Skip to main content

Steven Brill has a must-read cover story in Time this week detailing how the federal government's refusal to set rates for procedures, services and products means we all pay more for health care. I found this out first-hand last fall when my doctor tried to charge me $95 for a flu shot.

I was in for a routine physical and mentioned, "One of these days I need to go to CVS and get a flu shot." She said, "Oh, I can give you one right now." She grabbed a vaccine and gave me the shot - the whole process lasted about a minute. There was no discussion of price - I assumed it was either free or they'd charge me what the pharmacy does, about $25.

A month later I got this bill:

FluShotBill
My health insurance provider doesn't cover flu shots at all, so I called the doctor's office and told them I had no intention of paying $95 for a flu shot. I said I'd pay the $33 for the shot, but not $62 for the privilege of getting it. It took another call to remind the office, but they took it off my bill.

Considering the flu costs $10.4 billion in treatment alone annually, never mind untold billions in lost productivity, we shouldn't be charging people for flu shots at all - we should be giving them away. But we invest precious little in preventive care - there's no money to be made in keeping people healthy.

It's just one tiny window into the unnecessarily high costs of America's health care system as our multi-payer system offers multiple chances for graft. A single-payer, Medicare-for-all style system would provide much more effective cost-control and oversight. Obamacare takes some steps in the right direction, but the Obama administration chose to cut the best deal they could with insurance companies rather than take them on.

The best health care in the world? Please. Whenever I hear that, I know the person talking has a staffer to make their appointments, has never had to wait hours for treatment, and has someone else to sort out the bills.

Cross-posted from Blue Mass Group

EMAIL TO A FRIEND X
Your Email has been sent.
You must add at least one tag to this diary before publishing it.

Add keywords that describe this diary. Separate multiple keywords with commas.
Tagging tips - Search For Tags - Browse For Tags

?

More Tagging tips:

A tag is a way to search for this diary. If someone is searching for "Barack Obama," is this a diary they'd be trying to find?

Use a person's full name, without any title. Senator Obama may become President Obama, and Michelle Obama might run for office.

If your diary covers an election or elected official, use election tags, which are generally the state abbreviation followed by the office. CA-01 is the first district House seat. CA-Sen covers both senate races. NY-GOV covers the New York governor's race.

Tags do not compound: that is, "education reform" is a completely different tag from "education". A tag like "reform" alone is probably not meaningful.

Consider if one or more of these tags fits your diary: Civil Rights, Community, Congress, Culture, Economy, Education, Elections, Energy, Environment, Health Care, International, Labor, Law, Media, Meta, National Security, Science, Transportation, or White House. If your diary is specific to a state, consider adding the state (California, Texas, etc). Keep in mind, though, that there are many wonderful and important diaries that don't fit in any of these tags. Don't worry if yours doesn't.

You can add a private note to this diary when hotlisting it:
Are you sure you want to remove this diary from your hotlist?
Are you sure you want to remove your recommendation? You can only recommend a diary once, so you will not be able to re-recommend it afterwards.
Rescue this diary, and add a note:
Are you sure you want to remove this diary from Rescue?
Choose where to republish this diary. The diary will be added to the queue for that group. Publish it from the queue to make it appear.

You must be a member of a group to use this feature.

Add a quick update to your diary without changing the diary itself:
Are you sure you want to remove this diary?
(The diary will be removed from the site and returned to your drafts for further editing.)
(The diary will be removed.)
Are you sure you want to save these changes to the published diary?

Comment Preferences

  •  It Is Hard To Wrap Your Mind Around (12+ / 0-)

    I am blessed with amazing health. I don't even get colds.

    But about a decade ago I caught a one in 10M virus. Ended up getting cut from ear to ear and in the ICU with a tube down my throat for five days.

    It cost me $78,000.

    Now don't get me wrong, they saved my life. Thankful for that.

    But the cost, which later my insurance company (long story) refused to pay, seems a little over-the-top.

    When opportunity calls pick up the phone and give it directions to your house.

    by webranding on Mon Feb 25, 2013 at 05:15:13 AM PST

  •  Why didn't your insurance cover this? (4+ / 0-)
    Recommended by:
    theKgirls, Cassandra Waites, FG, chimene

    I assume that your doctor assumed they would, hence the ridiculously high charge . .. . .  (which makes it strange that insurance companies are always vilified on this site, I don't blame them for pushing back against this type of thing).

  •  $62 to administer a shot?? (7+ / 0-)

    That's completely insane! I wouldn't have paid it either.

    I can't get the flu shot, I always get sicker from the shot than from the flu itself. I do however get the pneumonia shot. My other half got his flu shot at Walgreens, because his doctor was out. Now I'm kind of glad he did so we didn't get charged like that LOL.

    "Madness! Total and complete madness! This never would've happened if the humans hadn't started fighting one another!" Londo Mollari

    by FloridaSNMOM on Mon Feb 25, 2013 at 05:19:42 AM PST

    •  My Grandfather Was A Small Town Rural Doctor (5+ / 0-)

      my uncle owned the only pharmacy in town. How this is the 60s, 70s, and 80s and they hated drug companies. I don't think my grandfather nor uncle ever filled a script for a brand named drug if there was a genric. They knew even back then the drug companies were screwing people and they wanted no part of it.

