RE: A Thought Experiment

I’ll also add that healthcare is one of the most manipulated markets I know of, which results in the kind of artificial greed stoking that you refer to. Our healthcare didn’t evolve to match market needs, it evolved to create and over inflate a market.

Consider that I’m a diabetic and have been for 20 years. At various times of unemployment, I’ve been content to buy generic Humalog, an insulin that’s been available over the counter at Walmart for about $30 a bottle without a prescription with a bag of old fashioned syringes for another $10, again without a prescription. Walmart also sells blood sugar monitors for about $10 and a container of test strips for something like $15. All in all, that generally means I can manage the disease on my own without seeing a doctor for years at a time. And if I should actually need to see a doctor, I know from experience that the non-insurance price will typically be about $60-$70 cash.

Now when somebody in the house is working and we have insurance (currently courtesy of the Federal government, my wife’s employer) the game instantly changes.

Currently I’m on 2 insulins (one fast acting, one longer term) of the maybe 30 or 40 of the latest and greatest on the market. The list price of each is somewhere in the neighborhood of $600-$700 a box every 6 to 8 weeks. But I’ve mastered the subsidy game over the years. Once they’ve billed the insurance company they all offer some variant of “can’t afford your medications?” program which kicks back the out of pocket by reducing the price to roughly $20-$80 depending on how sorry they feel for you (and trust me, noone really needs to feel sorry for me). What I have yet to figure out how the kick back program is legal, but what it’s designed to do is to allow the manufacturers to get favored status through usage stats with the insurers.

I could go on about the technology I’m hooked up to (a blood sugar monitoring system that costs twice as much as an iphone annually) and the free surgeries I’ve had, but the game is to be able to vary whatever by just a bit to get in the good graces of insurance and have the system pay outrageous money that you’d never pay on your own. Thus creating market demand even though there’s not strictly a need for it.

And COVID is a brilliant distillation of the thinking behind it. No, you can’t take a 50 year old anti-malarial, you NEED a new vaccine. With billions of government cash to sweeten the pot.

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