Simon: There's a reason why healthcare costs in the United States are so high. Drug companies manipulate drug prices to make you go broke.

In this episode, you will learn four strategies drug companies use to inflate treatment costs. Discover their dirty secrets and how you can lower your healthcare costs to almost nothing.

Intro jingle: Welcome to the Cancer Wisdom podcast. This podcast teaches you how to treat cancer with natural remedies without using toxic treatments.

Discover how to take charge of your health and not be a slave to Big Pharma medicine. Here's your host, Simon Persson.

Simon: Every year, insane drug prices ruin millions of Americans' lives and put them into massive debt. Their out-of-pocket costs have risen to unsustainable levels. Cancer treatments can cost tens of thousands of dollars, even with health insurance.

Therefore, many patients need to alter their spending habits to save money. They might cut back on groceries or other important stuff to afford their health spending.

Each month, cancer patients between the ages of 25-64 spend more than 1100 dollars out of pocket for treatments. Americans pay more for cancer drugs than any country in the world.

Pharmacologist Andrew Hill analyzed the drug prices in different parts of the world. He looked at different cancer drugs.

One example was the price of tyrosine kinase Inhibitors, TKIS. So, he used Indian government data to calculate the cost of pharmaceutical ingredients.

He then presented his findings to the European Cancer Congress in Vienna. Hill found out that the United States paid more than double the price than Europe for the same drugs.

The actual manufacturing cost was much less than the final cost of the drug. So Hill found out that the Novartis leukemia drug Glivec cost $159 to manufacture, but Americans paid $106 000 for the same drug for one year of treatment.

And Roche's Tarceva for lung cancer cost $236 to manufacture, but Americans paid $79 000 for the drug. And Novartis Ticarb cost $4000 to manufacture, but Americans paid $74 000 and they pay almost double the price than Europe.

Drug companies often blame the cost of drugs on research and development costs. They spend more money on marketing than on research.

For every dollar used on research, Big Pharma spends $19 on promotion and ads. In 2013,  nine out of ten pharmaceutical companies spent more on marketing than on research.

The biggest spender Johnson & Johnson spent about $17.5 billion on sales and marketing in 2013. The remarkable thing was they only spent $8.2 billion on research.

Pfizer spent 11.4 billion dollars on marketing and only 6.6 billion dollars on research and development. In the top ten, only Roche spent more on research than on sales and marketing.

 I tried to find out why the drug prices in the United States are so high compared to the rest of the world. And I found out four different reasons why drugs are so expensive in the United States.

So, the first reason why drugs are so expensive in the US is patent laws. In 1984, the Drug Price Competition and Patent Term Restoration Act happened.

It gave pharmaceutical companies exclusive protections for innovating a new drug. So, if they created a new drug, they could now patent their invention and monopolize the market. Until the patent expires, the company can use it to exclude any competitor.

It is a payoff for the high risk and cost of developing new drugs. Only the drug company that holds the patent can manufacture and market the drug. If other producers try to copy them, they can sue them for license infringement.

Pharmaceutical companies only invest in new drugs if there's a high chance of profitability and patent protection. They need to recoup their cost to develop the drug.

These costs include the expense of drug candidates who fail to make a profit. When the drug company is allowed to sell the drug, it's sold under a brand name. And in most cases, the drug patent is for around 20 years in the United States. However, the lifetime of patents varies between countries and drugs.

But the clock starts ticking for the patent before the clinical trials are finished. Therefore, drug companies only have seven to 12 years to use their license after the FDA approves the drug. So, they want to make as much money as possible because once the patent expires, other manufacturers can sell it.

These unpatented drugs are called generic drugs. So, in most countries, generic drugs have to be identical to the branded drug. It has to meet the efficacy, safety, and usage of a branded drug.

And once the generic drug is on the market, the patent holder can no longer have any monopoly. It encourages competition and results in a significant drop in costs.

As you might imagine, pharmaceutical companies don't like generic drugs because they lose their edge and can no longer sell their drug at high prices. But they use some dirty tricks to keep generic drugs off the market.

So, there are several ways they can stall generic drugs and stop them from selling their drugs. One strategy is to delay the generic drug.

If the drug company delays a generic drug for as little as six months, that means they can sell the blockbuster drug for a little bit longer.

One tactic that drug companies can use to delay generic drugs is to involve the FDA. They can initiate a petition against the generic drug producer. The drug company can ask the FDA not to give the green light to a generic drug.

