This is some good stuff:
Health insurance companies are rapidly adopting a new pricing system for very expensive drugs, asking patients to pay hundreds and even thousands of dollars for prescriptions for medications that may save their lives or slow the progress of serious diseases.
With the new pricing system, insurers abandoned the traditional arrangement that has patients pay a fixed amount, like $10, $20 or $30 for a prescription, no matter what the drug’s actual cost. Instead, they are charging patients a percentage of the cost of certain high-priced drugs, usually 20 to 33 percent, which can amount to thousands of dollars a month.
I am suspicious about single payer, but as I have often stated, I think it is an inevitability- big businesses want it, the number of uninsured in this country is untenable, our national standards for care have been declining (and you can choose your own statistic- infant mortality and so on), so my personal opinions really don’t matter much. I think the only questions regarding single-payer in the US are when, and how bad will the special interests loot the treasury in the process (will it be another boondoggle like Bush’s welfare plan for big pharm?).
Regardless, when I read crap like this, my attitude is how can it be any worse than the current system?
The Other Steve
Two questions do come to mind.
Why do some drugs cost so much?
Are there alternatives?
Why are drug companies still allowed to advertise? and ponder me this, why do we never see ads for generics?
jnfr
As long as the health care companies make more profit by not providing health care than they do by providing it, this system is simply not functional.
Every other industrial country provides universal health care, for lower cost with better outcomes. It can be gone, it’s just not in the interests of the insurance companies to allow it.
Walker
Marketing and advertising. Despite what drug companies will tell you, their R&D is a pittance compared to what they do to get doctors to prescribe their drugs.
I have talked to many doctors that are aware of this problem and have started to refuse drug company “gifts” in protest against the heavy-duty marketing carried out by drug companies.
Zifnab
I see ads for CVS and Walgreens on a regular basis. And, at this point, your eighty different strengths of Advil and Tylenol and Bear are pretty close to generic. Why do we never see ads for Generic Asprin? :p
And drug companies are allowed to advertise – ostentatiously – to inform people that remedies exist for their aliments. Since seeing a doctor is expensive (especially without insurance), Big Pharm has to let people know that their conditions are even treatable or no one will actively seek to cure their restless leg syndromes and night time seasonal allergies.
Still, all that doesn’t bother me nearly as much as the ban on foreign drug imports. I visited Sweden last year, and everything – from food to laundry to cab fare – was more expensive than in the states, with the sole exception of some allgery meds I picked up. 30 tablets of Loratadin Sandoz cost me about $10. I could have picked up 10 tablets of Allegra for $30. You do the math.
The Other Steve
Oh yeah, my latest… “How fucked up is this system” story.
I’ve been having severe stomach pains the past six months. It felt much like the gall bladder attacks I had 4 years ago. But since they removed my gall bladder, that seemed wrong.
I went to see a gastro specialist. He said it’s probably acid reflux, but he wanted to do an endoscopy to take a look and make sure.
The endoscopy is performed not in the clinic but in their parent hospital next door. Without thinking about it, I thought sure. It’s a pretty routine test, it’s like 15 minutes, in and out.
The test went fine, and he didn’t find anything but basically confirmed his original diagnosis. Told me to take prilosec, and truth be told it’s helped considerably.
This was back in january. A month later, I get a bill for $500. Turns out my insurance just this year added a $500 copay for hospital services. The total procedure cost $650, but they wanted me to pay $500 of it, solely because it was at the hospital.
If the test had been performed at the clinic, then it would have been fully covered minus like a $50 copay.
I mentioned this to the his nurse, and she was dumbfounded. She’d never heard of this before, but was going to mention it to the doctor. I suspect they’ll end up billing things like this through the clinic now instead of the hospital. Not that it’ll make any difference to me, but what a fucking joke.
The “hospital” is 50 feet down the hall from the “clinic”. That’s it. When I had read the insurance plan and they talked about this $500 copay, i assumed they were talking about a visit for surgery, or something like that. Not tests.
Yeah, our system is fucked up.
The Grand Panjandrum
This weeks edition of Frontline will cover health care around the world. They have a few trailers up, and it looks to be quite good.
The Other Steve
There was a hospital up in Duluth that banned all SWAG. They hauled something like 20 shopping carts filled with pens, notepads and such… shipped it to a school in Nigeria.
The Other Steve
You’re snarking me, ain’t ya?
Just how many people in this world have Restless leg syndrome?
