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The NYT shines a light on a nice little racket that doctors have got going in some states, where...

The NYT shines a light on a nice little racket that doctors have got going in some states, where they're allowed to dispense drugs to patients at massive markups. E.g. heartburn pill Zantac costs 35 cents a pop in a drug store but $3.25 in a surgery. It's costing taxpayers, insurance companies and employers hundreds of millions a year.
Comments (32)
  • Don't know if this is exactly a "racket." Surgery involves intravenous customer permission, and is full retail. Buying stuff off the shelf is different -- transaction permission and you're buying dozens at once.


    That said, surgery made necessary by lack of preventive care is a huge factor driving health care costs higher.
    12 Jul 2012, 01:56 PM Reply Like
  • Also you are buying one the hospital..100 people are getting the pills..only 5 are paying for it....its called socialism...
    12 Jul 2012, 02:02 PM Reply Like
  • I don't think you know what socialism means. You seem to think it's an all-purpose insult you can throw at anyone or anything you don't want. I find the over-use of it extremely ignorant. And it's steadily losing effectiveness.
    12 Jul 2012, 03:37 PM Reply Like
  • Stupid article. How many people get treated in the hospital and don't pay ? Racket what a moron.
    12 Jul 2012, 02:04 PM Reply Like
  • Like this is news?
    12 Jul 2012, 02:38 PM Reply Like
  • LOL - NYT looking for "little rackets" while cheering on the burning down of the whole healthcare system and our economy
    12 Jul 2012, 02:51 PM Reply Like
  • Right On!
    12 Jul 2012, 05:18 PM Reply Like
  • Pushing down the 17% of GDP that now goes to health care is the name of the game. The way to do that is with prevention -- everyone knows that. Pay for prevention and you limit your losses down the road, just as with your car.


    So how is guaranteeing payment for prevention burning down the house? Only in your dreams.


    Socialism! If what was passed is socialism, then Teddy Roosevelt was a socialist. As was Nixon. As was Bob Dole. As is the Heritage Foundation. And if you think those folks are or were socialists, you have a pretty strange definition of the term
    12 Jul 2012, 05:23 PM Reply Like
  • Not exactly a racket to charge for a pill that has to be purchased, stocked as a single pill, administered by a highly skilled and certified or licensed paid specialist, after being ordered by a Doctor who might have hundreds of thousands of school debt to pay off for getting the skills and the right to order that specific pill for a specific reason for that unique patient who may sue him/her for everything they are worth even though that pill is the perfect solution for them and has adhered to all applicable government regulations to do it and used all of their skills to diagnose it and prescribe it.


    If you go to a restaurant you can pay $8-$12 for a hamburger that you can buy for your self, cook and serve to your self for about $.50 from the grocery store. Quite a racket the restaurateurs have, but why is it that so many go out of business - probably because they can't make a living at it - due to the high costs of buying, cooking, serving and complying with government regulations in their kitchens and paying for insurance for the possibility of ecoli or some other problem in the restaurant or something else like the coffee is too hot and the customer sues for $10 million. Unless, of course they are selling billions like McDonalds does at a much lower cost and far less quality and can pay the $10 million suit. Everything has a price. You appear to be demonizing the very people you count on to save your live in a critical moment.
    You may soon get what you are looking for - low cost, low quality, medical services in the same hospitals you are now decrying for charging you what you demand of them. Is this really what you want a total McDonald system where one low quality level serves all? Good luck to you -- to and all of us in the US if that is what we want.
    12 Jul 2012, 03:36 PM Reply Like
  • This high drug price is like the alleged $600 toilet seat. It may be overpriced but the costs of specification, procurement, integration, storage etc is calculated in the cost. Is unfortunate that the news media for the most part doesn't focus on the real wastes of money.
    12 Jul 2012, 05:21 PM Reply Like
  • First off, the federal government prohibits a doctor from charging for anything other than his/her professional service. Any equipment, devices, or medications, are charged through the facility whether it be a surgery center or hospital. I agree with the other posts explaining that the costs of hospital administered medications reflect the costs of nursing care, pharmacists services, and burdensome government regulations.
    If your desire is to have a healthcare system that is more cost-efficient then we need to reverse course with healthcare reform and adopt a market driven healthcare system where patients are interacting directly with providers in regards to costs & healthcare delivered.
    Time and again capitalism & free markets have proven to be the most efficient way to deliver any goods or services. Healthcare is no exception.
    12 Jul 2012, 05:45 PM Reply Like
  • You are totally, completely, 100% wrong. We have had a market-based health care system. It is broken. It can't be fixed. Fee for service can't be fixed.


    What we know works is wellness, prevention, fee-per-patient. Incentives should be toward saving money, not spending it.


