Gyroscopic Investing

I have a regular maintenance prescription. One time I filled it at a new location and the pharmacist mentioned that the next time I order I should ask to purchase it direct instead of going through insurance. Apparently they could sell me a 90-day supply of the exact same drug for less than my copay for a one-month supply.

At the time I was just happy to have found a rare example of healthy cost competition in the medical realm. But in retrospect the idea of paying big premiums for insurance that actually increases the cost of simple prescriptions makes my head hurt. What's the copay on asprin these days?

I have a prescription for some psoriasis medicine that runs something like $700/bottle (fortunately it lasts a long time). I was therefore glad that my copay was only $25 and I even got it for free a lot of times with some coupons.

It went generic last year so I was expecting the price to go down significantly, but I was completely surprised when I went to pick it up and the copay for the generic version was $125.

Yes, something here is broken.

And in another example of brokenness I was watching a video by a doctor named Ken Berry and he talked about two medicines to treat intestinal worms. They required a prescription but the cost was only a few dollars. In other countries, they can even be bought over the counter.

Now they cost hundreds of dollars and the reason is that some pharmaceutical companies bought the patents to those drugs. I don't know if something similar happened to my psoriasis medicine but it wouldn't surprise me.

hardlawjockey wrote: ↑Sat Aug 25, 2018 10:26 am And in another example of brokenness I was watching a video by a doctor named Ken Berry and he talked about two medicines to treat intestinal worms. They required a prescription but the cost was only a few dollars. In other countries, they can even be bought over the counter.

Now they cost hundreds of dollars and the reason is that some pharmaceutical companies bought the patents to those drugs. I don't know if something similar happened to my psoriasis medicine but it wouldn't surprise me.

That's what the furor over Martin Shkreli's increase in the price of Daraprim was all about. The coverage focused on him, but it should have focused on the fact that this has become common practice.

Medicine is broken, indeed. My sister and I were talking about how many older physicians we are seeing retiring early, or semi-retiring by leaving large academic practices for part time low-key private practice jobs. I'm also now seeing lots of articles on physician shortages, which propose all kinds of solutions except the most obvious: roll back the web of regulations, many imposed by the Obama administration but others being increasingly introduced by overzealous and overpaid hospital administrators, that has led to this mess.

Additionally, two simple moves could solve a lot of the problems: 1) go single payer and put the private insurers to work managing the expanded Medicare program, and 2) mandate CPRS/Vista as the universal EHR system.