RSA
There was a nice article in TNR several years ago (during their slide to the dark side) that laid out an accounting of where pharmaceutical R&D funding comes from. The answer, if I recall correctly, is mainly NIH. That is, our taxes. We have a screwed up system, apparently, in which pharmaceutical companies can do an enormous amount of research on the public dime, but then take private profits via patents and so forth. (And these same companies, again if I recall correctly, put more money into patent protection than they do into basic research.)
John Cole
Obligatory Malcolm Gladwell Prilosec link.
Kirk Spencer
John, I think you’re right to be suspicious of single payer health care. I suspect in the end it’s going to be much like democracy – the worst possible solution, just better than everything else.
fwiw, I tend to believe that government should be in charge of, if not the predominate server of, any industry which provides for the “public good”. That’s because as a rule, public good is unprofitable. It’s made profitable by denying service to the “too expensive”. My favorite basic example is the US mail. UPS and FedEx are much more “efficient”. They manage by not having regular service everywhere in the US. Or by charging extra fees to cover the extra travel time, as the case may be.
Medical services are made profitable in two ways. First, by maximizing profit margin on a service. Second, by increasing repeat business. Both are the reason most insurance programs don’t encourage a ‘healthy lifestyle’ program — the healthier you are, the less often you need services, and the less likely you are to need the high-price service when you do need something.
The argument of the libertarian is that you can control the price and service because if it’s “too much for what’s provide” you’ll go to the less expensive or more efficient provider. That would work in a true free market (probably). But as long as a company can ensure that it’s the only provider of drug X, or that the only available solution for problem Y is drug X, then the market is not free. That there are good reasons (of public good) for making these restrictions does not change the fact of the non-free market.
So I think, in the end, single payer is the worst possible solution except for all the others.
mightygodking
This isn’t entirely accurate. In healthcare, the equivalent of “repeat business” is “routine physicals and addressing chronic conditions early.” There isn’t any incentive for insurance companies to cover this, because it adds additional expense to their bottom line; they already know it’s simply cheaper to cover much less of it, then argue strenuously and try not to pay your claim when that hypertension you’ve left untreated for years explodes into a world of personal badness.
The argument of the libertarian is that you can control the price and service because if it’s “too much for what’s provide” you’ll go to the less expensive or more efficient provider. That would work in a true free market (probably).
The problem is that this doesn’t work in health care, because in health care if you’re offering less expensive insurance, it’s because you’re reducing costs, and if you’re reducing costs, it’s because you’re screening out and denying service to very sick individuals, and if you’re denying service to very sick individuals, then what’s the point of getting insurance in the first place?
Speaking as someone who lives in a single-payer system (Canada), I’m the first to admit it has problems – it was underfunded for about fifteen years and we’re only just starting to fix all the problems that chronic underfunding caused (because new doctors and nurses and medical infrastructure don’t just, like, appear when you decide you want some – it takes time), and it tends to be overly conservative when adopting new medical technology (like MRIs).
But these are minor side issues. The simple truth is that for the vast majority of users, the Canadian system works perfectly well and provides excellent care.
Roket
There is only one solution to the problem and that is to remove insurance companies from the equation. I find it offensive that insurance companies are making a fine and dandy profits off of my illnesses.
Incertus
Someone ought to send a copy of “The Goose That Laid the Golden Egg” to the heads of the insurance industry. They’re going to be the ones who get us single-payer faster than any agitating will ever do it, and I’ll be applauding the entire time.
jenniebee
My college job was at the Science Museum of Virginia, in the Education department, and George “Macaca” Allen was the governor at the time. We got the word that we needed to run the museum “more like a business.” So we stopped development on new exhibits that would have cost some dollars, and the museum closed on the two days of the week with the lowest attendance numbers, and the Omnimax theater showed a travelogue about Indonesia because it was cheaper than showing Blue Planet, and a little more money was put into – I shit you not – the annual Christmas Trees from Around the World display because that brought in the crowds.
The thing is, the mission of the museum wasn’t to make money or to put on a display of International Christmas Trees, even though people do like it when politicians can scrape money out of budgets and people do like seeing pretty trees during the holidays. The mission of the museum was to educate people about science, and even if they lose money every year, if the museum fulfills its mission the city makes more money from tourists and school groups coming in to see the museum, and the country is richer from having more people knowledgeable about science and more kids getting excited about science and possibly going into careers in scientific fields. It’s hard to track on the museum’s bottom line how many more chemistry Ph.D.’s are going to be earned twenty years later for every hundred dollars invested in a crystals exhibit, and that’s why you don’t run a museum like a business.
