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You are here: Home / Anderson On Health Insurance / Do you pay too much for your penis pump?

Do you pay too much for your penis pump?

by David Anderson|  January 16, 20146:44 am| 42 Comments

This post is in: Anderson On Health Insurance

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If you do, you’re in the same boat as Medicare:

Vacuum erection systems — commonly known as “penis pumps” — cost the Medicare program $172 million over a six-year period, roughly double the amount the average American consumer would have paid at the retail level, according to a report released Monday….

The reason for this overpayment is that Big Dick has Medicare paying a high flat rate for a fairly simple and easily substitutable piece of durable medical equipment.  So let’s  talk about a couple of different payment models.

The administratively simple model is a fee schedule model where Medicare or anyone else says that for item or service Z, they’ll pay X amount.  This model is simple to run but it places minimal pressure on providers to lower costs.  A low cost provider has minimal ability to get customers to flock to the low cost value.  A high cost provider whose costs are of just slightly below the fee schedule won’t be force to cut costs.

Reference pricing is a modification of the fee schedule methodology.  Medicare says it will pay X and if an individual wants a more expensive penis pump, they’ll get X from Medicare and pay the rest out their own pocket.  If the price is under X, the individual pays nothing and Medicare picks up the rest.  Setting X at an intermediate level that cuts off some of the more expensive providers should save money while also at least giving the illusion of choice and option space.

There is one more, market based system to get penis pumps at good prices.

The final way that Medicare can pay for fairly generic durable medical equipment is to write a fairly specific set of specifications and then put those specifications out for bid.  Bidding for some types of durable medical equipment has been going on since 2011  and unshockingly, it has saved money.

This works because Medicare is often the largest buyer of medical equipment in the country.  Standard economics would predict that a big buyer of easily substitutable products made or sold by numerous entities should be able to use its size to get a great price.  Unfortunately, competitive bidding is a fairly isolated and unusual strategy as Congress is in hoc to Big Med that is scared of actually competing.

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Reader Interactions

42Comments

  1. 1.

    Baud

    January 16, 2014 at 7:09 am

    So let’s talk about a couple of different payment models

    Yes. I’m sure that’s what we’ll be discussing in this thread. Payment models.

  2. 2.

    TR

    January 16, 2014 at 7:13 am

    Payment models? Where’s the money shot?

  3. 3.

    Big R

    January 16, 2014 at 7:16 am

    There’s so many MORE tags that should be on this post beyond “wonkery.”

  4. 4.

    Botsplainer

    January 16, 2014 at 7:20 am

    I thought a penis pump was a separate 75 buck tip after a private lap dance.

  5. 5.

    NotMax

    January 16, 2014 at 7:28 am

    Nothing to add, really, as the post covers the long and the short of it.

  6. 6.

    Ash Can

    January 16, 2014 at 7:29 am

    I admire Richard’s nice, smooth segue from the discussion of dicks to the mention of a Congress that, if it actually gave a flying fuck about controlling government expenditures, would have long since required Medicare to bid on contracts.

  7. 7.

    Deffrey Jahmer

    January 16, 2014 at 7:30 am

    Where do you live, Botsplainer? Thanks to a generally crappy economy here in NC, a full-on HJ is a private dance +$30, tops. Most dancers will rub you off through the pants as a standard feature in the VIP room. Of course, some clubs are less of a jack shack than others.

  8. 8.

    Baud

    January 16, 2014 at 7:39 am

    Just a quick reminder that requiring insurance to cover birth control is totes immoral.

  9. 9.

    Richard Mayhew

    January 16, 2014 at 7:44 am

    @Baud: I am unaware of my audience and all internet traditions

  10. 10.

    Soonergrunt

    January 16, 2014 at 7:53 am

    Why cover penis pumps at all? The very idea is fucking stupid.

  11. 11.

    Baud

    January 16, 2014 at 7:54 am

    @Soonergrunt:

    It’s socialized fucking.

  12. 12.