The FDA  denies 80 percent of these petitions, but because the FDA has to respond to each petition, it means that the generic drugs has to be delayed.   

The FDA has to answer each petition, even if it is ridiculous. So drug companies can create silly appeals such as demanding that the generic drug needs to provide info to the FDA, which is stupid because that is required by the FDA each time that you want to sell a drug.

The drug company can create any petition, and the FDA has to respond, which further delays the generic drug. When drug companies challenge a generic drug in court, the FDA has to freeze its approval for 30 months.

Brand name drug makers often sue generic versions to keep them off the market. So, one example is Bristol Myers Squibb, which used court cases to delay generic versions  of cancer drugs like Taxol and BuSpar.  

It took years before a generic version of Taxol reached the market. By that time, Bristol had already earned hundreds of millions of dollars by keeping the copycats at bay. Their action hurt generic drug makers like Ivax and Watson Pharmaceuticals.

Another tactic to block a generic drug is by not providing samples of the brand name drug. Generic drug makers need to have a sample of the drug they are copying and show the FDA that it's equal to the branded drug.

So, by refusing to help the generic companies that cannot manufacture their drug, the brand-name drug maker can continue to sell their drug for inflated prices.

Another tactic that brand name companies can use to delay generic drugs is by bribing them. Let's say the annual sales of a brand-name drug in the United States are one billion dollars.

So, the patent has expired, and the generic company wishes to enter the market and sell the generic drug at 10% of the patented drug price.

The generic company would earn $100 million in drug sales. In this situation, the brand-name company can now pay the generic company $100 million to not enter the market.

Now, the brand-name company can generate $1 billion in revenues over the next year because they don't have any competition yet. They can squeeze every penny out of patients before the generic company hits the market.   

Both companies profit from this scheme, and the consumers have to pay the price. This sabotage leads to higher taxes that need to be covered by Medicare costs. Other effects include higher insurance premiums and financial ruin.

Drug companies lose a lot of money when drugs become generic. And that's the reason why they always try to create a new drug that replaces the old one. The difference can be minor, such as changing some molecules of the old drug and then selling it as a new brand name.

But the sad thing is that the FDA approves these minor changes, and then the brand-name manufacturers stop to manufacture the old drug and want the patients to use the new improved drug.

In that way, they force the patients to pay high prices because they believe that the new drugs are much better than the old one, when in reality, there's no big difference.

Another trick Big Pharma uses to keep drug prices high is by using lobbying. Big Pharma spent 3. 6 billion dollars on lobbying activities from 1998 through 2017, according to opensecrets.org. That's more than any other industry.   

By doing some lobbying, they gain favorable treatment from legislators. One such victory was the Prescription Drug Improvement and Modernization Act of 2003.   

This act prevented the government from negotiating prices with drug companies covered by Medicare. Medicare is a national social insurance program administered by the US government. It provides health insurance for Americans 65 or older.

Medicare also provides health insurance to younger people with some disability. In 2015, Medicare provided health insurance to over 55 million inhabitants. On average, Medicare covers about half of the health care charges for those enrolled.

Then, the patient must pay the remaining costs. They either have to do that by using insurance or pay out of pocket.   According to U. S. law, drug companies can set their prices for drugs.

It protects them from free market competition. By lobbying the nation's legislators, they can influence every American.
It affects health insurance premiums, but also the Medicare system.

In many European countries, they have public health care and governments often determine what drugs they will cover and at what price.

Countries sometimes refuse to cover medication they believe is too expensive. Private insurers in those nations then follow the government-negotiated rate. As a result,  medication can be half the price in Europe.

Big pharma also employs doctors, researchers, and institutions to make patients buy their specific drugs. Drug and medical device makers spend lavishly on doctors. They have company reps that talk to doctors to promote the company's drugs.

So they cover their meals, travel, seminars, and conventions that sometimes look like a vacation. And when the doctor tries a drug for your treatment, he can use the brand name drug the drug company just created instead of using a generic drug, which is much cheaper for the patient.

You can go to openpaymentsdata.cms.gov  to see if your doctor receives any payments from drug companies. So you can look at how much they get for research, gifts,  speaking fees, meals, or traveling.  

The third tactic that drug companies use to inflate drug prices is by chasing away natural doctors. The FDA bans natural remedies and allows only dangerous cancer drugs.

