As someone with hypertension, it costs something like $10/mo to treat with generic drugs. I know because I had to buy lisinopril out of pocket when I was between jobs. Not a good example. A better example would be something like diabetes, but I don't know if insulin can be denied or not (or whether there are other means for the poor to obtain it), maybe someone can clarify.
The larger point is, the "crazy expensive", acute part is already "universal". We just need to mop up the remaining stuff, formalize the arrangement, and call it a day.
Adams also makes another point in that this can't happen without downward pricing pressure for drugs and services and there currently isn't much. If you have a fancy insurance plan it doesn't matter to you if something costs $1000 or $10K or $1M - you aren't the one paying. What he suggests is insurance companies should give you a kickback if you find a service for less than a predetermined threshold. You already see this happening in some cases.
I believe Trump will create that downward pressure for drugs (as he promised many times during his campaign), but services are going to be an issue for years to come, perhaps until automation takes over.
Right, generic drugs are cheap, but you still have to find someone to prescribe it. If you show up in ED without insurance with a hypertensive crisis, they'll give you blood pressure drug doses to resolve/stabilize it, but I don't think they have to give you a prescription to fill. They might charitably do so, but what do you do on Day 29 of that prescription?
The "crazy expensive" part of health care is the long-term chronic conditions: they require a lot of care/tweaking/services over a long period of time. The lifetime costs of treating a diabetic exceeds the lifetime costs of the one-off hip replacement or hip fracture.
I dunno how Trump will create downward pressure on drugs without regulating prices on patented drugs or discouraging/defunding cost-ineffective interventions. That's how most other countries do it, but it seems incompatible with his philosophy.
Perhaps that's the part we really need to fix. I mean at least at the low end of the wealth spectrum it shouldn't cost like three hundred dollars to go to a doctor to prescribe a $10/mo drug. Heart disease is one of the leading causes of death, and it sounds to me like we could get a lot of bang for the buck, statistically speaking, by deregulating this and making prescribing blood pressure meds a "grocery store doctor" thing that doesn't cost much at all. As far as I can tell, the selection of drugs is really narrow for most people. I do agree it's tragic if someone who could be taking care of their hypertension can't do so just because doctors cost so much. I havent heard much about people dying due to lacking access to insulin, though, which leads me to conclude that it can be obtained even by those who don't have the means to pay the full price.
30.3 million people in the US have diabetes. Not all of them need insulin, but even those that do are millions of people, and lots of them are poor. It'd be a major cause of death if they couldn't get insulin. This means they are getting it somehow.
Most Type1 insulin-dependent diabetics start young, so it’s in the manufacturer’s interest to get you on their insulin for free in hopes that you get coverage later in life.
For type 2 diabetics, most are in or will be covered by Part D, so the manufacturers do the same thing.
But for a one-off treatment for those the middle aged, like the new HepC treatments, manufacturers don’t have the same incentives.
The larger point is, the "crazy expensive", acute part is already "universal". We just need to mop up the remaining stuff, formalize the arrangement, and call it a day.
Adams also makes another point in that this can't happen without downward pricing pressure for drugs and services and there currently isn't much. If you have a fancy insurance plan it doesn't matter to you if something costs $1000 or $10K or $1M - you aren't the one paying. What he suggests is insurance companies should give you a kickback if you find a service for less than a predetermined threshold. You already see this happening in some cases.
I believe Trump will create that downward pressure for drugs (as he promised many times during his campaign), but services are going to be an issue for years to come, perhaps until automation takes over.