I called her the other day after her first round of chemo just to see how she was doing. The conversation turned to the cost of her treatment. She had gone to her health care provider's website to look up the bills. With all of her treatments she had passed her out of pocket cap in January, so luckily for her everything will now be covered 100% by insurance. But what she relayed to me is staggering.
Her insurance was billed over $17,000 for the lumpectomy, and that's not counting the various radiology and lab charges. Chemotherapy costs $21,000 per treatment. $21,000. Online estimates are that the average oncologist makes $280,000 a year; that's good money, but not private plane, 6,000 sq. ft. McMansion money. And nobody is going to claim the nurses and technicians are getting rich. So what drives the high cost?
It has to be the drugs. I know it costs millions to research, develop and bring drugs to market. The drug companies and their shareholders deserve to make a profit. I'd be curious to know the profit margins on each IV bag of chemo drugs.
More importantly, I'd like to know what happens to those without health insurance.
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This is why we have to get a handle somehow on medical expenses. Drug companies build in extra profit to cover "charity" cases. It is out of hand.
My friend who just finished with all of her treatments had insurance with a co-pay. On a fixed income it was difficult but do-able. I believe that those without insurance would not be charged as much as those with insurance but still NOT do-able for most. So if I ever get very ill, oh well.....adios.
What drives the high cost? Greed.
Seriously, my wife audits some health care providers and the price gouging is staggering, especially for people without, or with inferior insurance. If a procedure is $12,000 for someone with insurance(only if you insurer is connected with this particular health care provider)then someone without insurance is being charged $20,000. Those without insurance get killed, while those with insurance pay less because their insurance companies have deals with the healthcare providers.
So yeah, GREED. The amount of profit in the healthcare field is crazy. But Obamacare rabble rabble rabble...
Ace, you are correct about the discounts that the providers negotiate. After the negotiated discount, the oncologist accepted $6,800 for the $21,000 bill. So why not just charge $6,800 and do away with the charade?
I also didn't know that those without insurance were billed a higher amount.
Of all the things our government should monitor with scrutiny is medical charges of all states. Drives me crazy to see exorbitant charges. And yes, they generally charge insurance companies more for the same processes, etc...than people who are uninsured. Doesn't make a lot of sense. Driving those costs up like that are what makes their original fees and charges outlandish in the first place. Viscous cycles.
Department stores like Macys, charge $160 for a coat (lets say), then two months later, it's on sale for 60% off. I get the retail industry workings, but that drives me crazy too.
BTW-my sister's daily medications for her MS cost close to $900 per month. That isn't even all of her expenses. She's on disability insurance through the state now. Prior to her acceptance there, her and her husband went through financial devastation.
It just doesn't seem right that people should be financially devastated because they get sick. In other Western countries such as Canada, the U.K. and Germany this doesn't happen.
First our guns and now our chemo drugs!!!
The average pharmaceutical company spends twice as much money on marketing and advertising (both to doctors and to the public) as it does on R&D (not to mention exorbitant executive salaries). Moreover, there have been very few breakthrough drugs released in the past couple of decades; most of their new products are what are known as "me too" drugs, copies or slight variations on existing medication that permit patent extensions but don't actually benefit patients (Claritin and Clarinex being a good example). Additionally, much of the research done on breakthrough drugs is funded by the US government in university laboratories, after which the licensing to manufacture and distribute the subsequent medication goes to big pharma, which reaps the profits. In other words you and I -- the American taxpayer -- foot the bill for much of the research, but then Phizer, Merck, and Lilly reap the financial rewards. Socialized costs but privatized profits.
I appreciate the "insider" perspective.
Pharmaceutical companies are not regulated. By act of Congress they can charge Americans more than anyone else in the world. By act of Congress Medicare is forbidden to get competitive bids on the costs of drugs as it might be disadvantage to drug companies.
Also: Pfizer.
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