      When opportunity calls pick up the phone and give it directions to your house.

      by webranding on Mon Feb 25, 2013 at 05:29:03 AM PST

      [ Parent ]

      •  Generics are fine, but of course (2+ / 0-)
        Recommended by:
        misslegalbeagle, chimene

        if generics were used exclusively, there'd never be any new drugs developed.

        And since, quite frankly, the existing ones don't work all that well in many cases, that's necessarily that good of a thing.

        In any event, that's an interesting comment for a diary that  shows that exactly the opposite of what you were ranting against is what the problem is in this case.

        •  Look I Don't Want To Get Into A Fight Here (5+ / 0-)

          but to say a genric drug doesn't work as well as the brand named drug is just BS. I mean you know there is a chemical compound of a drug and you can exactly replicate that and call it something else .... right?

          As for the R&D I get that. I do. Which is why our copyrights and patents are such it takes a long, long time for anybody to be able to offer a genric alternative.

          When opportunity calls pick up the phone and give it directions to your house.

          by webranding on Mon Feb 25, 2013 at 05:39:01 AM PST

          [ Parent ]

          •  No, it doesn't take that long (2+ / 0-)
            Recommended by:
            webranding, misslegalbeagle

            to be able to offer a generic alternative - often less time that the development of the initial drug cost.

            Again, if that's what society want - cheap drugs, with those available frozen in time, I have no beef against that.

            It's just that drugs (including vaccines) - no matter what the "obscene" profits made off of them happen to be - tend to be way cheaper than other forms of medical intervention.

            •  I Just Don't Agree (5+ / 0-)

              My father is 69. About a decade ago he had a mild heart attack. He was told it might be a good idea to eat better and lower his cholesterol intake.

              They just gave him a pill.

              I think he pays, well you and I do cause he was a former federal worker, around $200/month. This has been going on for a decade.

              Off the top of my head that is $24,000.

              You could have hired a personel chef to come teach him to cook better. Bought a treadmill. Had a ton of money left over.

              But just give him a pill ....

              When opportunity calls pick up the phone and give it directions to your house.

              by webranding on Mon Feb 25, 2013 at 05:55:59 AM PST

              [ Parent ]

          •  Not to mention the fact (5+ / 0-)

            that most of the R&D for new compounds comes from public universities with NIH/CDC funding (though the BigPharma gigacorp gets the patents), and the majority of BigPharma's costs listed under R&D go to marketing. You know, those television and magazine ads with all the fine print/fast-talking. And bribes to doctors, etc., too.

            A majority of the 'new' drugs for this or that are actually old drugs the patents are expiring on, re-purposed to treat something else entirely, or with some filler ingredient changed slightly so the patent will be removed. Pretty much a scam top to bottom. Which is why you see advertised asthma drugs with the side-effect of "Death By Asthma," and osteoporosis drugs for post-menopausal women that cause rampant, incurable osteoporosis.

            •  The NIH funds virtually no drug (0+ / 0-)

              development (and increasingly less basic research, for that matter).

              •  Where'd you get that idea? (2+ / 0-)
                Recommended by:
                VA Breeze, chimene

                The role of public-sector research in the discovery of drugs and vaccines [NIH]

                We found that during the past 40 years, 153 new FDA-approved drugs, vaccines, or new indications for existing drugs were discovered through research carried out in PSRIs [Public Sector Research Institutions]. These drugs included 93 small-molecule drugs, 36 biologic agents, 15 vaccines, 8 in vivo diagnostic materials, and 1 over-the-counter drug. More than half of these drugs have been used in the treatment or prevention of cancer or infectious diseases. PSRI-discovered drugs are expected to have a disproportionately large therapeutic effect.
                Drugs developed by Uncle Sam, PhD, play an outsized role in medicine
                ...public-sector research institutions (or PSRIs, for short) became more active players in drug development following the biotech revolution in the mid-1970s. Government-funded researchers used recombinant DNA technology and monoclonal antibodies to discover and invent biologic and small-molecule drugs. Patents proliferated, but few of these candidate drugs were licensed to the private sector. Then, in 1980, the Bayh-Dole Act and other federal legislation changed the rules on technology licensing, making it more appealing for drug companies.
                Health For Sale
                The key to the power of Big Pharma over the world drug market is the TRIPS agreement (Trade Related Aspects of Intellectual Property Rights) negotiated by the World Trade Organization (WTO) between its 150 signatory nations. TRIPS requires member states to grant drug companies patents for the exclusive manufacture of new drugs for at least 20 years. This enables them to maximize profits through artificially high monopoly pricing, unaffordable to all but the most affluent nations. Drug companies often hold 240 patents on the same drug and, in a process called "evergreening," obtain extended patents whenever they can invent a new use for a drug, however small its therapeutic value. A spokesman for the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) rationalizes charging as much as 100 times manufacturing costs as necessary to recoup the considerable costs of developing a new drug. Yet during the decade of the 1990s drug companies made a 25% profit on turnover (compared to only 3.3% by other consumer sectors), while spending only 12.5% on research but 36% on administration and marketing.
                •  Your links describe early discovery (1+ / 0-)
                  Recommended by:
                  chimene

                  and basic research (which is relatively inexpensive) and very little drug development or commercialization per se (which is relatively more expensive).

