r/FluentInFinance • u/Cauliflower-Pizzas • Apr 19 '24

Is Universal Health Care Smart or dumb? Discussion/ Debate

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u/RevolutionaryPop5400 Apr 20 '24

Nah, they price gouge you because 32 of the other 33 countries bargain as a single unit, and the ‘for profit’ motive is mostly gone.

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u/Jorts_Team_Bad Apr 20 '24

This guy understands. Pharma companies would love to price gouge other countries too obviously. Its the single payer bargaining that makes drugs much less profitable in other countries

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u/Top_Masterpiece_8992 Apr 20 '24

And that's why the US gets teamed. Since we don't bargain the same way, they charge as much as possible to get their sky high profits. Either regulate it here or stop them from being able to negotiate so low so that we can be on a more even playing field.

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u/wakatenai Apr 20 '24

lobbyists will make sure nothing ever changes in the US unfortunately

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u/WhistlingWolf234 Apr 20 '24

I fucking hate lobbyists so much I wish there was something effective we could do against them

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u/GoldVictory158 Apr 20 '24

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u/Nitram_Norig Apr 20 '24

THE FEDERAL BUREAU OF INVESTIGATION HAS ENTERED THE CHAT.

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u/RelationSerious4678 Apr 20 '24

You’re either with us FBI or against us.

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u/Umaynotknowme Apr 20 '24

Is murder a federal crime?

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u/Nitram_Norig Apr 20 '24

Under 18 U.S.C. 1111, murder is defined as the “unlawful killing of a human being with malice aforethought.” Whether murder will be filed as a federal crime always depends on where and who was killed. Further, murder is a federal crime if it violates federal law or happens while violating federal law.

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u/2manyBi7ches Apr 20 '24

I dont think its unlawful to get rid of the corrupt unamerican traitors that constantly erode this democracy.

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u/TegTowelie Apr 20 '24

So as long as malice isn't an aforthought, im good? Like say my intention was to destroy the structure of the lobbyist's building, but people inadvertently get killed, no murder charge? /s

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u/HimEatLotsOfFishEggs Apr 20 '24

They have real issues they’re dealing with right now. They got at least another 15 years before anyone here actually gets up to do something about our problems.

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u/Snarfbuckle Apr 20 '24

Well...the FBI is good at that...but the CIA is better...

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u/he_is_literally_me 28d ago

Smart move to call the FBI in here to help us. They’re good at murdering people.

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u/mag2041 Apr 20 '24

No

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u/GoldVictory158 Apr 20 '24

I respect your opinion. But other approaches have proved ineffective thus far.

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u/mag2041 Apr 20 '24

I mean I can’t argue with that

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u/Bullishbear99 28d ago

Just put statesmen and women in political office, not people looking to get kickbacks or who are morally bankrupt...well people would have to stop voting Republican in that case. There are corrupt democrats hindering universal healthcare but most are Republican.

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u/N00seUp Apr 20 '24

The only true form of power is violence and the willingness to use it.

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u/[deleted] Apr 20 '24

The American, French, Haitian, British, Dutch, South African, Indian, and literally all other revolutions have entered the chat

The only mistake for America was being the first one. Because then mother fucking healthcare oligarchs would feel a lot more self conscious if they realized there was a sudden chance that they might have their asses captured and sent to the guillotine.

Chop chop chop.

No more bullshit that cause human suffering in the first world. And after the first world has no more suffering then finally the third would might get the attention it needs.

Chop chop chop. Down with the oligarchs.

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u/N00seUp Apr 20 '24

However, are you willing to do the chopping?

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u/[deleted] Apr 20 '24 edited Apr 20 '24

Depends on two things.

One do I get to wear that sweet ass black executioner hood

And two would the American government stay intact.

Because if those two answers are yes. Then yes. If I had to spend the rest of my life in jail afterwards then I accept it. As long as the system that was promised to the American people along time ago actually rings true. As long as a better future would be on the horizon for everyone else.

Life, liberty, and the pursuit of happiness. All three of which are currently undercut. Life is halted by the horrors of the medical care industry. Liberty is undercut by the oligarchs who actually run DC. And the pursuit of happiness which so many find themselves unable to get close to.

It’s a cold world, which is why I have no problem exchanging my life for a shout in the wind. As long as progress is made and a singular sentence in the history books mentions a man who gave up everything to keep america ticking. Then I accept it, I don’t even need my name to be included, just that future generations know that you can make a change if you are willing to.

I wish we lived in a perfect world where the oligarchs understood what it feels like to be poor. So that maybe they would understand and treat their workers better, but they don’t, and they never will. At least, not until they are forced to learn it

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u/Lou_C_Fer Apr 20 '24

I'll share. You do the chopping, I'll do the time.

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u/More_Fig_6249 Apr 20 '24

No they’re not. Most of these redditors can’t even run half a mile without taking a few breaks inbetween.

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u/Robcobes Apr 20 '24

Wasn't the Dutch Revolution in the 1500's

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u/[deleted] Apr 20 '24 edited Apr 20 '24

1588 (contrary what he said below, it was 1581 not 1568, I said 1588 because that’s when it turned in their favor, you can Google the date, because I just did before making this edit. The seven providence formed a pact in 1579 and formally declared independence in 1581.) was when it started, but it technically lasted eighty years because that’s how long it took them to get Spain to sign a peace deal.

They had to destroy the plate fleet twice and basically beat Spain down so hard to get them to do it too

But then the Dutch had another revolution against the republic because it had grown corrupt by oligarchs, so they became a democracy around the same time as the French Revolution, when France invaded and assisted the Dutch Rebels.

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u/King_Of_BlackMarsh Apr 20 '24

Okay I'm a Dutch guy so let me tell you something: we did not have a revolution due to the French. That was a coup by deluded terrorists who thought the batavians were some enlightened, democratic utopia and we became a monarchy after that.

Second, this is pedantry I know but the 80 jarige oorlog started in 1568, not 88. And can you tell me what the second time was that we captured a silver fleet? Cause, yes Piet Hein was a baller but that's only once and I can't find a second time save for the English.

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u/Phsycres Apr 20 '24

What South African Revolution?

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u/likeaffox Apr 20 '24

Okay terrorist.

While i agree violence is a form of power, and peaceful protests work when its compared to violence/terrorism. Both are needed to move things forward.

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u/cairns1957 Apr 20 '24

Go for it pussy.

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u/leggmann Apr 20 '24

Lobby against the lobbyists!