They seldom punish drug companies, even if their drugs have horrible side effects. Instead, they go after alternative medicines and supplements that are too successful.  

One example is Latrile or B17. It's illegal to sell in the United States. You can find vitamin B17 in the pits of apricots and other fruits.

In the 1970s, national doctors used B17 as a cancer treatment. But remedies like B17 are a threat to the pharmaceutical industry.

So natural treatments can cure people at a fraction of the price. And therefore drug companies make everything they can to stop them.

The FDA banned B17 based on the lack of evidence of this chemical compound. They didn't try to see if this compound could be used to heal cancer. Instead, they just said that there was no evidence, and therefore, you can't sell it.

You can only sell solutions that the FDA approves. And it's only pharmaceutical companies that can afford these trials.
Even if alternative doctors could pay for these tests, the FDA would reject them anyway because they are in bed with Big Pharma.

So, it doesn't matter if the supplements show amazing results. The FDA will always find a way to discredit it. It is a useless agency that takes orders from Big Pharma.

So, the goal of this agency is to protect consumers from dangerous drugs. Big Pharma has people on the board of directors of the FDA and has a huge say in its decisions.

And the most disturbing fact is that most of the FDA's money comes from drug companies. Therefore the FDA takes orders from Big Pharma because they pay most of their wages. Big pharma is not interested in a natural remedy because you can't patent it.

And that's the reason why they spread negative propaganda about natural cures. Why would you buy a useless drug if you could buy a more effective supplement at a fraction of the price?  Or you can learn how to prevent cancer by changing your health habits.

Drug companies want everyone to believe that their treatments are the only ones that work so that you can be their slave. The only reason they do that is to get rid of the competition and protect their monopoly.

And that's the reason why they chase away alternative doctors and badmouth them. In a sense, they are like drug dealers on the street.

The only difference is that selling drugs on the street will get you in jail, while marketing prescription drugs will not. The only difference is that one group wears white coats, and the other one doesn't.  

I found out a fourth way why treatments are so much more expensive in the United States and that is the complicated billing system.

I watched an interview with celebrity doctor, Dr. Mike. He has a successful YouTube channel and in one interview, he revealed the shocking truth about health insurance. I will play some clips from this interview.

Dr. Mike: We don't have transparency in pricing. So if you, for example, want to have a cosmetic surgery in America, you can call ten cosmetic practices and say, "Hey, I want to get a nose job.

What's the cost of a nose job?" And they will tell you their price because they don't have to negotiate with an insurance company that you have to pay them.

So you can get fair pricing, and you could choose the one that you think is the best value. But good luck calling hospitals and saying, "Hey, I need an appendectomy because I have appendicitis. Which one is going to give me the best rates?

They won't be able to give you that because they have different prices for one insurance. They have an agreement with this other insurance, and it's a disaster.  

It's hybridized so far. It's almost like a mutated system. It started off in one way, then someone had another idea to bring one approach, then someone had another approach, and now it's so segmented.

This is largely driven by lobbyists who come in and start lobbying the government to say, "Oh, we need multiple insurance carriers.

We need these rules for insurance carriers." And as a result, if you walk into my practice and I tell you, you need treatment A, I can't even tell you what the cost of treatment A is because it's so dependent on variables that are outside of my control because it depends.  

For example, if a patient comes in and they tell me they fell, and I write that on the chart, patient fell, blah, blah, blah, in the note, I say, oh, they fell at work, they were doing X, Y, and Z, and I finish the note, I send it to their insurance carrier.

Their health insurance might deny that claim and say, "What do you mean, they fell at work. You said in your note." That means the worker's compensation has to cover it. Not us. The same thing will happen with a car accident. A patient will come to see me, and they'll say, "My back hurts."

 But in the note, they'll say, "Oh, I had a car accident four years ago." The insurance will deny it and say, "The auto insurance is supposed to pay for this."

So, it's a complete disaster in terms of care. You cannot imagine a more broken system, and the fact that it still somehow works, to some degree, is magical.  

Doctors in demand realize that working with insurance companies will yield a lower profit than working with individuals who have cash who want on-demand service. They leave the insurance game, and they say, "I'm only going to accept cash payments from now on."

And that way, they know exactly what they're getting paid. They don't have to argue with insurers. And as a result, they are more financially successful than doctors who accept insurance.  

