> I'd really love to see a comparison between 1) the $1MM bill 2) the "actual" negotiated money that changes hands 3) what it would cost in other countries wit

> I'd really love to see a comparison between 1) the $1MM bill 2) the "actual" negotiated money that changes hands 3) what it would cost in other countries with different healthcare systems. For example: Blood products in general (medication developed by publicly traded companies and formally approved by governmental bodies), which are regularly required for some rare diseases, generally cost around twice as much in the US compared to the rest of the developed world that has universal healthcare (excluding Switzerland). I have 2 rare immune-mediated neurological diseases affecting my peripheral nervous system, and I require a self-administered blood product to quite literally, stay alive. It is called subcutaneous immunoglobulin. It is the only treatment that has ever worked: I have tried about 10 different medications, plus combinations of them, to no avail. Anyways, the cost of this blood product (immunoglobulin--both intravenous and subcutaneous forms) in developed countries that have universal healthcare (excluding Switzerland and the US) is 40 Euro per gram. Right now, the exchange rate, Euro to US Dollar is 1 Euro per 1.13 US Dollar. So, currently, this blood product costs about USD $45.01 per gram. My US-based private medical insurance, pays for this medication at a contracted rate of USD $100 per gram. The provider (the billing party) is a very well known Pharmacy Benefits Management company, and bills for the medication at a rate of USD $500 per gram. I take very close to 250 grams per month of subcutaneous immunoglobulin. Let's do the math: What my insurance pays to the provider every month, for the blood product, via claims filed over the past 2 years = ($100/gram)(250 grams/month) = USD $25,000/month What the provider bills, and what I could theoretically owe, if something goes wrong = ($500/gram)(250 grams/bill) = USD $125,000 per bill So, if for some reason a mistake is made, with respect to honoring a prior authorization, I can literally end up with a bill over USD $100,000 for a "one month's supply" of medication, with no resolve. What a government in Europe (excluding Switzerland) pays per month for the medication (and I never have to worry about owing) = ($45.01/gram)*(250 grams/month) = USD $11,252.50/month