Why is healthcare cost so high?

Healthcare cost

Healthcare cost is one of my favorite upsetting subjects… 🙂 I’ll work on real-life examples, and if needed, I can provide documentation.

We have families in Brazil and France. It is quite easy to make comparisons, isn’t it?  Let’s start with my dentist. In January this year, I had dental hygiene with a root planing – cost after insurance: $411.60. Not cheap but necessary (according to my dentist).

Exact same dental act in Belo Horizonte, costs… in USD 80 bucks or R$320 (Brazilian Reals) – Why $411 vs. $80?

I asked a dentist, and he came up with several valid options:

• Poorly educated hygienist in Brazil vs. ours
• 3rd world country installation vs. top-shelf equipment here
• No guarantee on work, maybe

Picture of my Brazilian Dentist office

Then during my last visit, I asked my Brazilian dentist the same question and her answers are:

• Eu acho que na América e na Europa, os dentistas abusam dos preços – let me switch to English 🙂 I think that in America and Europe, dentists abuse their prices.
• In Brazil, we are not sued as it is in the US; we do not need costly liability insurance.
• In Brazil, we do not have to give health insurance huge discounts, no need to inflate our prices.
• The currency change in big favor of the US dollar, but in 2014 when the Dollar was at R$2.60, the price difference was around the same.
• Because Americans and Europeans are wealthy, they can pay for the high price 🙂

Let’s look at other medical services – like IVF. We have friends who went through the process as she is 40, the cost per attempt, including medication – about $35,000 – Medication alone was $5,000.

The couple went to Brazil after 2 failed attempts in the US. The cost dropped to $8,000 plus $600 in medication – the worst part is that the Brazilian medicine is exactly the same as in the US made by the same US manufacturers (I saw both boxes).

According to the couple, the facility in Brazil was even better than the American one. The support was also terrific, with the doctor texting the expecting parents directly. Not a nurse’s task to make contact, it’s part of the doctor’s job.

Now how can we justify the medication cost about 8 times more expensive in the USA? Same product, same brand, both manufactured in the US.

I think I have an answer. The American clinic pointed out that the medication was only available in one pharmacy in the city – the city of 3.5 million souls. One pharmacy only, no competition? Let’s dig a little…

The 7th and 8th richest company in the USA are pharmaceutical distribution companies… middlemen 🙂 why not the manufacturer itself? I know the 6th is… a healthcare insurance company…

Don’t you think we are pointing in the right direction for the healthcare cost? How comes companies that buy and sell medication are so rich…? Because they have HUGE markups thus the price of 2 identical drugs in 2 different countries is so different, in this case, over 8 times more expensive!

Another good example, my job is very stressful, and sometimes I need medication, so I rest better. My doctor prescribed medication and recommended that I buy it at the clinic’s pharmacy. It’s $1 a pill, way cheaper as many doctors, including herself, use them. She specified that at Walgreens, the same medication is $30 a tablet – 30 times more expensive!!!!! SAME PILL. I checked and a 30-day refill at Walmart, CVS, or Walgreens, the same exact price $299 compared to the clinic’s $30.

We need to focus on fixing this increasing problem of healthcare cost. First, we need more transparency – we need to know:

• What is the markup on medication, and why the competition has the same price?
• The exact cost of procedures and why out of network is way more expensive than in-network. In this case, it’s a simple neck scan. In blue “out of network”, in red “in-network” – Same hospital, same doctor… Also, we need to know what are “related” costs…
  
• Why we can’t have an upfront cost of medical acts. For my last lipid blood test, I asked, and “it depends” was the answer – I begged for a range, and it went from $35 to $232 depending on what the insurance says… Almost a 7 fold difference? When I received it, the bill said $101.

You have my point and can’t wait to hear yours!