    Botsplainer

    January 16, 2014 at 8:00 am

    @Deffrey Jahmer:

    That was a rate at one of the better Key West gent’s clubs, as I understand.

  13. 13.

    raven

    January 16, 2014 at 8:06 am

    This is much more interesting than ANOTHER FUCKING POST about whatever the fuck her name is.

  14. 14.

    Pamoya

    January 16, 2014 at 8:09 am

    So he is asking the government to subsidize his sex life. What does that make him? It makes him a slut, right? It makes him a prostitute. He wants to be paid to have sex. He’s having so much sex he can’t afford to get an erection. He wants you and me and the taxpayers to pay him to have sex.
    http://en.wikipedia.org/wiki/Sandra_Fluke

  15. 15.

    Baud

    January 16, 2014 at 8:11 am

    Pen!s pumps may be expensive, but balloon juice is always free.

  16. 16.

    Sarah, Proud and Tall

    January 16, 2014 at 8:16 am

    @raven:

    I know, right?

  17. 17.

    Ben Cisco

    January 16, 2014 at 8:19 am

    @Big R: “Wang-ery”, for one.

  18. 18.

    Big R

    January 16, 2014 at 8:25 am

    @Ben Cisco: I was thinking “wankery,” but that works too.

  19. 19.

    Big R

    January 16, 2014 at 8:26 am

    @raven: @Sarah, Proud and Tall:Does anyone ever see raven and SPT in the same room at the same time? That is a rather suspicious exchange….

  20. 20.

    Sarah, Proud and Tall

    January 16, 2014 at 8:27 am

    @Big R:

    I can’t believe we don’t have a Wankery tag.

  21. 21.

    Big R

    January 16, 2014 at 8:30 am

    @Sarah, Proud and Tall: Despite the 2009 crackdown on tag creation, I feel like this one is justified. Go for it!

  22. 22.

    Sarah, Proud and Tall

    January 16, 2014 at 8:32 am

    @Big R:

    Only if you haven’t realised we are all DougJ.

    Cole gave up blogging about two years ago, and Doug seems to be bored with sock-puppeting him, which is why we got both Betty and this “Richard Mayhew” persona.

  23. 23.

    Big R

    January 16, 2014 at 8:34 am

    @Sarah, Proud and Tall: Wait, if YOU’RE DougJ, and I’M DougJ…then who’s flying this plane?

  24. 24.

    Sarah, Proud and Tall

    January 16, 2014 at 8:35 am

    @Big R:

    Done.

    If I vanish, it was Cole what did it.

  25. 25.

    Big R

    January 16, 2014 at 8:43 am

    @Sarah, Proud and Tall: Cole won’t do anything to you; he’s too afraid you’ll tell everyone about the time on Pitcairn with the seven Polynesian girls and three Adelie penguins.

    DougJ, on the other hand, has no shame. He’ll announce his peccadillos from the rooftops. Of course, since his peccadillos include shouting on rooftops, this is sort of a twofer for him.

  26. 26.

    Deffrey Jahmer

    January 16, 2014 at 8:45 am

    @Botsplainer:

    Ah, that would explain it. $70 alone will get you a special massage in Los Angeles.

  27. 27.

    SRW1

    January 16, 2014 at 8:49 am

    @Soonergrunt:

    Catch 22! You can’t fuck stupid with a limp dick.

  28. 28.

    Richard Mayhew

    January 16, 2014 at 9:01 am

    @Sarah, Proud and Tall: Updated, just for you!

  29. 29.

    Sarah, Proud and Tall

    January 16, 2014 at 9:07 am

    @Richard Mayhew:

    You’re a treasure.

  30. 30.

    MikeJ

    January 16, 2014 at 9:15 am

    @Baud:

    Just a quick reminder that requiring insurance to cover birth control is totes immoral.

    The (very stupid) justification that I’ve heard is that ED is an actual medical problem that requires and responds to treatment and that birth control is a way of preventing something natural from happening.

