novo Nordisk via Charles Sauer in the Washington Examiner (and thanks to a correspondent who sent the link)

“.. the drug pricing system, .. is incredibly complex and has resulted in a lot of confusion around what patients pay for medicines….”

“As the manufacturer, we do set the “list price” … However, after we set the list price, we negotiate with the companies that actually pay for the medicines, which we call payers. This is necessary in order for our medicines to stay on their preferred drug list or formulary. The price or profit we receive after rebates, fees and other price concessions we provide to the payer is the “net price.”… “

Perhaps it’s clearest right there: “the companies that actually pay for the medicines, which we call payers.” What happened to people?

Notice also the graph. If you think it’s been getting a lot worse in a short time, you’re right.

Right out in the open, and clear as a bell:

…those price increases were our response to changes in the healthcare system, including a greater focus on cost savings, and trying to keep up with inflation. PBMs and payers have been asking for greater savings – as they should. However, as the rebates, discounts and price concessions got steeper, we were losing considerable revenue… So, we would continue to increase the list in an attempt to offset the increased rebates, discounts and price concessions to maintain a profitable and sustainable business. …

Right. We all can’t negotiate a better deal than average. We soon run out of other people’s money. (The state of California just discovered that too — trying to make PG&E “pay for” wildfire damages, it discovered that in the end all the money comes from customers in the end.)   more

10 Comments on The death of the healthcare market

  1. Look to most any problem that’s growing out of control and you’ll find a government program behind it. The more they involve themselves the more of a mess they create.
    They don’t seek to solve problems although they say that’s their focus, they’re really trying to create support.

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  2. “Pay no attention to the man behind the curtain!”

    The fact is, we enjoy the shadow play. We WANT to be lied to. If fact, we demand it.
    The World is a harsh place, but if we can convince ourselves that ours is a “Bambi” existence, then so be it.

    izlamo delenda est …

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  3. FUDGE doctors, insurance companies, demtards, rino’s, and every OTHER ShitbamaKare subcontractor, squaw in the ass! 😡

    I see my dentist, and that’s IT! I intend to die in the age of ShitbamaKare, because I wanna see who resurrects me first; the Shitbamessiah, or the TRUE Messiah.

    MY money’s on the latter…

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  4. Dittos to Bob M. …. I see my dentist 2x per year and occasionally my optometrist (every 3 years or so). I take no drugs, no chemicals (not even vitamins) and intend to go back to my Maker the way He made me. (except for the scars of Life received along the way).
    If I get sick, then self-remedy, and hopefully what does not kill you makes you stronger.

    When you see the old and infirm at the nursing homes, the assisted living places, the rehab places, then you realize the total loss of dignity and independence that is called ‘care’ at these places. Plus handing over your life, your $$, and your needs to the bureaucrats.

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  5. I had a surgical cervical disc replacement denied by insurance so I inquired about cost assuming it would be something along the lines of a max of $12k (outpatient, an hour procedure). WRONG. I was told the 40% off cash price was $29k! The cost is $48k? How can that be tethered to anything real. Countless examples of how cost has nothing to do with the actual procedure, people involved, facility etc.

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  6. This is a huge problem with medicine today. Drug, hospital and physician costs are all over the place. If you don’t have insurance you get charged the top price. Drugs are the biggest scam. Most people don’t know that physicians and hospital will sometimes bargain with them if you can’t pay. I blame physicians for ignoring these problems for too many years. As TP says, we are now in a situation where people want the government to take over health care because that has worked so well in other countries where health care is “free”.

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  7. What I’d like to do is simply have a catastrophic medical plan, yearly exam and an Rx refill for the year. I can apply my own band-Aids and clean out my ears, too.
    Think that would be simple, huh?

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