    And your ideological tag line is just as nonsensical as anything Lenin ever wrote. Markets are not an ideology. Markets are markets. Even the mafia has rules and enforcement of those rules. Every market must, or everyone gets robbed.
    13 Jul 2012, 10:50 AM Reply Like
  • Dana, you are the one that is incorrect on that statement. The health care system is NOT market driven. Very few people actually pay for the services rendered; the insurer pays for most services (and the accompanying products such as for heartburn). And because people don't actually pay personally for services rendered, the prices for health care are NOT set by supply/demand dynamics. As a result, health service providers set prices almost arbitrarily (which the particular article aptly points out.). Prior to the evolution of health insurance during WW2 and the establishment of Medicare, health care prices grew roughly in line with the CPI. You may be correct that the health system is not yet socialized, but you are absolutely wrong when you say it is market driven.
    16 Jul 2012, 09:48 AM Reply Like
  • The intent behind the ACA is to make this more market driven, which I assume is what you want. It changes the market incentives, dramatically, from trying to get rid of risk to trying to keep people alive at minimal cost.


    And, by putting a thumb down on costs from the insurance lobby, it makes the system more of a free market than what you described in your very kind comment.
    16 Jul 2012, 10:41 AM Reply Like
  • pjsburk wrote: "Time and again capitalism & free markets have proven to be the most efficient way to deliver any goods or services."


    Deliver, perhaps - as long as that delivery doesn't involve a Hino or Mitsubishi Fuso truck carrying goods unloaded from an Airbus or a Hyundai container. Where was your TV made? Your smartphone? Your shoes? All socialist countries, right? Do you think that the doctor's back-office work was outsourced to Baltimore or Bangalore? Why did they go to Bangalore, given that India's government regulations are at least as burdensome as the USAs? India is a socialist country, after all.
    12 Jul 2012, 09:22 PM Reply Like
  • I was just saying some of the cost of that one pill is that some people have chosen the path that they think you should pay for THEIR healthcare....and that means if you have taken personal responsibility and bought will be charged for the freeloader....and some people in our government thinks that is OK..the Socialists
    13 Jul 2012, 09:00 AM Reply Like
  • Uh, no. The purpose of the ACA is to end freeloading.


    Everyone has health risks. Always. Everyone is liable to need health care at any time. Always. At every time of life. If you're not buying insurance you're not participating in the market, you're not paying for something you know you need.


    Just as when you drive a car without insurance.


    This is regulation. This is Heritage Foundation stuff. This is not socialism. The constant repetition of "socialism" in regard to this act is the biggest lie of our time. And you, sir, are repeating it.
    13 Jul 2012, 10:51 AM Reply Like
  • Don't worry Odummer will make sure we all are miserable. He's equal opportunity when it comes to sharing misery. This all goes back to the health care bill and the rump swabs at the Times trying to make it seem like another racket is going on. I've never seen an in depth article from the times lambasting the administration for exempting themselves and the congress from the same plan. That is why Obama and the Times all suck. Hypocrite bastards.
    13 Jul 2012, 09:49 AM Reply Like
  • Taxes are lower than when the President took office. The health care bill was first written by the Heritage Foundation. And since everyone in Congress is covered by insurance -- since no one can opt out -- they're all covered by the ACA.


    Did the RNC bring you any more big lies? Or is lies all you got?
    13 Jul 2012, 10:53 AM Reply Like
  • To Dana-Yes or no question. Does the congress have a better plan than they're trying to foist on me, being a member of the dreaded private sector. Simple question.
    13 Jul 2012, 12:06 PM Reply Like
  • Depends. On where you are in the private sector. If you're a CEO, nope, not at all. If you're in the upper-middle class, making about $160k/year, nope, they're pretty much the same.


    If you're poor and can't afford health insurance, then yes, they have a better plan than you do. If you're a teacher or a cop, their coverage might be slightly better. But isn't the quality of the coverage supposed to be a product of the market, with those who can pay more entitled to more?


    Fact is, we can't focus on wellness unless everyone is in the pool. If large groups are excluded, if underwriters are in the business of avoiding risk, then you can't do that.


    And the way to cut costs is through wellness, through prevention. This is proven. It's fact. Denying it doesn't make it any less true.


    Why do you hate the Heritage Foundation and the nominee of the Republican Party, who instituted just this sort of plan in Massachusetts? Is Mitt Romney a socialist? If you think he is, don't vote for him.
    13 Jul 2012, 12:20 PM Reply Like
  • Dana the answer is yes. When the whole plan is put in place, you will wish you were in congress. You seem like a smart guy and I enjoy reading your posts so please let go of your ideology and give the health plan the same rigor you do regarding your other posts. I for one am a nationalist. I want what's good for America and my family. When you have the then speaker of the house saying we have to pass it to see what's in it,that should give you pause. I couldn't care less about what anyone says about the health plan and how good it is. I think for myself. The plan as written will fail.
    17 Jul 2012, 10:33 PM Reply Like
  • The same plan has been in Massachusetts for 5 years. It's fully implemented. It works as intended.


