No one pays $100/pill. It's "that much" in America because the manufacturer anticipates that the insurance companies are going to expect a big discount. Pricing it at $100/pill allows them to say "Well, for you Mr. Blue Cross, you do indeed have massive volume, we will offer an amazing 95% off and sell the pill to your very lucky customers for $5." Since it is now illegal not to possess health insurance in the United States, "no one" will be paying an uninsured rate.
However, companies aren't selling these pills directly to consumers, they go through pharmacies and doctors. If you don't have insurance or your insurance doesn't cover the medication, these pharmacies and doctors usually have multiple options at their disposal to increase the affordability of the medication, whether it's a manufacturer-provided financial hardship program, substituting the same medication from a different manufacturer (i.e., "generic version please"), assistance signing up for government-provided medical benefits like Medicaid, or something else.
Doctors do the same thing. Their "cash price" is a hyperinflated joke that exists only to anchor their negotiations with the insurance company. If you don't have insurance, you can and should ask about options to slash the sticker price. You can often get an instant 50% reduction just by asking.
The people who really get screwed are the people who have some type of billing snafu and end up with a cash price account in collections. This will haunt your credit report for at least 7 years and will make your life unpleasant in other ways, but even at this point you can usually negotiate a large discount. Such snafus can happen for various reasons and are unfortunately not rare, as you might guess from the ridiculous complexity of the system already described.
If the medical provider sues, it's possible a judgment could be entered against the individual for the cash amount that no one is ever expected to pay anyway. That is the worst case scenario, and it's bad, but even then most Americans are not stuck. They can file for bankruptcy protection and have the matter settled. In most states, bankruptcy will not require a person to surrender property that is needed for their daily maintenance, and some states have very strong homestead exemptions that ensure a homeowner will not be forced to sell his/her primary residence.
Of course, all of this is a massive disaster, but it should be known that in real life, virtually no one pays $100/pill. :)
Of course no one pays that much, directly. 90% of America cannot afford that all at once.
So the trick is to get Americans to pay $10/pill at the point of purchase, and an additional $3 taken out of every paycheck, before taxes, whether they get the pill or not.
The US healthcare system is a cesspool of interlocking scams and cons. Those who genuinely want people to be healthy, and for sick people to get well, are constantly at war with those who operate under the assumption that a person will hand over everything they own (and maybe even some stuff that other people own) for a decent chance at not dying before they're ready to go--and then still charge a little extra to help someone die when they are ready.
However, companies aren't selling these pills directly to consumers, they go through pharmacies and doctors. If you don't have insurance or your insurance doesn't cover the medication, these pharmacies and doctors usually have multiple options at their disposal to increase the affordability of the medication, whether it's a manufacturer-provided financial hardship program, substituting the same medication from a different manufacturer (i.e., "generic version please"), assistance signing up for government-provided medical benefits like Medicaid, or something else.
Doctors do the same thing. Their "cash price" is a hyperinflated joke that exists only to anchor their negotiations with the insurance company. If you don't have insurance, you can and should ask about options to slash the sticker price. You can often get an instant 50% reduction just by asking.
The people who really get screwed are the people who have some type of billing snafu and end up with a cash price account in collections. This will haunt your credit report for at least 7 years and will make your life unpleasant in other ways, but even at this point you can usually negotiate a large discount. Such snafus can happen for various reasons and are unfortunately not rare, as you might guess from the ridiculous complexity of the system already described.
If the medical provider sues, it's possible a judgment could be entered against the individual for the cash amount that no one is ever expected to pay anyway. That is the worst case scenario, and it's bad, but even then most Americans are not stuck. They can file for bankruptcy protection and have the matter settled. In most states, bankruptcy will not require a person to surrender property that is needed for their daily maintenance, and some states have very strong homestead exemptions that ensure a homeowner will not be forced to sell his/her primary residence.
Of course, all of this is a massive disaster, but it should be known that in real life, virtually no one pays $100/pill. :)