                  •  I don't know about you, (0+ / 0-)

                    but I'd rather pay $20 for a drug I didn't see advertised on TV or in some magazine - because my doctor thinks it will do the job - as opposed to paying $200 for the same drug because its Big Pharma gigacorp needs to pay for all that expensive advertising which led me to demand it from that doctor no matter what s/he might think about its efficacy. 36% for drug-pushing minions and advertising as opposed to 12.5% on research that's mostly done in the public sector (and tested at public sector hospitals)? What's that research for... how to dope it with a few grains of ibuprophen so it'll qualify for 240 patents for 20 years apiece? Meh.

                    So long as it's insurers spreading all that cash around, it's all okay? Sure, tens of millions of people who don't have usable insurance and can't get it at any price will suffer and die before they need to, but that's just business!

                    Call me unimpressed with this business plan.

                  •  P.S. Your comment was... (0+ / 0-)

                    "The NIH funds virtually no drug development (and increasingly less basic research, for that matter)."

                    That's not true, is it? In fact, it's Big Pharma that funds virtually no drug development or basic research. They have the NIH and public universities to do that for them.

                    •  Big Pharma funds virtually no basic (0+ / 0-)

                      science / drug discovery.

                      That's where public $$s are key (and what the links you provided were talking about).

                      By contrast, the NIH doesn't fund much drug development, very little past animal testing for sure.  They leave the expensive stuff - e.g., clinical trials, to Big Pharma.  Who is increasingly not even doing this in the USA anymore in any event.

                    •  Oh, besides the clinical trials (0+ / 0-)

                      scale up and manufacturing are another huge cost that the NIH doesn't pay for, except in very rare occasions.

                      One of these occasions is actually germane to this discussion, when they gave a company something like $1.5 billion to develop cell line-based production alternative to the current chicken egg based method for manufacturing influenza vaccine.

            •  My husband and I are both pharmacy technicians (3+ / 0-)
              Recommended by:
              Joieau, Cassandra Waites, VA Breeze

              and we are dumbfounded by the tactics that the big pharmaceutical companies will do to extend their patent. Combo drugs seem to be a big one: combine their drug with something that's been generic on the market forever or change what salt they mix the active drug with, and voila, a "new drug".  We were watching TV a couple of weeks ago when a commercial for "Intermezzo" came on TV.  We joked that they must have developed a "Ambien MLT", and were slightly horrified that we weren't all that wrong.  Zolpidem Tartrate, the drug that's present in both Ambien and Intermezzo has been available as a generic for the longest time, and now a company is making a ton of money by putting it in a dissolving sub-lingual formula with a lower dose.

              I'm currently applying for pharmacy schools and at one point wanted to do pharmaceutical research, but I don't think I could live with myself working for Big Pharma.  I think I'm going to stick with clinical practice where I can actually take care of people who need it.  

          •  Maybe a your mileage may vary thing (0+ / 0-)

            For a condition, I have a choice between a generic and a brand name.  The brand name costs far more with my insurance.  But the generic has terrible side effects, while the brand name doesn't bother me at all.  

            Anecdotal and all, but thought it was relevant.  

            •  Yeah, even the FDA admits (0+ / 0-)
              Generic drugs are required to have the same active ingredient, strength, dosage form, and route of administration as the brand name product. Generic drugs do not need to contain the same inactive ingredients as the brand name product
              link  

              and at the rest of the site tries to convince you that that does not matter (not all agree about that, however) -  the key thing to be aware of is that "inactive ingredient" probably doesn't mean what one might think it would just be reading the dictionary . .. .

  •  Help! I'm being oppressed by socialized medicine! (16+ / 0-)

    I live in Italy which doesn't even have the best of national health care programs, but I can waltz down to a regional health clinic and get a free flu shot.  

    Other fun facts:  My youngest son has been knocked out with the flu since last Wednesday.  After 3 days of temperatures between 102-103.5, I called his pediatrician who prescribed amoxicillin for him (after I described other symptoms).  Out of pocket cost for consultation:  0 Euros.  Cost of amoxicillin:  1 Euro.  My husband takes atorvastatin, and picked up his refill while at the pharmacy.  Cost for Lipitor equivalent:  2 euros.  

    I know I'm preaching to the choir, but I just can't understand why other Americans find such a system to be so oppressive.  Even in problematic Italy, we can get our basic health needs taken care of without worrying about the cost.

    •  flu doesn't need antibiotics (3+ / 0-)
      Recommended by:
      lina, MPociask, Cassandra Waites

      and antibiotics won't do squat to help with the flu.  it's a viral infection.  someone needs to slap your doctor.

      peace

      Please don't dominate the rap, Jack, if you got nothin' new to say - Grateful Dead

      by Cedwyn on Mon Feb 25, 2013 at 07:42:42 AM PST

      [ Parent ]

      •  Unless it was going into (3+ / 0-)

        pneumonia or bronchitis... or had turned into a sinus infection. A lot of times if I get something like the flu they'll put me on antibiotics because I have COPD and anything like that tends to turn into an infection in my lungs. SneakySnu said he ordered antibiotics after a list of other symptoms. I'd suspect the doctor knows the medical history  of this person well enough to make an accurate medicine choice.

        "Madness! Total and complete madness! This never would've happened if the humans hadn't started fighting one another!" Londo Mollari

        by FloridaSNMOM on Mon Feb 25, 2013 at 08:12:54 AM PST

        [ Parent ]

        •  Pneumonia can be viral too (1+ / 0-)
          Recommended by:
          FloridaSNMOM

          But you are correct in that there could be infection brewing as well.

