[HN Gopher] Walmart unveils low-price analog insulin amid rising...
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Walmart unveils low-price analog insulin amid rising diabetes drug
costs
Author : shivbhatt
Score : 200 points
Date : 2021-06-29 14:54 UTC (8 hours ago)
(HTM) web link (www.cnbc.com)
(TXT) w3m dump (www.cnbc.com)
| benjohnson wrote:
| It's good business to keep your customers alive.
| Threeve303 wrote:
| Unless you're a funeral director
| [deleted]
| cptskippy wrote:
| Has Walmart entered that market yet?
| trimbo wrote:
| Yes https://www.walmart.com/browse/home/caskets/4044_443161
| 1_105...
| tyingq wrote:
| If I change the sort order to Price Low->High, I get this
| really odd captcha telling me to "Press and Hold" a pill
| shaped button. And I can't solve it, it's in a "Try
| Again" loop. Weird.
| cptskippy wrote:
| Weird, it worked immediately for me.
|
| $879 is the cheapest casket if that's what you're after.
| The cheapest items were all urns.
| hansvm wrote:
| Short-term vs long-term gains. You want your customers to
| stay alive longer to have more kids and more total customers.
| ectopod wrote:
| If you sold them a funeral plan you want your customers
| alive.
| teitoklien wrote:
| Only until they stop seeing the point of the funeral plan
| cptskippy wrote:
| I mean they're partially to blame for it right?
| x13 wrote:
| No, that's a common misconception. Humans are born with
| different features and flaws.
|
| While one can increase their chances of developing diabetes
| later in life with poor diet choices (called Type 2), many
| people are born with diabetes. (Type 1)
|
| It's wild how diabetes is an epidemic in so many places.
|
| http://main.diabetes.org/dorg/PDFs/Advocacy/burden-of-
| diabet...
| cptskippy wrote:
| I was referring to the relationship between the incidence
| of Type 2 diabetes and consumption of excess sugars.
|
| Big box stores push refined and processed foods that
| contain excessive amounts of sugar these days. They have
| sugary snacks and drinks in the checkout lines. They carry
| very few products without added sugars; try to find a
| bread, pasta sauce, or soup without crazy amounts of sugar.
|
| It's not entirely their fault, but Walmart has demonstrated
| in the last 40 years that they can compel manufacturers to
| just about whatever they want. If they wanted, they could
| push for the reduction or elimination of excess sugars in
| processed foods.
|
| But then again, there wouldn't be as large a market for
| Walmart brand insulin if they did that.
| frakkingcylons wrote:
| > But then again, there wouldn't be as large a market for
| Walmart brand insulin if they did that.
|
| So... you think Walmart sells processed foods because it
| will increase their insulin sales? Not because they're
| extremely popular high margin sales items?
| cptskippy wrote:
| No, that was a joke.
| UnpossibleJim wrote:
| Depends on the type of the diabetes. There's both Type-I and
| Type-II diabetes. Type-I is an autoimmune disease where your
| body attacks the insulin producing cells in the body, and can
| no longer regulate your blood sugars (high or low) and the
| person must take insulin. Type-II is sometimes caused by
| obesity, but is also caused by age sometimes. This can be
| controlled by oral medications, exercise and diet, sometimes,
| and lower doses of insulin to assist with their blood sugars.
| It's often referred to as "insulin resistant diabetes".
|
| EDIT:
|
| Forgot to mention. COVID seems to have been causing a rise in
| Type-I diabetes cases in non-juveniles =/
| thehappypm wrote:
| I'm curious to see how people will vilify Walmart for this one.
| Making insulin more affordable is clearly a good thing, right?
| bingidingi wrote:
| Choosing to profit off of it is choosing to let some people die
| if they can't afford it. Doesn't seem like a clearly good thing
| to me.
| rbanffy wrote:
| We can vilify Walmart for a number of things even if this one
| is not one of them. They need to pull a lot of nice things to
| get to neutral.
| pempem wrote:
| Can we not vilify Walmart and still be upset that we're putting
| a small bandaid on a pretty huge gouge?
| RHSeeger wrote:
| This is huge news. Sure, it's not the end goal of
| cheap/affordable insulin for all diabetics, but it is a great
| step in that direction. Walmart should be applauded for taking
| this step (and I'm usually first in line to hate on Walmart);
| kudos to them.
| adventured wrote:
| And the US does not particularly need to urgently aim for
| ~$10-$15 as in many other affluent nations. This is a mistake
| commonly made by those griping about insulin prices, they
| expect that somehow magically we should just warp to $12
| insulin pricing. That desire for step-skipping is never going
| to happen, that's a great way to never get anywhere. The
| reality of the giant mess of a healthcare system the US has
| means it can't work that way, and thinking otherwise is pure
| fantasy. Instead, $30-$40 would do just fine compared to where
| we're coming from, it would be tremendous progress. Once we get
| there, we can target ways to reduce it further to try to get
| closer to in-line with other nations. As you note, this
| improvement is welcome, and we should then focus on going after
| the next step-forward improvement.
| bart_spoon wrote:
| Everyone in this thread rightfully outraged by insulin prices
| needs to look into the rebate system and PBMs in America. Its an
| absurdly complicated environment, born out of a desire to drive
| drug costs down, that paradoxically drives them up. There's
| plenty of approaches to tackling drug prices, but dismantling the
| rebate system needs to be included.
|
| And frankly, the best way to dismantle the system is through some
| form of publicly available, universal health insurance. I believe
| in the power of healthy, free markets as much as anyone, but the
| current healthcare system is anything but. The lack of a non-
| profit seeking provider of health care, in a space where
| customers options are to pay whatever is charged or simply die,
| is not a functioning market. The rebate system was born out of
| what was a legislative bandage over this issue. Continuing to try
| and come up with cute solutions that avoid government provided
| healthcare for all will see similar results. Its why Americans
| spend so much more on insulin, and most other forms of healthcare
| services, than the vast majority of the world.
| s3r3nity wrote:
| > ...in a space where customers options are to pay whatever is
| charged or simply die
|
| Look...I agree with the majority of your point, the majority of
| healthcare doesn't deal with such an obvious binary...and we
| aren't going to make progress on this issue unless we're
| willing to also have the conversation about healthcare within
| your control - e.g. individual responsibility for your
| healthcare.
|
| A number of close family members are doctors / surgeons of
| various kinds, so I've heard so many issues & complaints about
| the system. And while I would happily pay taxes to fix
| healthcare issues that are preventative (e.g. cancer
| screenings,) educational (e.g. nutrition,) and overall
| unpredictable (e.g. surprise brain aneurysms or the like,) I
| have no desire in paying for:
|
| - Someone who drank so much and annihilated their liver,
| requiring significant & expensive surgery
|
| - Someone who couldn't stop eating at McDonald's and hasn't
| touched a vegetable in a decade now wants lifetime insulin and
| kidney transplant
|
| - A hypochondriac who wants to see their doctor for every
| scratch, off-color skin mark, etc.
|
| - Someone voluntarily jumping off planes, doing dangerous
| sports, etc. without insurance, and expecting someone else will
| foot the bill
|
| - Someone who wants every and any blood test because they
| coughed once
|
| etc. etc. etc.
|
| Again...overall I agree with a more central payer system, but
| you won't get the conversation started with all the groups
| involved unless you acknowledge that there's some element of
| individual responsibility that you need to control for as well.
| joncrane wrote:
| Sometimes the cost of trying to avoid that type of
| misallocation of resources costs more than simply paying for
| it.
|
| The classic example is drug testing welfare recipients which
| was proven to cost more than just giving it out.
|
| Sometimes you have to chalk some of this stuff up to "the
| cost of doing business."
| gnopgnip wrote:
| So what should be done for all of those people? Just go to
| the ER every time they need healthcare? Start denying ER
| access to those that can't pay?
| heavyset_go wrote:
| From a purely selfish perspective, countries with universal
| health coverage pay less than Americans do for healthcare,
| and those countries have better healthcare outcomes, quality
| of care, shorter wait times and they manage to insure
| everybody. You'd enjoy not only lower prices, but better care
| adopting such a model.
