The Great Rip Off

#52
#52
AM64 said:
I keep trying to impress my wife with that fact when we discuss selling this house. She watches all the home improvement shows and is convinced that we need to spend a bundle - new kitchen cabinets, etc, etc. I keep telling her to see who sponsors those shows. Realtors and lenders always want the home to sell for top dollar - they just don't care about how much you recover to sell at top dollar. Wives never listen. I'd much rather buy a house and do improvements I want, than buy one where someone has slapped on cheap paint and put down cheap carpet, etc. The key is figure out who has the most to gain when it's your money on the line.
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You are right. Wives don’t listen.
 
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#53
#53
volkyries said:
I am not saying insurance doesn't drive up costs, but according to google, doctors in Peru make on average $53,100 USD per year US while American doctors make over 4 times more at $228,000 USD. I dislike insurance as well, but the comparison is not apples to apples if costs are 4 times different to start with.
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It would be more applicable to look at Lima alone rather than all of Peru.

And besides, costs being "4x different" (they're really not) don't justify the 10x+ difference in price for almost everything. A doctor's salary is not representative of all of healthcare.
 
#54
#54
ButchPlz said:
It would be more applicable to look at Lima alone rather than all of Peru.

And besides, costs being "4x different" (they're really not) don't justify the 10x+ difference in price for almost everything. A doctor's salary is not representative of all of healthcare.
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I was in Lima several years ago and really don't remember it being that inexpensive, but I was staying in the tourist area a few blocks from the ocean.
 
#55
#55
VolStrom said:
I was in Lima several years ago and really don't remember it being that inexpensive, but I was staying in the tourist area a few blocks from the ocean.
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In the tourist areas it really isn't inexpensive. Where I usually am (and where we just bought an apartment) it's pretty drastically inexpensive. My wife is also Peruvian and I know enough Spanish so we can usually avoid the gringo tax too. Examples: went to have dinner in Miraflores last night, cost us about $50 for four, and that was only a "light" dinner. When we go out for dinner in Callao we have a ton of ceviche, jalea, and beer and it costs us maybe $30 for six of us.
 
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#56
#56
Rasputin_Vol said:
Oh, and it appears that you are suggesting that the salaries of doctors is a driver of costs? Is that what you are suggesting?
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It is an input that needs to be considered, I never said it was a driver. That said, I think it would be silly to assume shots would be $8/shot in the US if it wasn't for insurance when doctors clearly make more in the USA then they do in Peru. The doctor would still need to make their salaries, plus staff and other operating costs all of which i would guess would be more than in Peru. So without insurance, they would still be quite a bit more than $8 a shot at a doctors office here to get the shots (assuming the shots in Peru were given at a doctors office).
 
#57
#57
ButchPlz said:
In the tourist areas it really isn't inexpensive. Where I usually am (and where we just bought an apartment) it's pretty drastically inexpensive. My wife is also Peruvian and I know enough Spanish so we can usually avoid the gringo tax too. Examples: went to have dinner in Miraflores last night, cost us about $50 for four, and that was only a "light" dinner. When we go out for dinner in Callao we have a ton of ceviche, jalea, and beer and it costs us maybe $30 for six of us.
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How did you wind up in Peru?
 
#58
#58
Another note on Peru. It appears heath care is basically run by the government there according to the link below which lists only 10% at most covered by the private sector (assuming 0% for both the miliary and policse). So do we need to have universal healthcare as well?

The Peruvian healthcare sector is comprised of five core decentralized entities; four public and one private, each with its own separate facilities. First, the Ministry of Health’s health insurance program, Seguro Integral de Salud, is the largest insurance provider covering 60% of the population. Second, the Ministry of Labor’s social security program, EsSalud, covers those in the formal economy, or 25% of the population. The remaining 10% of the population receives services from the Armed Forces, National Police, and the private sector.

https://www.trade.gov/healthcare-resource-guide-peru

ETA: the numbers only add up to 95% so not sure what is going on, but clearly private sector is a small piece of the pie.
 
#59
#59
volkyries said:
Another note on Peru. It appears heath care is basically run by the government there according to the link below which lists only 10% at most covered by the private sector (assuming 0% for both the miliary and policse). So do we need to have universal healthcare as well?

The Peruvian healthcare sector is comprised of five core decentralized entities; four public and one private, each with its own separate facilities. First, the Ministry of Health’s health insurance program, Seguro Integral de Salud, is the largest insurance provider covering 60% of the population. Second, the Ministry of Labor’s social security program, EsSalud, covers those in the formal economy, or 25% of the population. The remaining 10% of the population receives services from the Armed Forces, National Police, and the private sector.

https://www.trade.gov/healthcare-resource-guide-peru

ETA: the numbers only add up to 95% so not sure what is going on, but clearly private sector is a small piece of the pie.
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You're purely looking at insurance, which is a single aspect of healthcare. Many people are eligible for those coverages, but don't use them. Coverages in general are also almost exclusively catastrophic or for things like pregnancies, which I've also noted a dozen times in this thread. For most minor incidences that Americans would go to an ER or Urgent Care for (and use their insurance), Peruvians largely visit private clinics, labs, hospitals, or- in many cases- pharmacists, who are frequently licensed similarly to nurses and can give injections and administer medicines and care like a nurse would. Almost none of these places accept insurance- they're all cash-or-credit card based.

My point all along is that the bureaucracy of ever-expanding insurance is what is driving costs in the US. All you're doing is missing the point. And again, you note that the numbers don't add up, and you chose to post it anyway?
 
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#61
#61
volkyries said:
It is an input that needs to be considered, I never said it was a driver. That said, I think it would be silly to assume shots would be $8/shot in the US if it wasn't for insurance when doctors clearly make more in the USA then they do in Peru. The doctor would still need to make their salaries, plus staff and other operating costs all of which i would guess would be more than in Peru. So without insurance, they would still be quite a bit more than $8 a shot at a doctors office here to get the shots (assuming the shots in Peru were given at a doctors office).
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Doctors don't have to administrate the shot- it's insurance that has driven that insanity. I noted a hundred times that the shots I got were given directly at a pharmacy. Did you even read my posts?

And do you know what the actual manufacturing costs + R&D costs for pharmaceuticals are spread over time? It ain't that drastic for the average medical product.
 
#63
#63
Vol737 said:
It’s an app. Put it on your phone and you can shop prices among multiple pharmacies in your area for prescriptions. Guess you could say it a coupon app for prescriptions.
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GoodRX has saved the folks and family i know mucho money. I have no idea how it works, nor does anyone i have talked to...but it does.

My primary care actually keeps up with which pharmacy has the best prices on common prescriptions and will suggest sending your scripts there to save you money. He has also pulled out his phone more than once and looked up where is cheapest before sending my prescription off...he is a conservative btw and his views align with most posters here about big government etc. I am sure he doesnt just bring that up as he treats plenty of folks who see things differently, but anyway....

GoodRX shows some meds that are over $1000 at say walgreens will be $13 at walmart. Another med may be the exact opposite with the same spread...its insane.
 
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