        •  Sadly, many doctors will prescribe antibiotics (2+ / 0-)
          Recommended by:
          MPociask, Cedwyn

          for patients who do not have any conditions that would warrant preemptive antibiotic treatment to prevent flu complications, but instead to placate their patients.  Since many people only go to the doctor when they're "really sick", they expect to get medicine to "make them better"  when in reality the only treatment for the flu is rest, plenty of fluids, and the appropriate (typically OTC) medication to help with the symptoms.  Bacterial resistance to antibiotics is becoming a very serious problem, and a lot of that is due to inappropriate use.  Additionally, taking antibiotics when they aren't warranted can deplete your natural bacterial floral, and make you susceptible to more serious infections.   Doctors need to stop treating antibiotics like placebos, and save them for patients who actually have serious bacterial infections.  

          •  I understand that.. (1+ / 0-)
            Recommended by:
            historys mysteries

            But we don't know that it wasn't warranted in this case is my point. We don't have enough information or a medical degree to make that decision. There are cases in which it IS a good idea.

            "Madness! Total and complete madness! This never would've happened if the humans hadn't started fighting one another!" Londo Mollari

            by FloridaSNMOM on Mon Feb 25, 2013 at 09:55:27 AM PST

            [ Parent ]

          •  It's also possible to go the other way (0+ / 0-)

            and not prescribe antibiotics where they are needed.

            See also: the doctor who wanted me to use Clarinex - which he knew did diddly-squat for me even in the height of allergy season - to fix what was diagnosed as a sinus infection and pooh-poohed me taking a decongestant because 'that will only treat the symptoms' and had an office staff who only considered 'I have been exposed to folks with recent overseas disease exposure' a sign for taking something seriously if you personally had gone overseas - the first locally-infected patient of a respiratory epidemic would get little aid from his office and wouldn't have even had reported exposure noted in his/her chart, to judge by the fact the nurse stopped writing when I explained I hadn't traveled myself.

            (So glad I don't live in the same state as him anymore and have a local doc who listens to 'no allergic reaction to it, but that drug has no therapeutic effect on me' reports.)

            There has to be a balance.

            Prayers and best wishes to those in Japan.

            by Cassandra Waites on Mon Feb 25, 2013 at 11:42:28 AM PST

            [ Parent ]

        •  Heck, if we're criticizing the diagnosis... (5+ / 0-)

          Why would you get one over the phone?  Personal story:

          A few weeks ago I was knocked down by an illness, had a terrible fever.  Went to a urgent care, the doctor didn't even examine me, said based on the symptoms I had (which had been relayed to him by the nurse, but I don't think 100% relayed as I had told them, since he interpreted "my back has been hurting from bad sleep" to "body aches"), it was the flu.  I said, you're not going to do a test?  He said, nope, don't need to do a test, he gave me some anti-flu scrips and a mask to cover my mouth and nose.

          Went to another doctor's office, they did a test.  I had strep throat and an ear infection.  Gave me completely different scrips, which cleared it up.

          I got a refund from the first place.

          •  Moral of the story? (3+ / 0-)
            Recommended by:
            FloridaSNMOM, MPociask, Roadbed Guy

            Be your own advocate!  Congrats to you, MPociask.  It's just unfortunate that when you're sick, you still have to be the smartest "consumer" you can be...  

            I've said this to my mom and others many times -- don't just take things blindly from medical professionals...they're like anyone else -- could be having a bad day or just mis-hear what you're saying (or, as you said, the nurse didn't convey symptoms appropriately).  

            One of the oddities of today's medical world -- the nurse or physicians' assistant will come in and ask you for your symptoms (and take your temp and bp), and then the doctor reads what the asst/nurse said.  If you're lucky, the doctor will go over it with you and make sure it's right (love my internist -- she's good at this sort of thing, and she actually listens to me and explains things to me...that's a big part of why I go to her!).  

            If you're not lucky, they'll just read it, take it as gospel and treat based on that -- if that's what they do, run like hell to another doctor.  :-)  

            Why isn't my IRA worth $100M???

            by Jill on Mon Feb 25, 2013 at 10:41:40 AM PST

            [ Parent ]

  •  My dog has been ill and needed several (13+ / 0-)

    prescription meds recently.  Obviously the dog isn't on our insurance.  I was shocked at the price the drug companies charge for some meds.  

    One drug, doxycycline, was $4.00 the first week, but rose to $191.00 for the same 21 pills the next.  The pharmacist was so shocked she refused to sell it to me at that price until she could look for a pharmacy with a better price.  No luck.  Even Costco was hideously overpriced for it ($128.55).  

    Doxycycline is a routine derivative of tetracycline.  It's been around for years.  It isn't some new "big gun" antibiotic and it is generic.  It absolutely should NOT be expensive.  You should be able to buy a wheelbarrow full of it for $10.00.  

    The pharmacists all told me that the drug companies do this with older meds.  They just stop making them, so they become rare and they can charge zillions for them.  They get away with it because insurance picks up the difference for most people.  For most folks it would be a $15.00 copay.  It's criminal.

    We finally found Walgreen's had a cheaper supply, plus I enrolled the dog in their "W Club" so he can get a break on his prescriptions.  

    Just obscene...making a killing on sick people!  