|
| But yours isn't even a selfish perspective, but a moralizing
| one. You don't like the idea of someone getting healthcare
| that you feel doesn't deserve it, and it seems like you don't
| care if that means you pay more for healthcare or receive
| worse health outcomes as long as _those_ people can 't see a
| doctor.
| srtjstjsj wrote:
| Inheritance tax can pay for that. Use undeserved money to pay
| for underserved care.
| bart_spoon wrote:
| Ultimately the choice will come down to creating a system in
| which the unfortunate are protected at a cost of also
| subsidizing the irresponsible, or sacrificing the unfortunate
| for the sake of punishing the irresponsible.
|
| None of us want to be taken advantage of, but I weigh
| protecting the most vulnerable and unfortunate, of whom there
| are many, more heavily.
| pessimizer wrote:
| Ultimately the moral debate is purposeless. Our health care
| system is designed and run by predators, and propped up by
| a sentiment that we're willing to pay twice as much to
| support a system that includes the most vulnerable and
| unfortunate, and the wealthy, but impoverishes or excludes
| the working classes.
|
| The easiest way to find out if someone lacks health care
| access is to ask them if they work with their hands.
| rickspencer3 wrote:
| What if paying for all of those things resulted in overall
| lower health care costs for you? If, theoretically, we all
| pulled our resources and collectively provided healthcare for
| everyone and, as a result, your overall health care costs
| went down (i.e. your share to cover everyone was less than
| your current expenses to cover yourself + whatever taxes you
| currently pay) would you be willing to pay for those things
| in your list?
| majormajor wrote:
| So how much money are you willing to spend on doctors who are
| doing nothing but figuring out which patients were "too
| irresponsible" versus which ones will get covered?
| ryanmcbride wrote:
| All those people still deserve healthcare. Just about every
| other developed nation has no problem supporting everyone, so
| I don't see why things should be so different for us.
| Treatment of others shouldn't be determined by your personal
| morals. What if that extended to everything else that is
| socialized in our system?
| pjerem wrote:
| > - Someone who drank so much and annihilated their liver,
| requiring significant & expensive surgery
|
| That's called an addiction. It's a disease. And that should
| (and can) be fixed by a doctor.
|
| > - Someone who couldn't stop eating at McDonald's and hasn't
| touched a vegetable in a decade now wants lifetime insulin
| and kidney transplant
|
| Same thing + metabolism issues, aggravated by voluntarily
| aggressive marketing. Can and should be fixed by a doctor.
|
| > - A hypochondriac who wants to see their doctor for every
| scratch, off-color skin mark, etc.
|
| Psychiatric issue with real psychiatric or physical pain :
| can and should be fixed by a doctor.
|
| > - Someone voluntarily jumping off planes, doing dangerous
| sports, etc. without insurance, and expecting someone else
| will foot the bill
|
| Just make insurance mandatory for extreme sports like in most
| countries.
|
| > - Someone who wants every and any blood test because they
| coughed once
|
| Same as above. Hypochondriasis is totally documented as a
| real suffering and psychiatric issue.
|
| All your examples are situations that can be prevented with
| preemptive medicine which is the norm in countries where you
| can see a doctor long before being sick. I'm not saying it's
| easy or perfect, but it's easier for doctors to prevent
| diabetes if they can follow patients regularly and check
| their vitals than if they only see them once a year or less
| because they can't afford it.
| chadash wrote:
| I think you are in line with how many people feel. The
| problem is that whether you like it or not, you _are_ footing
| the bill for all of these people under the current system. My
| health insurance is $600 /month because I'm in a pool of
| people who are mostly healthy, but the insurance company runs
| the risk that one or two of us could cost a fortune. In fact,
| I'd probably pay a lot less towards healthcare if the
| government was the payer since they can leverage their size
| for much better prices.
| pessimizer wrote:
| _Good AIDS vs. Bad AIDS_
|
| https://www.dailymotion.com/video/xc3x84
|
| Why keep your moral condemnation limited to taking health
| risks? What constitutes healthy behavior is very fuzzy at the
| edges, I would prefer to condemn people based on who they
| vote for, or their religion. Why would I want to support the
| continued lives of people who I think cause health problems
| in _other_ people?
| memetcn wrote:
| It absolutely blows my mind that people are hyped about a
| Supermarket started selling insulin at low cost.
|
| And I'm writing from Turkey which you would think it would be
| terrible in managing any public infrastructure including health.
|
| My company pays equivalent to 400 USD per year for private health
| insurance, gives me unlimited access for surgeries, any treatment
| that I need to stay at hospital and a check-up per year. The
| insurance is valid in any private hospital including the ones
| that look like straight out of Space Odyssey.
|
| You know what's more interesting? If you think this is a good
| deal, then almost everyone in Turkey thinks this kind of service
| should be provided by public healthcare system and demand it. Not
| only for the people that can pay 400 USD per year.
|
| edit: I realized it sounds like you need to pay 400 USD for
| unlimited healthcare but you don't need to pay anything for the
| state hospitals. The insurance is for zero-cost treatment at the
| private hospitals. You do pay a contribution fee around 3-5 USD
| for every visit plus prescription at the state hospitals though.
| I believe it is for discouraging unnecessary visits to the
| hospitals but even that causes a stir.
| ipnon wrote:
| "Americans can always be trusted to do the right thing, once
| all other possibilities have been exhausted."
| grecy wrote:
| > _almost everyone in Turkey thinks this kind of service should
| be provided by public healthcare system and demand it_
|
| In virtually all developed countries, it is provided. Hundreds
| of millions of people around the world live this way, right
| now.
| msandford wrote:
| We could do it in the US too! Convince the Democrats to give
| up $x billions in $something to do universal healthcare and I
| bet you could get a bunch of Republicans to support it.
|
| The problem is that neither party wants to make deals. They
| both want to have their existing programs AND to add extra
| ones on too.
|
| Everyone follows their incentives. None of them have the
| incentive to make a deal and get de-elected. They have lots
| of incentive to grandstand and call the other side bad-guys
| for being bad and not agreeing to this thing that "we all
| know is moral and right" that clearly we don't have some kind
| of 90% super-duper extra majority that all agree it's right.
| If we did, it would most likely be done already.
| ansible wrote:
| > _We could do it in the US too! Convince the Democrats to
| give up $x billions in $something to do universal
| healthcare and I bet you could get a bunch of Republicans
| to support it._
|
| Nope.
|
| Leaving aside the the current psychotic break the GQP is
| experiencing this year, universal health care is not
| something they've ever wanted.
|
| Why? Well, the insurance companies and for-profit hospitals
| have big lobbying efforts to ensure that sort of thing
| absolutely will not get passed. Because it would kill the
| need for them (insurance) or hurt profits (hospitals).
|
| UHC will not happen until there is serious reform with how
| politicians get elected, and how lobbying works.
| msandford wrote:
| > Nope.
|
| Nope to that!
|
| See I can make unfounded assertions too! It's fun.
|
| > Leaving aside the the current psychotic break the GQP
| is experiencing this year, universal health care is not
| something they've ever wanted.
|
| There's a difference between "I would never, ever vote
| for this under any circumstances because NO WAY" and
| "I'll get voted out if I allow an increase in spending on
| something that my voting base doesn't want".
|
| In the same way that Democrats couldn't go to their
| voting bases and say "see we got universal healthcare! "
| if they had to give up the necessary funding in other
| places in order to make it budget-neutral, Republicans
| could only hope to get re-elected if they could go to
| their voting bases and say "look yeah we compromised, but
| it was on a thing that was budget-neutral! We didn't get
| a tax break for you, but we did eliminate all these other
| $horrible programs!"
|
| I'm not saying that's good or right or what we want. But
| both sides are playing to their audiences and very much
| tuned in to what they want. That's what you have to do to
| get re-elected. That's why neither side is interested in
| compromising to make a deal. They'll get crucified for
| "not standing up for what WE believe in" and
| "compromising with that other side full of awful, evil
| people"
|
| I don't really like that the US hasn't done much
| legislatively in the last 20 years. But, I, personally,
| myself don't get to decide how all this works. And
| neither does anyone else.
| ansible wrote:
| You seem to be under the impression that the large blocks
| of voters actually understand and care about the issues.
