I had a patient in the office today who doesn\’t have
This medication had all of the usual components that most hemorrhoid creams have. The real difference was the delivery system: it\’s a . There is no generic substitute for this, apparently. As I spoke with this man, it became clear to me that this is a central issue in the crisis in .
What? Hemorrhoid foam is the cause of the healthcare crisis?
No, that is not what I am saying. The significance of this encounter is that the $100 medication is one that I prescribe frequently, and that insurance companies have never rejected. The insurance companies are paying $100 for hemorrhoid medication. True, they probably have wrangled some sort of discount, but the reason the company who makes this magic medicine can charge $100 is that somebody pays $100 for it. I don\’t think there are enough constipated millionaires to explain this phenomenon.
The main problem in healthcare is the total lack of value. We pay a lot for care and don\’t get a lot in return. Costs are going up but we are not seeing an increase in quality along with those rising costs. Why is this happening? $100 dollar hemorrhoids show us what\’s going on. The medications contained in this concoction are not anything expensive – mainly cortisone. The delivery system isn\’t space-age. The company spends very little money on(I don\’t think I\’ve ever seen a drug rep for this hemorrhoid foam). The R&D budget was probably spent on researching a way to get someone to pay $100 for hemorrhoid foam.
While in Vegas last week Dr. Wes told us about a patient he put in for 23 hour observation with a who racked up a $180,000 bill. Insurance got a discounted rate but still covered $120,000. How can they justify this? How come there isn\’t someone at the insurance company who says: \”Hey, that\’s an awful lot to spend on a 23 hour visit,\” or \”Wait a minute, why the heck are we paying $100 for hemorrhoid medication?\” The answer is at the root of our system\’s problem: they pass on the cost to us.
If I was in the hemorrhoid foam(my kids wouldn\’t tell their friends, I am sure), I would accept the $100 check for each can of foam. I\’d even start singing \” .\” But I am not in that business (my kids are relieved), and instead I have people with insurance rates so high that they have to drop it.
Something is wrong with this picture. $100 is more than I get paid for most of my visits, and congress is now arguing about whether they are going to cut my pay; yet nobody seems to be bothered by $100 for hemorrhoids?
Will I get paid better if I claim to shrink swelling and relieve itching? Will it help if I deliver my care as a foam?