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In case anyone is confused, the Part B “negotiation” is essentially price-fixing: If you reject the government’s final offer, your product is subject to a punit

In case anyone is confused, the Part B “negotiation” is essentially price-fixing: If you reject the government’s final offer, your product is subject to a punitive federal excise (sales) tax no matter who you sell it to. That’s in no sense what we typically think of as a “negotiation”.

twoodfin 3y ago
Sorry, Part D, the drug benefit.
HDThoreaun 3y ago
Never enter into a negotiation without leverage. This sounds exactly like the type of negotiation I engage in.
- twoodfin 3y ago
  Yes, the federal government has a great deal of leverage over all individuals and businesses in its domain. But nobody would consider it a fair “negotiation” in any typical sense if the Feds offered you a choice of 60% of the market value to purchase your house or a 20% lien on your income for the next 20 years.
  - toomuchtodo 3y ago
    > But nobody would consider it fair Life ain’t fair. Selling to Medicare is a privilege, not a right. You’re free to find other markets more favorable if preferred as a pharma company, that’s a choice. But they won’t, because other markets already turn the screws on them with their health systems (which they should, but that’s a philosophical argument depending on your belief system). Exploiters just mad the game changed.
    - twoodfin 3y ago
      Yes, in any negotiation, either party can walk away. But it’s a strange kind of “negotiation” where one party gets to take much of what they wanted in the first place when the other party walks away. When people hear “Medicare negotiating drug prices”, they think, “The feds using their purchasing power to negotiate lower rates.” But existing Part D purchasers were already giants like Aetna, with tons of leverage of their own. It wasn’t enough, so now we have selective price-fixing, dressed up as a “negotiation”. Maybe it’s a great policy, but if so, its supporters should stop lying about what it is and defend it on the merits.
      - toomuchtodo 3y ago
        > Maybe it’s a great policy, but if so, its supporters should stop lying about what it is and defend it on the merits. Agreed! "The Federal Government is using its authority to dictate reasonable Medicare pricing to pharma companies that have a proven history of gouging the American public for self enrichment of management and shareholders." is a reasonable way to communicate the topic. Be honest, of course, but steamroll bad actors. They'd withhold medical necessities if it earned them a few more cents per share, the evidence on this is clear. https://features.propublica.org/drug-prices/high-cost-drugs-the-price-they-pay/ https://features.propublica.org/drug-prices/high-cost-drugs-... https://youtu.be/3b7IL1sSOoE https://youtu.be/3b7IL1sSOoE https://youtu.be/mxBaboLLJOg https://youtu.be/mxBaboLLJOg
        toomuchtodo 3y ago
        Additional citation: https://kffhealthnews.org/news/article/biden-drug-pricing-caps-inflation-reduction-act-pharma-reaction/ https://kffhealthnews.org/news/article/biden-drug-pricing-ca... (“Patients See First Savings From Biden’s Drug Price Push, as Pharma Lines Up Its Lawyers”)

twoodfin 3y ago

Sorry, Part D, the drug benefit.

HDThoreaun 3y ago

Never enter into a negotiation without leverage. This sounds exactly like the type of negotiation I engage in.

twoodfin 3y ago
Yes, the federal government has a great deal of leverage over all individuals and businesses in its domain. But nobody would consider it a fair “negotiation” in any typical sense if the Feds offered you a choice of 60% of the market value to purchase your house or a 20% lien on your income for the next 20 years.
- toomuchtodo 3y ago
  > But nobody would consider it fair Life ain’t fair. Selling to Medicare is a privilege, not a right. You’re free to find other markets more favorable if preferred as a pharma company, that’s a choice. But they won’t, because other markets already turn the screws on them with their health systems (which they should, but that’s a philosophical argument depending on your belief system). Exploiters just mad the game changed.
  - twoodfin 3y ago
    Yes, in any negotiation, either party can walk away. But it’s a strange kind of “negotiation” where one party gets to take much of what they wanted in the first place when the other party walks away. When people hear “Medicare negotiating drug prices”, they think, “The feds using their purchasing power to negotiate lower rates.” But existing Part D purchasers were already giants like Aetna, with tons of leverage of their own. It wasn’t enough, so now we have selective price-fixing, dressed up as a “negotiation”. Maybe it’s a great policy, but if so, its supporters should stop lying about what it is and defend it on the merits.
    - toomuchtodo 3y ago
      > Maybe it’s a great policy, but if so, its supporters should stop lying about what it is and defend it on the merits. Agreed! "The Federal Government is using its authority to dictate reasonable Medicare pricing to pharma companies that have a proven history of gouging the American public for self enrichment of management and shareholders." is a reasonable way to communicate the topic. Be honest, of course, but steamroll bad actors. They'd withhold medical necessities if it earned them a few more cents per share, the evidence on this is clear. https://features.propublica.org/drug-prices/high-cost-drugs-the-price-they-pay/ https://features.propublica.org/drug-prices/high-cost-drugs-... https://youtu.be/3b7IL1sSOoE https://youtu.be/3b7IL1sSOoE https://youtu.be/mxBaboLLJOg https://youtu.be/mxBaboLLJOg
      - toomuchtodo 3y ago
        Additional citation: https://kffhealthnews.org/news/article/biden-drug-pricing-caps-inflation-reduction-act-pharma-reaction/ https://kffhealthnews.org/news/article/biden-drug-pricing-ca... (“Patients See First Savings From Biden’s Drug Price Push, as Pharma Lines Up Its Lawyers”)