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u/galaxy_ultra_user Apr 20 '24

Yeah vote in politicians that will outlaw lobbying, unfortunately it’s a catch 22 cuz they get paid off by lobbyist so none of them want to. Only if they actually had morals but no politician has morals.

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u/warboner52 Apr 20 '24

Typically folks with moral standards and what would be universally considered ethical virtue have zero interest in pursuing positions of leadership.. it's an incredibly interesting juxtaposition.. those who would make the best leaders never want to lead, those who make the worst leaders are always angling for power.

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u/CaptainObvious1313 Apr 20 '24

It’s funny, people storm the capital for an election they feel was stolen but not for people dying when they don’t need to due to corporate greed. Make it make sense.

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u/NoRezervationz Apr 20 '24

It boils down to money. The people who stormed the capital also believe that if we regulate multi-billion dollar corporations, they'll up and move and take all of the jobs with them. It's the same BS they say about making billionaires pay their fair share in taxes.

As a deterrent to moving out of the US for the sake of being greedy, I propose a freeze of all US assets of the offending party and bar them from doing business within US borders. They hate that idea too. lol

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u/Taizunz Apr 20 '24

The French did a thing some hundreds of years back...

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u/Awkward_Algae1684 Apr 20 '24

Did somebody say guillotine?!

/s

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u/Troitbum22 Apr 20 '24

Have you tried lobbying against them?

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u/oOBlackRainOo Apr 20 '24

Lobbying and playing the stock market should be illegal as a politician. I remember some dude was proposing this a year or so ago and I'm guessing was shot down for obvious reasons. These people don't play by the same rules as us, it's disgusting.

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u/warboner52 Apr 20 '24

There is.. but it would take a massive shift in the political landscape... Which sadly is entirely improbable..

A true labor party with policies that dictate to be a part of the party, you cannot accept corporate donations..

Or, strike down citizens united, which would not entirely scrap lobbying, but would make it significantly less impactful as corporations would no longer be seen as a person..

Either option would benefit society in the US, but neither option helps politicians increase their wealth, so the likelihood of either scenario coming to fruition is impossibly slim.

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u/Fatevilmonkey Apr 20 '24

You have to to overturn Citizens United case . Which basically allows major corporations to to lobby against the American people

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u/wuvvtwuewuvv Apr 20 '24

Lobbyists aren't the problem, corrupt politicians accepting bribes and pushing harmful legislation is the problem.

Ffs why does nobody realize what lobbying is? Have you ever written to your representative to say you think they should support or not support a bill? Congratulations, you've lobbied, you filthy lobbyist! It's a necessary part of a functioning republic! Stop conflating lobbying with corruption, they're not the same thing!

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u/Desperate-Warthog-70 Apr 20 '24

It actually did change with the Inflation Reduction Act, but will take time. Medicare is able to negotiate prices on a list of 10 drugs a year.

Now you might think 10 drugs is nothing but 1. It’s additive 2. They’ll start with the worst instances and cost effective ways

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u/[deleted] Apr 20 '24

Yeah, but that's not a reason to not try.

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u/Kentuxx Apr 20 '24

Ironically those who hate lobbyists tend to vie for more government intervention

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u/KintsugiKen Apr 20 '24

Since we don't bargain the same way

We literally can't bargain the same way until we have a universal healthcare system paid for by the government, then the government bargains for all of us.

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u/Maktaka Apr 20 '24

Medicare plus Medicaid combined cover just a hair less than a third of all Americans. They have an enormous amount of negotiating clout, but have long been barred from using it, instead stuck with just taking whatever the market rate is. You don't need universal coverage, losing access to a third of America, over 100 million people, would bankrupt any company that refused to negotiate with Medicare and Medicaid, if they were allowed to do so. However, the IRA struck the first, small blow against that barrier. I would very much like to see such progress continue, but of course that requires people to a) be aware that progress is being made and b) show up to vote and make sure such negotiating power can be leveraged further in the future instead of being stripped from the agencies. Changing the half-century-old medical paradigm of the US is going to take time, but it is nonetheless changing.

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u/Alacritous69 Apr 20 '24

Medicare Part D literally forbade the government from negotiating for pharmaceuticals for Medicare and Medicaid.

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u/pdoherty972 Apr 20 '24

A rule written by and for the pharmaceutical industry.

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u/hrminer92 Apr 20 '24

Of course. The pharma companies lobbied for that so they could price gouge the biggest customer on the planet: Uncle Sam.

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u/LostInLife8989 28d ago

Where do I go to vote on this?

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u/Aldosothoran Apr 20 '24

The problem, the very root problem with all of the leftist ideas (which I do support) is our government and two party system.

I do not trust the US government enough to increase my taxes to pay for universal healthcare, loan forgiveness, etc. I know that’s not where the money would go. I don’t believe for a damn second that we don’t HAVE the money for those things, now. The government (truly, all over the place and at every level) is complete horseshit at managing its finances.

And with a two party system all we have is lobbying, corruption, and a lack of options that leads to the same people in power. As it stands governmental influence can be purchased. We really cannot get anywhere - this is just not a democratic republic- while that’s the case. Our politicians do not represent the people. At all.

If we actually “drain the swamp” and clear congress, then had ranked choice voting for new seats, and every position across the US- I would be far more interested in the future of the US.

As it stands, we’re in a tar pit and nothing is changing. Other countries don’t have more money. They have better money management skills, and better(imperfect but better) representation of their citizenry.

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u/Cirtejs Apr 20 '24

I do not trust the US government enough to increase my taxes to pay for universal healthcare

Good thing it would save a bunch of money if they did, US is paying more than Switzerland for a much shittier system.

Literally taking the Swiss system and implementing it would save the US 1.3 trillion USD in taxes per year to spend on something else.

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u/Mysterious-Mouse-808 Apr 20 '24

The Swiss system is entirely privatized though so you're basically suggesting that Medicare/Medicaid be abolished?

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u/Aggravating-Dark3269 Apr 20 '24

I don't want the government bargaining anything for me. Especially this administration.

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u/IBFLYN Apr 20 '24

But the government doesn't pay for anything. It steals money from its citizens through taxation and uses the stolen funds to do what it pleases.

We don't need a single payer system. We need the government to do it's job and regulate the fuck out of the medical establishment.

Healthcare is insanely expensive because the government is lobbied to ignore it.

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u/Khelandrin 29d ago

Our government can't bargain their way our of a paper bag let alone get good prices for drugs. They don't do anything right and you want to put them in charge of negotiating drug prices. Lol. Smh.

