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Comment by apwell23 | Hacker News Reader

what do you mean? you expect american doctors to prescribe you medicines from german pharmacies?

I'd assume it was their telling them specifically not to get it from a foreign country that was the odd part, as opposed to simply prescribing it from a US pharmacy since ofc that is what a US doctor will do. Maybe enough patients tried this, to save costs, that it resulted in some kind of issue for the doctor and that is why they brought it up.

I actually do expect doctors to have even a tiny concern for not making their patients go bankrupt, yes.

Is that really such a high bar?

You need to understand that the system is deliberately so opaque that doctors don't even know what your costs would be. Sure there's a sticker price, but for most medications that's so high as to be absurd. From there, it's entirely dependent on your insurance, coinsurance, pharma benefits, etc, etc.

They try, but they're not in a position to do anything about it.

> They try, but they're not in a position to do anything about it.

Well, somebody's got to be, and the doctors seem like the ones with the most leverage to get those people to do something about it, right? Customer/patient pressure obviously isn't working.

> the system is deliberately so opaque that doctors don't even know what your costs would be.

You're telling me professionals who make $300k after 20 years of education have 0 clue about what their patients might pay, or have never had patients who expressed concern over costs? Or don't have friends or relatives who expressed dissatisfaction with a high-deductible plan? Or aren't complicit in getting kickbacks for prescribing opioids?

We gotta stop absolving people of accountability. And that includes EVERYONE in the chain who benefits. Yes, this includes doctors.

Btw, I have had doctors who do try, and many more now will accept reasonable cash prices for their services. That should be encouraged and commended.

They often don't. There are a lot of variables that affect the price. The doctor is not going to know all of them.

Indeed. At the end of the day, the entity underwriting the insurance plan decides the price. This is often the individual's employer. Your doctor does not know what your HR team decided to ask for when designing their health plan.

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