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My spouse struggled with a medical condition for years and was lucky to finally get a prescription for something that actually resolved the problem. The medication was expensive ($1000+ a month), but since we literally tried everything else, insurance would “let” it be covered.
Then I lost my job and had to move over to a new company’s insurance plan. And they won’t cover it.
The fact that your employment in the US determines what medical care you can get is absolutely bonkers.
A medication being more expensive usually indicates rarity. This means the instance of required coverage by insurance companies is also rare. The fact any medication, needed to mitigate the risk of simply being born, might not be covered by “insurance” is bonkers.
I think we need to start a new industry to take it to insurance companies every time they deny coverage. Bury them in complaints and legal actions. Go so hard on every case that they give in immediately upon seeing the letterhead.
Most meds take dollars to make. It ain't rarity.
That's their point. If I need to setup a production facility but there's only demand for a thousand doses a year, then the long term capital costs are going to drive the unit price up.
But there's also greed. Stuff that's a dollar to make and a thousand dollars to use.