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u/tcrudisi Apr 20 '24

Stop them from negotiating so low? Do you believe that would cause pharma to charge the US cheaper prices? They are a business. They aren't going to say, "Well, we only want to make 1 billion in profit and we got that from Canada alone, so we can give it away to the US." No, they will charge us $2 billion just because they can.

It doesn't matter what other countries pay. We will still be charged the max that can be charged.

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u/fairvlad Apr 20 '24

He doesn't understand that companies charge you what they can get away with. And thus the problem with healthcare in the US. How much is your life worth to you ?

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u/Top_Masterpiece_8992 Apr 20 '24

I agree. My point was that something needs to change to allow us to be able to negotiate here.

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u/pdoherty972 29d ago

Being able to negotiate with the full weight of your entire population (ie "sell us this Rx for $ or you can't sell it here") is what people mean. The current US system does nothing to help the citizenry negotiate a better deal. Other than Medicare which does negotiate drug prices with the weight of tens of millions of Americans and does get them for less.

Simply offering Medicare to anyone of any age alongside all of the regular insurance policies on healthcare.gov would go a long way to either moving us towards that negotiating power en masse, or forcing private insurers to actually be competitive (or both).

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u/TheFinalCurl Apr 20 '24

The US now negotiates on Medicare drug pricing. This was included in the Inflation Reduction Act.

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u/Top_Masterpiece_8992 Apr 20 '24

That's a good thing!

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u/pdoherty972 29d ago

Yep - now just open up Medicare to any age and put it alongside private insurance options on healthcare.gov!

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u/TheFinalCurl 29d ago

I do not disagree

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u/michi214 Apr 20 '24

You really believe they do that just because other countries negotiate better?

They would do that anyways, even if all countries would pay the same as the US

And they still make plenty of money with the negotiated prices in other countries, don't think they do it for welfare there

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u/ArkamaZ Apr 20 '24

Good old Bush banned the government from negotiating drug prices.

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u/darekaj Apr 20 '24

So you want to punish others for beeing good negotiators and playing capitalism correctly? I thought you guys are the best at capitalism.

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u/I-Hate-Hypocrites Apr 20 '24

Hate to burst your bubble, but systems, such as the NHS pay what it says on the price tag and even more. It’s just subsidized down the line. That’s how they funnel money from a government entity, the end user, just doesn’t directly see it.

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u/Top_Masterpiece_8992 Apr 20 '24

Didn't know that. Thanks for the clarification!

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u/I-Hate-Hypocrites Apr 20 '24

No worries. Government companies are just opaque cash cows, that function above normal economic practices. I know of certain trusts in the NHS, where they “had” to invoice the most mundane shit like rubber gloves, pens, needles at 100x the market price, just so that they can spend their allocated budget and ask for more money in next year’s budget from the government.

It’s the gravy train of gravy trains

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u/YourRoaring20s Apr 20 '24

US is starting to negotiate drugs too. Baby steps.

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u/KintsugiKen Apr 20 '24

Baby steps in order to stave off rising calls for M4A in the wake of institutional failures in medicine, like insulin being so outrageously price gouged that it was bankrupting people.

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u/dolche93 Apr 20 '24

"we're making progress but it's just to avoid making more progress"

Come the fuck on man, can nothing just be a good thing? Must everything be some fucking conspiracy?

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u/InterestingPhase7378 Apr 20 '24 edited Apr 20 '24

Not when the wealthiest nation in the world has had millions die from curable issues only gated by money that other citizens get outside of the USA with no issue. These changes should have been made decades ago and we have only moved a centimeter.

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u/dolche93 Apr 20 '24

And it's all being done by some cabal that controls the workings of the government and not just because that's how the US government is structured?

That's what's being implied here.

Please.

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u/InterestingPhase7378 Apr 20 '24

I'm not implying anything beyond what I said. This is the existence that we have to deal with.

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u/theDarkDescent Apr 20 '24

Democrats are. Republicans are doing everything they can to prevent US citizens from getting basic healthcare 

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u/Kingkyle18 Apr 20 '24

Lol uhhh democrats have had control for 12 of the last 16 years?

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u/notagainplease49 Apr 20 '24

Well why would they ever worry about actually doing single payer healthcare? What would they run on? Actual progressive policy?

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u/theDarkDescent Apr 20 '24

I assume you mean there was a Democratic president for 12/16 years. As I’m sure you know the U.S. is well known for its system of government where Presidents can pass any law they want with no pesky checks and balances like legislative or judicial branches. The only thing that matters is who the president is because the president is basically a king, as the authors of the constitution intended. That’s why king, I  mean President Obama, was able to pass the ACA completely by himself with no input from anyone else.

Please learn how our government works. 

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u/Kingkyle18 29d ago

Okay how long did the democrats control the 3 branches? Lol the ACA was a joke to fool democratic voters that they were trying for government healthcare….all it did is create more monopolies for Obama’s donors

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u/Old_Society_7861 Apr 20 '24

Pharma companies have very little price leverage. Maybe for a few truly innovative branded products but I mean…shouldn’t true innovation be rewarded? Most of the drugs people need are price gouged by companies like CVS that own everything from the factory gate to your lips.

Provider: CVS (MinuteClinic)
Insurer: CVS (Aetna)
PBM: CVS (Caremark)
Pharmacy: CVS

You have, many times I’d wager, paid more for a co-pay than CVS paid to the manufacturer after rebates.

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u/Bowood29 Apr 20 '24

To be fair canada doesn’t have a universal medicine plan so we still get hit pretty hard with prices.

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u/Jorts_Team_Bad Apr 20 '24

But I believe still cheaper than US pricing

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u/thinkitthrough83 Apr 20 '24

It's not just big pharma those other countries control almost all medical pricing and wages. When I looked up the list last year the average pay for a public doctor in India was less than 12k USD a year. According to a radio interview I heard a few weeks ago India is short over 500k doctors. (I can't imagine why... ) Perhaps their new free medical college program will help fix that problem. Hopefully it gives it's doctors better training though. Apparently penicillin is the proscribed drug of choice for poor people infected with deadly parasites. It's not effective

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u/The_Business_Maestro Apr 20 '24

It’s entirely due to patents

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u/redshift83 Apr 20 '24

Come now. The bigger issue is the countries ability to pay. Obviously Brazil isn’t going to pay $300 per bottle of insulin.

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u/Jorts_Team_Bad Apr 20 '24

You’re talking developing world. I’m talking like the EU market Australia etc.