| Large corporations and their considerable advertising and
| lobbying efforts are what's really important. Much of
| this effort is to frame issues to the public in the way
| they choose.
|
| The "stances" the voting base take are largely shaped by
| influence campaigns of powerful interest groups. Both
| major parties (the minor ones too) are affected by this.
| Though one of the groups has gotten even stupider
| recently, and they actively vote against their own best
| interests.
|
| _Edit:_ grammar.
| msandford wrote:
| > You seem to be under the impression that the large
| blocks of voters actually understand and care about the
| issues. Large corporations and their considerable
| advertising and lobbying efforts are what's really
| important. Much of this effort is to frame issues to the
| public in the way they choose.
|
| The idea that it's the voters that vote is actually true!
| That's how the system works. Corporations can influence
| that of course, probably to an enormous degree. But the
| corporations themselves don't vote. That's the system
| we've got.
|
| The primary mechanism in our system is people. And people
| aren't logical, rational, economically-maximizing, or any
| of it. People are far more narrative-driven than they are
| rationally-driven.
|
| THAT's what I would say that Republicans would get on
| board with a universal healthcare bill in which they
| could claim that they "destroyed" the Democrats by
| "obliterating" a bunch of "socialist pork". But that's
| absolutely going to ensure that the Democrats that
| "caved" in order to get something important done won't be
| able to get re-elected. And they care more about getting
| re-elected than they do about doing the right thing! Same
| on the other side of the isle! This isn't a partisan
| issue. Everyone wants to get re-elected way, way, way
| more badly than they want to do the right thing.
|
| I don't like it. I don't think it's right. But it's
| extremely easy to see that neither party is compromising
| in any meaningful way these days. Both take hardline
| stances and don't budge. That's not a bug, it's a feature
| of American Democracy. It was designed such that if there
| wasn't wide agreement (or elected officials who would
| compromise) that things would grind to a halt. That was
| done so that nobody could run roughshod over the other.
|
| Until we start getting richer such that the increases in
| spending are coming out of even bigger growth or we
| somehow manage to convince everyone that paying more and
| getting less is totally-A-OK this is going to be how it
| continues to go. Neither side wants to compromise, so
| their counterparties don't want to either. Deadlock is
| the name of the game.
|
| > and they actively vote against their own best interests
|
| I can understand how you'd think that. It makes a lot of
| sense. But it belies a terrible ignorance on your part.
| Animals don't make decisions on purpose to make their own
| lives worse in ways in which they KNOW they will end up
| worse. You can try and project your ethics onto other
| people all you want and use their relative-to-you
| irrationality to belittle them. But it doesn't work!
| Putting people down doesn't change minds. In fact putting
| people down might be the very thing that got Trump
| elected (re: deplorables).
|
| I'm not saying Trump is good and Hilary is bad BTW. I'm
| just using that as an example of how unfortunate it can
| be to generalize one's personal ethics to the entire
| country and draw conclusions as a result.
| racl101 wrote:
| It's never a really straightforward thing though.
|
| I'm from Canada and we have Universal Health Care which is
| great.
|
| So when it comes to health care many Canadians like to shit
| on the US.
|
| On the other hand, Canadians are always complaining about not
| making enough money, getting taxed high and stuff. And many
| dream about going to the US where their money making
| potential is apparently higher.
|
| So to many Canadians, at some point, the potential to make
| more money outweighs the UHC enough to leave Canada and go to
| the US to make it big.
|
| So depending on where you are the capitalist nature of the US
| is a terrible thing and the thing that provides opportunities
| not afforded by one's own country.
| sangnoir wrote:
| > On the other hand, Canadians are always complaining about
| not making enough money, getting taxed high and stuff. And
| many dream about going to the US where their money making
| potential is apparently higher.
|
| I bet those Canadians are young and healthy, so they (think
| they) don't have to worry about healthcare costs. Those who
| suffer from chronic illnesses or are semi/retired aren't so
| hyped. In summary, what's good for a certain demography
| isn't necessarily good for the rest of the citizenry (like
| friends and family, who don't necessarily factor into the
| decision on where to work).
| lc9er wrote:
| > I bet those Canadians are young and healthy
|
| Exactly. I know a Canadian that's in their late 30's, has
| children, and mixed health record. Now that the
| adventures are over, they're eager to move back. Similar
| stories for European friends that married and had
| families with Americans.
| inglor_cz wrote:
| Being in top 20 % of the USA is great and I know several
| talented people from my acquaintance circle who moved to
| America and made the cut.
|
| Being in bottom 20 % of the USA seriously sucks.
|
| That is the tradeoff...
| Barrin92 wrote:
| It's not even really a trade-off because at the end of
| the day both live in the same country. The friction and
| dysfunction that is caused by this division also shrinks
| the space of the top 20%, who end up in a golden cage at
| best.
|
| I'm German from a low income family and I went to school
| with kids of millionaires and everyone walked through the
| same streets and went to the same bars. First time i went
| to the US I noticed what living in a bubble actually
| means. And the kids of the 'winners' seemed as neurotic
| as the kids of the 'losers'. There's an entire mindset of
| "if I not go into college X will I be where my parents
| are", "is such and such street safe", "should we move to
| X neighbourhood, is it better than Y". Even the
| "opportunities" that the people in the top 20% is
| basically are pure stress.
| syshum wrote:
| I can find many many many Canadians that complain about the
| level of care they get from the Canadian system warning
| Americans never to allow a system like theirs to happen
| here..
|
| Long Wait times, inability to see specialists, or get
| surgeries or MRI's etc
|
| US Care is expensive, and we need to solve that, but I
| still am not convinced turning it over to our inept
| worthless corrupt government is the best or only solution
| to the problems with paying for US healthcare
| grecy wrote:
| Funny you should use that example.
|
| I live in Canada, I've also lived and worked in the USA.
|
| I suggest you go and live and work in the USA. Be part of
| their system. Use their healthcare, send your kids to
| school, walk through WalMart, live your life.
|
| Sure, when you're in the top 30% or so life is pretty good,
| as long as you can avoid everyone else in society who are
| struggling HARD. It doesn't take a rocket scientist to
| figure out why there is so much violent crime, so many
| people in prisons and so much violent policing in the USA -
| tens of millions of people are desperate and struggling for
| the essentials they need just to live.
|
| You simply don't have that in Canada, the social safety net
| takes that away.
| Teever wrote:
| > So to many Canadians, at some point, the potential to
| make more money outweighs the UHC enough to leave Canada
| and go to the US to make it big.
|
| It isn't so cut and dried.
|
| At any point these people can return to Canada and receive
| free healthcare again after only a year of waiting.
|
| What these people are doing is betting that they won't have
| any crippling healthcare incidents while they're young and
| banking on the fact that they can always move back to
| Canada to receive free healthcare for the chronic health
| conditions that accrue in old age.
|
| Many of these people are effectively leaches on the
| Canadian health care system as they do not pay taxes into
| it and then make use of it in old age when they return to
| Canada.
| Amezarak wrote:
| Can't they just get on Medicare in the US in old age? Why
| do they need to return to Canada? Are they ineligible?
| HDMI_Cable wrote:
| You don't even need to wait in most circumstances. If
| your family still lives at the same residence, and you
| remember to keep for health card up to date, you can most
| likely get service as if you never left.
| gwright wrote:
| It doesn't make sense to just talk about insurance premiums if
| you are existing within a system also funded by tax dollars.
|
| Phrases like "you don't need to pay anything for the state
| hospitals" just means you are ignoring tax contributions, which
| isn't going to lead to any sort of reasonable comparison with
| other systems.
| memetcn wrote:
| I'm not ignoring the tax contributions. You would pay 25-40%
| income tax for pension plus social security depending on your
| income. I'm super glad to pay that and willing to pay more if
| that means parents don't have to go "shopping for insulin at
| a supermarket" for their children. It's just insane and can't
| wrap my mind around it.
| softveda wrote:
| How much does the specialists earn in Turkey? In Australia
| Surgeons, Anaesthetists and internal medicine specialists top
| the highest earning professionals chart. Registered Nurses and
| allied healthcare staff also gets paid quite high. Then there
| is stupid high cost of prosthesis in a country where we do a
| lot of knee and hip replacements. Do you have those private
| space odyssey type hospitals distributed in the whole country
| or only near Istanbul?
