[opless]

The real solution is a single major social healthcare program, throughout all the states paid for by federal taxes.

A single major provider of healthcare will have better negotiating powers than the multitude of hospitals and insurance programs as is at the moment.

Of course, with it being federally funded, the health system will be wanting to keep costs down. Congress can help this by forcing bad actors to behave ethically by removing their licenses to operate, and stripping them of their patents. Something other governments have done in the past.

However, in the US, you have a president that sides against the people, and for big pharma. https://www.bbc.co.uk/news/business-44087735

[tracker1]

Then the drug companies pony up to the politicians who allow for the huge ever increasing expenditures and because nobody really sees the bills, nobody really cares and the tax rates and national debt only climb higher.

[refurb]

Two things:

1) The largest private insurers in the US cover more people than many single payer countries, like Canada for example. They don’t get better prices.

2) As someone who works in the drug industry, Trump is actually the first President in recent history that is freaking out the pharma companies. His “international price referencing” proposal is being taken very seriously as it would have very negative consequences.

[dhshahsndeisjwn]

They don't get better prices because they are operating in a system where access to key drugs is a key differentiator. Penny pinching on access drugs (as does NICE in the UK on behalf of the NHS) wouldn't be a good look for an insurance company as they pitch for your business. The only way negotiations with Pharma companies will work is is you actually refuse to pay over-inflated prices, again as-does NICE. And the only way this can be justified is to have a centrally mandated $ per unit 'utility' (aka QALY) beyond which you won't pay.

Private insurers aren't motivated to do any of this because high drug prices don't hurt their bottom line.

[refurb]

I agree with your first point. Having talked to a number of pharmacy directors at private insurers, there is a huge amount of pressure to cover all drugs, regardless of the price.

Insurers who say “no” (Aetna) is a good example, quickly lose customers to insurers who say “yes”.

He’ll, even Medicaid and Medicare at home flack for not having a drug on their formulary.

Very unlike other countries.

[Ididntdothis]

”The largest private insurers in the US cover more people than many single payer countries, like Canada for example. They don’t get better prices.”

I don’t think they really care about prices as long as they can pass them on through higher premiums.

[opless]

Just to add to the other comments to your reply.

Dealing with a nation's major provider is very different to insurance companies. As I said, if you try to price gouge then they governing body will take what they need as a matter of national security/public health safety.