天美麻豆

Big pharma has very deep pockets and has no problem buying off politicians. l mean no problem making campaign donations 馃槀馃槀.

Eisenhower warned about the聽 鈥漨ilitary industrial complex鈥�. l think there is also the 鈥漰harma industrial complex鈥�.

I could drone on and on about this.聽 Medical expenses are just beyond ridiculous in the USA.聽 It is a complete disgrace.聽 The media is also complicit in a major way.聽 This is a huge story, and what do they do instead, they amplify the inconsequential outrage/fear narratives to distract from real issues.聽 There is something obviously wrong when you get a medical bill for $7,000 and the negotiated rate is $500 - yet uninsured individuals are expected to pay the fake $7,000 rate.聽 @mberigan you are absolutely correct about the difference in drug pricing.聽 The examples are endless - but the rot goes much much deeper.聽 It's the entire medical establishment in the US.聽 It is obviously broken.聽 Everyone knows it, yet our congress is bribed to do absolutely nothing and instead talk about the idiotic outrage of the moment - and then the media turns on the echo chamber.

Here is another particularly galling example (and something everyone needs to be aware of):

Insurance company "clawbacks".聽 I got a Rx filled at Costco recently.聽 They ran it through my insurance and my co-pay was $147.聽 I then called Costco and requested they not go through my insurance.聽 The cost was then $24.聽 WTF?聽 Actually, I have been aware of this for years.聽 You have to be careful when you fill prescriptions and check the pricing without insurance.聽 You'd think this would be illegal, but apparently it isn't.

The US Medical system is just shameful.

Because Americans like a for-profit healthcare system -- a bit cynical but true. Anytime anyone suggests a single-payer universal insurance system, it is voted down. Just recently a proposal to allow Medicare to negotiate prices with pharmaceutical companies was rejected by Congress. Americans believe that their system is the best and that it requires such atrocious prices for drugs, insurance premiums, and co-pays.

I have has the same experience in Brazil -- drugs are less than 10% what they cost -- and if you are a Brazilian citizen or resident, then most drugs are free. I had a recent experience in Europe where I needed an antibiotic: the pharmacist apologized that they only had the brand name and not the generic in stock and that it would be substantially more expense than the generic -- I was prepared to pay US$60+... it was US$16 -- the generic would have been less thanb US$10... in the US the co-pay would have been more... and the charge by the pharmacy to the insurance company would have been for more than US$60...

On a recent trip, I was hospitalized with dengue while traveling in Germany... had to stay in the hosptical for four days: paid out of pocket -- I was shocked when the whole bill came to less than US$3000 -- think about what a four day stay in the US with medication would have cost out of pocket in the US...

But, Americans continue to vote to the party that seeks to abolish Medicare and they vote consistently against universal insurance... the pharma and insurance lobby is very very powerful...

@mikehunter -- what is interesting that when you get bill with the "fake" charges, you can negotiate and mos tof the time the hospital or physician will settle for a fraction -- and still make a handsome profit... well, I guess, the yachts and salaries of the insurance executives need to be paid somehow...

@mjs30170 Yep, it's immoral IMHO.聽 I'll get off my soapbox now.

"medical tourism" just to be able to afford required medication.聽 聽 聽-@mberigan

Yes.聽 Medical tourism has been happening for a while.聽 My brother in law living in BC, Canada had elective surgery scheduled - but got the surgery done in Taiwan while on vacation - all for a fraction of the cost.聽 This was at least 10 years ago.

The best medical care tends to be depending on what you need.聽 US is great for new and innovative treatments - all very expensive - but not for low margin businesses.聽 That's why brand name meds are promoted over generics.

In order to stretch your reals, it is important to know where to go in order to get the right treatment.聽 For example. you would not go to a dentist whenever you need a cleaning - and a hygienist is sufficient.

I think that people would prefer to buy generics in Brazil than pay high prices for brand name equivalent.聽 But this is a personal choice.

What is the preferred medical insurance plan for retirees in Brazil?