| mustacheemperor wrote:
| You get a whole _check-up_ per year at that rate? Here in the
| states I had to see a doctor (in network with my health
| insurance) twice during the pandemic, each visit lasted under
| 40 minutes in an online video call, combined cost out of
| pocket: $1000 USD.
| memetcn wrote:
| I am not sure what you'd mean by whole check-up but I had one
| last year at this hospital and it was included in the private
| health insurance for free. It does not list every item but it
| might give you a rough idea (yes, I had a chest x-ray and a
| general ultrasound check):
|
| https://www.livhospital.com/en/liv-branches/check-up-center
|
| One last thing, probably there is a better English term for
| this but we have these government institutions in each
| neighbourhood. They are small and they employ 4-5 doctors and
| a couple of nurses that provide first level healthcare. (I
| would say there is a doctor for around 5000 to 10000 people)
| If you would go to your assigned doctor and ask for it, they
| do many of the blood tests at the same day and hand the
| results. This is a common procedure afaik and your doctor
| would be encouraging to do it every 12 months even if you
| don't ask for it.
|
| Yes, we don't make too much money and pay about 25-40% income
| tax but we don't need to shill thousands of dollars for a
| facetime call with a doctor.
|
| My suggestion would be to visit Turkey and spend those couple
| thousands USDs on check up and some nice vacation :)
| Teever wrote:
| I believe that the person above was using a common english
| expression to put emphasis on the fact you received a
| complete medical check up that probably included your
| doctor's undivided attention for over an hour as well as
| blood tests and a follow up by your doctor as part of your
| $400USD annual healthcare costs.
|
| They are contrasting that with their brief online sessions
| with their doctor that cost them $1000.
|
| The emphasis on whole is to distinguish being the partial
| check up that they received for more money.
| krab wrote:
| Wow, that's expensive.
|
| An average person's healthcare costs a few thousand dollars
| per year in EU. That includes people with innate conditions
| or other expensive treatments. Most of the countries have
| zero or only nominal out of pocket expenses.
|
| https://ec.europa.eu/eurostat/statistics-
| explained/index.php...
| giarc wrote:
| How is this sold to Americans as a good option? Is it that
| you have "choice" of insurance providers? Is it that you
| might pay less if you are healthy? I don't get it, why do so
| many American's vote in politicians who advocate for this
| type of healthcare?!
| ansible wrote:
| The debate in the USA is framed with the implication that
| if you (the health care consumer) does not have "choice"
| then you will be forced to only see a really terrible
| doctor, and get substandard care at a high price. And that,
| with a little effort on your own part, you will be able to
| select a better doctor at a affordable price.
|
| Therefore, if you have a bad doctor or expensive care, it
| is your own damn fault. You just didn't try hard enough to
| find a good one.
|
| It is the same thing with the debate about school vouchers
| vs. a standard public education for everyone. A heaping
| dose of "the free market fixes everything", for all life's
| problems.
|
| I would rather not have a "choice". I would like to be able
| to select _any_ nearby doctor, and be assured of getting
| competent care.
|
| I'm not often in the situation where I have a wacky
| tropical disease that presents odd and incongruous
| symptoms, which would take a Dr. House to figure out. I am
| far more likely to have run-of-the-mill heart disease or a
| common form of cancer. I just need a doctor with some basic
| level of competence, who can just listen to me and help me
| through the common health problems of modern life.
| dantheman wrote:
| Are you against school vouchers? Why would you want
| parents to not be able to select the school their
| children go to?
| rrrrrrrrrrrryan wrote:
| I never understood the concept of vouchers. Taxes are
| connected from everyone to pay for public schools, which
| can be used by anyone's children. They're not to pay for
| the schooling of _your own children_.
|
| I don't have children at all, and I don't mind paying
| taxes to fund schools, because when I'm old I want the
| doctor who is younger than to have gotten a good
| education. I don't expect any vouchers just because I
| don't have kids consuming public education.
|
| Vouchers always seemed to me like an obvious scheme to
| defund public schools and let them rot, thereby punishing
| kids who were unlucky enough to be born poor.
| ansible wrote:
| If parents want to send their kids to religious schools,
| they can pay for it themselves.
| throwawayboise wrote:
| They are. Their taxes pay for the vouchers.
| g00gler wrote:
| Religious schools aren't the only use of vouchers either.
| There are also charter schools. Charter schools can often
| provide specialized programs. Montessori schools seem
| awesome as well.
| Amezarak wrote:
| In my experience, doctors are like programmers.
|
| Nobody really has any effective way to evaluate them, or
| at least, nobody does so on a broad basis or
| consistently. Some of them can't pass fizzbuzz. Some of
| them can churn out CRUD apps, but have no idea what
| they're doing when it comes to anything else. Some of
| them are extremely dogmatic about design patterns and
| tooling and ignore anything they don't like. Some of them
| are inattentive or poor listeners. Some of them assume
| it's Problem X they've seen a million times, but it's
| not. Some of them are assholes. Some of them are really
| sharp and really engaged, but get overly excited and
| reinvent the wheel or spend a lot of time doing stuff
| that's completely unnecessary and maybe even harmful.
|
| I don't know how to evaluate doctors until I see them, I
| have no idea if better doctors cost more or less, I doubt
| there's a strong correlation because nobody else can
| evaluate them either. They either help me or they don't.
|
| I think it absolutely is necessary that I should be able
| to have a history and see the same doctor, and that I
| should be able to see another doctor any time I want for
| the same condition for a second, third, or fourth
| opinion. I have seen this be absolutely necessary for
| myself and others with common conditions that were
| resolved after seeing a different doctor.
|
| I assume this is still possible in most if not all public
| health care systems (I live in the US but local doctors
| and hospitals are all government run, an interesting
| aside), but I am not sure. I recently had a conversation
| with a Canadian friend who has debilitating autoimmune
| disease his specialist is doing basically nothing for and
| he made it seem like it wasn't possible, but I didn't
| want to press.
| Amezarak wrote:
| Because it's not the insurance that's expensive, it's the
| medical care, and rooting out the zillion reasons that's
| expensive is difficult and involves attacking some sacred
| cows.
|
| Plus, about a quarter of Americans have "free" care
| already, via Medicaid and Medicare. Many of the rest have
| their employer hiding the true cost from them - they think
| the premium that comes out of their check is the actual
| cost. Some employers apparently even pay 100% of the
| premium cost.
|
| So all these people are okay with the status quo, or even
| want to defend it. It's the people on (increasingly common)
| high deductible plans, people with no insurance, or people
| who experience a catastrophic edge case (out of network
| provider for example) that hate it.
| dcolkitt wrote:
| The high cost of healthcare in the US has very little to do
| with the structure of insurance. Insurance industry profits
| only account for 2% of aggregate medical expenditures.
|
| The reason that Turkish healthcare is much cheaper than
| American healthcare is primarily because Turkish doctors
| are paid much less than American doctors. There's a very
| simple solution to that. All you have to do is let Turkish
| doctors come to the United States and practice medicine. Or
| better yet let Turkish hospitals open entire branches in
| the United States and wholesale import their staff,
| equipment, and drugs from Turkey.
|
| The reason that doesn't happen is because we have a cartel
| called the American Medical Association that continuously
| lobbies for antiquated barriers to foreign competition.
| Unless a physician does a residency in America (which good
| luck, if you're a foreigner from a foreign school), you
| will never be allowed to practice in the US.
| tidydata wrote:
| To be quite honest, most of it is sold by the media, who
| have mutually beneficial arrangements with the for-profit
| healthcare/insurance industry. If you've ever seen how many
| advertisements on American TV about prescriptions, health
| plans, etc, you know what I'm getting at. The debate is
| kept tightly constrained to make the capitalist system seem
| more robust and successful than it actually is. So: media
| propaganda, more or less.
|
| Also want to add: my child's birth cost $20,000 (with
| insurance). When I would tell other Americans about this,
| the response was (usually) "you know you can get on a
| payment plan, right?"
| mulletbum wrote:
| They aren't voting for their own best interests. They are
| voting to stop people from killing babies and stop
| socialism (or whatever else they are told).