    I don’t begrudge anybody treatment for any medical condition. I think it would be shameful to deny somebody treatment just because we would rather giggle about it or refuse to talk about sex at all. Of course I also think that when a doctor prescribes birth control, insurance ought to pay for that too.

  31. 31.

    Big R

    January 16, 2014 at 9:20 am

    @MikeJ: The response is that pregnancy is nothing more than an opportunistic parasitic infection; birth control is preventative health care, and thus under ACA must be covered with no co-pay (oh, look; right result, stupid reasoning. The best we can hope for from Republicans these days, I think).

  32. 32.

    Matt

    January 16, 2014 at 10:20 am

    If Medicare buys the penis pump, does that mean we get to watch the fucking (by El Rushbo etc logic on contraception)?

    Wait, Medicare… Lemonparty… NEVER MIND.

  33. 33.

    Cervantes

    January 16, 2014 at 10:28 am

    Do you pay too much for your penis pump?

    It turns out I definitely paid too much for my goose denippler.

  34. 34.

    Villago Delenda Est

    January 16, 2014 at 10:38 am

    @Big R:

    It will be difficult for a man in Georgia and a woman in Australia to be in the same room.

    Just sayin’.

  35. 35.

    Villago Delenda Est

    January 16, 2014 at 10:42 am

    @MikeJ:

    Of course I also think that when a doctor prescribes birth control, insurance ought to pay for that too.

    Of course, the doctor might very well be prescribing birth control pills for a medical condition, not for contraception, which was the case that Sandra Fluke was testifying about…and not herself, by the way.

    This did not stop certain parties from making even greater asses of themselves on the public airwaves, however, to savagely characterize Fluke as a working girl who wanted a government subsidy for her personal expression of sexuality. You know, sort of like using the public airwaves to bloviate about Fluke’s sexual activity in a totally fact free manner.

  36. 36.

    currants

    January 16, 2014 at 10:45 am

    @Pamoya: THIS.
    @MikeJ: Medical or mechanical? You know, hydraulics? Just curious.
    @Big R: Can we use the same definition and apply the same logic to … you know … abortion? Or … why do I think the problem is something to do with XX-COOTIES-GROSS?*

    * (where XX=female, of course)

  37. 37.

    Villago Delenda Est

    January 16, 2014 at 10:45 am

    @Soonergrunt:

    Well, does the VA cover various medications for limp dick syndrome? Not that you deal with that on a daily basis, as an IT person, but you might glean some info as you are performing your IT duties.

    I know my doctor asked (once) if my plumbing was working properly, as if to be fishing for the opportunity to add to my already extensive list of medications.

  38. 38.

    Austin Danger Powers

    January 16, 2014 at 10:51 am

    That sort of thing ain’t my bag, baby.

  39. 39.

    The Ancient Randonneur

    January 16, 2014 at 11:37 am

    OK this might be the best comment thread ever. Not the subject matter but the fact that the spoofing and trolling has gone so meta we can’t find DougJ anymore. Where’s Waldo has got nothing on BJ.

  40. 40.

    divF

    January 16, 2014 at 12:55 pm

    @The Ancient Randonneur: I know, I’ve been sitting in a cafe reading the thread and giggling to the point where the other lounge lizards here are starting to stare.

  41. 41.

    slippytoad

    January 16, 2014 at 2:34 pm

    @MikeJ:

    don’t begrudge anybody treatment for any medical condition.

    Au contraire, I vehemently begrudge these withered old Congresspricks their socialized off-jacking.

    I took care of my body, and I don’t feel like I should be subsidizing their artery-clogging, virility-sapping overindulgent ways.

Comments are closed.

Trackbacks

  1. GOP Still Obsessing Over Growing Success of the Healthcare Act | The Daily News Report says:
    January 19, 2014 at 11:25 pm

    […] citizens; anyone sixty-two or older usually has Medicare.  (And just as an aside, why does Medicare spend $ 29 million a year to pay for penis pumps?  No, […]

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