Outcome Improvement
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February 2024
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Fat, Dumb and Happy No More
Filed under: Healthcare, Problems and Inequities
Posted by: Tom @ 7:54 am

When The Pentagon was found to have charged taxpayers $434 for a hammer and $600 for a toilet seat cover, people were outraged. What they failed to realize was that the same thing is happening to us all the time. Unless we see something blatant that affects us directly, we do not even think to question what is going on. A case in point is a healthcare system with similar excesses. 

The other day, I stopped at my local drugstore to pick up a new prescription that I had left to be filled.  The drug had not been in stock.  In retrospect, that should have been a red flag.  Others were probably too smart and were not buying it.  Anyway, when I went to pay the bill, I learned that it would cost $121.37.  This, by the way, was for a prescription strength version of a medicine that is available over-the-counter for a fraction of this amount.  My first reaction was that my insurance had not paid its share.  But no, they had disallowed the claim and I must pay the entire amount as if I had no insurance at all.  Needless-to-say, the drug got put back on the shelf.

For an accountant like me, it is easy to see what is happening.  Costs are what they are, but who pays and how much they are charged is another matter.  One way or another, costs are going to be marked up and allocated to someone for payment.  Nature abhors a vacuum so if there is pushback in one place, something else must give way.  When an insurance company avoids paying at all, so much the better for their bottom line.  If they negotiate too many discounts or too many people who lack insurance and cannot pay are subsidized, everyone else foots the bill.  The consumer has little say in the matter.  Costs simply get spread through the prices of products that we buy, the taxes we pay, insurance premiums, co-pays and deductibles, contributions that we make and so on.  It is anyone’s guess what the true cost or price should be for anything.

There are different prices.  Some people pay nothing out-of-pocket at all.  Until the alarm goes off, we simply take whatever comes along without question.  In my case, I had one other piece of information about medicines that most people do not know.  I had learned from Bloomberg Businessweek that roughly half of the costs of prescription medicines are wasted because they do not work as the prescribing doctor had intended. In 2008, this amounted to $145 Billion wasted by all of us in that year alone. A year ago, I spent $100 on a co-pay for eye drops that did not work. Quite frankly, I was not ready to risk adding to this waste especially when there were other options. 

Looking at the world around us, I believe that it is important to find out the facts, tell it like it is, and fix what is wrong. If you agree, please join in by sharing your comments and experiences with us.            


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