It should be the same with health care. The mission of health care should be to create a healthier population. You mix the profit motive into it and you get a situation where if you live paycheck to paycheck, even with insurance you’re only one high fever away from damaging your credit rating, and people with more serious illnesses are facing bankruptcy or just dying because they can’t afford the treatment, but Viagra is cheap and plentiful.
Health Care isn’t a business, and we have no business running it like one.
jake
Meanwhile our fearless leaders tell us that if we purchase the same drugs made by the same manufacturer from Canada we’ll die horrible, boil-covered deaths.
Yep. The members of AHIP are already less popular than herpes and this will only make it harder for their pet Congress critters to obey their wishes. Bleating about socialized healthcare will only take you so far before people start hurling rocks.
jcricket
I know you were being semi-rhetorical, but It won’t be worse, and everyone’s waking up to that. I think health care is going to be like Jim Crow laws, where Republicans are going to actively fight to be on the wrong side of history on another critical issue. They’re ideologically incapable of seeing health care the correct way, much like their anti-science agenda shapes their views on Global Warming.
Even if we implement a system as crappy as what England has, with their paltry (worst out of most developed countries by 1/2) NHS spending/funding, we’ll get better results for everyone. Yes, everyone. Remember, the rich (10%) will still be able to pay for the “best of the best” care and jump to the front of the line, at least for a while. Everyone who is poor, uninsured or increasingly underinsured (50% of population) will get better, cheaper, more comprehensive, simpler to understand coverage (that doesn’t go away when they lose their jobs, switch jobs, etc). Those of us in the middle (40%) will, at worst, get something that’s a sideways trade (better in many ways, worse in a few).
The most telling thing is that doctors (like my father and my brother-in-law), who as recently as a decade ago were staunch critics of any kind of nationalized health coverage, are now begging for it.
BTW – As many have already pointed out the “innovation” from Big Pharma that is supposedly threatened by single payer is often not innovation. More importantly, most of the innovation comes first (as Tim F can probably attest) from government-funded basic science research. If we’re so worried about pharmacalogical innovation, let’s go to single payer and massively ramp up government spending for basic research.
Let’s take the same amount of money we spend now, and spend 1/2 on national single-payer coverage, and the other 1/2 on research & development. We’d get the best coverage in the world, by a mile (or at least a kilometer). While we’re at it, get rid of the distinction between “drugs” and “herbs”, and “western” and “alternative” medicine, so we can show people that most of the $14 billion they spend on “alternative” therapies is just wasted money. Imagine the stimulus effect that might have as they instead buy useful things, like iPhones, or big screen TVs :-)
jcricket
Amen. The only acceptable future for a system like ours is the dustbin, unless society all agrees that if you get sick, you should just die/suffer. If we can just agree on that, then our goal should be to just can the health insurance thing altogether.
Shygetz
The reason insurance companies don’t cover health maintenance so much is that they know that twenty years down the road, when the health maintenance program will actually start to reap benefits, you are most likely to be in a different job with a different insurer who will be reaping the benefits of your health maintenance program. So, why bother?
Insurance companies want you healthy–they make the most money when they collect (and invest!) your premiums and have no pay-outs. But when there is as much mobility from insurer to insurer as there is, there is no reason for an insurer to pay for you to be healthy so someone else can reap the rewards. So they just try to limit their current costs, which has little to do with making you healthier.
Health care in the free market has the problem of infinite pricing power for limited supply; how much would YOU pay to save your life? How long are you willing to shop around for the most cost-efficient hospital when you are having a stroke? Are you willing to negotiate price in the waiting room before they crank your chest open and give you that bypass you need?
Single payer might have problems, but I have yet to see a single workable market solution for the problems of health care. By now, I’m willing to risk the socialist boogeyman.
Jeff
Part of the reason these drugs cost so much is lack of volume as well as the US is the only place these drug companies can make a profit.
One MS treatments cost $25k a month. Part of the reason is that it is an infusion treatment that takes hours at the doctor’s office. However, it also used by less than 200,000 people.
We should stop calling the pharmaceutical companies evil for charging a rate that allows them to make a profit, take on the risk of lawsuits, and developing new more powerful medications. Instead, we should go after the Europeans and Canadians for not paying their fare share for the drugs from which they benefit. . They, by force of law, make the pharmaceutical companies charge less. Volume discounts I understand; other means of forcing the costs back on the companies is another thing entirely.
