Michael Moore's Latest Target: Your HMO

[Schneed10]

Originally Posted by Southpaw

For the record, the vast majority of drugs are insanely marked up. I understand that the research and development side is expensive, but look at cancer treatments, which have been basically the same for 20+ years. My father has been on aggressive chemo and radiation for several months now. He was getting one of each treatment almost weekly for a while, and racking up around $10,000 in bills per week. It's friggin ridiculous that people are being charged insane amounts of money for drugs that are easily mass produced and haven't changed dramatically for over two decades.

OK here's the lowdown on cancer drugs. Essentially, the federal government is retarded, and incapable of catching unscrupulous practices by the pharmaceutical industry.

You're right, there are cheap cancer drugs like Vincosar, Troposar, and Neosar. They're mass produced and aren't all that expensive. But pharmaceutical companies know that Medicare patients are the most frequent recipient of cancer treatments. And the pharmaceutical companies know that Medicare administrators aren't always on the ball. So, knowing that Medicare will reimburse the pharmaceutical companies at 80% of AWP (the average wholesale price), the pharmaceutical companies jacked up the AWP of cheaply manufactured generic cancer drugs. They'll charge $700 for a 2 mL dose of Vincosar, knowing that Medicare will reimburse them 80% of it ($540 per dose).

So Medicare pays this high price because they're not on the ball, and as Medicare continues to pay that price, it only lends validity to the high price in the marketplace. So... if you don't have Medicare? You better have solid insurance that has an agreement in place with the Pharmaceutical companies to pay a reasonable price for the drug (Aetna at 30% of AWP, etc.). If you don't have insurance? You're on the hook for all $700 per dose. Blame the pharmacuetical company for being unscrupulous with the pricing, blame the federal government and Medicare administration for being too inept to catch the problem, and blame yourself for not getting a job that has good insurance coverage. Plenty of blame to go around.

One of the true horrific examples of our bullshit system.

Does your father have insurance coverage? Is it commercial coverage or is he on Medicare?

[Southpaw]

Originally Posted by Schneed10

Does your father have insurance coverage? Is it commercial coverage or is he on Medicare?

I believe he has commercial coverage through his employer, but I know he was basically fighting his insurance company to get them to cover some of the costs. And thanks for the info. I always assumed that federal government was involved, but your example makes them sound completely inept(shocker...) instead of being in on the scam.