[quietbritishjim]

Please back up such an unlikely sounding claim with several excellent sources.

Here in the UK, there is exactly one layer: the NHS. It negotiates prices directly with drug suppliers, and as the sole buyer (monopsony) is able to get a great deal. It also sets the prices paid by consumers (the prescription price), which is a flat price charged for all drugs (yes really all of them) and is currently £9.15 (about 11 USD) for a prescription (i.e. a full course of multiple tablets of the drug). If you are given drugs in a hospital as part of an inpatient treatment the charge is usually nil.

[arpinum]

Drugs are more streamlined, but most of the NHS looks a lot like the US system. There are 8 major private electronic health systems, and many have not signed interoperability pledges. 145 CCGs. Foundation Trusts, remember just 10 years ago GP Practices would become part. Quasi-private GP Practices. Mergers going on every year (195 CCGs to 145 last year). Funding comes out of a myriad of mystery buckets (winter funding).

[quietbritishjim]

The NHS employs about 1.4 million people (and I don't think that includes GP practices). Of course an organisation that big is going to have quite a bit of structure. I never intended to dispute that.

I was disputing that specifically drug purchasing is a "racket" with "more layers" the US system, which is what the parent comment claimed. None of the organisations or organisational units that you mention have anything to do with drug price negotiation, so I don't see what they have to do with the conversation.

[_pmf_]

The "Kassenärztliche Vereinigung" in Germany is a tremendous lobbying force for doctors, and they are fully driving health policy here. I've yet to see them do anything positive for me as a patient.

Glad to hear things in the UK are so jolly.

[splintercell]

Are these drug companies British?

[hkt]

Some. American drugs companies too, though. They want our bargaining power to be mediated by the coming UKUSA trade agreement so we have to pay through the nose like Americans do. At the moment they either sell to us or lose out on our custom (the NHS is not above refusing to buy a drug on expense grounds). They're trying to make this impossible for us to do by levering political power, because single payer healthcare doesn't permit them to abuse their market power over here.

[votepaunchy]

> They're trying to make this impossible for us to do by levering political power, because single payer healthcare doesn't permit them to abuse their market power over here.

You’re saying that if you joined some sort of union that you could negotiate from a much stronger position, similar to single-payer healthcare?

[splintercell]

Have you ever looked at the amount of money we spend on pharmaceuticals a percent of our total Healthcare spending?