Rats ‼️‼️

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AUTHOR: R Quinn on 3/29/2025

Back in the 1960s I processed health insurance claims. Employees came to me with their receipts and I helped them put a claim together and then submit it for payment. 

One day an employee presented a receipt from a hardware store- for rat poison. I thought it was a mistake or a joke. I almost laughed. However, he was quite serious. Rat poison is a blood thinner and it was prescribed by his doctor. Unfortunately, it wasn’t eligible for reimbursement.  Good thing it was only a dollar or so. Heck, an office visit was $5.00. That would be $52 today – good luck with that. 

As crude as that may seem today, apparently it did the job- very affordably. Just imagine getting your health care at Home Depot instead of Walgreens. 

Today we know better. We even have a choice of drugs to accomplish the same thing as rat poison- except kill rats – at a price, of course.

The cost of popular blood thinners like Eliquis and Xarelto can vary significantly, with a 30-day supply potentially costing around $550 to $600. 

Older blood thinners like Warfarin can be significantly cheaper, around $20 to $30 per month. Warfarin was developed in the 1920s as a result of research on cows dying from a blood thinning disease. Just like we do to rats. 

You can get D-Con rat pellets for $8.64 at Walmart, but not Walgreens. 

No, I’m not serious. 

The thing with health care is we tend to want the latest of and perceived best of everything, regardless of cost as long as someone else is paying. 

I recently read a woman’s rant on social media complaining that she incurred a $3,000 expense because the insurance company “refused to pay.” It was her deductible, but she didn’t see it that way. She expected 100% coverage. 

Also, the way we use health care is not driven by demand, but by supply. More competition does not lower prices, it increases utilization. 

Let’s say a new scanning/MRI center opens a mile away from an existing facility. It invests a million or more into equipment. The goal is not to attract with lower prices, but simply to do more MRIs. 

The United States has 37.98 MRI units per million population. The second highest in the world. Everyone has to be paid for. The UK has 8.6 MRI scanners per million people, which is fewer than the average of 12.4 in the EU. 

Your doctor is likely paid by private insurance, Medicare and Medicaid. What each pays for the same service is in that declining order. A practice couldn’t survive on what Medicaid or even Medicare pays. So guess what happens to other prices and utilization? 

A 2017 study found that physicians themselves estimated that around 20.6% of overall medical care was unnecessary. A 2019 study in the Journal of the American Medical Association estimated that roughly 25% of total healthcare spending in the U.S. is wasteful.

Even competition among insurance companies is backwards. Too many competitors doesn’t lower premiums in an area, it dilutes their ability to negotiate lower fee payments because their ability to deliver patients is lessened. 

It seems that all we know about economics doesn’t apply to health care. I chalk that up to the people expectation factor.