    Metaphors be with you.

    by koosah on Mon Feb 25, 2013 at 05:31:54 AM PST

    •  Doxy???? PetMeds has it 100 50mg $19. (8+ / 0-)

      Even if I knew that tomorrow the world would go to pieces, I would still plant my apple tree. -Martin Luther

      by the fan man on Mon Feb 25, 2013 at 05:40:54 AM PST

      [ Parent ]

      •  It's a first line treatment for common infections, (0+ / 0-)

        very cheap. Something's not right with what the pharmacist told you.

        Even if I knew that tomorrow the world would go to pieces, I would still plant my apple tree. -Martin Luther

        by the fan man on Mon Feb 25, 2013 at 06:01:02 AM PST

        [ Parent ]

        •  Costco, Walmart, Safeway all had the same (11+ / 0-)

          story. All were surprised BTW.  Even Walmart.  Last week the drug was available and not expensive.  This week, exorbitant.  Last week it was on Walmart's "$4.00 List" that most pharmacies honor...this week it is not.  

          I got the same reaction everywhere I checked: shock!  The supplier raised the price on these stores.  Safeway told me they are paying $9.00 per pill to get it.    

          Only Walgreen's still had it listed for a reasonable price.

          The market is being manipulated.      

          Metaphors be with you.

          by koosah on Mon Feb 25, 2013 at 06:10:05 AM PST

          [ Parent ]

          •  I can get it from CVS, Walgreens, Walmart, (2+ / 0-)
            Recommended by:
            Maudlin, FloridaSNMOM

            and Rite Aid from $10 -14 per 60 100/mg. What part of the country do you live in?.

            Even if I knew that tomorrow the world would go to pieces, I would still plant my apple tree. -Martin Luther

            by the fan man on Mon Feb 25, 2013 at 06:15:17 AM PST

            [ Parent ]

            •  Western Oregon. (2+ / 0-)
              Recommended by:
              Maudlin, FloridaSNMOM

              Our Walmart quoted a price of $154.00 IIRC.  It was about $50.00 cheaper than Safeway, but more than Costco which offers it for $128.55.  Walgreen's pre-club price is $18.58/$15.00 with club.  This is for 42 100mg tablets.

              I personally spoke with the Costco pharmacist who told me the same story as Safeway pharmacist:  The price went up in one week.  They are as shocked as I was.

              To her credit, the first pharmacist (Safeway) wouldn't sell it to me at that price and insisted we look elsewhere for it and helped with that.  She is the one who told me the Walmart price, which was the cheapest she found of the places she checked for me.  I called Costco and Walgreen's myself.

              I live in a small town, but Eugene isn't far and most places follow their prices because they know we will just drive up I-5 to get it cheaper.  For this, though, I could have driven to Portland and saved money.

              Again...someone is manipulating this problem with doxy and it isn't the pharmacies.  My relative could not get his Rx even filled for a time and had to use an alternative.  He lives in a different Oregon town and uses a different pharmacy.

              Metaphors be with you.

              by koosah on Mon Feb 25, 2013 at 06:33:37 AM PST

              [ Parent ]

              •  Just called Walgreens, retail is $22 for 42 100mg. (2+ / 0-)
                Recommended by:
                FloridaSNMOM, koosah

                I'm in NYS.

                Even if I knew that tomorrow the world would go to pieces, I would still plant my apple tree. -Martin Luther

                by the fan man on Mon Feb 25, 2013 at 07:41:16 AM PST

                [ Parent ]

                •  That's where I finally went to get it. (1+ / 0-)
                  Recommended by:
                  the fan man

                  $18.58 retail, $15.00 for Club price.  The dog has another pricey med that made joining their Walgreen's club worth the $20.00 fee.  

                  The main issue I have is that most people with insurance would just pay their copay and never even know that their insurance was paying so much extra for it.  It's outrageous.  No one with insurance is going to look at the regular price and say, "Sorry, nope, put it back, I'm going somewhere cheaper even if my copay is only $15.00."  There is no market pressure, or if there is any, it is skewed and adulterated by the presence of insured customers who can ignore the real price.  

                  If we had single payer, the govt. could tell the suppliers how much they would pay for it and that would be that.  The govt. would offer the contract to the supplier who could meet their price or who had the lowest price.  The suppliers couldn't get away with price-gouging like this.    

                  Metaphors be with you.

                  by koosah on Mon Feb 25, 2013 at 08:41:24 AM PST

                  [ Parent ]

                  •  THAT is a very important point! But I have to say (1+ / 0-)
                    Recommended by:
                    koosah

                    at least with every insurance co we've had, they are very price sensitive. I've had meds that I've been on go from $10 to $50 co-pay because of fights between insurance and drug cos.

                    And I just called Walmart, $142!!!!! It's "off their list" of meds they can get at a discount.

                    Even if I knew that tomorrow the world would go to pieces, I would still plant my apple tree. -Martin Luther

                    by the fan man on Mon Feb 25, 2013 at 09:44:47 AM PST

                    [ Parent ]

              •  There are other mentions of the problem on-lline (1+ / 0-)
                Recommended by:
                koosah

                Saw one thread in a discussion of horse owners, and an announced product change for birds from another site. Someone in the horse thread linked to this:

                Reason for the Shortage

                Mutual states the reason for the shortage is a raw material shortage.
                Major, Watson and Heritage state the reason for the shortage is supply and demand.
                Lannett, Mylan, Par, VersaPharm, and West-Ward could not provide a reason for the shortage.
                Major discontinued most doxycycline presentations in February 2013.

                http://www.ashp.org/...