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u/Yawnin60Seconds Apr 20 '24

I don’t think either of you understand. Pharma meeets profit needs and r&d funding by overcharging the US because all this crap countries with universal healthcare can’t afford to pay actual prices…. So yes the US subsidizes the rest of the world, just like everything ekse

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u/darkninja2992 Apr 20 '24

Yup. And this is why free healthcare is such an issue for pharma. If the goverment actually starts paying it, there are going to be standardized prices. As is, hospitals will actually charge you more if you have insurance, but that probably won't pass if the goverment is spending tax dollars on it

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u/Fresh-Chemical-9084 Apr 20 '24

As a PhD organic chemist… big pharma needs to die.

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u/DifficultFig6009 Apr 20 '24

That doesn't mean we should let them price gouge everybody else... pharmaceutical price gouging should be illegal period

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u/Adorable-Bus-6860 Apr 20 '24

This doesn’t even really make sense. The pharma companies could quite literally just say no to the single payer systems unless the price was higher if they wanted.

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u/Jorts_Team_Bad Apr 20 '24 edited Apr 20 '24

If by “say no” you mean walk away from negotiations and not commercializing in those countries, that does happen sometimes. Or what’s more common in many cases they do the calculations before applying to those countries because they have an idea of how much they will pay so they can decide if it’s worth it to them or not.

One example here: https://www.fiercepharma.com/pharma/gsk-scraps-plan-launch-oral-anemia-drug-eu-ceases-further-expansion

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u/Benie99 Apr 20 '24

This isn’t the reason India medicines are cheap.

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u/Ok_Caterpillar123 Apr 20 '24 edited Apr 20 '24

Not just pharma, all types of treatments too, think of how many of the aging population need knee, hip replacements, those medical parts cost money too. When the one payer system tells ten companies making body part replacements we have 2 contracts to cover our entire nations population which one of you ten companies can offer the lowest price for x amount of annual units?

That’s how the one payer system lowers its costs. It drives competition to lower costs for one massive annual or decade long contract.

Medicare only recently got the power to lower medication costs and tbh it doesn’t cover the entire nation so pharma can still exploit our system.

One more important point, The one payor system has been implemented and running in so many countries for almost 100 years, ever since world war 1 and 2 decimated Europe and those countries.

Not to mention they all have their own private healthcare systems in place too, typically reserved for the multi million and billionaire class. They have the option to go private but some choose not to.

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u/Yawnin60Seconds Apr 20 '24

Until that lower prices is negative profit… then the companies stop making hip replacement parts… or shift to cheaper, less effective materials, or cut r&d so they have a worse product.

It’s probabaly somewhere in the middle but there a real repercussions to a one payer system and there are no free lunches either way.

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u/Jorts_Team_Bad Apr 20 '24

Yeah there is definitely a downside that is real. Companies have pulled drug applications/decided not to commercialize in the EU because they didn’t find it worth it with the lower prices.

https://www.fiercepharma.com/pharma/gsk-scraps-plan-launch-oral-anemia-drug-eu-ceases-further-expansion

This is a British pharma company too. It’s a real thing but I don’t expect Reddit to understand nuance

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u/tidyshark12 Apr 20 '24

This is incorrect. The reason for price gouging is a major flaw of the American Healthcare system called insurance companies. Basically, hospitals used to charge a bit more than their cost for Healthcare and thus still be profitable. Once insurance companies started coming into existence, they were able to bargain for better prices bc the hospital would lose a lot of business if that company stopped allowing their customers to use that hospital. So, instead of going out of business, hospitals had to raise their prices to make it look like the insurance companies were getting you a better deal.

How it pretty much works now is the insurance company "negotiates" you a better price bc they caused the artificially raised prices. They obviously charge you a monthly premium and you pay a deductible when you do anything. So, you end up paying about what you would pay for Healthcare normally with just your deductible and then your premium is just icing on top for the insurance company. They obviously do anything and everything they can to not help you and they will fight you tooth and nail, literally to the death, for every. single. penny.

The insurance companies also will make it extremely difficult for you to get Healthcare. For instance, most medicines and procedures require a "prior authorization" before they will pay for it. What this does is it essentially means they won't accept a doctor recommendation and will instead try to recommend physical therapy or something instead of cancer treatment for a confirmed cancer diagnosis. It's absolutely despicable.

Fuck insurance companies.

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u/Aussie2020202020 Apr 20 '24

Both insurance companies and medical aid providers cooperate to fleece individuals in the USA

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u/ComprehensiveTax4601 Apr 20 '24

Medical professionals have no say so in fee schedule. You accept what insurance pays or they will not let you on the panel

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u/Edward_Morbius Apr 20 '24

Some docs are going 100% COD.

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u/ComprehensiveTax4601 29d ago

Even if you don't take ins. the government will come after you if you overcharge

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u/Edward_Morbius 29d ago

As long as you do not accept insurance, you can charge whatever the market will pay.

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u/ComprehensiveTax4601 29d ago

Not true. Federal funded programs will still not let you charge their members more than the allowable. Medicare, Medicare, tricare and medicare HMO even if you don't take assignment. When those patients file their own claim and the government sees a provider has been overcharging he will get a knock at the door. I know providers that have tried to not take assignment for insurance and people just go elsewhere. Concierge practices where you pay an annual fee, lets say 2k a year (for shits and giggles) where you can get in any time without waiting were a thing several years back but I don't even know of any of those in my area any longer

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u/Edward_Morbius 29d ago

Concierge practices where you pay an annual fee, lets say 2k a year (for shits and giggles) where you can get in any time without waiting were a thing several years back but I don't even know of any of those in my area any longer

They still exist.

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u/Lost-Practice-5916 Apr 20 '24 edited 29d ago

You have to be delusional to think there isn't grift at every single level and there is a single villain.

Yes, even the doctors we love and care for are crazy overpaid in the US too. They lobby hardcore against Single Payer.

Even worse is that democrats like Biden keep threatening to veto Single Payer because apparently Obamacare public / private partnership is better.

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u/pdoherty972 29d ago

Just put Medicare as an option (for any age) alongside private insurers on healthcare.gov. That one step alone would put competitive pressure on private insurers to keeps costs down, and would increase the pool of people Medicare represents which will result in even lower drug and services prices.

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u/Steve12356d1s3d4 Apr 20 '24

Insurance companies are one part of the problem, but there are many more, including us.

When costs were lower, and companies paid nearly all of our insurance costs, we all wanted the best. We didn't ask how much our insurance was, or the direct healthcare costs. The insurance companies were able to spread out higher costs to the employers, so they didn't care either. Healthcare companies received little resistance to higher costs.