    People who work in the field tell me that wellness and prevention are the key to holding down costs. You get that by having everyone in the pool in some way. Even the Heritage Foundation realized that, which is why they originally endorsed this kind of plan.


    What we had before was a game of picking risks. Insurers would only accept younger, healthier people, dropping them at the first sign of illness. That's not health care.


    The result was results no better than Cuba, at a cost 50% higher than those of our trading partners. Business can't handle that.


    Medicare, Medicaid and the VA all take on higher risks than the private insurers are willing to take. Yet they deliver care for a fraction of the cost of conventional insurance.


    This plan is necessary for private insurance to have a hope of competing with real "socialized medicine." Without it, you would see a faster move toward these public programs, away from the private sector.


    It's either the Romney way or single-payer. Your way leads directly to single-payer by pricing people out of the market for care. Once the majority is outside the market, demand for single-payer would overwhelm all objections.


    You can't have a society where a small number of wealthy oligarchs live for a century in their castles while the peasants drop like flies. That is unsustainable.
    18 Jul 2012, 11:53 AM Reply Like
  • Dana- You may think things are working in Mass. but you must talk with the providers. Everyone in the healthcare industry is working harder for less. The number of doctors retiring early or going into concierge medicine is expanding at an alarming rate. The lack of portability and tort reform which wasn't written into the plan is a disgrace. I'm all for reform but reform which is equitable. The Mass. medicaid budget is an outrage. You should go to Lynn or Lawrence for an eye opener. Please just stop with the Heritage foundation as well because if you go to their home page everything is about repeal of the ACA. I'll bet we're probably closer to agreement on many of these issues and could craft a better plan that's in play now. Lastly, it's fun to have this discourse. Thanks for that.


    guess that if we went out for a couple of beers we would find we're
    18 Jul 2012, 12:30 PM Reply Like
  • Everyone is working harder for less? That's success.


    Fact is, Massachusetts citizens like what they have. That's the key test. It's fully implemented, nearly everyone there now is covered, and as you say "everyone is working harder for less" --- which means the savings are starting to appear.


    Everyone has to be in the pool. Otherwise the market can't function. You must have incentives built-in for prevention and wellness, or you have so much sickness you can't afford to deal with it.


    Mississippi is moving toward the system you seem to favor. Life expectancy between rich and poor is diverging at an alarming rate. It's not a good thing.
    18 Jul 2012, 02:11 PM Reply Like
  • How can working harder for less be a success ? When your busting your back and reimbursements are reduced to levels which prevent a business/entity from getting a reasonable return on investment,hardly a success. The patient will suffer. You have to be reasonable with all aspects of health delivery. The trouble is, the government always takes the easy route and goes after the provider. You need reasonableness in all negotiations. If you structure health care properly you will continue to get the best and brightest. Otherwise you'll get second stringers. I know if I'm on the table I want the best. Everybody talks cost etc. until they need the operation. I'm in the business and have had a lifetime of it.
    18 Jul 2012, 08:41 PM Reply Like
  • No. You want more money for less care. We can afford to spend less money and get more care.


    We need fewer specialists, and more people involved in primary care. We don't need medical temples. We need doctors who are integrated into the community, not gods in lab coats.


    This is why doctors' groups opposed health reform so strenuously. They didn't want to lose money. They didn't wan to lose power. But that money and power were strangling the economy.


    Funny. You may be happy that teachers' groups are being broken, and unions are being broken, and police groups are being broken, on the rack of economic change.


    Now you're going to be broken. That's the way it is. Yet people will still get care.
    19 Jul 2012, 11:22 AM Reply Like
  • Dana- On a different note, what do you like for a stock ? What's your best pick.
    18 Jul 2012, 08:43 PM Reply Like
  • I'm still heavy into tech. I think we're gonig to enter a new era of abundance in the next few years, as a permanent cap is put on energy prices with the rise of alternatives.


    I also don't think this Internet thing has played out. Not at all. It's because of what I call Moore's Law of Training. There is no Moore's Law of Training. Meaning there is an immense amount to be learned about using this resource, and of course an immense amount of productivity still to be gained from it, in all areas.


    Change, in short, is going into overdrive. You want to be invested in change.
    19 Jul 2012, 11:25 AM Reply Like
  • Dana I'm sorry, you threw me a softball. I'm most interested in (Change)
    and I (Hope) it's to my liking. Hey, hope and change, where have I heard that. he-he
    19 Jul 2012, 06:55 PM Reply Like
  • I thought it was a knuckler, but it didn't knuck, so you hit it out. My fault for watching Phil Niekro all those many years....
    20 Jul 2012, 12:00 PM Reply Like
  • Dumbass you want to be invested in progress. 30 years as a journalist? Have you know learning curve?
    21 Jul 2012, 03:35 PM Reply Like
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