| [deleted]
| Rebelgecko wrote:
| I thought in post-ACA America, all health insurance has to
| cover 100% of the cost of your annual physical? Were your
| visits explicitly preventative checkups?
| patrickthebold wrote:
| Are you on a high deductible plan?
| kasey_junk wrote:
| Were you seeing a specialist of some sort? For comparison I'm
| in the states and a wellness visit is -mandated- to be free
| per year and my primary care provider charges $60 for a 30
| minute video call outside of that. I use a high deductible
| plan so this was not my copay or anything it was the full
| cost after insurance negotiated rates.
| Natsu wrote:
| How did they cost that much? We had several doctor visits,
| virtual and otherwise, and never had more than a $20 co-pay,
| with most of them being free.
| dougmwne wrote:
| The system in the US is exactly as crazy as it seems. It
| generates lots of profits and lots of financial hardship for
| patients. There is just about zero political will for any
| political party to fix the situation and we all expect it to
| continue to get worse.
| inetsee wrote:
| The retail price of my Humalog is $280 a vial. I have insurance
| so my cost is a fraction of that. Also, I don't know how Novolog
| compares to Humalog, but $73 a vial is a step in the right
| direction for diabetes patients who are uninsured or
| underinsured.
| ska wrote:
| Out of curiosity if you don't mind, how many vials/[unit time]
| do you need, and is this variable per person or mostly just
| between people?
| rharb wrote:
| Can't speak to the parent but vials per time can both change
| per person and between people.
|
| My wife requires quite a bit more insulin while pregnant for
| example - she had to make changes to her pump's settings
| while in the hospital to accomodate it.
| ska wrote:
| Thanks! I looked up some rough usage stats due to the
| recent related discussion, but didn't easily find something
| clear about variability.
| wanderingmoose wrote:
| It is variable. But I'm 220, 6'6" I use ~24 units per day
| basal rate (continuously pumped, amount programmed over 24
| hours) And 1 unit of insulin per 15 grams carbohydrate. I
| usually average ~50 units per day.
|
| Additionally my pump (tandem x2) has a lot of loss due to
| their loading system. For 300 units loaded, you get 250
| deliverable units. Reloads happen about every 5 days.
|
| For use per month, I have 2 vials per month prescribed.
|
| If you are thinking about cost: pump insertion sets and
| continuous glucose monitoring sensors are all very expensive
| as well.
| inetsee wrote:
| I am an unusual case: I am LADA (Latent Autoimmune Diabetes
| in Adults), sometime called Type 1.5. I am autoimmune (and
| therefore insulin dependent) but I didn't become symptomatic
| until my early 40s. Also, my weight hovers around 160 lbs, so
| my comments do not apply to type 2 diabetes patients who are
| significantly overweight.
|
| I use Lantus as my long acting insulin, and Humalog as my
| fast acting insulin. I receive a shipment of three 10ml vials
| of each every 3 months (so I use 1 a month). I use 30 units
| of Lantus a day, and a variable number of units of Humalog,
| averaging 25 units a day. Thus, 1 vial of Lantus lasts me
| slightly over 30 days, which is how long you should use a
| vial of insulin before replacing it.
|
| Figuring out how many units of insulin to take can be
| difficult. This year I got a Freestyle Libre 2 glucose
| monitor which has alarms which will alert me if my glucose
| goes above or below preset limits. Fortunately, I am
| sensitive to hypoglycemia; sensitive enough that I will wake
| up if I go low while I am sleeping, but I can still get as
| low as a glucose reading of 40 point before I feel the
| effects, which upsets me and freaks out my wife. The alarm is
| set for 80 points, so I can take some carbs before I get
| seriously hypoglycemic.
|
| I adjust my Humalog injections based on my glucose readings
| and my carb intake using a formula I have adjusted over long
| experience. I may take as little as 1 unit (if I just need to
| bring my glucose reading down) or as much as 12 units with a
| meal, but most of the time I take about 8 units with a meal.
| nefitty wrote:
| I was curious about this too. Hopefully someone with
| firsthand experience will correct me/add on to my comment. I
| hear about insulin a lot but I've never gotten an idea of how
| dosage works.
|
| What I found: 1 unit of insulin will cover 10g of
| carbohydrates [1]
|
| Humalog insulin comes in 3 mL (300 units) vials or 10 mL
| (1000 units) vials. [2]
|
| The list price of a Humalog U-100 10 mL (1,000 units) vial is
| $274.70 [3]
|
| In type 1 diabetes, most people need a total of 0.5 - 0.8
| units of insulin per kilogram of body weight each day. [4]
|
| In patients with type 2 diabetes, marked obesity, and insulin
| resistance, total daily insulin doses of 200 to 300 units are
| often required. In this setting, management for most patients
| includes a total of 1.0 to 2.0 units of insulin per kilogram
| per day; thus, in very obese patients, a larger total dose is
| required. [5]
|
| In type 2 diabetes, the average weight is 96.5kg - 98.9kg.
| [6]
|
| The average American weight in 2020 was 181 lbs. So around
| 82kg. [7]
|
| With the above details, in type 2, about 100 - 200 units are
| needed per day. That's $989 - $1978 per year. In type 1, $494
| - $791.
|
| 1. https://www.medicalhomeportal.org/link/3822
|
| 2. https://www.nationwidechildrens.org/family-resources-
| educati...
|
| 3. https://www.lillypricinginfo.com/humalog
|
| 4. http://www.diabeticretinopathy.org.uk/prevention/insulindo
| se...
|
| 5. https://www.patientcareonline.com/view/insulin-dosing-how-
| hi...
|
| 6. https://care.diabetesjournals.org/content/29/3/493
|
| 7. https://news.gallup.com/poll/328241/americans-average-
| weight...
| CollinEMac wrote:
| "1 unit of insulin will cover 10g of carbohydrates"
|
| This varies significantly from patient to patient actually.
| The same goes for basal rates (how much insulin you need to
| maintain a healthy blood glucose level excluding what you
| eat). As you mentioned, weight is a big factor but so are
| other things like age, sex, diet, activity level, stress
| level, and just how well your body reacts to the insulin.
| Some people respond very well to artificial insulin while
| others just don't for some reason. I believe it can also
| depend on how long you've been using insulin. Your body can
| slowly stop responding as well as it used to.
|
| The numbers you came up with as an average sound pretty
| reasonable, but it's important to remember that daily
| dosage will vary quite a bit between individuals.
| ska wrote:
| This is the part I had trouble finding any quantification
| of (not that I looked properly).
| CollinEMac wrote:
| I've used both Novolog and Humalog (depending on what my
| insurance likes) and I didn't notice any difference in
| effectiveness for me. Everyone's different though.
| tj-teej wrote:
| Everyone will have kids one day or knows someone who will. And if
| that kid is born with type-1 diabetes they will require insulin
| everyday or else they will die.
|
| The inventor of insulin sold the patent for $1 because the
| thought that it would not be available to all was unconscionable.
|
| It is absolutely unacceptable that insulin is not free and
| available to all (including to those who can afford it at the
| cost of financial stability).
|
| The idea that someone without means should have to pay Walmart
| $86 for a worse low-budget insulin is disgusting.
| bart_spoon wrote:
| > The idea that someone without means should have to pay
| Walmart $86 for a worse low-budget insulin is disgusting.
|
| Its not worse, its significantly better. The version of insulin
| sold for $1 is human insulin, which has been available at
| Walmart for $25 for many years. The version being discussed
| here is human analogue insulin, which was invented by the
| pharma companies in the past few decades. Its significantly
| better tolerated, and the rates at which the body can uptake
| the insulin can be tweaked to be much faster or long-lasting.
| Its like comparing a Tesla to a Ford Model T.
| whymauri wrote:
| >Its like comparing a Tesla to a Ford Model T.
|
| Honestly, yeah. The quality of life improvement between the
| two is humongous. I've heard treatment on the older insulin
| therapies described as "a life ruled by the clock where a
| mistake means death."
| SirSavary wrote:
| The $86 insulin is not worse.
