Tuesday, May 29, 2012

Paying for medicine

Yesterday I took Elli to the doctor and got her a prescription for an antibiotic.  Recently Elli has been on a few different antibiotics to try to fix her up and they cost $25, $35, and $55 respectively.  Although obviously it is wonderful that we have the option of spending a little money to cure an infection like this (unlike humankind for the past 100,000 years) the $55 price seemed to me to be a bit high since it is only a few milligrams of stuff after all.  This is probably a bit irrational of me because when we are talking about only a few milligrams of material I can't see why $25 is more reasonable than $55 other than I am more used to the former.  I asked the doctor if there was a generic version that was cheaper; she was aghast at the cost and spent quite a bit of time checking her books and calling the pharmacy to try to figure out if that price was right and if so, why.  I don't know if she did this for me because she thought that the price was just out of line or because she thought that the price was out of line for me being as I sure don't look like I have any money.

I had a similar experience awhile ago when I was getting a prescription for an antibiotic for a lung infection from a different doctor.  He asked me if I had drug coverage and when I answered no he explained that the best drug was $200 but there was a reasonable alternative for $30.  I think he figured that if his patient was dressed poor man style and had no medical coverage they simply might not be able to afford $200 for treatment.  That wasn't the case for me and I paid to get the better stuff but I have no idea what the difference in efficacy actually is.

I wonder how often doctors are forced into taking these sorts of things into account.  I am sure it is easy to recommend the best and most expensive treatment for everything but clearly that becomes a problem eventually regardless of who is paying for it.  If society pays then we end up with a truly crushing cost of medical care and if the individual pays they may end up not getting treated at all or breaking themselves financially.  I suspect that must be a really tough position for a physician to be in when they look at a person and know that the best solution from a healing perspective is not feasible economically.  In particular doctors must end up having to guess as to what their patients need and can afford and those guesses can easily be wildly wrong.  I know this for certain as my 'money radar' became really quite acute when I was in sales but I still read people wrong here and there and any mistake I made wasn't conflicting with professional ethics (hah, professional sales ethics...) or binding oaths.

At least here in Canada the great majority of serious medicine is covered by the state so doctors aren't so often forced into the economics of health; it must be a much worse conundrum when profiteering insurance companies and individuals without any coverage are the norm.

1 comment:

  1. The problem caused by this is really severe. That $200 drug would never cost $200 if people weren't getting it for free. They don't think anyone will pay for a more expensive alternative, they think that most people have health coverage so if they make a more expensive alternative they can make it as expensive as they like. Everyone will health coverage pays anyway through increasing insurance premiums, but those are normally paid by the employer. So they pay indirectly, but indirectly enough that they don't notice.

    This helps the drug companies and the insurance companies make money and can basically get worse and worse every year as last year's high prices provide the precedent for this year's even higher prices.

    Maybe there is a some medical research proving that a more expensive drug is better, but a lot of the time they aren't better at all, just twice or five times or ten times as expensive.