Egilsson
I work for an insurance company. Insurance companies make more money by obtaining premiums for a pool of people, and then “managing the risk” within that pool. Optimally, that will result in excluding those in that pool most likely to get sick.
So, if you off load costs for medical treatment back on the sick people, that’s a huge improvement in someone’s performance plan, and will result in them making more money. Could be a lot more, and in this day and age, an executive just needs to score for a few years and then they are set for life. They don’t actually have to face long term consequences.
Of course, this approach totally defeats the concept of shared risk that is the nature of sustainable insurance, but this country has really retarded views about medical insurance.
Our system is so messed up.
People really need to be outraged, and to stop buying the right wing nonsense about “socialized medicine”.
Bush himself says that everyone is covered; they just have to go to the emergency room. So, apparently we are covering everyone, we are just doing it as stupidly and ineffeciently as we can.
It’s time to try a smarter way.
D-Chance.
*dingdingdingdingding
We have a winnah! We live in the era of boutique drugs, where R&D can’t be easily spread around. That new drug may, indeed, be a miracle; but if it only has a few thousand customers yet cost millions of dollars and years of time and red tape to develop and produce… that’s the blessing/curse of modern medicine. We’ve reached the point where everyone may have a pill of salvation; but, if you’re illness is not widely spread, then the smaller base must by necessity share a larger cost.
Real numbers example: if I have a product that costs $1 million to produce, and I have 1 million customers; then I break even by garnering just $1 from each of them. But if I have only 100 customers, then they need to fork over $10,000 each.
Lesson: if you’re going to get sick, catch something common.
Kirk Spencer
I’d buy this, I really would, if I didn’t read financial statements. Let’s take Pfizer, just for an example.
In 2007, Pfizer had $48.5 Billion in gross revenue. Its R&D was $8.1 Billion. It had a final net income – after everything including taxes and ‘one time expenses’ – of $8.1 Billion. In other words, it has a profit to revenue of 16.7%.
And 2007 was a bad year for Pfizer.
So I hear what you’re saying, but it doesn’t match what I see when reading the financial statements.
Next?
John
Canadian guy here…
I sprained my ankle last week walking the dog. After some ice, elevation, a few ibuprophen, and a whiskey, I realized that the pain wasn’t going to go away, and made for Vancouver’s St. Pauls.
After 30 minutes wait I was having my vitals taken.
Another 10 minutes to see a doctor.
10 minutes waiting for an xray.
20 minutes for results and final consultation then I hobbled out the door.
Total time spend including travel – 2 hours, and all I had to do was show my healthcare card. Yup… us commies got it all wrong.
That said, results vary across the country, but that’s because other provinces are full of rightwingers who are still too stupid to realize that if you want good care, you’re going to have to pay. They’d rather save $300 bucks on their annual taxes, and buy a new stereo every year, then ensure that they have access to solid healthcare.
Seriously, stop letting these bloodsuckers rip you off when you’re sick. Show them the door.
Pat
It is truly disgusting that those that truly need what they have been paying for years are now given only the sharp end of the stick. All of the comments have been correct in the conclusion that our system is broken and needs to be fixed. Placing the blame on conservative or liberal, Republican or Democrat is not taking care of the problem nor is it a full and true picture of how the system works. Kaiser for example is a health care system that was established for and continues to be a union/liberal/democrat supporter. They worked behind closed doors with Hillary on her ill begotten health care reform years ago. In no way could you call them conservative/republican controlled. Yet they have this 4th tier system for the federal employees. The end result of these high dollar charges to very sick people will in many cases be the same as the one the liberal voters in Oregon put into law in order to protect an individual’s right to die. Someone that is very sick and does not want to be a burden to their family can choose to die in either case (don’t take your medicine or do take the medicine) and who profits …. not the patient, family, not the community. THE DRUG COMPANIES AND INSURANCE COMPANIES. What is the answer? Much to complicated for one person to get it right but I think that the first step should be a bipartisan one. Get rid of every one that now calls themselves Senator or Representative. Wouldn’t it be nice to have Statesmen rather than lifetime high rollers making decisions about the lives of everyday Americans? We have a system that is out of touch, out of control and in my opinion out of their minds most of the time.
Mark Mills
Although I agree insurance companies shouldn’t have to cover near 100% of the cost of a drug that would help ease the symptoms and possibly the progression of a chronic disease, I do think the drug companies have a responsibility to ease the cost to the insurance companies and make their money from volume sales when there may be a very large population of people in need of these drugs.
