Last night, my wife, in reaction to my post on the skyrocketing price of EpiPens and the discussion in comments that ensued, observed that the subject of EpiPens touches a nerve. So many people are very emotional about it since it they or a parent or a child (or their income) are dependent on it. That makes it a poor starting off point for the more general point I was making in my post.
I responded that I was aware of that but that wasn’t just the case for the EpiPen but for everything in healthcare which is why reforming healthcare is so hard.
Good point. I participate in a number of health care forums, so not sure if I have noted it here before, but we see this with a lot of health care. We know, for example, that a lot of surgery just doesn’t work. Most knee arthroscopies and many back surgeries, yet insurers still pay. When they try to stop paying there is public outcry. People whose back surgery “worked” (placebos work about 33% much of the time) come out in support of the surgery and people get angry if they think the surgery will be denied. We see this now with some of the expensive chemo agents. Studies may show the agent does not work, and makes people more miserable during the few months they have left, but you always get a big outcry (and often articles in the Wall Street Journal) about how the public should not be denied these drugs, or manufacturers denied their profits. In short, as you have identified, really your wife, there is a huge emotional component involved with health care that you don’t see with many other products or services.
Locally, we (our network) has one primary competitor. They are very good. They are better than us, not by much, in a few areas and we are better than them, not by much, in a few areas. We both rate well on quality surveys. However, we beat the heck out of them on costs. We run about 20% lower on almost everything. So do we see people pouring in? Nope. People won’t drive an extra 5 miles. They don’t want to go to a new place. They don’t want to be farther from family (or their pets which is often a big deal). Mostly, I think, they just blindly follow the referrals of the PCP who they see. We need to lower costs, but even then that may not be enough, unless we get everyone’s costs lowered.
Steve
I would add that the emotional nature of the issue is not only a barrier to solving the problems, but also contributes to the development of the problem in the first place. Case in point here with Epipens, a CEO sees an opportunity to play on parents’ fears to lobby for laws requiring schools to stock them (what a huge increase in market share that must have been, and if required by law to make the purchase, with few or no competitors, the schools had no negotiating leverage.) Throw in a family connection to a US Senator and these results were predictable. But you know, they had to do it, for the children!
I guess that should have been “huge expansion of the market” rather than “huge increase in market share.”
Just a clarification. The only federal law I can find does not require that schools carry the pens. It says that schools that carry them will get preference in funding for the Asthma initiative. The laws requiring that they be stocked have been done at the state level.
Steve
Here’s a reference to the state-level laws. Around here most school districts require the schools to carry them.
I understand the difficulty, but I don’t think its a good starting point for policy. Free beer for everyone is still good politics. I want free college. I want free medical care. I want free financing………
Great. Who wouldn’t? But if people thought it was costless and easy it wouldn’t be marketed, as it always is, in stealth positions. For the children. For the sick. For the poor. For fairness. For every aggrieved individual…………I happen to like and support – to hell with the others. As has been covered here a number of times, a look at the actual expenditure of dollars indicates its a sham. Some money makes it to the poor, sick and deserving. But vast amounts are siphoned off to administration of the machine, to the favored, to the politicians. So much is just recycled, especially through Federal and state levels of government. The best argument a politician can make is that he/she will bring home more bacon than you send in. It a poker game. See Robert Byrd. See re-elected politicians.
It seems to me that if we just throw our hands up and give in to the free lunch mentality we have embarked on the road to the end. In my adult lifetime things have materially declined in this respect and politics in general. Hillary Clinton wouldn’t have a chance at the White House; and she wouldn’t have an adoring press that are now officially just whores. Donald Trump would have been laughed off the stage as a creepy clown. But today, the what-do-I-get-for-free mentality and don’t bother me, the Kardashians are on TV mentality prevails. For those who think this just an idle rant I ask – how are things going in the good old US of A?