Drug Prices

[Berzerker]

I'm really so very sorry @Berzerker you're going through this, how on top of your medical condition you're also having to deal with stress for getting and paying for your medication.

I guess I'm really lucky, my prescription I have to take is free at Meijer.

No stress, ironically the prescription I got costs less than the OTC acid reducers I was buying at the supermarket. But thanks I am checking with my insurance how to change my policy though in case I do need help in the future for prescriptions.

 

[Broken_Erika]

Discount supermarkets with pharmacies in them are a good place to get prescription drugs.(i.e. i get my meds at food basics for like half the cost of getting them at shoppers drug mart.)

 

[civvver]

The reason they do this is most people have insurance with fixed copays, like $10-25 dollars for generics, $40-100 for non generics, so they don't comparison shop. If a drug is $40 they pay $10, if it's $200 they pay $10, so what do they care? My insurance is all deductible based- I pay 100% of contracted cost until deductible is met and 20% after til out of pocket max is met (never gonna happen unless I get cancer or something). So I will comparison shop more. Also my insurance is now requiring maintenance meds to be done by mail through them since it's cheaper. Your ppi would qualify as something like that.

Still you should be glad your insurance will even cover ppis as most are available over the counter now and thus many people's insurance won't even cover it. It's like if your doctor prescribed motrin 800 mg after a surgery or something for pain, your insurance might say nah buddy just take double the over the counter dose, we aren't paying for that.

I take otc ppis, not every day, but I'll do the 14 day course every couple months or so. I get the kirkland brand from costco and it's only $16 for 42 pills (three 14 day courses/packs). That would only be like $12 a month. They have brand named prilosec too for $25 for 42 count.

 

[Berzerker]

I'm on 40 mg a day now so the otc kroger cheapies of 42 pills last me 21 days for $16, now it costs $12 for a month of 40 mg

I hope they work better than the otc stuff

 

[warpus]

I guess I'm really lucky, my prescription I have to take is free at Meijer.

I'm really lucky too, I don't live in the U.S.

 

[MaryKB]

I'm really lucky too, I don't live in the U.S.

My mother lives in Ontario and she can't afford her medications, she has to pay like $300 a month. I keep asking her to explain, I really don't understand at all.

 

[Broken_Erika]

Probably gets them at shoppers drug mart or some place like that.

 

[warpus]

My mother lives in Ontario and she can't afford her medications, she has to pay like $300 a month. I keep asking her to explain, I really don't understand at all.

Depending on the situation $300 could be a lot or it could be very cheap, we have no idea what sort of medication this is and what sort of coverage she has.

I keep seeing drug and hospital prices in the U.S. and it all seems insane to me. I have no idea how you guys manage to keep your country together. No offense, I'm just used to social safety nets, etc.

 

[MaryKB]

Depending on the situation $300 could be a lot or it could be very cheap, we have no idea what sort of medication this is and what sort of coverage she has.

I keep seeing drug and hospital prices in the U.S. and it all seems insane to me. I have no idea how you guys manage to keep your country together. No offense, I'm just used to social safety nets, etc.

I grew up in Ontario, honestly I don't see much difference really, except in Ontario you pay through taxes and things and in the United States you pay through premiums and copays and deductibles, but like everyone still has to pay. So I just did a quick google check, and it says a family in Ontario pays about $11,000 a year for healthcare, and that's every year. My premiums for health insurance here are about $1,000 a year, and my out of pocket maximum is $4,000, and I have $1,000 from my HSA, so my total I'd ever be out in worst case scenario would be $4,000, which is really not too bad, but if I'm healthy I might only be out that $1,000 premium, and if I can save up my HSA money for a few years (which I have because I'm healthy) I can really be very much okay if the worst happens and I need to use everything (like hopefully in a few years I'll be having a baby). So like when you're hearing about costs of procedures, you're probably hearing about what initially gets billed to your insurance company, but they can just make a large part of that unpayable, and you get charged for a smaller amount, but either in the United States or Canada everything still has to get paid for and that money has to come from somewhere, you know? And I don't even really understand what my parents are paying for with $300 per month, I'm totally confused by that.

I do have good insurance from my employer, and some people aren't really as lucky, but like a lot of hospitals have systems to help you out if you can't pay. Like at the hospital where my boyfriend works, if you're making less than 250% of the poverty line, you don't have to pay for services at all, and above that you can get some help also depending on your income. And they guarantee mothers won't have to pay if you can't afford your baby's delivery, but I'm not sure how many people really know about that, even though you can find information all over the place.

And my mother's been suffering for three years waiting for her hip replacement surgery in Ontario, and she's still having trouble seeing a doctor to get things booked, so like everywhere has their horror stories, you know? I feel from my experience Americans are really bad about doom and gloom, lol.

 

[civvver]

Depending on the situation $300 could be a lot or it could be very cheap, we have no idea what sort of medication this is and what sort of coverage she has.

I keep seeing drug and hospital prices in the U.S. and it all seems insane to me. I have no idea how you guys manage to keep your country together. No offense, I'm just used to social safety nets, etc.

It's cus the pricing models aren't consistent, no one actually pays out of pocket some of those prices, it's all insurance and part of why costs keep going way up. For example my wife had her foot xrayed, insurance was billed for around $300, but only paid $30 per contract. If you're in an auto accident though they pay the full amount. It's all screwed up.

