Quote:
Originally Posted by dillywho
The biggest problem I see with the drug increases is that they are absolutely unnecessary. The same goes for drug costs, period. Thank the drug companies for that one. Drug companies try to justify their pricing by claiming they need to pay for research. Practically every commercial break on TV is touting some drug; the same for magazines. How is that paying for research? They could do a multitude of research with the money they spend on that! All those ads are not cheap and we, the consumer, are paying for it with our dollars; sometimes with our health. If your doctor does not "know if xxdrug is right for you", then maybe it's time to find another doctor.
As for HMO's, I will never participate in another if there is anyway to avoid it. I do not want any doctor telling me that I cannot go to a specialist or which one I have to use if I do get "permission". Many times with those, it is not even the doctor but some insurance person making the decision. I had that experience back home when I retired and had to go the HMO route since I was still eligible for company insurance and too young for Medicare. My doctor knew how to beat them at their own game, though. Long story short, they denied an MRI. When he called back to have me admitted to the hospital in order to isolate my problem, they did an about-face and I got the MRI as out-patient. Fancy that!
We are enrolled in PPO's and can stay in network or go out, our choice. I am willing to pay a little more to get the doctors and care I want without having to go the "Mother, may I?" route.
|
Unfortunately, it's not that simple. Beyond the TV advertising cost, there are armies of drug reps going from office to office touting their version of a drug is better than the other guy's, complete with incentives to influence the prescriber. However, like the old saying goes, you have to spend money to make money. The goal of all this product promotion is to increase sales, and since big pharmaceutical companies have astute business people in charge, I doubt they would be running their advertising at a loss. Remember, drug costs are incremental---it takes about $750 million to make the first pill, and then 1/100 of a cent for the rest. So sell 750 million pills---$1/pill, 7.5 billion pills--10 cents a pill. This results in lower costs to the consumer (even if you don't believe it) It's also good for the employees, the stockholder, and the economy if general. The cost that they cannot control is product liability. I'd like to know the advertising cost for "1-800-BAD-DRUG", because ultimately you are paying for that as well
Now before you think I'm in the drug companies pocket, no, far from it. They do some real slimy things, such as distribute their research, development and marketing costs across the domestic market only. This is why, prior to going generic, Lipitor cost $1.75/pill in the US, 0.84 in Canada and 0.38 in India. They then turn to Congress whenever price regulation comes up and plead poverty based on their R&D&Marketing costs. They also have a tendency to cherry pick their data, which may be why certain drugs get yanked within months of their original release.
But all that aside, we are far better off with the pharmacology of today than we were 50 years ago
As far as HMOs and insurance prior authorization for procedures goes, this is just a cost cutting measure. They will make me personally get on the phone with their medical director after denying a test. It takes time , but no biggie. I have never had a test denied after speaking to them. Either they already know the test is indicated and are just going thru the motions, or in many cases just don't know, in which case I'll talk over their heads for a while and they'll approve it.
As far a dentists go, they are not regulated to any degree and can charge whatever they want, so all you can do is find one that you trust