In ERs, it's very common that a hospital system would contract an ER employer, who then has a bunch of ER doctors that work for them, and then they'll just place them at certain shifts at different hospitals.

So they don't even work for the hospital. They work for the ER employer, who then puts them in different staffing locations. And then you have private practices. My dad currently is a primary care doctor and he has a private practice.

Those are getting bought up by hospital systems. They'll pay the provider a small amount of money or a large amount of money, depending on how successful their practice is.

And then say, "Okay, we essentially own all of your patients. They're members of our practice. So that if you refer patients, it should be within our system, et cetera, et cetera."

And now all of these smaller doctors that used to run their own sort of shops, if you will, are now part of a great health system, like a bigger health system.

So there's less and less individualized practices. There's like ten different insurance companies that have ten different rules. So when a patient comes into my practice, I'll fill out a note, and then I have to bill that note to the insurance company.

But let's say I write a code for their condition that, let's say, doesn't fit the test requirement that they have to pay for that blood test. The bill will go to the patient, and the patient say, "What the heck? Why is this not being covered?"

And it's because the insurer didn't like the code that I put. So this creates this huge administrative burden on doctors where we're like, "Screw this. We don't want to practice this way. We want the hospital systems to take care of it." 

But then, when hospital systems take care of it, it loses that personal touch that you have with your doctor because now, essentially, you're a contractor being contracted to see a patient every 15 minutes.

The cost of health care in America has ballooned over the last 20-30 years. And it's not because doctors cost more to the system. In fact, doctors' cost of the system has stayed pretty stable, or has gone up slightly with the cost of inflation.

But, the idea of healthcare has skyrocketed because for every doctor, you need like 10 to 15 administrators. You need a person to argue with the insurance company.

You need a person to make sure the billing is right from the doctor's side. You need someone doing prior authorizations to argue for your patients to get certain tests done. It's literally a disaster.

Some people will argue against that, and, if we're being honest, whatever the government does usually isn't the most effective or efficient way of doing things. You could easily see more troubles arise in that scenario as well.

Insurance costs have gone up. They wanted to make it seem like they didn't. So, the insurers are really good at hiding the costs from you of what your care actually costs.

So what they do is, let's say, ten years ago, you would pay a thousand dollars a month for your health insurance. But at that time, you had some co-pays which were small and no real deductibles.

Now, you'll still pay a thousand dollars a month for your insurance, but now the first five thousand dollars you have to pay, which is your deductible. So, the cost is tremendously higher, but when you're making your monthly payments, you don't even realize that it's higher.

So insurers, instead of making less money because they're not efficient at handling our healthcare system, they just push the cost burden back onto the consumer.

Always argue every bill. Every bill. The reason why is a lot of times, it's an error on coding. I didn't write the code that would get your test covered as a doctor, because I have no idea.

Someone in the administration can change the code and get it covered. That's number one. Number two, when health insurers charge you a fee, let's say you're paying out of pocket for a condition, like you have no insurance, and you go to the emergency room.

And the hospital charges a hundred, I'm making this up, a hundred dollars for an emergency appendix removal. They have to charge you as a cash user the same amount, by law, in order to charge it to the health insurance company.

But they know the health insurance company, why they're charging them 100, because they'll only pay them 60. So when you get the bill for 100, and you argue, they'll right away lower it to 60.

They just can't do that by law, but they can do it if you claim financial hardship. Always argue your bills because a lot of them are mistakes, and if they're not mistakes, there's financial support programs.  

Simon: Medical billing errors are a common problem in the United States, and it can be extremely costly for consumers. America has such a complex billing system.

So that leaves room for errors on medical bills. These errors can cause the consumers a lot of money. Billing advocates and other health professionals estimate that up to 80 percent of medical bills contain errors. There can be various reasons why billing errors happen.  

So one reason is that the healthcare  provider used the wrong medical code. Each time a  A doctor treats a patient, they use a specific  medical code  so that the patient knows what treatment they got.

But sometimes the doctor can use the wrong code. Coding errors can be honest mistakes such as coding for a 15 minute, meeting as 20 minutes, and that can lead to a higher charge.  

If these upcharges happen intentionally,  then it's considered upcoding and is fraudulent and illegal. Sometimes when you refuse tests, medicines, procedures  or supplies they can still show up on your bill by mistake.   