03/08/24 @mberigan.聽 It's widely known that the drug companies fund their research by overcharging Americans.聽 The US is not only their biggest market, but one with rigorous quality controls and virtually no price controls:聽 a perfect world for them, a perfect storm for consumers.

A few years ago, Congress set up a program for testing drugs that pre-dated the Pure Food and Drug Act and had been grandfathered under the law when passed.聽 A company that conducted the required new-drug testing on these very old drugs would receive a royalty on sales.聽 Some patent pirates zeroed in on colchicine, the standard treatment for gout for the past three thousand years.聽 They set up the program,聽 got the FDA cert, and got their royalty.

Gout runs in families, including mine, and we go through a lot of colchicine.聽 It costs me about five cents a pill in Brazil, about the same for my brother who lives in Ireland.聽 Under that law, the price for my nephew's meds shot up to five dollars a pill.聽 Now, whenever his father and I visit the US, we always bring him an extra supply.

I have heard of Americans going to Mexico to get meds. From what l understand, it鈥檚 much less expensive for the same drugs.

@mberigan Sometimes cost is only one part of the picture. When I was in R.I. caring for my late father i tried to get a dental appointment, but they were not taking new patients anywhere. I finally had my teeth fixed when i moved to Brazil.

Roddie in Retirement

聽 03/05/24聽 @mberigan Sometimes cost is only one part of the picture. When I was in R.I. caring for my late father i tried to get a dental appointment, but they were not taking new patients anywhere. I finally had my teeth fixed when i moved to Brazil.Roddie in Retirement-@roddiesho

The coming crisis in dental care in the US has been creeping up on us largely unnoticed.聽 The widespread use of fluoridation spared kids billions of cavities, but prevented millions from developing the habit of annual checkups.聽 Another manifestation of the Law of Unintended Consequences.聽 The dental profession responded rationally, by reducing supply.聽 My Alma Mater聽 closed one of the oldest Schools of Dentistry in the country over three decades ago (last graduating class 1990) and wasn't alone; none of those dental schools are coming back.聽 Now, every good dentist's patient list is full, and there aren't enough young dentists to take over the practices of the ones who want to retire.

Price pressure will eventually bring practitioners and patients back into equilibrium, but like the imbalance, the correction will probably also be transgenerational - and quite literally painful.

@mberigan

I started to laugh when I was told the amount/month for my oral medications in Brazil. A fraction of the cost in the US.

Even the injectables like Ozempic or Humira although not covered by insurance normally in Brazil are reasonable when paying out-of-pocket. Have to find out if there is a way to get even more help with this. I will have private insurance but maybe "SUS" will help? Any info will be appreciated.

10 months until retirement!

@56tbourne

I am getting my Enbrel 50mg injectable syringes here through CEDMEX (a part of SUS, I think!)

After a long 4 months of bureaucracy, and many visits to the Rheumotologist and various other locations for many tests, I was approved to get this medicine for FREE.聽 I actually got this free in the USA also, as part of a program there to help lower-income people afford their (ridiculously overpriced) medications.聽 Here, in Brazil, as in the USA, this specialty medication (for arthritis) is only a mere R$ 10.0 mil/month.聽 $2000!聽

Fortunately, I was able to tough it out, and persevere through all the ridiculous hoops I had to jump through!聽 Now, I only need to go there to CEDMEX once/month to pick it up...聽 Hope this may be helpful to some of you...

Very helpful!....Now I wonder about Ozempic. Not for weight, but Diabetes.

Yeah good example why Americans go to Canada for things like insulin shots. Caused a concern in terms of supply and demand in Canada as Canada prefers who can pay scenarios over their own citizens lives lol. But at peak dystopian situations like that governments generally have some form of control for suggested pricing index based on type of medications against GDP ratios that allow some countries to pay more than others.

At the end of the day is greed no matter how you paint it lol

Thanks Dr Donna. That's a useful link.

I think the point made about being cautious about information provided on medical tourism websites is most important.

When I make choices about meeting my medical needs here, there are a whole lot of inputs that I consider from a large number of family members, including doctor family members. And still, just like in

the USA, I often get second or third opinions via actual doctor visits...... not just picking info off of a marketing website.

mberigan