Yes, We Have No Libra

fbshotI recently quit my Facebook account with more of a whimper than a bang.

Today, we read of Facebook’s dive into cryptocurrency.  Thanks, but no thanks, I say.  It’s apparently aimed an enrolling (enslaving?) 1.5 billion unbanked folks around the world.

Glad to be on the sidelines for this one.

Medical Economics

Walmart Bill
One product, two prices

Herein lies a tale. A family member was prescribed a drug by a friendly physician. It’s a generic equivalent to a well-known product. Generics are good, right? Lower cost alternatives to puffed-up name brands.

Not exactly. The doc phoned in the 90-day prescription, and we set off to our local pharmacy. Arriving at the cash register, they were about to ring up $760. Whoa.

We had Part D Medicare with a deductible, but the deductible was not the issue. (It was mostly filled already.) Our “generic” was Tier 4 – a least-favored category.

To shorten the story, we discovered coupons. Mysterious codes you can use to get better prices. (Check goodrx.com or download the goodrx app.) The coupon price can vary a lot between pharmacies. For us, CVS was still high, but Walmart delivered at $48.47. This price does not use our insurance, but that’s fine with me.

Walmart hasn’t been a go-to place for us, but now they certainly are.

The final shock was to look at Walmart’s printed statement that indicates a cash price of $1830.18. So we got an 87% discount. Lucky us.

It’s no news if you follow these things, but drug pricing is really broken. Of course, what matters is what we actually pay, not some fictional list price. But the real scandal is that there are probably many who would have paid $700 for a product that could be had for $48. A “low information” buyer (perhaps a lower-income buyer) would have dug deep or done without.

I don’t know how the coupons come to be, but I expect they depend on ignorance in the marketplace. If everyone used them, they’d disappear.

The stupid and unfair medical/pharma system. Can it ever reform?