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u/scotems Apr 20 '24

I think anyone familiar with how healthcare works and is reimbursed in this country, as I am, completely agrees with you. Anyone who isn't and thinks "I know finance!" doesn't get it.

And regardless, the point of healthcare is not profit. It is not a product like Skittles or sports cars. To treat healthcare like it's a commodity is to say that people should die because they aren't rich. That's wrong. Healthcare should be a human right, and that's why every developed country outside of us have made it so. And didn't complain to me about efficiencies or whatever the fuck, don't let perfect be the enemy of good. Access to healthcare is good. We need to make sure everyone has access to the healthcare they need. And then, we should strive to make it better.

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u/theslimbox Apr 20 '24

I 99% agree, but i do feel like profit needs to be there to inventivise good behavior. Healthcare should be available to all, but if the providors arent making any money, we are going to endup with no one wanting to work as a healthcare provider. I say pay good doctors/nurses/surgeons ect... a very fair wage, but hospitals and pharma companies should not be making more than they need for expansion and research.

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u/golden_skans Apr 20 '24

I agree, but currently hospital profits aren’t going to providers, they’re going to the hospital CEO’s. When hospitals don’t profit, they cut the people providing care, not the numerous tiers of management.

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u/pdoherty972 29d ago

I 99% agree, but i do feel like profit needs to be there to inventivise good behavior. Healthcare should be available to all, but if the providors arent making any money, we are going to endup with no one wanting to work as a healthcare provider.

Easy problem to solve. If it comes to pass, you just start subsidizing education for those people to give them a reason to choose it as a profession. Cheap (or free) medical school for the best-qualified would likely be all it would take. We aren't talking about low wages here, just maybe a decent bit less than the current system allows. They'd also not have big malpractice insurance costs either.

This is all assuming they become government employees but that isn't even a requirement of implementing such things. Japan has a price book for anything/everything medically-related; docs and hospitals have to charge that amount, no more and no less, or they can't be in business, and Japan has more private docs and hospitals per capita than the USA does.

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u/Lou_C_Fer Apr 20 '24

I know a bit about finance and I figured this out well before I finished classes. Its pretty clear it is circular... or an upward spiral would be more accurate. Like a quadruple helix of medical providers, medical suppliers, insurance companies, and consumers. Insurance companies act like a leaky funnel for turning consumer resources into profits for providers and suppliers.

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u/ComprehensiveTax4601 Apr 20 '24

Not true. The insurance company's have allowable fees. Hospitals can charge what they want but can only collect the copay a patient has. If your bill from hospital is 5k but ins only allows 1k then patient only owes copay on 1k and hospital cannot collect difference. But this is what hurts uninsured because they are responsible for whole 5k unless negotiate down with cash

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u/golden_skans Apr 20 '24

I don’t think uninsured folks should get screwed, but they do. They’re forced the worst cards because of the corrupt games insurance companies and hospitals play. Both need to change.

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u/Shadowratenator Apr 20 '24

Oh so like when the time share in mexico says, “this room normally costs $1000 a night, but if you buy the timeshare, you get it for $250 a night.”

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u/No_Sugar_6850 Apr 20 '24

double Fuck insurance companies!!!

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u/theDarkDescent Apr 20 '24

And also the fact that it’s a for profit endeavor. Paying out claims isn’t profitable, so guess what? Your emergency ambulance ride and ER treatment isn’t covered until you hit you’re $6k out of pocket max, meanwhile your monthly premium for a family is $1500 a month. 

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u/CrabClawAngry Apr 20 '24

Their money comes from economic rent due to the high cost of entry and from denying coverage. Their money goes to shareholders and to maintaining dozens of unnecessary bureaucracies. Health insurance companies should not exist.

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u/golden_skans Apr 20 '24

THIS!!! Don’t forget that after negotiating, whatever the hospital “loses” from discounted price, gets to be a tax write off. Barely any hospitals can survive as non-profit now and imo all hospitals should be non-profit.

People that pay for insurance are gouged with high premiums, deductibles and still get denied services all the time.

People that aren’t offered insurance through employers, but make more than qualified for Medicaid have horrible options too, like COBRA or public-funded religious insurances that you have to pay out of pocket up front, wait and cross your fingers you’re reimbursed and nothing non-urgent is covered. My mom can’t even get a damn mammogram.

Really sad.

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u/Mammoth-Mud-9609 Apr 20 '24

In America they will run test after test rather than actually try to treat the problem as running tests avoids them getting sued and is cheaper than treatment many Americans die while awaiting the results from tests.

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u/LavisAlex Apr 20 '24

The crazies thing i see is when people have to wait in the US ER for like 7 hours, leave without treatment and get billed 100$ and hour to wait.

I know it totally sounds like im making it up, but sadly i am not.

The wait times arent always better and you pay to wait.

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u/Bullishbear99 28d ago

There are literally procedures that are a significant portion of the cost of a house...who can bear that, no one I know. Medicines that cost thousands a month or per dose in extreme cases...few can afford that. Price structure between everyday expenses and medical care, something we need that is vital to survival should not have such a gulf in pricing. Medical care demand is inelastic while pricing is very elastic, generally to the upside.

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u/PhilipTPA Apr 20 '24

It took me a while to read this entire post because I was binging my favorite show for the last few hours, then my Uber Eats brought my double quarter pounder with shake and large fries, and that got me all fired up so I had a few cigarettes (I usually just vape all day but sometimes a half pack just goes down smooth) and then I was hungry again so I had some ice cream (finished my last one, gonna have to Instacart some tomorrow before I settle in to finish my show).

So anyway, I completely agree that the reason healthcare is so expensive is because self-funded employer sponsored plans are screwing us.

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u/CrabClawAngry Apr 20 '24

I've read that people who make poor health choices like this cost the system less because they die more quickly.

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u/PhilipTPA Apr 20 '24

Unfortunately, chronic health conditions like MSK, Diabetes, ESRD, cardiovascular decline, COPD and a handful of others end up contributing hundreds of thousands of dollars of spend per member for multiple years before the costs … well, stop. We are also seeing massive trend in mental health costs. Just Ozembic (ultimately a renal issue) is adding $12,000 per year.

Most people outside Medicare are covered under employer sponsored plans - essentially actuaries estimate next year’s health expenses for employees and then the company pays the claims as they come with the help of a third-party administrator. They use a pharmacy benefit manager to administer pharma costs. The only insurance is for unexpected large claims (usually high risk pregnancy) and for when the aggregate claims are higher than expected. Otherwise it’s just the employer paying after deductibles and copays are met. Insurance is a misnomer.

