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Comment by jcbeard | Hacker News Reader

"When Mylan bought it, EpiPens cost about $57 each."

I can concur. I have a family member I purchase these for. At first, it was like...okay, $50 after insurance. Now $100 after insurance. The thing is...nobody really seems to care until things spiral out of control. Who the hell is watching our backs in America? Is it the FDA, the FTC, Congress (likely too busy defunding AMA to care), the DoJ? No idea. I wonder if gov't agencies like the DoD who stock tons of epipens pay the same prices that we the public do? Does the DoD purchase from another market to get out of the huge sticker price? I'm curious to see how many people in the gov't get around purchasing these in the US for their own agencies yet didn't raise extreme alarm at the ballooning prices for the American consumers.

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Judging by what we recently learned about the Army's finances, well funded government agencies like the DoD probably don't notice or don't care about this kind of thing.

Who the hell is watching our backs in America? Is it the FDA, the FTC, Congress (likely too busy defunding AMA to care), the DoJ? No idea.

The problem is, we have no price controls on medicines or medical procedures in the US. Prices are set by the makers of drugs or devices. We are the only 1st world country on the planet without price controls. Everything terrible stems from this and that there is no real competitions between medical providers (because prices are not published).

Health care capitalism in America is like the invisible hand giving all consumers a permanent prostate examination.

We need to nationalize health care (all drug and insurance). There is no other solution.

what is really amazing is the epi pen, even for those who need it, is a tiny fraction of our healthcare costs. the gorilla in the room is doctors pay, in which the US purposely keeps low in supply to keep the wages high.

doctors easily make north of 200k after residency(a number almost no engineer will ever come close to), and people complain over hundred dollar epi pens.

You really think the problem is doctors' pay?

absolutely. we pay over a hundred dollars for a single 15 minute (if that) visit, most of which is hidden by insurance. even family care pulls home 200k+, add a specialty and your talking 300k+/year. the high cost of doctors pay limits our face time with them, limits our desire to schedule an appointment even when we are sick, and those costs cascade on us in the future.

even if you dont agree with me, the cost of paying the doctors far exceeds the cost people are paying in epipens, worse on worse is that everyone bears that burden, not just the people who need an emergency pen.

while the commenter above points out they have long hours, thats not uncommon for many professions including engineers who spend their weekends and nights learning new skills, or people on wall street that it is politically correct to envy how much they make, were as you can see on HN the very mention of doctors making too much brings a flurry of down-votes. "hey, he disagrees with me, silence him! hail our new kings and queens with MDs!"

and about those long hours? if we increased the supply of doctors to bring down the costs, those hours would reduce drastically as well.

Interestingly, I find that most of the time I know far more about the inner workings of the body than the docs that "treat" me. Then again, I have a bio/molecular bio/comp bio background...so that might be the cause. Seems the memorization that drives our docs in the USA forward often doesn't translate into understanding the concepts as a whole. I do agree salaries are getting out of control. Look at PhD's they contribute quite a bit to society, have an even harder time getting the PhD than an MD and yet...aren't similarly rewarded. Don't get me started on "oh, well, we have lives in our hands." You know what, so do the programmers, engineers, technicians that make the tools that make medicine possible. So...our incentive system is a bit out of whack in the USA. It wasn't this way a few decades ago, and it won't be that way a few decades from now. For the moment though, there are lots of perverse incentives skewing costs. Chief amongst them is the 3rd party payer system.

Take home pay for physicians represents about 10% of healthcare spending (http://economix.blogs.nytimes.com/2008/11/14/do-doctors-sala...). On top of the cost of 4 years of college, you've got 4 years of medical school (average med student debt is $167k - http://www.cbsnews.com/news/1-million-mistake-becoming-a-doc...). On top of that, you've got 3-7 years of residency where residents barely make $50k/year while working ~80 hours/week (this is a reduction from ~120 hours/week after regulations were passed). Becoming a doctor is expensive, requires massive sacrifices in time, and doctors don't earn their full salaries until almost a decade after most people start their careers. It doesn't seem like physician salaries are a clear cut problem.

engineers barely make more than a doctor in residency. virtually no engineer on earth makes as much as any doctor after residency.

i dont know about you, but i pulled 80+ hour weeks working, studying, and skill training to get myself where I am today. If I am lucky, and If I spend nights reading code interview books, practicing my skills, maybe I'll get a great job at google/facebook after 4 interviews and some connections making 1/3 - 1/2 as much as an average doctor.

I'd be more inclined to buy your argument if you supported it with evidence. Also we're talking about the impact of physician salaries on healthcare spending. Engineer salaries aren't relevant in this discussion.

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