4 ms·

I agree 100%. The approach I like is what I call "lowest negotiated price". How it would work is that buyers (i.e. insurance companies) could still negotiate

I agree 100%. The approach I like is what I call "lowest negotiated price". How it would work is that buyers (i.e. insurance companies) could still negotiate for a lower cost, but whatever that cost ends up being is the cost _everyone_ pays. This allows buyers to continue to try to get a better price if they can, while likely making sure the price that is agreed upon is fair to all.

newnewpdro 8y ago
That sounds like an interesting solution. It makes me ponder a "highest negotiated salary for $position" approach to combat income inequality
- jamroom 8y ago
  We have most of that in a union. You can literally trace the decline of middle class income to the decline of union membership - i.e.: https://www.russellsage.org/sites/default/files/Stone_Arthurs_TablesFigures.pdf https://www.russellsage.org/sites/default/files/Stone_Arthur...
refurb 8y ago
There is evidence that this would actually increase prices across the board. How do we know? Such a system already exists. The price that Medicaid plans pay is either 23% less than the average price paid or the “best price” (if lower). When this was instituted, drug companies actually pulled back on their discounts to non-Medicaid accounts, so as to not trigger the “best price”.
- jamroom 8y ago
  Right now there's likely to be 100 different prices for almost any medicine or procedure - it depends on who's paying. I think one of the frustrating aspects is that if you are uninsured, you are likely to pay the HIGHEST rate - even though you are likely to be the least able to afford it. I agree that on non-generic drugs that the price would likely remain high - however if everyone paid the same rate (low or high) then it would at least discourage some of the type of pricing we see now where a procedure is provided below cost to a specific group of users to make sure those members (i.e. customers of specific insurance companies) are able to be kept "in network", while charging much, much higher rates to others to make up the difference.
- briffle 8y ago
  Another part of this is the rise of 'rebates' for PBM's and insurance companies, that does not change the price paid for the drug.
- LorenPechtel 8y ago
  Except Medicaid is contaminated by rebates from the drug companies to the states. That's one of the things that needs to be banned.

newnewpdro 8y ago

That sounds like an interesting solution. It makes me ponder a "highest negotiated salary for $position" approach to combat income inequality

jamroom 8y ago
We have most of that in a union. You can literally trace the decline of middle class income to the decline of union membership - i.e.: https://www.russellsage.org/sites/default/files/Stone_Arthurs_TablesFigures.pdf https://www.russellsage.org/sites/default/files/Stone_Arthur...

refurb 8y ago

There is evidence that this would actually increase prices across the board. How do we know? Such a system already exists. The price that Medicaid plans pay is either 23% less than the average price paid or the “best price” (if lower). When this was instituted, drug companies actually pulled back on their discounts to non-Medicaid accounts, so as to not trigger the “best price”.

jamroom 8y ago
Right now there's likely to be 100 different prices for almost any medicine or procedure - it depends on who's paying. I think one of the frustrating aspects is that if you are uninsured, you are likely to pay the HIGHEST rate - even though you are likely to be the least able to afford it. I agree that on non-generic drugs that the price would likely remain high - however if everyone paid the same rate (low or high) then it would at least discourage some of the type of pricing we see now where a procedure is provided below cost to a specific group of users to make sure those members (i.e. customers of specific insurance companies) are able to be kept "in network", while charging much, much higher rates to others to make up the difference.
briffle 8y ago
Another part of this is the rise of 'rebates' for PBM's and insurance companies, that does not change the price paid for the drug.
LorenPechtel 8y ago
Except Medicaid is contaminated by rebates from the drug companies to the states. That's one of the things that needs to be banned.