                The site lists quite a long list of drugs that are in shortage. One being: Aspirin (buffered)

                "No one life is more important than another. No one voice is more valid than another. Each life is a treasure. Each voice deserves to be heard." Patriot Daily News Clearinghouse & Onomastic

                by Catte Nappe on Mon Feb 25, 2013 at 09:07:14 AM PST

                [ Parent ]

      •  Exactly. (5+ / 0-)

        Like I said.  You should be able to buy a wheelbarrow full of it for $10.00.  Agriculture uses it extensively.  This is a case of pharma totally ripping off PEOPLE with insurance coverage.

        Unfortunately, we needed the Rx for the dog right away.  If this is a med the dog will be taking long term, then we will (obviously) be looking at internet alternatives.  

        A human relative is also taking doxy (long term) and told us that he experiences occasions when he simply can't even get it at any price.  The drug manufacturer/supplier is just effing with this market to manipulate the price.  

        But hey...at least I don't live at the whim and mercy of the oppressive socialist medicine machine (TOTAL snark).  

        Metaphors be with you.

        by koosah on Mon Feb 25, 2013 at 06:01:44 AM PST

        [ Parent ]

    •  i have a discount drug (4+ / 0-)

      card both for me and for the dogs. Check here.  it's not the same as the one I picked up at the clinic. Couldn't find it on teh google. mine is from "Health Trans". It saved me over 60 bucks on a recent antibiotic Rx.

      Only thing more infuriating than an ignorant man is one who tries to make others ignorant for his own gain. Crashing Vor

      by emmasnacker on Mon Feb 25, 2013 at 05:58:54 AM PST

      [ Parent ]

      •  Guess that's the downside of "cheap" (4+ / 0-)
        Recommended by:
        koosah, MPociask, Cassandra Waites, MGross

        generics - companies tend to stop making them when there's no money to be made . . ..

        A similar trend afflicts many (or at least several) bedrock cancer drugs that have been around for like forever.

        •  Another downside, for controlled substances, (2+ / 0-)
          Recommended by:
          koosah, Roadbed Guy

          is that the government doesn't force a split between brand and generic production but the insurance companies can still require generic.

          For a while maybe a year or two ago, there was a situation with that and ADD medications - the adults and kids with the disorder who needed the drugs couldn't find generic the insurance companies would cover and couldn't afford full price brand name, BUT the street dealers with forged or otherwise inappropriately obtained prescriptions could afford brand name because they'd be getting the money back plus profit.

          Nothing said they had to produce any generic. Laws said they were limited in how much they could make - and the brand+generics limit was below the estimated level needed for legitimate legal prescriptions anyway.

          So in the name of the US government and the profit motive, a controlled substance's legal production was basically pipelined right into the street-level illegal drug trade.

          It was a mess.

          Prayers and best wishes to those in Japan.

          by Cassandra Waites on Mon Feb 25, 2013 at 11:29:40 AM PST

          [ Parent ]

    •  Doxy is so cheap my supermarket gives it away (2+ / 0-)
      Recommended by:
      koosah, FloridaSNMOM

      free - with a script, of course. I'm in upstate NY.

      We're in an intense Lyme area so many people need it for prophylaxis, so we all keep some on hand.

      But I should point doxy is one drug you do NOT want to stockpile for the long haul.  Old doxy doesn't just get ineffective, it becomes damaging to your liver.  Discard it at its use by date.  Don't take a chance.

      Araguato

      •  Thanks for the info about stockpiling it. (3+ / 0-)

        My Mom used to think I was nuts because I was always going through her prescriptions and throwing out old stuff.  To her, I was throwing away money in the bank.  To me, I was keeping her from poisoning herself at worst or under treating her problem at best.  

        :^)

        Metaphors be with you.

        by koosah on Mon Feb 25, 2013 at 07:31:29 AM PST

        [ Parent ]

    •  something is wrong (1+ / 0-)
      Recommended by:
      koosah

      Walmart gives out doxy prescriptions for free - at least they were doing so this past summer.

  •  TREATMENTS. Some of the Best Treatments in the (4+ / 0-)

    world can be bought here. Yachts, too.

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Mon Feb 25, 2013 at 05:33:10 AM PST

  •  And to think ... (0+ / 0-)

    You could go down to your local DHS and get the shot for free, no questions asked but you do have a little wait.

    Didn't they have you sign something that says you are not allergic to the shot? That would have been a good time to say "No!"  They can't do an invasive thing like a shot without your consent.

    Sounds like you might need to change doctors ... for various reasons.

    "Life without liberty is like a body without spirit. Liberty without thought is like a disturbed spirit." Kahlil Gibran, 'The Vision'

    by CorinaR on Mon Feb 25, 2013 at 05:34:34 AM PST

    •  Not in our county, they're means testing or you (3+ / 0-)

      pay a fee. (Must be on public assistance)See my comment re docs/insurance/in office fees.

      Even if I knew that tomorrow the world would go to pieces, I would still plant my apple tree. -Martin Luther

      by the fan man on Mon Feb 25, 2013 at 05:48:47 AM PST

      [ Parent ]

    •  Diarist wanted the shot (0+ / 0-)

      And the sign off form on allergies and conditions wouldn't have warned that the bill was going to be for $95, so s/he had to reason to say "NO" based on the information available at the time.