| xattt wrote:
| RN with some diabetes education experience here. Some of the
| ultra lente insulins (degludec, glargine) are q 24h to q 36h
| dosing, which approaches the convenience of an insulin pump
| (which are wildly expensive). Insulin pumps requires some
| maintenance but not as inconvenient as regular injections. This
| is not the kind of insulin that Walmart is announcing.
|
| What is going on is that big pharma is now charging a premium
| for the user experience, and not the actual cost of the product
| or amortizing R&D.
|
| (Of course the caveat here is that a therapy regimen that uses
| ultra lente insulins exclusively may be suitable for some type
| II diabetics who hadn't achieved appropriate glucose control on
| oral antihyperglycemics, and that insulin dosing with meals
| using rapid acting insulin on top of a ultra slow acting
| insulin may follow after a while).
| panzagl wrote:
| Sounds similar to what happened to Epipens- the drug is long
| out of patent, but the injector/delivery system gets
| continual minor tweaks to stay proprietary.
| m3kw9 wrote:
| Which corp is gonna distribute something for free? This is a
| government's job.
| artificialLimbs wrote:
| The government never distributes anything for free. They
| distribute it with money taken forcibly from citizenry. Be
| careful what you're asking for in begging the government to
| take care of you. They just may.
| staticassertion wrote:
| wow huh, never thought of that - just learned about "taxes"
| being a thing from hacker news, thanks for the insight, no
| one here ever would have made the massive leap to know that
| governments are funded through taxation
|
| good thing there are two comments about it!!!
| _jal wrote:
| A disturbing number of people think they're actually
| adding value by doing this.
|
| Orwell called it 'Duckspeak'.
| gnulinux wrote:
| > They distribute it with money taken forcibly from
| citizenry.
|
| Yes that's exactly the point. I make $150k a year, live
| very comfortably and pay almost 30% tax (in USA). If the
| government stops funding endless wars and starts using my
| tax money to help people get healthcare and education, we
| wouldn't have this problem.
| mrtranscendence wrote:
| Agreed on all counts. I make just a touch under 150 and I
| can afford the taxes. I'd happily pay more if that meant
| offering better healthcare and education options for
| everyone.
|
| Take half the DoD budget, add in medicare and medicaid
| outlays, and throw on what most of us pay for insurance
| already, and you're most of the way to paying for a
| decent health care system. It's criminal that Americans
| in 2021 could die from diabetes complications due to lack
| of affordable insulin.
| srtjstjsj wrote:
| The wars are why you get $150K/yr instead of someone
| else.
| dnautics wrote:
| Many non-profit corporations distribute things for free?
| xtracto wrote:
| Reminded me of my tourist trip to Las Vegas. At some point
| we got on a bus to travel from one hotel to other.
|
| I asked the driver if that bus was the free one (meaning,
| if that was the bus in which I didn't have to pay). The
| driver replied a bit angry that the bus trip was not free,
| it was complimentary.
| pc86 wrote:
| For free, or at cost?
| barbacoa wrote:
| Government doesn't do anything for free it's the tax payer
| that pay.
| pjerem wrote:
| Yeah that's the point of a government. Oh, and that's also
| why they are elected democratically.
| YinLuck- wrote:
| When was the last time you read anything? Last century? The
| government funds as much of its spending through printing
| as it does taxing.
| hourislate wrote:
| I agree that Insulin should be free for everyone, it just makes
| sense. But you make it sound as if Walmart is making money on
| this. I would bet it barely covers their cost (Break Even).
| They did this because they have the power to do this (twist
| some arms). Don't blame Walmart, blame your government for
| allowing Big Pharma to charge 80% more in the USA than they do
| almost anywhere else in the World.
| subsubzero wrote:
| This is a thing somebody like Bill Gates or Buffet should take
| up, scrap together a company and provide these life saving
| drugs at rock bottom prices, I feel like alot of their stuff
| has not been very relevant considering the $$$'s behind their
| non-profit ventures.
| solarkraft wrote:
| Why would it be worse?
| cabraca wrote:
| Because this old style insulin acts slower than the more
| modern version and requires a rigid eating schedule.
|
| See: https://diabetesstrong.com/walmart-insulin/
| wbl wrote:
| The article says that this is one of the newer ones
| distinct from the formulation they already sell.
| guardiangod wrote:
| > Because this old style insulin acts slower than the more
| modern version and requires a rigid eating schedule.
|
| Good thing the article is about Walmart now selling 'analog
| insulin' ie. modern version of insulin
| loeg wrote:
| The one the article is talking about unveiling is the new
| style ($86 at Walmart). (The old style can already be found
| at Walmart for $25.)
|
| Walmart sucks in a lot of ways, but this article does not
| demonstrate that.
| csnover wrote:
| Last year, Minnesota passed the Alec Smith Insulin
| Affordability Act, which requires the major insulin
| manufacturers to provide 30-day emergency supplies of insulin
| for no more than $35, and 90-day supplies for no more than $50,
| for anyone meeting the program guidelines[0].
|
| The law was modelled around the companies' existing patient
| assistance programs, and despite assurances from industry reps,
| PhRMA sued the state anyway just hours before the law was due
| to take effect[1]. This spring, their lawsuit was dismissed[2].
|
| This law isn't a great solution if you think that insulin
| should be free to all, but it is at least something that other
| states can use as a model to try to help their citizens access
| to cheaper, high-quality insulin.
|
| [0] https://www.mninsulin.org/
|
| [1] https://www.minnpost.com/state-government/2020/07/why-so-
| man...
|
| [2] https://www.twincities.com/2021/03/16/alec-smith-insulin-
| aff...
| arcticbull wrote:
| This is the weirdest socialized medicine I've ever seen,
| "offer valid only for COVID tests, COVID vaccines and Insulin
| (terms and conditions apply)." This kind of targeted quick
| fix is kind of the epitome of the little patches you put on a
| leaky kids swimming pool.
| xtracto wrote:
| Just yesterday my wife and I were watching "last week
| tonight" episode on US health share orgs. (Like a health
| insurance, but religious and unregulated).
|
| My impression was: The crazy hoops and loops that Americans
| will go through for healthcare just to NOT implement a
| sensible social healthcare program.
| gunapologist99 wrote:
| I certainly understand that reaction, but I don't think
| it's crazy.
|
| I just joined one. My primary care physician recommended
| it. It's about 28% the cost of the regulated ACA plans in
| my area for my size family. Read that number again. And,
| it covers everything (except no pre-existing conditions)
| except for things like cosmetic surgery.
|
| The list of things that the ACA plan didn't cover at all
| was confusing and pretty lengthy, and it had a $9k
| deductible (or more, many of the cheaper plans had $15k
| deductibles) _per family member_ , and double that (two
| family member's worth) for a max family deductible. To
| me, _that_ is crazy. And, for the cheaper plans, they
| required coinsurance, so if I had a disease that would
| cost $200k, I would owe $67k.
|
| Most amazingly, there's no deductible except for the
| $400-per-visit deductible. (There's no free maintenance
| or co-pays or anything like that.) Everything is covered
| after the $400-per-visit deductible, and there's
| virtually no maximum. Go to the ER, max of $400. Go for a
| checkup, probably pay it yourself (unless it exceeds
| $400).
|
| (One could argue that they should cover an annual
| checkup, but if it was just a matter of adding $150/year
| to everyone's plan, what's the point; that's an arbitrary
| amount that can be budgeted in once you know to expect
| it. Since it's people of that religion only, some built-
| in pre-qualification occurs to eliminate people who would
| just abuse the system.)
|
| These health share non-profit organizations have paid out
| billions by cooperating and coordinating among their
| members, and you negotiate with the hospital directly as
| a cash patient and make your own choice of care and
| providers.
|
| It's somewhat akin to how a credit union is dissimilar to
| a bank.
|
| I personally find the idea fascinating and certainly
| prefer it to forced socialized medicine.
| lolc wrote:
| Diabetes is a pre-existing condition for many. I'm lucky
| I live in a place where I can change insurer, despite my
| diabetes.
| slumdev wrote:
| > $400-per-visit deductible
|
| $400 is pretty close to the cost of an office visit,
| physical exam, metabolic panel, lipid panel, and EKG,
| which is what a primary care doc is going to order
| annually on something like 90% of Americans after a
| certain age.