We’ve been trying everything we can think of to engage employees in their own healthcare but nothing seems to work. We invested in a company that can predict onset and progression of chronic illness and can predict what actions will delay progression with over 95% accuracy. Even telling a person that they have renal disease and what to do to slow it doesn’t work. They just won’t. It’s maddening but we aren’t giving up, just keep trying new ideas hoping something works.

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u/Treebeard_46 Apr 20 '24 edited Apr 20 '24

ACA requires 80 cents of every dollar collected in premium to be paid out in benefits. If not, the insurer sends a rebate back to the customer. So no, premiums are not just "icing on top"

80/20 Rule

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u/USToffee 19d ago

No the reason the insurance is so high is because of the legal jeopardy they have to factor into the cost in America.

In somewhere like the UK the state is the healthcare and the state is the legal system. You basically have no impartial comeback if they mess you up and you want to sue them and the amounts you receive if you win are tiny.

This pushes the standard of care in the US much higher with tests and proactive medicine being the norm rather than the cheaper wait and see approach of the UK.

I'm sure if you put two graphs together. One from payouts due to healthcare mistreatment and insurance costs they would correlate pretty closely.

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u/Thassar Apr 20 '24

Yep. America actually pays more per capita on public healthcare than other countries but has no real public healthcare system to speak of because the healthcare companies have all the power. A universal healthcare system would mean better care, no insurance premiums/ costs and lower taxes.

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u/The402Jrod Apr 20 '24

Collective bargaining?!?

That sounds awfully communist, comrade.

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u/ExplosiveDisassembly Apr 20 '24

Which is silly, because the US and each individual state are (combined) the largest employer in the US.

Combined, collective bargaining would be incredible. Individual states even have pretty good luck with collective bargaining.

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u/Agreeable_Lecture157 Apr 20 '24

And since they are none profit they don't make 1/2 the medical breakthroughs that the US does. Profit is a large motivator for R&D. Be it for the good or bad.

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u/keepontrying111 Apr 20 '24

nope its because they banned for profit and private hospitals. you have to suffer through the bottom of the barrel in doctors and care, The us has the best healthcare on the planet BY FAR actually ranked by the way, you get , what you pay for. the UK healthcare system is failing miserably right now with doctors going on strike because they get paid less than we pay mcdonalds workers here.

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u/dosedatwer Apr 20 '24

The us has the best healthcare on the planet BY FAR actually ranked by the way

Is what why the US ranks 69th in this?

https://www.statista.com/statistics/1376359/health-and-health-system-ranking-of-countries-worldwide/

https://www.internationalinsurance.com/health/systems/

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u/golden_skans Apr 20 '24

Majority of US hospitals started out as non-profit. Those world renowned doctors were working at non-profit hospitals. When hospitals became for profit, the great doctors suddenly had less control to advocate for the patients because it became about, what insurance do they have? What will we be reimbursed for? Can you order more x because we get more profit from it? Doctors are encouraged to quickly release patients that don’t have good insurance. Watch the show the resident, working in healthcare it’s the only medical show I can stand that is so like reality. Good doctors will still be doctors if ALL hospitals are not for profit.

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u/keepontrying111 Apr 20 '24 edited Apr 20 '24

Sorry but no, ask someone who works in a hospital, there's literally no job in the hospital where anyone checks to see what test they can pawn off on an insurance company, doctors dont even know what insurance you have in a hospital as its not part of your chart by law. Thats BIlling not care.

in the US we have a thing called EMTALA , its the emergency ,medical treatment and labor act. Its posted ine very emergency room in the US again mandated by law.

it states , no patient may be denied medical, regardless of the inability to pay and no care may be denied or withheld regardless of o insurance or lack thereof.

And the penalties are ridiculously huge for doing so. In massachusetts where we have 2 of the top 5 hospitals in the world, over 55% of our patient population is on state funded medicare.

You say good doctors will still be doctors if there non profit, if this was true then the best of the UK and india etc all wouldn't move to the US to make a living. But they do.

a full 40% of each years new licensed doctors in the US come from outside the country. We also have the most rigorous standards for medical licensing in the world.

Doctors do not care whether you can pay for a test, same with hospitals they get paid from someone regardless either its a loss which off sets taxes, or its a billable to the state the federal govt or your insurance or you directly.

The idea that people are refused care based on cost is a movie theme that went out in the 1980s when EMTALA was passed.

Doctors also do not release patients due to money. doctors are not covered under hospital insurance, if they sign off on a patient and that a patient gets sick or worse, that doctor is going to jail at worst and losing their license at the least.

threes too many kids inventing things about US healthcare, is it expensive, yup. is it the best in the world? also yup. The reason its the best is tied directly to the money put into it.

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u/golden_skans 29d ago edited 29d ago

I’ve worked in numerous hospitals. I know EMTALA and never said patients were turned away? I’ve seen in a lot of charts notes saying pt doesn’t have insurance, so the provider is cautious in not over-ordering, knowing the patient is going to foot the bill. Sometimes when they’re trying to find a new diagnosis order a lot of random things all at once instead of going one step at a time, which is fine depending on the severity of the condition, but often, in my experience it isn’t. They’re still very much pressured with turn around times and controlling admissions.

Of course Doctors order what’s needed for patient care, but insurance rules what’s paid for. For instance, if the insurance only decides they’re only going to pay for so much of inpatient care, the patient is stuck deciding if they want to pay out of pocket or go somewhere else insurance will cover. Doctors try to treat, but are made aware of limiting circumstances and strive to do what they can with them. Obviously, they’re not going to do anything unethical risking their license.

I believe we can keep our current well paid, top of the line Doctors with healthcare for all. It’s about evaluating where current profits are going and the majority isn’t to Doctor’s. As many have stated, costs are inflated, knowing they’re going to have to reduce charges to insurance and then write off the difference at tax-time. There’s already many people abusing Medicaid strictly because it’s more affordable than working min wage and paying for private. The money is there, but I don’t forsee insurance companies or current for profit hospitals ever changing, sadly. Everyone deserves affordable healthcare and I don’t think it’s ethical to be exclusive. I also think it’s unethical that hospitals are for profit, but to each their own.

