Couple more strikes against letting health insurance cover everything

[charrison]

Doc in the boxes are opening up at the local grocery stores. Menu prices, $65 without insurance to see a PA and there is a real doctor on call. Reasonable prices for those without insurance.

The allergy medicine allegra went OTC this month. Before it went OTC it was $30-$50 copay with insurance for a 30 day supply. This month it went OTC and you can get a 90 day supply for $35.

Allowing insurance to be involved in every healthcare transaction has warped the market.

Markets work when you let them.

 

[Infohawk]

Doc in the boxes are opening up at the local grocery stores. Menu prices, $65 without insurance to see a PA and there is a real doctor on call. Reasonable prices for those without insurance.

The allergy medicine allegra went OTC this month. Before it went OTC it was $30-$50 copay with insurance for a 30 day supply. This month it went OTC and you can get a 90 day supply for $35.

Allowing insurance to be involved in every healthcare transaction has warped the market.

Markets work when you let them.

The only real hope for fans of free market medicine (which we haven't had for decades before anyone quips in) is that doctors and patients will become so frustrated with all these HMO / regulated medicine routes that they just decide to deal directly with each other. There's still a long way to go though. Doctors aren't necessarily great business people and don't even know their own prices sometimes.

 

[Londo_Jowo]

Doc in the boxes are opening up at the local grocery stores. Menu prices, $65 without insurance to see a PA and there is a real doctor on call. Reasonable prices for those without insurance.

The allergy medicine allegra went OTC this month. Before it went OTC it was $30-$50 copay with insurance for a 30 day supply. This month it went OTC and you can get a 90 day supply for $35.

Allowing insurance to be involved in every healthcare transaction has warped the market.

Markets work when you let them.

I used to get Allegra last year at a $20 copay for a 90 day supply. I'm damned glad I use Astelin spray now which is a $20 copay for a 90 day supply.

 

[Bowfinger]

[ ... ]
The allergy medicine allegra went OTC this month. Before it went OTC it was $30-$50 copay with insurance for a 30 day supply. This month it went OTC and you can get a 90 day supply for $35.

Ummm ... based on my experience, either your health insurance or your doctor is deficient. My experience is roughly the opposite of yours; this OTC change is substantially increasing my cost. I was paying a $5 monthly co-pay for an "Allegra" prescription. There is a difference, however. When the patents on Allegra expired, my doctor switched me to the generic, fexofenadine. Doctors who continued to prescribe the expensive branded version weren't doing their patients any favors.

I'm also curious where you're finding a 90 day supply of OTC Allegra for only $35. I'm finding it more in the $50 to $60 range.

Allowing insurance to be involved in every healthcare transaction has warped the market.

Probably true, but I don't think your example is a good one. It's more an example of the way intellectual property laws protect innovation at a cost to consumers. I suspect it's also an example of why big pharma spends more on marketing than it does on R&D. I'm sure many doctors continued to prescribe the branded version and consumers continued to demand it because pharma marketing trumped sound financial and medical judgment.

Markets work when you let them.

Maybe, though I suspect it depends on your definition of "work." I recognize it's a dearly-held talking point of the right, but it seems to me to be based more on speculation and wishful thinking than objective evidence. What most pseudo-free markets around the world seem to have done is allow a very small number of companies to become so mammoth they eventually control their markets, with the most competitive markets being those with the tightest controls on corporations and wealth.

The retort is traditionally something about these markets not really being free and that is the government that enables such business oligarchies. I have yet to see any real world counter-examples, however. Instead it's just empty dogma earnestly and tirelessly repeated to other true believers until they all just "know" it must be true. In short, it's a great tale but I'd like to see actual data.

 

[charrison]

Ummm ... based on my experience, either your health insurance or your doctor is deficient. My experience is roughly the opposite of yours; this OTC change is substantially increasing my cost. I was paying a $5 monthly co-pay for an "Allegra" prescription. There is a difference, however. When the patents on Allegra expired, my doctor switched me to the generic, fexofenadine. Doctors who continued to prescribe the expensive branded version weren't doing their patients any favors.

As my understanding allegra just recently became available as generic. Feel free to correct me on this. I have used a several different insurance companies over the past 10 years and allergra was pushed to the to the most expensive tier copay as their plenty of good allergy meds OTC now. My insurance is not a bad plan, but they were just pushing consumer to more affordable options.