|
| It shifts the expense of routine care and checkups to the
| patient. If you view insurance as indemnification against
| unexpected loss, it shouldn't be paying for expected,
| routine costs.
| srtjstjsj wrote:
| It should because those routine costs prevent disasters.
|
| That's also why car insurance pays you to install LoJack
| and homeowners insurance pays you to install fire alarms.
| slumdev wrote:
| Those are small discounts against a large premium.
|
| A health insurance analogy would be: Customer A pays
| $100/mo because he gets an annual checkup and takes the
| medicines the doctor prescribes. Customer B pays $200/mo
| because he hasn't seen a doctor since college.
|
| Customer B could reduce his total out of pocket by $800
| per year if he paid for the $400 visit.
| gunapologist99 wrote:
| > That's also why car insurance pays you to install
| LoJack and homeowners insurance pays you to install fire
| alarms.
|
| But this isn't true -- at least for any car insurance or
| homeowners insurance that I've purchased. You often
| receive a small discount, but the discount alone doesn't
| cover the cost of purchase/maintenance.
| fra wrote:
| > And, it covers everything (except no pre-existing
| conditions)
|
| You're foisting the sick and the elderly onto government
| programs, and patting yourself on the back for pulling
| yourself by your bootstraps.
| arcticbull wrote:
| I watched in one breath a former president explain to a
| group of AARP members that socialized medicine was evil,
| medicare was the best, and he'd do whatever it took to
| preserve medicare. I had a full on shocked pikachu face.
| srtjstjsj wrote:
| Uh, the people building healthshare programs _are_
| building sensible healthcare programs.
|
| They aren't the ones running government.
| xtracto wrote:
| Right but my main point is that those things look A Lot
| like social healthcare, except for the name.
|
| It's like the stuff we did when we were kids: "I'll do it
| because I want to, but not because you tell me to".
|
| Things like the NHS or Germany health system (both I've
| experienced) are pretty good. But hod forbids the US
| implements those /socialist/ systems.
| Gatsky wrote:
| It's no use expecting moral behaviour from a for-profit pharma
| corporation, which is an inherently amoral entity.
|
| You have to utilise incentives and regulation to keep prices
| down. One option is to adjust patent law to enable generic
| manufacturers to create competition. The downside of this is
| the generic pharma companies are usually off-shore (more profit
| that way) and also seem to just pretend to make the actual drug
| with some regularity (also more profit that way). Another
| option is for the US government to negotiate drug prices. The
| US market for medicine is so large that they would have
| incredible power to cut good deals. The downside to this option
| is that it will inevitably lead to some form of corruption eg.
| the drug negotiators don't try too hard so they can get a cushy
| job at the drug company next year in their drug negotiating
| unit.
|
| Anyway, I am fairly sure the latter option will happen soon,
| perhaps for some group of essential medicines.
| [deleted]
| UseStrict wrote:
| But they are selling both under their store-brand ReliOn. The
| less effective original formulation for $25, and the analog is
| the more effective one being sold at $86. Still an absurdly
| high cost in my opinion, but to get the higher quality analog
| insulin for like a quarter of the price of the name brands is
| going to be life saving for a lot of people.
| jessedhillon wrote:
| In case anyone else has no experience with diabetes and is
| looking for key quantities to understand the context here:
|
| - "Most people with diabetes need at least 2 insulin shots a
| day. Some people need 3 or 4 shots for good blood sugar
| control." (https://www.aafp.org/afp/1999/0801/p649.html)
|
| - "In November last year, Walmart launched the ReliOn Novolin
| 70-30 insulin pen. The cash price for a pack of five pens is
| $42.88, compared to $300 for the brand name option."
| (https://www.wfmynews2.com/article/news/verify-yes-walmart-
| do...)
|
| So we're talking about $25 for 1-2 days of vital injections.
| Approx $4,500 - $9,100 annually.
| srtjstjsj wrote:
| A pen is expensive because it's got single serve packaging.
|
| A vial has 1000units and lasts about 2 weeks.
| profile53 wrote:
| Insulin pens are multi dose as well. Usually last a few
| days to.m a week each.
| RHSeeger wrote:
| > The inventor of (a specific kind of man-made) insulin sold
| the patent for $1
|
| Analog insulins are different than the type that the $1 patent
| is for. They are much more advanced and are much more complex
| to make. That doesn't speak to whether or not the current
| prices for insulin are reasonable (they're not)... but you make
| it sound like "someone invented this and made the patent free,
| and now people are selling it for $86"... which is not the
| case.; not even remotely.
| friedegg wrote:
| But the patent on this, insulin aspart (humalog is insulin
| lispro, the competitor), is now expired, so the patent isn't
| a factor in the cost. The fact it costs 10x more than it did
| when it was introduced to the market in the mid-90's is just
| absolutely crazy.
| lb1lf wrote:
| -Do you have any idea how large the vials are?
|
| My curiosity got the better of me, so I rang up my mother
| who's had type 1 since childhood.
|
| She said 5x3ml vials of Lispro (or just about any brand)
| was approx. $40 in the pharmacy.
|
| Once she's spent more than $275-ish in a calendar year, the
| insulin is free (well, tax funded) until December 31st.
|
| This is in Norway, where the state presumably negotiates
| good deals with big pharma as they are basically a single
| customer buying goods for however many of a population of
| 5.5M need insulin (injected, that is)
| bart_spoon wrote:
| Its middlemen. Lilly has been pretty adamant that their
| revenue per unit has been inline with inflation, despite
| the sticker price skyrocketing. Presumably that can be fact
| checked with their financial data. They insist that its
| PBMs and insurers gaming the rebate system. Unfortunately
| the rebate system is incredibly opaque and PBMs insist on
| keeping this way to protect trade secrets.
| RHSeeger wrote:
| My understanding is that it's both of them.
|
| - Lilly wants to set the price at, to pick a random
| number, $100 per bottle.
|
| - PBM says "I need to tell the insurance company I saved
| them 50%, so you have to charge _my_ client 50% of list
| price"
|
| - Lilly wants their business, so changes the list price
| to $200.
|
| - Then Lilly "graciously" lets people without insurance
| use a coupon to _only_ pay $100 for it.
|
| Everybody gets to pretend they're the good guy. But the
| insulin costs $5 to make.. so really, they're not (once
| again, made up numbers).
| srtjstjsj wrote:
| The only thing wrong here is a bit of silliness in the
| structure, the people who _do_ have insurance but don 't
| get the good negotiated price, and your _made up_ numbers
| grumblenum wrote:
| So someone who isn't you should pay for its development cost,
| manufacture, quality control, shipping, storage, and
| distribution? Or should the people who do those things be
| conscripted into labor for the glory of these heartfelt
| convictions?
|
| Prior to 100 years ago, this conditions would have just been
| fatal. That you can keep yourself alive today for less than the
| cost of your mobile phone bill is a pretty good value
| proposition. I just don't understand the outrage.
| ceejayoz wrote:
| > So someone who isn't you should pay for its development
| cost, manufacture, quality control, shipping, storage, and
| distribution?
|
| Did these costs _double_ between 2012 and 2016?
|
| https://www.reuters.com/article/us-usa-healthcare-
| diabetes-c...
| kube-system wrote:
| No, and I agree with your point 100%, but that article does
| note that part of the increase was due to people changing
| types of insulin. So it's not as simple as companies
| charging 2x for the same insulin.
| ceejayoz wrote:
| > "Use is pretty flat, and the price changes are
| occurring in both older and newer products. That
| surprised me. The exact same products are costing
| double," she said.
| loeg wrote:
| I'm with you for most of the comment, but:
|
| > The idea that someone without means should have to pay
| Walmart $86 for a worse low-budget insulin is disgusting.
|
| The article is talking about the modern formulation for $86.
| The older-style worse formulation is $25. As I understand it,
| and I may be mistaken, $86 is very competitive in this space. I
| don't disagree that maybe insulin should be funded by
| government at zero cost to the individual, but your description
| of the $86 formulation described in the article seems
| inaccurate.
| tibbydudeza wrote:
| American healthcare and drug companies are the modern robber
| barons.
| ipnon wrote:
| Anti-trust should be directed at them first before Facebook and
| Google.