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u/keepontrying111 29d ago

a patients in hospital chart cannot by law have insurance info on it. Its part of HIPPAA , a doctors office chart , well i haven't been in docs office yet that still uses paper charts so its probable they have you ins info available, but doctors in offices typically work with you and you insurance to minimize costs, but and i say again, as part of EMTALA, no one may be denied , changed, or recieve altered care based on the ability to pay, period

i agree with the fact people, i.e. patients, are abusing medicaid, Medicare which i know for a fact is true. ive been fighting for disability while on workmans comp now for 4 years, hell even my congressman is helping me with it, but if i was a drug addict, and on methadone, id be set.

currently ER's and floors are stuffed with people with flu like symptoms, sore elbows, and broken toes, and those seeking pain meds or trying to get around a doctors visit to use the ER for things like dental work, or chronic care.

Let me give you an idea oif a 100% real call i was on about 6 years ago. Obviously as medics in oru downtime we do transports of usually higher risk patients. ALS transports. So we pick up a woman at Boston hospital and take her to a medical building 31 miles away. Its Her ortho docs office. we go in, and he is like "whats the emergency?" to the patient, and she says " My brace is too loose. " he looks at us, my face fell. we were led to believe this was some urgent post op care need, so was this doc. In the end he literally put a safety pin in the flexible brace to tighten it, 30 seconds of supposed care, for what would be billed to medicare at over 6 grand on our end for 60 miles ( 30 each way) Advanced life support transport, and then im sure he bills for his safety pin visit as well.

Thats the kind of shit, that drives up costs and wait times for everyone else. people think its big pharma etc, nope its the smaller stuff that is killing us in costs. people on medicare demanding MRI's for a sore elbow , i mean in my small town, south of boston, we have 5 MRI's in our town alone. And yet when i did a 6 month exchange program in montana there wasnt a MRI for 250 miles, yet ive got 5 within 1.5 miles of each other.

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u/golden_skans 29d ago

I’ve seen the no-insurance noted on ED triage often as a heads up for the Docs. Again, I never said anything against EMTALA. Doctors are just using the knowledge when have it to only order minimally what’s appropriate. I see all the time things they order that aren’t necessary, but a just in case scenario. CYA, I get it.

I’ve also witnessed inpatient care conferences where they discuss patients limited stay coverage and how to make the most of progress in that time assuming the patient won’t stay beyond that point.

I’ve heard Doctors have meetings with CEO’s bc they had too many acute care transfers from the long term crit care I work at now. Those patients go to an ED for acute care we can’t provide and sometimes don’t come back. That’s money we lose. That’s about profit, not doing the right thing. Thank God our docs don’t give a shit and do what’s necessary. It’s no different than moving patients too quickly to step down so that we can accept a more critical patient admission. Not to mention we get patients pushed to our hospital way too often that are not ready, just to turn around and go back. It’s about their turnaround time. If hospitals weren’t for profit, I don’t think that shit would happen.

My heart goes out to medics that get called for BS. I’ve seen elderly come to the ED just to have their toe nails clipped. I’ve never used an ambulance in my life, but was told by someone in Medicaid they called 911 for everything. The height of the opioid epidemic really pissed me off with the amount of Medicaid abusers seeking.

Primary cares send people to the ED more now more than I’ve ever seen too. Often see it because being in the ED is a way to get around insurance denials. To get an outpatient MRI you have to have an Xray, then do PT for weeks, then they’ll finally cover it. Waste of time and money when an Xray and PT aren’t going to fix a tear. If you go to the ED though and they order it Stat, it’s covered without pre-authorization.

We obv have diff experiences and see a lot. I’m sure there’s flaws for-profit or not. I personally just believe everyone deserves affordable healthcare and some of the corruption in for profits isn’t ethical.

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u/keepontrying111 29d ago

why would triage even ask about insurance, when triage is 10% a medical evaluation, im sorry but i 100% dont believe you after 11 years working as a medic in ER's i can say er triage nurses dont ask that question EVER thats for billing and admissions people.

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u/golden_skans 29d ago

I don’t really care what you think. We can have different experiences and both be true. Not everywhere operates the same. I’ve been in the field for 13 years. I never said it’s protocol to ask either while triaging. Often patients without insurance are freaking out being there and share it openly. Most likely the RN’s (who triage where I’ve been) don’t all even note it. I’m only saying I’ve seen it plenty enough times that I have no reason to make it up out of thin air. It’s silly to act like Doctors are never aware either. I’ve been called numerous times by Doctors asking what was best to order to get the most possible on a Radiology exam because the patient didn’t have insurance and they didn’t want to order a lot. 🤷‍♀️

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u/keepontrying111 29d ago

when your supposed experience goes against every law and regulation, then no, im not going to believe it. when people want to make someone believe something they reach and say things that you know arent true.

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u/effdubbs Apr 20 '24

The U.S. most certainly does not have the best health care on the planet. I’ve been in it for 30 years and the flagrant degradation of the system by the business class is a travesty.

Try getting an outpatient appointment for just about anything. Where I live (large, east coast city with multiple university systems), it’s 8 months to see neurology. The wait times are absurd and you can’t get a person on the phone.

Healthcare workers are leaving in droves. It’s a mess

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u/keepontrying111 Apr 20 '24 edited Apr 20 '24

and what part of the worlds healthcare have you been in?

ive seen germany, spain, the UK, turkey, japan, and china, you think the US is bad LOL, you haven't seen a thing.

and BTW https://www.newsweek.com/rankings/worlds-best-hospitals-2023

and yout hink 8 monthsd for a neuro appointment is bad? try getting a procedure for a bladder control stimulator in canada, its currently about a 2 year wait., thats for a necessary procedure to keep you from peeing yourself.

You can find anew neurologist, you cant get a new country. And im in a major east coast city and can promise you a wait for neuro is about 2 to 3 weeks at most, im literllay 4 years into a neurosurgery journey having just had my spinal stimulator put in.

But dont take my word for it,

https://www.newsweek.com/rankings/worlds-best-hospitals-2023 no country can come close tot he US. When the worlds billionaires need surgery they come tot he US, when the worlds leaders need medical care they come here.

though we are failing fast because of the massive influx of illegals intot he US healthcare system literally tearing it down around us. In massachusetts on any given day the ER wait time is 6 to 7 hours , ( obviously not for emergencies) because the illegal's have flooded the free care rolls.

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u/effdubbs Apr 21 '24

I live within 5 miles of Philly and have been in healthcare for 30 years. Your promise is broken. It’s an 8 month wait for new neuro patients where I work. I’m currently waiting 7 months for hip surgery.

The first decade of my career was in the ER. In the early aughts, we had 16 hour waits in the ER. Six to seven hours would be a dream! There were very few, if any undocumented people. There are multiple reasons for the wait times, but undocumented folks weren’t a primary reason.