Therefore, you need to review each bill to make sure that they have listed the right treatments and not things that you haven't done yet.

Another error is data entry errors. So this error can happen when someone enters the wrong insurance company. And that can result in your claim being denied. And then you need to pay for the whole treatment yourself. Sometimes doctors can enter the wrong dates.

So you need to double check that the dates  of your hospital visits. If you stay for a few hours, but your bill says that you stayed all day or overnight by mistake, then you've been overcharged and you need to reclaim that because you can be charged much more money if you don't say anything.  

Another error, is something called code unbundling. It's when a coder uses multiple codes for a treatment instead of just using one bundle code. Itemizing bills in this way can result in higher bills.

And your health insurance provider may deny a  claim that's higher than what's expected. You need to double check that you haven't been charged more than once for tests.

Sometimes you can be double charged for a treatment. Therefore you need to double check every time that you haven't paid for the same treatment twice.

There are ways to lower your treatment costs. One way is to call your provider and ask them for an explanation of questionable items on your bill and request that they remove them, such as double charges or other errors that you find.  

Always say that you want to see your bill in the first place, because otherwise you can't see if there are errors. So if you find errors, you can also call your insurer.  

Another way you can fix the issue is by calling your insurer and ask them why they don't want to pay for the treatment. Maybe they didn't like the code. If that doesn't work, then get the help of a medical bill advocate.

If your medical bills  get sent to collections or you get sued for unpaid balance,  an attorney may be able to offer advice on how to respond and negotiate a resolution.

Another trick that you can use to lower your treatment price is asking if your medical bill is negotiable. And if you're offered a discount,  ask if they can make a better offer. You can also check if you qualify for financial assistance. These policies can be generous.

Also, obtain your itemized bill with the billing codes and check to make sure that it's accurate and fairly priced.
This information can be the evidence that you need to negotiate a reduction in the bill.  

Now, you might ask, is a universal healthcare solution what we need in America? Universal health care is not free because it uses tax money.

So that means that you might pay more taxes on your salary. But it's a better system because it won't financially ruin you as in America.

But whatever solution any country uses, the system is already broken because the Big Pharma model won't fix your issues.

Even if you receive treatments, they won't solve your health problems because the system was never created to solve your issues, only to sell drugs and treatments.

If you put lipstick on a pig, it's still a pig. Drug companies are all about profit and not what's best for the patients. They earn more money by treating cancer symptoms than by curing cancer.  

If you cure a patient, you remove your profit, and drug companies want to make as much money as they can. They don't care if they bankrupt the nation as long as they make a handsome profit. Every treatment makes them more money.

If they cure the patient, they can only profit once. I know several people who have heart issues, and they could have solved that by eating a plant-based diet and avoiding unhealthy fats. But instead, they just get new drugs or treatments for their issues, which doesn't solve their problems.

Drug companies like the subscription model because that means a steady income for the rest of the patient's life. Drug companies want to squeeze out every penny from each patient, and whether the patient dies or not is irrelevant.

The pharmaceutical industry generates higher profit margins than any other industry. Some drugs can cost upwards of $ 100,000 for a full course, and the manufacturing costs are a tiny fraction of this.

The pharmaceutical industry is a billion-dollar industry. They control the FDA and the media and can do whatever they want.   

The best way to save money on treatments is by staying healthy. Diseases occur when we live an unbalanced lifestyle. If you look at the longest living people on earth, they follow certain health principles.

They ate a mostly plant-based diet, have good connections with their friends and family, exercise, have a reason for living, reduce their stress, and have a higher purpose in life.

And that's the reason why they live so long. And when we stop living according to these health laws, we become sick.   But if you work on your stress, diet, sleep, exercise, and get enough sunshine, you become less sick.

So you need to take charge of your health, and if you do that, you don't need to go to hospitals. I haven't gone to hospitals in a long time because I know I can stay healthy by taking care of my body.

By learning how to stay healthy, you can save tons of money and have more energy than before. You can watch the Cancer Crash Course to learn how to stay healthy.

In the first module, you'll learn the mechanism of cancer and why you get it. And in the second module, you'll discover ways to stay healthy by following certain health principles.

And in the final module, you will learn more about the corrupt medical industry and why you shouldn't trust it.   You can watch this course for free.

So I will provide a link to this course in the description box below. Thank you for listening to this episode and I'll see you in the next one.