      "No one life is more important than another. No one voice is more valid than another. Each life is a treasure. Each voice deserves to be heard." Patriot Daily News Clearinghouse & Onomastic

      by Catte Nappe on Mon Feb 25, 2013 at 09:11:57 AM PST

      [ Parent ]

      •  I was going by what was stated (2+ / 0-)
        Recommended by:
        Catte Nappe, Roadbed Guy
        I was in for a routine physical and mentioned, "One of these days I need to go to CVS and get a flu shot." She said, "Oh, I can give you one right now." She grabbed a vaccine and gave me the shot - the whole process lasted about a minute.
        It wiounded as if the dairst had not been given a chance to ask any questions or think about things.

        I am also going by my own experience with my docs ... generally, they have been very good aboutletting think about procedures and answering any of my questions about prices and what will happen. Still, I would seriously consider whether I want to stay with a doc who does not give me the information I need.

        I guess I also assumed that, since I live in the middle of Blood Red Oklahoma and the shots are free at DHS, more enlightened states would have a similar or better system.

        My bad.

        "Life without liberty is like a body without spirit. Liberty without thought is like a disturbed spirit." Kahlil Gibran, 'The Vision'

        by CorinaR on Mon Feb 25, 2013 at 11:09:22 AM PST

        [ Parent ]

        •  To my NP's credit (0+ / 0-)

          Once I asked her about a flu vaccine, and she said it would be cheaper to get at the pharmacy; and that she would have to order it and schedule a different appointment anyway.

          And I too am in a red state (TX), and our county health office will give free flu vaccines to non-low income folks IF they have excess available as the season progresses. I generally prefer not to wait that long.

          "No one life is more important than another. No one voice is more valid than another. Each life is a treasure. Each voice deserves to be heard." Patriot Daily News Clearinghouse & Onomastic

          by Catte Nappe on Mon Feb 25, 2013 at 11:44:09 AM PST

          [ Parent ]

        •  Good catch about the speediness (0+ / 0-)

          involved - maybe THAT was what the ginormous fee was all about.

          Even though it's quite a while back, I still have memories of sitting, and sitting, and then sitting there waiting some more whenever I took my kids in for routine vaccinations.

          Believe me, it NEVER transpired nearly that quickly!

  •  The flu shot/insurance/doctor retail price is (7+ / 0-)

    a strange beast. My doc charges $65, Walmart/Walgreens is about $30. They understand why we go elsewhere for our shots. (By the way, same for our vet's office and vaccines vs "health clinics" in pet stores. It's just what they need to charge to make it pay to stock the products and administer.) My wife works in the Dept of Health county job. The county's health insurance won't cover flu shots or any other vaccines for family members. Penny wise.

    Even if I knew that tomorrow the world would go to pieces, I would still plant my apple tree. -Martin Luther

    by the fan man on Mon Feb 25, 2013 at 05:46:39 AM PST

  •  That's the unspoken key to the HCR debate (4+ / 0-)

    Too many people get too wealthy from health care in our country.  It's like defense contracting. Single payer wouldn't in itself solve that...it would just make government the sucker.

    You know, I sometimes think if I could see, I'd be kicking a lot of ass. -Stevie Wonder at the Glastonbury Festival, 2010

    by Rich in PA on Mon Feb 25, 2013 at 06:01:08 AM PST

    •  My Grandfather Was A Doctor (6+ / 0-)

      small rural town. He made more money then my family can spend in a lifetime.

      After he passed away I was helping my father clean out his office. We came across this file cabient. I asked what it was, note cards written in short hand.

      My father explained that not everybody could afford my grandfathers services. But he'd never turn anybody away.

      That as a kid, when somebody would come by at X-Mas with an apple pie, and I was told they where a distant Aunt, that wasn't true. That person was paying back him for his services the only way they could.

      He held them to their word. Those note cards outlined their deal.

      Oh did I mention he made a ton of money .....

      When opportunity calls pick up the phone and give it directions to your house.

      by webranding on Mon Feb 25, 2013 at 06:15:15 AM PST

      [ Parent ]

  •  $95 for a flu vaccine (6+ / 0-)

    that is only 9% effective for seniors, to boot.

    •  exactly...flu vaccines are kinda silly, imo (0+ / 0-)

      and there is absolutely no point in non-vulnerable population members receiving them.

      it's cooked up on a best guess scenario of what the next season's active strains will be.  hit and miss crapshoot.

      Please don't dominate the rap, Jack, if you got nothin' new to say - Grateful Dead

      by Cedwyn on Mon Feb 25, 2013 at 07:44:45 AM PST

      [ Parent ]

      •  Herd immunity (1+ / 0-)
        Recommended by:
        Cedwyn

        Especially since it is less effective in vulnerable populations. Reduces the chance that a senior might be exposed to the illness if younger adults are protected from infection. It's how child hood vaccines work, too.

        "No one life is more important than another. No one voice is more valid than another. Each life is a treasure. Each voice deserves to be heard." Patriot Daily News Clearinghouse & Onomastic

        by Catte Nappe on Mon Feb 25, 2013 at 09:09:20 AM PST

        [ Parent ]

        •  herd immunity works (1+ / 0-)
          Recommended by:
          Catte Nappe

          when the vaccination is properly targeted.  with flu, they don't even know for sure which strains will be in circulation the next flu season.  it's all guesswork and a crapshoot.

          http://www.usatoday.com/...

