I mean, OK, this is definitely a success story. You got your medical problem resolved and paid nothing extra on top of whatever your insurance costs you.
But you almost certainly didn't get $100,000 "worth" of medicine, or anywhere close to it. The "sticker price" of most medication in the US that you supposedly pay OOP is almost totally fictional. Basically no-one ever pays it; it's probably several orders of magnitude above the cost of production and distribution of your dose; and quite probably at least one order of magnitude over the total cost of everything to do with the drug, even including marketing, research, approval, and allowance for research for failed drugs.
It depends a bit what you're optimising for. The US system is almost certainly not optimal overall, and it *definitely* isn't optimally efficient (the US spends a lot on healthcare relative to outcomes, even allowing for it being wealthy overall and arguably subsidising drug-research for the rest of the world).
The UK has a basically simpler, and more "efficient" system, in that it spends dramatically less and doesn't get outcomes proportionally worse. But it allocates scarce resources essentially by queueing and hassle, which generates deadweight loss. This isn't great, and is particularly bad if you're rich, since you presumably value your time more highly in money terms. But of course, in the UK you can still get private healthcare, and unlike in the US, they won't present you with the choice of an insurance beauracracy or ludicrous list prices and risk you having to pay 10x the actual value of the treatment. On the other, other hand, the existence of the NHS means there's a lot less private healthcare around, so your options are more limited.
I'm convinced that healthcare is a particularly hard part of the economy to make work in any remotely sane way. Somehow we seem to muddle along anyway.
While this worked out well for you, this strikes me as a failure of capitalism more generally (though the failure is at least partly due to regulation). You have a situation where a pharma company is charging a ton for a medication, and seemingly one with an alternative (the pills). You would never pay that price yourself, meaning your revealed preference is to not use the drug, but you are, of course, happy to take it if it's free to you.
Pharma knows this, so they give out free samples to get you interested, provide representatives to sweet-talk you, and (presumably) to argue with regulatory agencies to force your insurer to provide it. When your insurer throws up its last safeguard against people from taking overpriced, potentially unnecessary drugs - a copay - Phamra gets around that too, by comping the copay. The end result is that you got the medication for free, but everyone's insurance premiums go up.
This is a classic agency problem. It's the equivalent of wining and dining the procurement officer to convince them to buy something the company doesn't really need, which leads to significant inefficiencies in the system. It's why healthcare in the US is so expensive.
I wouldn't totally place the blame on capitalism, as we're dealing with an area of significant regulation. Everything from patents creating monopolies on drugs, to FDA drug approvals, to laws governing what insurance companies can charge in premiums, to regulators having a role in deciding what insurers have to pay for, distorts the system. But this story is really more evidence of a broken system than capitalism working in the end. Had capitalism worked, you wouldn't have wound up using something that cost way more than your revealed preference.
I'll just add that, while there's definitely room for tweaks (I'd ban comping co-pays, or at least let insurers do so), that doesn't mean there's an obvious better system. Both "Medicare for all" and anarcho-capitalist medicine have their own problems.
I mean, OK, this is definitely a success story. You got your medical problem resolved and paid nothing extra on top of whatever your insurance costs you.
But you almost certainly didn't get $100,000 "worth" of medicine, or anywhere close to it. The "sticker price" of most medication in the US that you supposedly pay OOP is almost totally fictional. Basically no-one ever pays it; it's probably several orders of magnitude above the cost of production and distribution of your dose; and quite probably at least one order of magnitude over the total cost of everything to do with the drug, even including marketing, research, approval, and allowance for research for failed drugs.
It depends a bit what you're optimising for. The US system is almost certainly not optimal overall, and it *definitely* isn't optimally efficient (the US spends a lot on healthcare relative to outcomes, even allowing for it being wealthy overall and arguably subsidising drug-research for the rest of the world).
The UK has a basically simpler, and more "efficient" system, in that it spends dramatically less and doesn't get outcomes proportionally worse. But it allocates scarce resources essentially by queueing and hassle, which generates deadweight loss. This isn't great, and is particularly bad if you're rich, since you presumably value your time more highly in money terms. But of course, in the UK you can still get private healthcare, and unlike in the US, they won't present you with the choice of an insurance beauracracy or ludicrous list prices and risk you having to pay 10x the actual value of the treatment. On the other, other hand, the existence of the NHS means there's a lot less private healthcare around, so your options are more limited.
I'm convinced that healthcare is a particularly hard part of the economy to make work in any remotely sane way. Somehow we seem to muddle along anyway.
While this worked out well for you, this strikes me as a failure of capitalism more generally (though the failure is at least partly due to regulation). You have a situation where a pharma company is charging a ton for a medication, and seemingly one with an alternative (the pills). You would never pay that price yourself, meaning your revealed preference is to not use the drug, but you are, of course, happy to take it if it's free to you.
Pharma knows this, so they give out free samples to get you interested, provide representatives to sweet-talk you, and (presumably) to argue with regulatory agencies to force your insurer to provide it. When your insurer throws up its last safeguard against people from taking overpriced, potentially unnecessary drugs - a copay - Phamra gets around that too, by comping the copay. The end result is that you got the medication for free, but everyone's insurance premiums go up.
This is a classic agency problem. It's the equivalent of wining and dining the procurement officer to convince them to buy something the company doesn't really need, which leads to significant inefficiencies in the system. It's why healthcare in the US is so expensive.
I wouldn't totally place the blame on capitalism, as we're dealing with an area of significant regulation. Everything from patents creating monopolies on drugs, to FDA drug approvals, to laws governing what insurance companies can charge in premiums, to regulators having a role in deciding what insurers have to pay for, distorts the system. But this story is really more evidence of a broken system than capitalism working in the end. Had capitalism worked, you wouldn't have wound up using something that cost way more than your revealed preference.
I'll just add that, while there's definitely room for tweaks (I'd ban comping co-pays, or at least let insurers do so), that doesn't mean there's an obvious better system. Both "Medicare for all" and anarcho-capitalist medicine have their own problems.