[heironimus]

There are so many reasons the EpiPen costs $318, corporate greed being one of them. One of the huge reasons that no one talks about is that most rarely actually sell for $318. It's priced at that, but insurance companies negotiate a lower (unpublished) price in most/all insurance purchases. It's only those with no insurance or who are buying it without insurance that pay the full price.

This is true for nearly all drugs, medical equipment, or medical procedures in the US. This is one of the huge problems with our system. Everyone puts a huge price-tag on their stuff knowing that insurance with negotiate down.

To me, this seems like the biggest problem here.

[timdavila]

I have never understood this.

It seems like there's a lot of overhead, a lot of staff, time, and money that goes into these negotiations that doesn't add any value and could be avoided entirely if the medical industry worked like every other industry.

As a patient, this negotiating is completely opaque and feels very shady. I have no idea what to expect to pay for medical procedures, and the bills I receive are impossible to decipher - there's no clear bill of sale like there is for example when I take my car to the shop. Even worse, some providers (for example, an anesthesiologist) decide they are out of network or work independently from the hospital. Then I receive a bill that may or may not be legitimate, from a person I didn't choose to do business with, with costs seemingly pulled from thin air. If the person who installed the fuel pump at my auto shop decided to send me his own bill, I would laugh at him, but this is apparently normal practice in healthcare?!

I don't know how to fix healthcare, and I understand costs can be unpredictable when you are first admitted (especially in an emergent situation) but making costs consistent, clear, and transparent and discussing them at time of service, where possible, seems like a good first step.

[atonse]

Yes but I spoke to a parent who said that in many cases and situations, they are required to purchase more than what insurance covers.

Nobody cares about what insurance companies pay. Like you said, they have professional negotiators on their side. But cash patients, people without insurance, or people required to buy more than what their insurance covers, do need the help.

[hnal943]

I recently had a hospital bill where they forgot to bill my insurance. They automatically gave me a 40% discount, before I even asked them. That's not to say that the price doesn't matter, but that no one should actually pay MSRP for medical care regardless of insurance.