| rbanffy wrote:
| That's a false dichotomy. The US should obviously do both.
| imwillofficial wrote:
| Great job Walmart!
| abruzzi wrote:
| My insulin copay every three months is $100 ($50 for the Novolog
| fast acting, and $50 for the Tresiba slow acting insulin.) My
| insurance's portion is closer to $4000 for that 3 months, lst
| time I looked. Type I Diabetes is expensive, there was a period
| when I was unemployed and uninsured where I had to pay for type N
| and type R out of pocket, but the analogs like Novolog and
| Tresiba is so much easier to control. This is a very good thing.
| solarkraft wrote:
| This was bound to happen, huh? From what I've read the insulin
| market was/is protected against new competitors with tons of
| legal red tape someone with enough capital "just" had to get
| through.
|
| Edit: Wait. Novo Nordisk, their producer, is one of the
| established insulin vendors. Why are they helping to reduce
| prices?
|
| Also, does anyone have an estimate of how high the margins still
| are?
| friedegg wrote:
| Because there's a push for insulin affordability, and they look
| really really really terrible when someone brings up a chart of
| the rise in the price of insulin over the past few decades.
|
| https://divabetic.org/2017/06/08/transparent-pricing-works-h...
|
| They fear a Congressional inquiry and federal price caps.
| Normally, you'd expect a new medicine entering the market to
| get cheaper as the production ramps up, yet it's gone the
| opposite direction, even after the patent has expired.
| bart_spoon wrote:
| > Wait. Novo Nordisk, their producer, is one of the established
| insulin vendors. Why are they helping to reduce prices?
|
| The big insulin makers like Novo and Lilly have been bearing
| the brunt of the PR disaster that is drug pricing, but reaping
| little of the benefit, as, according to them, their revenue per
| unit has barely budged in decades. Increased costs are to
| appease the insurance companies/PBM middle men (because due to
| the rebate system, they don't actually have to pay those
| increased costs). Both Novo and Lilly have attempted ways to
| cut out the middle men, with reduced payment programs, like the
| one mentioned in the article, or through "savings cards".
| However insurance companies have gone out of their way to
| combat these, limiting their effectiveness.
|
| I think what's notable here is that Walmart actually has enough
| corporate muscle to allow a pairing with the pharma companies
| that the insurance companies will struggle to combat.
| gruez wrote:
| >according to them, their revenue per unit has barely budged
| in decades
|
| source?
| dangerboysteve wrote:
| Donated to openinsulin.org yesterday which is a very cool
| project.
| LQexplanation wrote:
| Before commenting about exercises and healthy diet - check
| difference between Type 1 and Type 2 diabetes...
| avelis wrote:
| It's surprising that not many know about T1D. Also that the
| inventors gave the patent for free to prevent what we are
| seeing today in corporate America.
| missedthecue wrote:
| _" More than 34 million people in the U.S have diabetes, and
| about 1.5 million Americans are diagnosed every year, according
| to the American Diabetes Association."_
|
| Wow. That's double the rate of a country like France. An ounce of
| prevention really is worth a pound of cure.
| mkr-hn wrote:
| Do France and the US use the same diagnostic criteria?
| [deleted]
| kaesar14 wrote:
| U.S Population: 328.2 Million People France Population: 67.06
| Million People
|
| The America bashing on this site really does get tiresome,
| especially with comments like this one that are just totally
| meaningless. Especially when America and France have the same
| percentage of diabetic people:
| https://ec.europa.eu/eurostat/web/products-eurostat-news/-/E...
| s1artibartfast wrote:
| >Especially when America and France have the same percentage
| of diabetic people
|
| Your link doesn't show that comparability.
|
| France is the highest rate in EU at 10% for ages 15+, EU
| average is 6.9.
|
| US average for ages 18+ is 13% [1] West Virginia has the
| highest adult rate of US states with 15.7% [2]
|
| https://www.cdc.gov/diabetes/data/statistics-
| report/diagnose...
|
| https://www.americashealthrankings.org/explore/annual/measur.
| ..
| missedthecue wrote:
| I'm using data from the World Bank which shows that Americans
| are far more prone to developing diabetes than most other
| countries.
|
| https://data.worldbank.org/indicator/SH.STA.DIAB.ZS
|
| France was just an example, but even your link proves my main
| point. It's not just diabetes. Heart disease is 2x as common
| in the US as in many other developed countries as well. I
| don't see how this is "america bashing" (of which I myself
| have been critical of in the past on this website). What I've
| presented is useful data that contributes to the discussion
| over healthcare costs.
| rland wrote:
| Insulin is primarily used to treat Type 1 diabetes, which is
| related to diet and lifestyle in a far more opaque and unknown
| way than Type 2 diabetes.
|
| You cannot improve your lifestyle to prevent Type 1. However,
| it is epidemic across the entire western/developed world --
| incidence doubles every ~6-7 years.
| hansvm wrote:
| France has 6% of the population diagnosed with diabetes,
| contrasted with 8% in the USA. Both countries are estimated to
| have a total rate (including undiagnosed individuals) of
| 10-11%.
| s1artibartfast wrote:
| Do you have a source for equivalent undiagnosed prevalence?
|
| Looking around, first response on google shows US prevalence
| is much high higher and increasing while France is lower and
| decreasing
|
| https://www.indexmundi.com/facts/indicators/SH.STA.DIAB.ZS/c.
| ..
| EarthIsHome wrote:
| > An ounce of prevention really is worth a pound of cure.
|
| We have the technology. The cure is cheap. It's criminally
| insane that the US doesn't make life-saving or life-bettering
| drugs more available for free.
| lm28469 wrote:
| The market is self regulating don't worry ;)
| bigmattystyles wrote:
| Yes, but isn't the real 'cure' in modifying our diets so it
| doesn't happen in the first place? At this point, tax and put
| warnings on sugar and carb-rich foods. Use the revenue to
| subsidize healthier foods to offset the regressive effect of
| a sugar/carb tax. I know about food deserts and fresh food
| availability, but the real way to fix this issue is upstream
| from already having diabetes.
| pwinnski wrote:
| You seem to be confusing Type I and Type II diabetes, a
| pretty common error. Insulin of the sort referenced in this
| article is used primarily for Type I diabetes, which has
| little or nothing to do with sugar or carb-rich foods.
| s1artibartfast wrote:
| The top-level post was about combined rates in the US, so
| I think they were commenting on that. Type II rates in
| the US is about 20X that of Type I
| pwinnski wrote:
| The linked article mentions Type I specifically also:
| "The annual cost of insulin for people with Type 1
| diabetes in the U.S. nearly doubled from $2,900 in 2012
| to $5,700 in 2016, according to the most recent data
| available from the Health Care Cost Institute."
|
| Insulin of this type is used primarily to treat Type I
| diabetes.
| s1artibartfast wrote:
| Right, but the top level post was talking about the
| different but related topic of overall diabetes
| prevalence.
| missedthecue wrote:
| I was talking about combined rates, not just diabetes
| treated with the insulin generics discussed in the link.
| pwinnski wrote:
| How is modifying our diets a "cure" for Type I diabetes?
|
| The only "cure" I know about for Type I diabetes is
| insulin, the subject of TLA and as far as I can tell, the
| subject of GP's comment also. Your comment appears to be
| the first introducing the idea of diet, which suggests
| that maybe, as I said, you're confusing diet-related Type
| II diabetes ( _not_ the subject of the article) with Type
| I diabetes (the subject of the article).
| davidthewatson wrote:
| It's worth noting that not all states in the United States
| require a prescription to buy insulin. To me, this raises
| questions about the statement in the CNBC article:
|
| "Starting this week, the retailer will sell an exclusive private-
| label version of analog insulin, ReliOn NovoLog, to adults and
| children who have a prescription."
|
| What's the implication for those who live in a state like
| Pennsylvania and do not need a prescription to buy insulin, much
| to the dismay of many in the medical community.
|
| https://www.researchgate.net/publication/42769372_Murder_by_...
|
| And finally, Wal-Mart has been driving this agenda through low
| priced insulins for years and deserves praise for that effort to
| affect change. Can we expect the same from Amazon now that
| they've chosen to enter the pharmacy business?
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