For example, there are 1.3 million people in the USA alone and many more throughout the world with Rheumatoid Arthritis. Humira is a proven drug for easing symptoms and progression of moderate to severe RA along with many other diseases. Yet the average cost for 2 injections per month is $1500.00. Most insurance companies are requiring one third of the cost be paid by the insured making the cost $500.00 a month plus the monthly premium. Reducing the cost by just 1/3rd would make it accessible to more disease sufferers and reducing the cost by ½ would benefit even more people…and the drug companies would still make their millions.
I have moderate to severe Rheumatoid Arthritis and was on Humira for 3 years. It was a like a miracle. I was able to function better and with much less pain. It is a wonderful drug and helped me be more active and productive in society. When the co-pay increased to $500.00, I could not afford it anymore. I have been without Humira for six months now and almost daily feel and see the deterioration this disease is causing to my body, both physically and mentally. To function daily is quit a chore. I’m not looking for handouts just a far price on these drugs so that I will have a chance to live the rest of my life somewhat comfortable and be productive. And…I would like to know I will be able to hold my grandkids when that time comes.
Chuck Butcher
John, I suspect that your suspicion relates to the idea that socialized medicine will be a problem versus the market model (I didn’t say “free”). If you look at the mess from a market perspective it becomes clear that it is already socialized. Because emergency medical care cannot be denied and because even draconian bankruptsy laws won’t finance that care, the insured do it. Your private health care policy is the socialized medicine we operate under today. It simply shifts the burden very unfairly and leaves a profit motive for some. It is not a case of whether or not socialized medicine, it is a matter of doing it reasonably. The only “whether not” model is to deny emergency care without guaranteed payment.
You notice I do not address any of the pros/cons of preventive care, etc; simply the existing model.
Shawn Pendley
Kirk,
I hear what you are saying, but it’s really not that simple. It’s easy to blame the big, bad Pharma, Inc. but just remember that Pfizer is a public company — required to make its stockholders happy.
Jeff had a point. What most people don’t understand is that it takes years and years to develop a drug costing millions of dollars (most drugs never even make it to phase II despite millions having been spent), and then they only have a couple of years to make a profit before the patent runs out. Then they have to find the market.
ImJohnGalt
Dude, just because you include numerals in your “example” doesn’t make it a “real numbers” example.
Show me a drug that cost $X million to develop that wasn’t underwritten by NIH grants, and then show me what the size of the market for that drug was, if you want to convince me. That would be a “real numbers” example.
I call serious bullshit on most of these claims. The bulk of the spending that Pharma companies do is on marketing, not R&D. They also spend way too much money “tweaking” existing products to avoid patent expiry than developing new drugs.
If Canada was not paying enough for the Pharma companies to recoup costs, they would stop selling to Canada. Free market FTW! Amirite?
Oliver's Neck
Chuck,
On first blush that’s a really good argument in favor of change.
As I am an advocate of single-payer I would frame your argument as a hybrid economic and moral one – finishing by offering the moral choice of whether or not to entirely deny healthcare to the “poor”. (scare quotes to denote that, particularly within this context, that would be a significant group)
Furthermore, if one were inclined to choose the more truly market-based approach offered in your argument they could be led down an investigation as to what point of care denial they would be comfortable with – thereby pointing out that very few people would be able to handle all healthcare costs all by themselves (even with insurance) and the amount of expert knowledge one would need to truly know if he/she could meet that financial burden would be as staggering as the final bill.
Hmmm, good stuff – thanks. Is it originally yours?
Kirk Spencer
Shawn, you lost me.
Pfizer spends ten cents of its annual revenue per year on R&D. Notionally – and we can certainly expand the math if you wish – this means that it takes one year to recover ten years of development of a given drug. Two for twenty years. Since the life of an exclusive drug is… I forget, is it ten years or seven? Let’s assume it’s that narrow seven.
Now you’re probably going to mention all the drugs that didn’t pan out. At which time I’m going to point again to the fact the R&D cost is TOTAL. In actuality the 10 cents per dollar of revenue INCLUDES the failed drugs.
For fun… Pfizer spends about 20 cents per dollar in “cost of revenue”, and another 10 for “R&D”. It spends roughly 30 cents per dollar on “other sales and administration.” That’s… a heck of a lot of promotional goods and dinners for the doctors.
