Thanks for the specifics. The drug prices problem has a quite direct solution for single buyer systems: competitive tenders for generics, and QALY price ceiling

Thanks for the specifics. The drug prices problem has a quite direct solution for single buyer systems: competitive tenders for generics, and QALY price ceilings for patent drugs. If a producer asks for a too high price compared to the health outcome of their drug, the total budget is reassigned among existing drugs, thus forcing all pharmaceutic companies to compete to deliver the best overall healthcare outcome for a given budget. Too bad the politics in USA prevent this and dismiss it as "death panels", and people are led to believe the hard trade-offs in healthcare can somehow magically go away.