I'm also curious where you're finding a 90 day supply of OTC Allegra for only $35. I'm finding it more in the $50 to $60 range.

costco!

Probably true, but I don't think your example is a good one. It's more an example of the way intellectual property laws protect innovation at a cost to consumers. I suspect it's also an example of why big pharma spends more on marketing then it does on R&D. I'm sure many doctors continued to prescribe the branded version and consumers continued to demand it because pharma marketing trumped sound financial and medical judgment.

In this case it is more of a matter of big phara charging more to the insurance company, because the consumer is not directly paying for the end product. They pay their copay, $5 or $50 and go on. When the product hits OTC retail, consumer have a choice and the pricing is reflected.

Maybe, though I suspect it depends on your definition of "work." I recognize it's a dearly-held talking point of the right, but it seems to me to be based more on speculation and wishful thinking than objective evidence. What most pseudo-free markets around the world seem to have done is allow a very small number of companies to become so mammoth they eventually control their markets, with the most competitive markets being those with the tightest controls on corporations and wealth.

The retort is traditionally something about these markets not really being free and that is the government that enables such business oligarchies. I have yet to see any real world counter-examples, however. Instead it's just empty dogma earnestly and tirelessly repeated to other true believers until they all just "know" it must be true. In short, it's a great tale but I'd like to see actual data.

You are right, there is very little free market in the health care industry as it is very heavily regulated. However every now and then something this shows what is possible when markets are allowed to work.

 

[DaveSimmons]

Are you joining with Anarchist420 in saying drug patents shouldn't be allowed to exist?

The OTC version is cheap now because the patent has expired and the maker decided to get approval to sell a branded OTC version to keep profits higher. It doesn't really say anything about different health insurance models.

However, without the patent and the initial higher cost via prescriptions, it probably would never have been created and you wouldn't be able to buy it at all.

 

[Doppel]

If I am in a major accident and need four weeks in the ICU I cannot cover it and never will be able to. Insurance or gov-backed is the only way the average person can ever hope to cover major incidents, similar to home owner's insurance. I agree it's messed the market up, though.

 

[charrison]

Are you joining with Anarchist420 in saying drug patents shouldn't be allowed to exist?

The OTC version is cheap now because the patent has expired and the maker decided to get approval to sell a branded OTC version to keep profits higher. It doesn't really say anything about different health insurance models.

However, without the patent and the initial higher cost via prescriptions, it probably would never have been created and you wouldn't be able to buy it at all.

No i have no problems with patents. I do believe that have insurance involved in every transaction for healthcare greatly distorts the market.

 

[charrison]

If I am in a major accident and need four weeks in the ICU I cannot cover it and never will be able to. Insurance or gov-backed is the only way the average person can ever hope to cover major incidents, similar to home owner's insurance. I agree it's messed the market up, though.

That is of course what insurance is for, not for every little thing that could occur.

 

[her209]

That is of course what insurance is for, not for every little thing that could occur.

You're saying "no" to "Cadillac" health insurance plans??

 

[ichy]

I agree that having insurance cover primary care visits is silly. Health insurance should be there for catastrophic, unpredictable expenses like cancer or getting hit by a bus. Having them pay for everything leads to mountains of unnecessary paperwork.

 

[werepossum]

Doc in the boxes are opening up at the local grocery stores. Menu prices, $65 without insurance to see a PA and there is a real doctor on call. Reasonable prices for those without insurance.

The allergy medicine allegra went OTC this month. Before it went OTC it was $30-$50 copay with insurance for a 30 day supply. This month it went OTC and you can get a 90 day supply for $35.

Allowing insurance to be involved in every healthcare transaction has warped the market.

Markets work when you let them.

Agreed. We've fallen into an entitlement mentality where all our health care should be provided by "someone else". Co-pays distort our perception because insurance companies have to at least break even, which includes all the paperwork, those fine buildings, and executive perks. The insurance company has to pay the actual costs plus markup, and even if your insurance is 100% paid by your employer, that's still part of the cost of employing you.

Ichy said it best, so I'll simply agree with him/her.

 

[Genx87]

I dont know the history on Allegra 100. But I have been on Fexofenadine since 2005. The only thing I will say is the price varied greatly between visits. It going OTC is a good thing imo. No idea why it remained prescription only for so long.