Yes, there’s a point in the argument that the drug development companies must cover the cost of development, and must charge some places to cover the ‘forced low cost’ in others. But the point keeps running into the fact of the companies’ profits.
carsick
I’m self employed and a single parent (yes, sometimes dads do get custody). I’m also insured. I just got a bill for around a thousand dollars for an MRI on my back. I pay over $9k a year for health insurance for my preteen and myself. The number is less than $10k only because I have a high deductible.
The funny thing is, my insurance company raised my rates just weeks before the MRI bill arrived. I’m now expected to pay over $10k a year! Woo Hoo!! I must be rich!!
Of course, I’m just another elitist for Obama.
Anyone know of a good boxed Pinot I could buy so I can live up to the media definition of an Obama supporter?
I’m gettin’ the feeling I’m supposed to be either an angry black man or livin’ on Martha’s Vineyard.
Amanda
“my attitude is how can it be any worse than the current system?”
A-FREAKIN-MEN
Honestly, at this point I’d take the hobbled and underfunded British NHS over what we have. At least everyone’s guaranteed care and they don’t have to go into bankruptcy or have a bake sale if they get cancer. So there’s rationing. There’s rationing in our system too — we just don’t name it rationing. And I would bet their rationing at least has a tad of logic to it, as opposed to our system where people with tons of $ get as much care as they need but people who are in true need either wait forever or are out of luck, period.
No plan is a panacea. But I just don’t see how any system could be worse than ours — horrible outcomes for the highest price. INSANE.
Thursday
Biggest reason why a single-payer system is cheaper:
I was installing a new deadbolt on my front door when the drill caught, and I got a sore wrist. I figured it for a sprain (old plug-in Makitas can BITE) and gave it some drugs and rest. The pain was still there (and just as sharp) two hours later, so I decided to have it checked out.
Ends up I had broken my scaphoid – the wrist bone that anchors your thumb. So much for it being a sprain!
The visit and X-ray cost me nothing, and the doctor insisted I have a hard cast on it. Had the visit cost me, say, $20, how long would I have waited before going and having it examined? And if the X-ray had cost another $100, how many days would I have waited for that? How much would I have simply tried self-medicating instead? You can buy an awful lot of generic aspirin for $120, after all.
Long and short of it: the scaphoid has it’s own blood supply, and it’s very easy for a broken one to pinch off the artery that feeds it. When that happens, the bone dies, resulting in permanent debilitating arthritis in that hand. Go a day without using the thumb of your primary hand and see what happens.
Care to hire a one-handed locksmith or electrician? No worker’s compensation for me, so no retraining paid for. I’m out of the jobs I know, and into… what? I sure won’t be earning enough to pay taxes, and may have to go deeper in debt until I can match payments with income again.
All told, that ounce of prevention saved one hell of a lot of cure.
And that’s not even going near diseases that are easily cured if detected early enough – amazing how many of them resemble the flu in their early stages…
moderate indy
But the pharma companies have to charge that to recoup their R&D costs………. What a joke! First Big Pharma has been making record profits for nearly two decades. Profits people, not revenue (which has also been at record levels). That means they are recovering their costs, and making so much cash that they can’t use accounting tricks to hide their cash. If you knew all the unethical crap that almost every company employs to keep their patents active you’d crap yourself. Perhaps the most telling stat about R&D when it comes to the industry is that 3 out of every four drugs in the developmental pipeline are simply slight derivatives of drugs that already exist and are huge profit makers. The so-called R&D is almost always a different deliver system. The end game is simple……they want a new patent on an old drug. For instance, the patent for Claritin was almost up and was soon to be generic. The solution? make Clarinex which is the exact same drug except you only have to take it once a day or once a week. For the convenience, you get to pay 10 times the cost. Most people don’t realize there is no difference so when the doctor prescribes the new drug, you simply pay the piper. 75% of all R&D is spent on this type of “new” drug.
The real problem with our system isn’t the uninsured. That is morally reprehensible. The under-insured is where our biggest problem lies. Some say that up to 85 percent of the population is at risk of economic collapse from a catastrophic illness. How many people in Canada or Europe have had to declare bankruptcy due to medical bills? Zero. It is the leading reason in the US , (or second behind divorce, I can’t recall) Single payer universal with the ability to buy supplemental is the best solution. Consider the boom in new small businesses, if people don’t have to worry about purchasing health insurance. Will it mean higher taxes, of course, but my guess is that considering how much most people pay to their employers as part of the premiums, the majority of people will actually end up with more take home pay