I just love reading your stack, Matt. Always informative, most often infuriating -- only because we all know the system is broken. Or "incoherent," as you aptly put it.
Knowing that there are doctors like you out there gives me hope.
Medical schools churn out clones who memorize the answers and bed side manner is no longer taught. Most Drs. wind up in groups who are owned by either a hedge fund or private equity or part of a hospital because of that they can only spend at the most 15 minutes with each patient (customer). Everything is a transaction. Drug companies give out “bonuses” to the good Drs. who prescribe the “new” drugs which are like you mentioned old drugs combined into one new one and given a fancy name which patients (customers) can recall by the dance number from TV. If said drug isn’t on the pharmacy benefit managers list that makes them the most money you’ll be rejected or need a “prior authorization” for people who have zero medical education whatsoever but are in charge of your medical care and outcome. Most Drs. will bow to these asshats instead of drawing up the required authorization as that takes up more of their time as they try to keep on schedule seeing as many customers as possible daily. It’s all a fucking grift anymore. We spend the most on healthcare than any nation on the planet and have not only the worst outcomes but our life expectancy has shrunk which means we are living less time on the planet than other people living in any other nation on earth. Shit needs to change and it needs to change fast. Stay away from hospitals they will kill you in them.
Wish all doctors were like you. Though I know most doctors are fairly decent--it's the system that's rapacious.
I recently had to get Doxy (antibiotics) for a tick bite. The price without insurance was $161. When I went to the pharmacy and updated my insurance info, the price dropped to $5.41.
I truly feel sorry for those with no insurance. Even a standard drug like Doxycycline can be expensive if you have no insurance.
Isn't this easily solved by always asking the pharmacist (or doctor) if a generic equivalent medication is available? Or using GoodRx?
That said, the system is skewed enough it's basically become a wealth transfer process.
Best investment we can make is to spend a LOT of our free time reading about ways to reduce those costs.
BTW, I asked Grok about how to save money on an elective surgery... started with phrase "self pay" b/c my anesthesiologist buddy used that phrase, was informed it's just asking for cash price, then gave the top ways that doctors agree to reduce the cost. Ask AI the question like you'd ask your doctor friend... and then read the links provided. Might help... but I should add the informed consent YMMV warning here, please sign...
I just love reading your stack, Matt. Always informative, most often infuriating -- only because we all know the system is broken. Or "incoherent," as you aptly put it.
Knowing that there are doctors like you out there gives me hope.
Medical schools churn out clones who memorize the answers and bed side manner is no longer taught. Most Drs. wind up in groups who are owned by either a hedge fund or private equity or part of a hospital because of that they can only spend at the most 15 minutes with each patient (customer). Everything is a transaction. Drug companies give out “bonuses” to the good Drs. who prescribe the “new” drugs which are like you mentioned old drugs combined into one new one and given a fancy name which patients (customers) can recall by the dance number from TV. If said drug isn’t on the pharmacy benefit managers list that makes them the most money you’ll be rejected or need a “prior authorization” for people who have zero medical education whatsoever but are in charge of your medical care and outcome. Most Drs. will bow to these asshats instead of drawing up the required authorization as that takes up more of their time as they try to keep on schedule seeing as many customers as possible daily. It’s all a fucking grift anymore. We spend the most on healthcare than any nation on the planet and have not only the worst outcomes but our life expectancy has shrunk which means we are living less time on the planet than other people living in any other nation on earth. Shit needs to change and it needs to change fast. Stay away from hospitals they will kill you in them.
Wish all doctors were like you. Though I know most doctors are fairly decent--it's the system that's rapacious.
I recently had to get Doxy (antibiotics) for a tick bite. The price without insurance was $161. When I went to the pharmacy and updated my insurance info, the price dropped to $5.41.
I truly feel sorry for those with no insurance. Even a standard drug like Doxycycline can be expensive if you have no insurance.
so here in UK, I can get this online
https://www.cloudpharmacy.co.uk/online-doctor/chlamydia/Doxycycline/
for £17 + postage (total about $24) with an "online assessment".
No insurance at all (and this is not even NHS coverage)
Isn't this easily solved by always asking the pharmacist (or doctor) if a generic equivalent medication is available? Or using GoodRx?
That said, the system is skewed enough it's basically become a wealth transfer process.
Best investment we can make is to spend a LOT of our free time reading about ways to reduce those costs.
BTW, I asked Grok about how to save money on an elective surgery... started with phrase "self pay" b/c my anesthesiologist buddy used that phrase, was informed it's just asking for cash price, then gave the top ways that doctors agree to reduce the cost. Ask AI the question like you'd ask your doctor friend... and then read the links provided. Might help... but I should add the informed consent YMMV warning here, please sign...
always good to read Dr. Bivens - thank you Matt for all you do
After theCovid social experiment the lot of ya should be glad you remain litigation free and that anyone trusts you
Thanks.