          Yet the Centers for Disease Control and Prevention also acknowledged Friday that influenza vaccines, on average, are only about 62% effective.

          ...With relatively low efficacy, the flu shot today doesn't have much power to produce true "herd immunity," Osterholm says. Herd immunity is achieved when enough people are immunized with an effective vaccine that the community's viral load drops, protecting even the unvaccinated.

          Please don't dominate the rap, Jack, if you got nothin' new to say - Grateful Dead

          by Cedwyn on Mon Feb 25, 2013 at 09:31:44 AM PST

          [ Parent ]

    •  Yeah, almost all the "flu" out there (0+ / 0-)

      almost certainly isn't actually influenza.

      People are hosts to thousands of viruses, most of them benign most of the time - when a few get out of hand, meh, let's just call the "the flu"

  •  England (2+ / 0-)
    Recommended by:
    phonegery, Cassandra Waites

    In England general practitioners (primary care physicians in US terms) get a bonus for hitting a percentage target of their patients in various groups who they give the flu vaccine.

    I get a letter reminding me each year (am over 60 and have had asthma in the past from chemicals allergies, two strikes!) and follow up SMS texts if I forget to book in for one. Last Fall, they arranged a series of clinics so the phlebotomist and nurse practitioner could ask the health check questions while the doctor flitted between the two with the vaccines. No charge to me of course.

    She said, "Oh, I can give you one right now." She grabbed a vaccine and gave me the shot - the whole process lasted about a minute. There was no discussion of price - I assumed it was either free or they'd charge me what the pharmacy does, about $25.
    Did you actually give your consent to her injecting you? If not, this sounds remarkably like an assault.

    "Who stood against President Obama in 2012?" - The trivia question nobody can answer.

    by Lib Dem FoP on Mon Feb 25, 2013 at 06:32:34 AM PST

  •  Every health care provider (5+ / 0-)

    should be required to provide a price list of all their services.  I don't think that would be a very controversial law.

  •  My favorite grocery store has a pharmacy (0+ / 0-)

    and when I had the flu shot late Fall, I had a minimal co-pay and then they gave me a $20.00 gift card for groceries.

    Insurance coverage for so many things varies wildly as certain employers don't want to pay much for their employees.

    In my area, there is almost a monopoly by a health system-own doctor practices, hospitals outpatient clinics, ect. The health insurance is very expensive and the co-pays are high.

    There is just as much horse sense as ever, but the horses have most of it. ~Author Unknown

    by VA Breeze on Mon Feb 25, 2013 at 12:24:31 PM PST

  •  Thanks Obamacare. flushots Now Free of charge (0+ / 0-)
    Immunization Services for Adults
    Adults 19 years and older who are enrolled in new group or individual private health plans will be eligible to receive vaccines recommended by the ACIP prior to September 2009 without any cost-sharing requirements when provided by an in-network provider as of September 23, 2010.

    Hepatitis A
    Hepatitis B
    Herpes Zoster
    Quadrivalent Human Papillomavirus vaccine for females
    Influenza
    Measles, Mumps, Rubella
    Meningococcal
    Pneumococcal
    Tetanus, Diphtheria, Pertussis
    Varicella

    Influenza Vaccine    An expanded recommendation on influenza vaccine for all adults 19 to 49 years of age.    Effective March 2, 2010.    Plans and issuers will be required to provide coverage without cost-sharing for this service as described in the recommendation and in the 2011 schedules in the first plan year (in the individual market, policy year) that begins on or after March 2, 2011.
    The Affordable Care Act and Immunization | HealthCare.gov
    http://www.healthcare.gov/...

    Facts

  •  It's an old scam (0+ / 0-)

    Back in the day, doctors charged patients a fee for service. Patients paid the doctor's fees.

    Insurance companies got into the health insurance business, and when the average schnook wondered why he should bother with insurance instead of just paying the doctor's bills like he'd always done, the insurance company claimed that "the power of numbers" would keep the cost down.

    Insurance companies said they could get better prices from doctors by allowing them access to hundreds then thousands of patients.

    This led to two consequences: insurance companies strong armed their subscribers into only going to insurance company approved doctors (evereyone with health insurance knows about that one) but it also led to insurance companies negotiating a percentage off doctors' fees. Instead of paying in full, the insurance company would pay 60%, or 80%, pass some of the savings along to the patient and pocket the rest.

    As doctors came to rely more and more on health insurance to pay their fees, they raised their fees so that the percentage they got from insurance companies was enough.

    Insurance companies competed with each other to get lower and lower percentages so they could lower their premiums, doctors fought back by accepting a lower percentage and raising their fees. The doctors stated fee for any particular service became an accounting fiction, except for cash and carry patients. You see, if everyone got a discount, the health insurance companies would claim the discounted rate was the true fee, and insurance would only pay a percentage of the lower amount.

    So you wind up with $95 flu shots. The doctor's office was willing to remove the charge because if they were dealing with an insurance company, they wouldn't have gotten much more than $33 for giving you the shot anyway. But they had to charge you for it, in order to maintain the fiction that $95 is their true fee for that service. It's just how the game is played.

    "The problems of incompetent, corrupt, corporatist government are incompetence, corruption and corporatism, not government." Jerome a Paris

    by Orinoco on Tue Mar 05, 2013 at 05:26:23 AM PST

Subscribe or Donate to support Daily Kos.

Click here for the mobile view of the site