I received a lot of emails in response to Who’s to Blame for Rising Healthcare Costs? Some reader suggestions might save you some money.

Overpaying for Generics

“Dr. P” a front line working family physician for 30 years writes ….

Hello Mish

Thank you for exposing some of the many scams on health care insurance. Here is another example of industry wide ripoffs:

Many generic medications now cost $4.00 for 30 days or $10.00 for 90 days without insurance. Sadly, many mail in companies require patients to pay a $15.00 – 30.00 dollar co-pay for 90 days for the same drugs.

Just this week one of the mail in companies informed a patient of mine that they will be only filling the prescriptions for 30 days and will require a $15.00 co-pay monthly for a medication which is only $4.00 per month.

My patients were surprised when I told them to just go to a local pharmacy and not use their insurance. One patient had 4 medications he was paying more than double for. In the most flagrant example, a patient paid $60.00 per month for his medications that he could get for 90 days for $40.00 if he did not use his employer paid insurance. That is $180 instead of $40!

The insurance company walks away with the money on the back of the patient in all of these instances. I find this way over the top in the ethics department.

To your health,

Dr P.

Drugs from Canada

“CB” writes …

Hello Mish

Keep up the good fight.

I want to let you know, however, that Americans can buy drugs from Canada – as individuals. No bulk purchasing for resale is allowed, but to get one’s own drugs at a big discount (like I do), the place to check out is called Canada Meds. Their phone number is 1 877 542 3330. I save 50%. I pay directly for them, so trying to buy from Canada under an insurance plan might not be possible. I don’t know.

The drugs I get from Canada Meds come from other countries, and are usually made in India, but they are the exact same thing and I’ve been taking them for years now with no ill effects.


I cannot and do not vouch for the above claims nor do I deny them. I simply do not know. Moreover, I do not know if buying drugs from Canada is against any state laws. I did check and I do not see complaints against Canada Meds, so that is a good sign.

Another physician Chimes In

“MB” MD writes ….

Hello Mish

I am a long time reader and have written previously. I am also a physician.

Your post regarding health care costs hits close to home but I think you have missed the real crux of the issue. I will not pretend that I can offer a comprehensive review in a short email. There is more than enough blame to go around. Who shares the blame? Insurers, the Congressmen they’ve bought and the Americans who can look only at the fact that they can get mostly free care (Medicare and Medicaid recipients, government employees and a decreasing number of lucky beneficiaries of large corporate policies) and many of my peers who are paid per service regardless of need, benefit or outcome.

One need only look at the enormous amount of waste in the system in regards to gross and repeated over-testing to no patient benefit. I could write pages about over-testing.

I have a little aphorism that I believe sums up the failure of American health care: 30% of health care delivered was never necessary and 30% of necessary health care is never delivered.


Cost of Illegal Aliens

“JC” writes …

I know a nurse in a major metro area and she deals with the illegal immigrants flooding into her hospital emergency room every day. They come with their diagnosis in hand from the country they left. Major metro hospitals are magnates for illegal aliens coming to the US for free medical treatments.

In my post of who is to blame I came up with this list.

So Who’s To Blame?

  • Obama
  • Congressional Republicans
  • Democrats
  • Insurers
  • Public Unions
  • State Government

President Obama just wanted a bill. He did not really give a damn what was in it, as long as it did not upset public unions. Moreover, Obama sold the youth vote right down the river. There is nothing but pain for them.

Public unions do not give a damn about healthcare costs because they and their families pay next to nothing with deductibles that are next to nothing. Taxpayers pick up the cost.

Democrats also did not want to upset the unions.

Republicans refused to allow competition between states or cheaper drugs coming in from Canada.

State governments pander to unions and also act to restrict competition.

The insurers bribed both parties to get what they wanted out of the legislation.

Other Notables

  • Lobbyists for pharmaceutical companies, lobbyists for insurers, lobbyists for lawyers so tort reform is not passed, etc.
  • Local Governments for pandering to unions.
  • Fear Mongers who talk of “death squads” every time a discussion comes up regarding health care rationing.
  • Organized religion for fighting to keep brain-dead zombie patients alive at enormous expense. A nurse friend of mine told me how hard it is to “pull the plug”.
  • The public at large for obesity, poor eating habits, smoking, etc.

Case for Rationing

At some point the system just has to say no. Spending hundreds of thousands of dollars to extend someone’s life by three months is simply not rational. Nor is spending hundreds of thousands of dollars when the odds of success are slim. Yet every time the discussion comes up, political hacks start screaming about “death squads”.

Other than the public at large, everyone has a vested interest in not fixing the system. It is pretty tough to get reform when nearly every major industry group is against anything and everything that is likely to do any good.

If additional comments come in, worthy of posting, I will add an addendum.

Mike “Mish” Shedlock
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