To me, the scarier thought is a new conflict between hospitals and pharma. Currently, drug companies market directly to consumers. consumers ask for drugs from

To me, the scarier thought is a new conflict between hospitals and pharma. Currently, drug companies market directly to consumers. consumers ask for drugs from doctors, and get prescriptions health care companies have to pay for. Doctors have no reason to deny patients what they want (and the sexy pharma rep keeps encouraging them too). In the new system, the same "entity" writing the prescription is paying for it, as well as "paying" for the cost of not taking it. I imagine doctors will have an incentive to examine the cost/efficacy of a drug, but pharma will hate that. To get around it, pharma will probably launch marketing saying "if your doctor doesn't give you this drug, shes killing you". ACO's fighting drug companies, using the human psyche as the battleground.