> The USA does the opposite; requires governmental medical insurance providers NOT to bargain with pharma companies and instead explicitly requires them to pay

> The USA does the opposite; requires governmental medical insurance providers NOT to bargain with pharma companies and instead explicitly requires them to pay whatever price the pharma company sets. That’s either a gross misunderstanding or deliberate misinformation. There is both price negotiations and significant rebates negotiated by pharmacy benefits managers who will often make 75% of the profit on the sale of the drugs back as rebates. They then distribute that back to insurers and other parties. Sadly those enormous rebates don’t seem to reach or benefit the patients.