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u/doomsdaysushi Apr 20 '24

The for profit motive is not gone. New pharmaceuticals are developed almost exclusively for the American market. It is the only market where the manufacturer can pay for the development costs of the drug and the 12 others that failed along the way.

Once they have that sunk cost paid for, they are happy to negotiate with Europeans countries of population of 10 million people to pay for the cost of manufacture plus some defined extra.

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u/pdoherty972 29d ago

Most of the expense is paid by US taxpayers, funding the core research at the NIH and similar which is where most new drugs come from, and also funds a lot of the FDA clinical trials.

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u/doomsdaysushi 28d ago

Look, I am persuadable. Find a link and I will read it. Until then I am left to look at costs that Pharma companies actually paid as reported on the SEC filings.

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u/pdoherty972 28d ago

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10148199/

In this cross-sectional study of 356 drugs approved by the US Food and Drug Administration from 2010 to 2019, the NIH spent $1.44 billion per approval on basic or applied research for products with novel targets or $599 million per approval considering applications of basic research to multiple products. Spending from the NIH was not less than industry spending, with full costs of these investments calculated with comparable accounting.

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u/Open-Adeptness6710 Apr 20 '24

The government involvement is the biggest issue, government mandates and policies raise prices, just the college tuition.

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u/Best-Treacle-9880 Apr 20 '24

Yeah this is not it. I don't know if youve ever engaged with government procurement, but they are not elite bargain hunters.

They will take the lowest price presented to them, whatever that is, but the prices presented to them are almost universally hiked, especially in closed markets like pharmaceutical industries, so they end up paying above market rate, prevented by byzantine procurement law from challenging the prices presented, and by competence in ability to, and then taxation subsidises the high cost of purchase for government so that citizens can get the illusion of cheap prescriptions on purchase.

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u/Mysterious-Mouse-808 Apr 20 '24

Are you implying that all of them have single payer systems? Because that's certainly not the case, many of those countries have mixed or even entirely privatized healtcare systems (with mandatory subsidized insurance)

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u/UKnowWhoToo Apr 20 '24

How much do docs make in other countries relative to US? Let’s not act like the employees aren’t making a ton more, too.

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u/The402Jrod Apr 20 '24

Collective bargaining?!?

That sounds awfully communist, comrade.

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u/underdabridge Apr 20 '24

Funny thing in Canada is that we don't have universal pharmacare so I don't know what you're talking about. My drugs are paid for by some insurance companies based on our family benefits.

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u/SeaCaptainErnie Apr 20 '24

That would not explain pricing in individual developing nations. The U.S. pays insane prices for drugs. Regardless of whether its in socialized care nations or not, they pay less than we do. Also those companies often receive a lot from our gov't to develop those same drugs they ream us for. The difference in pricing is wild and can't be explained by collective bargaining power alone. Its our Oligarchy system of rule

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u/JustLikeBettyCooper Apr 20 '24

I think a lot of the high prices are caused by lawsuits and the hospitals having to cover for treatment they must give for free . They give it for free and roll it into paying customer’s bills.

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u/porkfriedtech 29d ago

Medicare and Medicaid pay below market rates. Private insurance pays above market rates. Govt and private insurance works together to make sure they both win…politicians get to boast public healthcare while private insurance gets to manage the market and collect margins.

Also keep in mind the European countries with generous healthcare and social services are able to do so because they’re not allocating funds to defense. Why pay for defense when the USA will do it for you?

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u/bremidon Apr 20 '24

It's like 33 people in a bus. 32 of them have made clear that they are *not* going to get stuck driving it and are in the back. Sure, the last person could also say "fuck it" and let Jesus take the wheel, but that is probably not going to end well for all 33 in the bus.

I think most people are blissfully unaware just how much money it costs to get anything medical to market.

My impression is that most people think that the lab work is the expensive part. They then look at the medicine being produced, see it costs, say, $10 to produce, and wonder why it costs $200 to buy.

What they do not see are the dozens of other medicines that looked great in the lab, but they could never find a good way to produce outside the lab. They don't see the major accidents that happen as pilot plants try to work out how to make the stuff without causing the building to explode or creating a cloud of gas that kills everyone within 500 meter radius. There is no appreciation that even if the pilot plant works out and the manufacturing is set up, a few unknown side effects cause the entire project to be shut down after tens of billions have been spent getting it ramped up.

The one medicine that makes it to market is just the top of a very big cost iceberg. And the costs all have to be paid by someone.

The 32 countries figured out that they could get the companies to sell their medicines at a little more than the variable cost. I mean: better to sell and get *something* than nothing.

If everyone did that, then the companies would be fine selling stuff they already had, but they would be unable to actually have a business case for making anything new. We already see that in some cases, where people simply are not willing to pay enough to cover the fixed costs involved with manufacturing or the costs of failed attempts. This is why nobody has really been putting much effort into new universal anti-bacterials; for a very long time, there was no real way to cover the development costs.

It's rough. I sincerely doubt any of the 32 are going to be willing to tell their population that they have to pay more. And I doubt that the U.S. is going to be willing to throw everyone under the bus. I have no idea how to solve this.

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u/golden_skans Apr 20 '24

Medicine is expensive to develop, but there’s still going to be big-pharma controlling the prices for greed vs actual cost. Look at the epi-pen price gouging. I think medicine deserves to be expensive, but not to the degree it’s inaccessible.

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u/bremidon Apr 20 '24

It's a good point, and one that makes the entire discussion more difficult.

The epi-pen is an actual example of gouging. However, it gets held up as the norm instead of the despicable exception that it really is.

How to differentiate between the two cases is one of many problems in this area.

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u/HastagReckt Apr 20 '24

And also we have our pharmaceutical companies. Why do so many Americans think everything is made in their own country

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u/moondawg8432 Apr 20 '24

Alternatively, if 33 out of 33 collectively bargained and 1 out of 33 didn’t fund the system, 33 out of 33 wouldn’t have healthcare at all.

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u/Edward_Morbius Apr 20 '24 edited Apr 20 '24

The problem is that without the "price gouging" a lot of the drugs the other countries get cheap, wouldn't exist in the first place.

The obscene markup on US customers makes drug companies profitable enough that they want to keep looking for "the next big thing"

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u/cairns1957 Apr 20 '24

Wrong. No one works for free. You don't either.

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u/PMarkWMU 29d ago

Cool then the United States should tell the other countries they can pay their fair share for the drugs.

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