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>List price is an anchor for price negotiation As someone who hails from a place whose enormous single-bloc healthcare system can dictate the terms you're desc

>List price is an anchor for price negotiation As someone who hails from a place whose enormous single-bloc healthcare system can dictate the terms you're describing, I don't think that statement is the explanatory gotcha you intend it to be. Those regulations are there for a reason -- to ensure your for-profit healthcare system makes profit. What if the middlemen were gone and it didn't have to?

incrudible 5y ago
Sure, middlemen make profit, but nobody makes that kind of profit. Nobody pays these prices. Drug prices in the US system may be elevated, but in the grand scheme of things it's a modest part of the total cost. Furthermore, the reason that these prices can be charged is the regulatory moat, courtesy of the government. Suppose that same government would enact a single-payer system, what makes you believe it wouldn't pay outrageous drug prices, courtesy of the taxpayer? The mechanism that gives the pharma lobby free reign won't just disappear over night.
- revolvingocelot 5y ago
  > Sure, middlemen make profit, but nobody makes that kind of profit. Nobody pays these prices. Drug prices in the US system may be elevated, but in the grand scheme of things it's a modest part of the total cost. "Aw, it's not so bad!" >Furthermore, the reason that these prices can be charged is the regulatory moat, courtesy of the government. Suppose that same government would enact a single-payer system, what makes you believe it wouldn't pay outrageous drug prices, courtesy of the taxpayer? The mechanism that gives the pharma lobby free reign won't just disappear over night. "But also it's super bad, and it's obviously the best we can do." Don't know what to tell you -- seemed to work everywhere else. I guess that's American exceptionalism for you!
  - incrudible 5y ago
    > "But also it's super bad, and it's obviously the best we can do." I didn't say that, but it might actually be true. Having the same people that created the current system design a single-payer system or attempt price fixing is unlikely to lead to a better outcome.
    - revolvingocelot 5y ago
      Yeah, seemed clear that that was your opinion; that's why I phrased it that way. They say you get the government you deserve!

incrudible 5y ago

Sure, middlemen make profit, but nobody makes that kind of profit. Nobody pays these prices. Drug prices in the US system may be elevated, but in the grand scheme of things it's a modest part of the total cost. Furthermore, the reason that these prices can be charged is the regulatory moat, courtesy of the government. Suppose that same government would enact a single-payer system, what makes you believe it wouldn't pay outrageous drug prices, courtesy of the taxpayer? The mechanism that gives the pharma lobby free reign won't just disappear over night.

revolvingocelot 5y ago
> Sure, middlemen make profit, but nobody makes that kind of profit. Nobody pays these prices. Drug prices in the US system may be elevated, but in the grand scheme of things it's a modest part of the total cost. "Aw, it's not so bad!" >Furthermore, the reason that these prices can be charged is the regulatory moat, courtesy of the government. Suppose that same government would enact a single-payer system, what makes you believe it wouldn't pay outrageous drug prices, courtesy of the taxpayer? The mechanism that gives the pharma lobby free reign won't just disappear over night. "But also it's super bad, and it's obviously the best we can do." Don't know what to tell you -- seemed to work everywhere else. I guess that's American exceptionalism for you!
- incrudible 5y ago
  > "But also it's super bad, and it's obviously the best we can do." I didn't say that, but it might actually be true. Having the same people that created the current system design a single-payer system or attempt price fixing is unlikely to lead to a better outcome.
  - revolvingocelot 5y ago
    Yeah, seemed clear that that was your opinion; that's why I phrased it that way. They say you get the government you deserve!