 

[ShawnD1]

I agree that having insurance cover primary care visits is silly. Health insurance should be there for catastrophic, unpredictable expenses like cancer or getting hit by a bus. Having them pay for everything leads to mountains of unnecessary paperwork.

In countries with government healthcare, the general idea is that poor people are treated so they can get back up and get to work again, or at least stop spreading infections everywhere. Those poor people overall cost the system money; they get significantly more out than they put in. This is why mandating private insurance to cover such things just doesn't work. If someone is poor and can't afford healthcare, having private insurance doesn't magically make it cost less. I think that's what Obama was going for - everything would magically get cheaper for no reason at all.

Overall this doc in a box thing is a good idea. For the people who don't have insurance, the costs can be a lot lower.

 

[JeffreyLebowski]

In countries with government healthcare, the general idea is that poor people are treated so they can get back up and get to work again, or at least stop spreading infections everywhere. Those poor people overall cost the system money; they get significantly more out than they put in. This is why mandating private insurance to cover such things just doesn't work. If someone is poor and can't afford healthcare, having private insurance doesn't magically make it cost less. I think that's what Obama was going for - everything would magically get cheaper for no reason at all.

Overall this doc in a box thing is a good idea. For the people who don't have insurance, the costs can be a lot lower.

They tried to apply economies of scale to the idea. While on the surface it sounds like it would work, but no one in the Obama Admin actually has any real understanding of economics and failed to see how having 300 million people paying in and 300 million people taking out actually even out. 300 million people averaging paying in 900 billion sounds like you could cover anything. Then realize that 300 million people all with coverage that is supposed to cover more than we have now, are going to use more than their $3,000 they put in in a year.

 

[drebo]

If I am in a major accident and need four weeks in the ICU I cannot cover it and never will be able to. Insurance or gov-backed is the only way the average person can ever hope to cover major incidents, similar to home owner's insurance. I agree it's messed the market up, though.

No one has ever said that MAJOR MEDICAL insurance should not be around.

But, needing insurance to visit the doctor for yearly checkups or to buy medication is just stupid.

 

[lothar]

As my understanding allegra just recently became available as generic. Feel free to correct me on this. I have used a several different insurance companies over the past 10 years and allergra was pushed to the to the most expensive tier copay as their plenty of good allergy meds OTC now. My insurance is not a bad plan, but they were just pushing consumer to more affordable options.

Allegra has always been a generic for the past 3-4 years, if not 5 years.

 

[Rockinacoustic]

What does the scope of health care have to do with the FDA approving a medication to be sold OTC?

You could have payed cash for fexofenadine before it went OTC, but then again you'd be dropping ~$90 per month.

 

[IronWing]

We tried a non-insurance based system. It failed most of the people most of the time. Doctors were for the rich. Most people simply didn't get treatment and they got better on their own, ended up permanently damaged, or they died. We've moved on.

 

[charrison]

You're saying "no" to "Cadillac" health insurance plans??

Did not say that at all. The Cadillac plan should have a fat employer funded hsa to take care of all the little stuff.

 

[charrison]

Allegra has always been a generic for the past 3-4 years, if not 5 years.

That does appears to be the case, but it also appears generic was not much cheaper.

 

[charrison]

What does the scope of health care have to do with the FDA approving a medication to be sold OTC?

You could have payed cash for fexofenadine before it went OTC, but then again you'd be dropping ~$90 per month.

Now its a 1/3 of that.

 

[charrison]

We tried a non-insurance based system. It failed most of the people most of the time. Doctors were for the rich. Most people simply didn't get treatment and they got better on their own, ended up permanently damaged, or they died. We've moved on.

We have largely been conditioned to think docs are just for the rich as we need insurance to go see one. It was not always like that.

 

[manimal]

If you guys think that Rick Scott and his ilk have anyone's interest in mind than you are daft and need to see a doctor...

 

[Zebo]

Cool story bro?

I'm not sure the point of this as is does not address full physicals, expensive lab work or if something actually goes wrong.

For example last year I had a tune up from an old motorcycle accident
http://www.youtube.com/watch?v=qKeJd0j2J4E
Seems like a basic surgery but ran 40 thousand dollars.

How you fix that??