>Any attempt to bring costs down in the US - whether single-payer or market-based - would result in higher costs for drugs and other supplies to the rest of the

>Any attempt to bring costs down in the US - whether single-payer or market-based - would result in higher costs for drugs and other supplies to the rest of the developed world[0]. Put another way, countries like Denmark and Canada and the UK have the appearance of negotiating leverage only because they're such a tiny market[1] compared to the US - and, crucially, a completely segregated market as well. So even if pharmaceutical companies end up selling drugs at very low rates there, they can easily make up the difference in revenue by increasing prices in the US[2]. I see this economic fallacy so often and crop up in so many different places that I'm thinking that it might actually need a name - maybe the "fallacy of immutable profits". For example, elsewhere: * If you raise the minimum wage, the inevitable outcome is that people will be fired and prices will rise so that the "natural" state of the company's profit remains unchanged. * If you raise land taxes then landlords will just raise rents so that their return on investment remains static. As a profit making entity, this is naturally what you'd want to bluff people into thinking would happen. It's not what actually would happen though, except in one very specific scenario (the profit making entity has all the power and the other parties have no leverage). The reality is that if you put economic pressure on one valve and there are three potential exit points, the pressure will be distributed across them relative to the leverage on each side. Has Walmart employed way more people than they need or are they barely getting by with what they have? The answer to that determines whether how much their profits get cut and whether employees get fired. Can customers just get their stuff off Amazon if walmart raises prices? If yes, then Walmart has to eat a shit sandwich of lower profits. If the power of the drug companies relative to the power of Denmark is very high then Denmark will eat the losses. If the reverse is true, well, then Pfizer will eat shit. Pfizer, of course, hate negotiating with large parties - especially whole countries because their relative leverage is much lower. They will lobby furiously to try and break the country down so that they can lobby on a more local level. This is also partly why Congress barred medicaid from negotiating with drug companies - it was hitting drug companies in the profit margins. Can't have that. And, I think Pfizer's power on the global drug market is consistently overestimated, though most proposed "free trade" deals coming out of the US (e.g. TPP) seem focused on increasing the leverage of companies like Pfizer - e.g. with the ISDS and stronger intellectual property provisions.