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Bonkers for pricing "free" flu shots show what's wrong with US health care



A pharmacy uses the sign to advertise the pharmacy.
Enlarge / Regardless of the crazy pricing, you should get the flu shot.

Annual flu shots, free of charge to health insurance holders, are not immune to curvy and unimaginable price bonds that shake the US health system.

Health insurance companies pay wildly different amounts for the same vaccines, depending on how negotiations with individual healthcare providers across the country. In some cases, providers forced insurance companies to pay three times the price they paid to other providers, according to a study conducted by Kaiser Health News.

At the exit, a Sacramento doctor's office in California said it was an insurer who would pay $ 85 for an influenza shoot for $ 25 for uninsured patients.

Although the US dollar appears to be a significant amount in the inflated program of the US health system, these prices are rising rapidly because tens of millions of people get the flu vaccine each year. The Economic Care Act requires insurers to cover all the costs of all federally recommended vaccines, including the flu vaccine, while economists have to pay KHN to insurers' patients with higher insurance premiums.

Examining how insurers are paying for flu vaccines, KHN found that the costs range from $ 25 to $ 85. A CVS in downtown Washington received $ 32 from Cigna for the same shot, while a doctor in Long Beach, California paid $ 47.53 to Cigna for a shot. A CVS in Maryland just 10 miles away got $ 40.

My insurance did a little better than them. My doctor's office in the Columbia District received my insurance company, Aetna, for $ 35 for my flu, and Aetna paid them a $ 24.50 bargaining fee.

However, this is still well above federal bargaining rates. The Centers for Disease Control and Prevention negotiated a price of just under $ 14 for the same attraction. The agency reported that the private sector is about $ 18. Likewise, Medicare and Medicaid Services Centers pay $ 18 for vaccination.

Aetna paid about 35% more than my identical shot – and there was no way I knew about it before I fired. Secret bargaining rates make it impossible for patients to shop. And that's not just a problem for flu shots. There are wild price differences for everything from diagnostic scans to surgeries.

Glenn Melnick, a health economist at the University of Southern California, Glenn Melnick, a health economist at the University of Southern California, “We don't have a functioning health market. “The prices are inconsistent and confusing for consumers,” he said. “The system doesn't work to provide effective care and the flu vaccine is an example of how these problems persist.”


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