 

[warpus]

everything still has to get paid for and that money has to come from somewhere, you know?

Yes, but the U.S. has the most inefficient healthcare system and the highest prices in the western world. There are so many middlemen the U.S. ends up spending more per capita on healthcare than anybody else, and they get less of a bang for a buck than all other western countries. High drug prices in America are a well known part of the problem, it's why some Americans like to order that stuff via the mail from Canada.

Depending on your own personal situation, healthcare could of course be cheaper in the U.S. for you.

It's cus the pricing models aren't consistent, no one actually pays out of pocket some of those prices, it's all insurance and part of why costs keep going way up. For example my wife had her foot xrayed, insurance was billed for around $300, but only paid $30 per contract. If you're in an auto accident though they pay the full amount. It's all screwed up.

The problem is with the people who don't have insurance. I've also heard crazy stories of people getting chaged $2,000-$4,000 for an ambulance ride, and insurance only covering a part of that.

A part of the problem is you guys don't have single payer, and you have all these different people and groups and middlemen negotiating prices with each other. In Canada we have the government doing all the negotiating on behalf of all Canadians, which gives them a lot of power to negotiate affordable prices.

 

[MaryKB]

I'm totally a huge fan of single payer, like what I'd like best would be if there was like just one insurance company, that's non-profit and everyone has to be a part of, and if you're employed then your company pays your premiums otherwise it's something like medicare, but they negotiate with medical providers to control costs and services and everything, and it'd be independent but constitutionally controlled like how the post office is.

I don't think I'd call American healthcare inefficient, I mean there's a lot good about it, like if I have an issue I can probably get seen by a specialist today and get treated quickly, and I wouldn't see any costs right away, a lot really goes on behind the scenes, you know? I also feel costs are confusing, because there are so many layers, and like even people know it get confused! But like when you get a bill, it goes to your insurance company, and they have rates they can like control how much gets charged, so a big portion gets chopped off, I don't even really fully understand, but having grown up in Canada I heard all sorts of myths I found out just weren't true when I moved to the United States and started working.

 

[Synobun]

Discount supermarkets with pharmacies in them are a good place to get prescription drugs.(i.e. i get my meds at food basics for like half the cost of getting them at shoppers drug mart.)

Has Food Basics changed in the past 5 years? It was always super expensive while I was growing up. My parents would only ever step foot in there when, *dry heave*, Belgian endive was in season since they were the only ones who sold it.

 

[civvver]

It is really bad for people without insurance, cus not only do they pay out of pocket but they have to pay sticker price. Insurance and medicare pay contracted rates which are ten times lower in some cases.

And as far as being efficient, it's hard to say, you have to look at where most of the money is being spent. I see a lot of articles about how it's spend on end of life care and memory assisted living for elderly. But other articles also refute that. One thing is sure though that most of the money is spent on a small percentage of the population, either elderly or those with chronic diseases. One downside of all this private insurance is there's no central database to compare everything.

https://www.theatlantic.com/health/archive/2017/06/how-we-spend-3400000000000/530355/

People will often say arbitrary statements like the US spends more on healthcare than any other country yet has some of the worst outcomes of the developed world. Which of course is true if we're willing to spend $80,000 for a surgery on someone in their 80s that extends their life 3-4 months. And that happens. Whether that's a bad outcome or not depends on your perception I guess.

 

[Broken_Erika]

Has Food Basics changed in the past 5 years? It was always super expensive while I was growing up. My parents would only ever step foot in there when, *dry heave*, Belgian endive was in season since they were the only ones who sold it.

Mine is the cheapest supermarket in town, it's the low-cost discount arm of Metro.(Metro bought it off A&P a few or Several years ago, i can't remember exactly when.....)

 

[warpus]

I don't think I'd call American healthcare inefficient

It's inefficient in that Americans spend the most on healthcare out of any western country, and get the least for it.

 

[Synobun]

Mine is the cheapest supermarket in town, it's the low-cost discount arm of Metro.(Metro bought it off A&P a few or Several years ago, i can't remember exactly when.....)

Hmm. Maybe it was just where I lived. My town had one grocery store, an IGA-turned-Foodland. Food Basics was in one city (50 minutes away), Zehrs in the other (40 minutes away). Not a whole lot of choices. The Foodland was always cheapest of the three.

 

[civvver]

It's inefficient in that Americans spend the most on healthcare out of any western country, and get the least for it.

But that's what I mean, by what metric? What is least? Number on uninsured? Number of bad or good outcomes? The amount of surgeries performed?

 

[warpus]

But that's what I mean, by what metric? What is least? Number on uninsured? Number of bad or good outcomes? The amount of surgeries performed?

Just the amount of $ spent, and services rendered and drugs distributed, etc. In pure economic terms.

 

[hobbsyoyo]

I also feel costs are confusing

No kidding. I have point-blank asked a doctor how much an x-ray would cost and she had no idea. The best she could do was put me in touch with a person who could give me information to give to another person who could look it up in a table and provide an estimate with error bars of +/- 50% assuming everyone in this telephone chain was at their desks. Of course I needed the x-ray faster than the 3 day turnaround that phone tag promised so I just got it then and there at the doctor's office.

If the person selling you a service can't honestly tell you how much the service costs then how can this be considered a free and open market? Factor in that we are not talking about the market choice between picking up an xbox or a playstation but rather life and death decisions and it's an absurd situation.