Quote:I can't understand how you can justify the charge of $26 for delivery of a pill that cost pennies or a fraction of a penny...The percentage of profit on that is outrageous...It doesn't matter if the insurance company pays that amount or not, the consumer without coverage will be billed that cost...

 

You really can't have a "free market" for healthcare facilities because only the health care industry can have them...it's not like you can turn the neighborhood tavern into an unregulated private healthcare facility open only to members of the tavern...You can't make health care facilities like country clubs where you buy memberships, you certainly can't open your own hospital and it's doubtful you would ever get licensed to open an urgent care facility either because they health care industry mainly hospitals want ALL the business...

 

When they made it a law that hospitals could not turn away patients because they didn't have the ability to pay, they would have created some form of compensation for that occasion...Some of which you stated above...

 

Using your example above, you make it sound like the difference between carry out and delivery is the same as the difference between selling their pizza at $10 for pick up and $12 for delivery rather than a pill that was purchased for pennies or a fraction of a penny and sold for $26...There is a HUGE difference between the two...I don't have a problem with the deliverer mechanism, I have a problem with the huge differential between the cost to purchase the pill and the price sold to the consumer...I would be ok with something like $2 - $5, but $26 is just way too much and they should be investigated for price gouging... .

 

FIrst, you don't know the cost of the pill to make that assumption, you're basing it on your out of pocket cost at the pharmacy. Last week I had a treatment where the medication cost over $6,000. You assume that the cost is less than a penny and that skews your entire perception. Going to a hospital is going to a billion dollar facility staffed by professionals who are very expensive to retain. The cost of everything is calculated into the price of the services and products rendered there and someone has to pay for it. 

 

And your repeated complaint about mark up is really something you should complain about in every industry. Ever bought popcorn at the movies? How about a cup of coffee at Starbucks? The mark up on those is in the thousands of percentage points. To just assume that health care shouldn't do the same thing is to assume that they can stay in business with no margin. The pizza metaphor is the difference between you picking up Domino's and you going to a 5 star restaurant for dinner and ordering pizza. The pizza won't be the same price because the delivery mechanism is different (you'll even pay more to tip the server!), even if the quality is the same. $5 at Domino's vs $40 at the 5 star = 700% markup entirely based on WHERE you got the pizza. The same thing happens when you go to the ER for care, and it applies to every service, not just the meds, because the delivery mechanism is outrageously expensive.

 

And as for access to services? Yes, you can create a private healthcare facility, they exist all over the country.There's also concierge medicine where you pay for a membership to have exclusive access to your doctor. 24 hour access and house calls, no office appointments needed, you have his phone number and can call whenever you want. Those are both free market solutions to the "health care problem" that are working. And you could turn your neighborhood tavern into a healthcare facility if the state didn't forbid it. Why do they forbid it? Because they can. Why don't we have more hospitals? Because the process to get a permit to build one takes years and hundreds of thousands of dollars, and sometimes a lawsuit so a judge can decide who gets to build it. But again, those are levels of complexity added by the over-regulation of the industry that drive up the costs. Just because we DON'T have free market healthcare doesn't me we COULDN'T have it.

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