Non-profit’s $300 hepatitis C cure as effective as $84k alternative

Re:Non-profit’s $300 hepatitis C cure as effective as $84k a... by pbhjpbhj on Thursday April 12, 2018 @07:19PM (#16825822)

>Medicare (in aggregate) reimburses 7% less than costs //

So, do I have this right, Medicare is state funded - they pay the doctor less than the cost of manufacturing the medicine and the doctor over-charges other people's insurance companies so as to pay for fixed costs and add profit, to the drug company and themselves?

Your expansion under [1] makes no sense - you were billed $1000, the insurance paid $300 and charged you $50 of that; who is paying the $700? Are you just saying that those at the point of delivery barter by trying to charge $1000, hoping you'll pay it, but the insurance company negotiates a 70% discount? Rather than having an actual cost for a treatment.

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Re:Non-profit’s $300 hepatitis C cure as effective as $84k a... by realbarack on Thursday April 12, 2018 @11:31PM (#16826950)

Re: your last paragraph: yes, that is how it works. That $1000 rate is known as the "chargemaster" rate and it's absurdly, incredibly inflated. A hospital maintains a chargemaster list, which is how they bill uninsured patients. Insurers negotiate rates which are a fraction of this chargemaster rate. The chargemaster rates are also not public, I believe.

So, unintuitively, uninsured people (at least the ones who can pay their bills) are great for care provider revenue.

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Re:Non-profit’s $300 hepatitis C cure as effective as $84k a... by npongratz on Friday April 13, 2018 @10:47AM (#16830451)

Here's where I am further confused, then. If the provider has this list of chargemaster rates (inflated though they may be), and I tell them I'm paying cash, no insurance of any kind involved, shouldn't they be able to tell me at that moment what they will charge me?

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Re:Non-profit’s $300 hepatitis C cure as effective as $84k a... by pg_bot on Thursday April 12, 2018 @09:22PM (#16826403)

"So, do I have this right, Medicare is state funded - they pay the doctor less than the cost of manufacturing the medicine and the doctor over-charges other people's insurance companies so as to pay for fixed costs and add profit, to the drug company and themselves?"

For certain things, yes that is the way it works. I believe most medical practices are losing money when they administer a vaccine.[0]

[0]: http://pediatrics.aappublications.org/content/124/Supplement...

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