After promising health care execs that Medicare for All was dead, Pelosi's team plans toothless pharma deal

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Related but not totally On Topic…
Did GWBush and his
Prescription Drug Benefit
for Medicare give Big Pharma
the initial push to raise drug prices?
When “the government” (you) pays for
anything …the prices sky rocket.
College tuitions, as one example.
For some reason that came to mind,
which doesn’t necessarily mean

Here’s a link to the actual underlying reported piece from Politico, rather than the commentary on commentary on commentary linked above.

Turns out we don’t know what “Pelosi will ask” because the details are still being worked out, and members of Congress who dislike the arbitration idea have yet to weigh in on them.


…ensuring that poor Americans are insured by private companies who get to bill the US government virtually unlimited sums in exchange.

This sounds really bad, but it doesn’t actually refer to anything real, does it?


Pharma companies get a big fat 50% R&D tax credit even though many spend more on M&A than R&D. Maybe stripping that credit from the bad actors who negotiate price hikes far in excess of inflation would help curb the incentive to price gouge.




It depends how they do it. In New Zealand, the govt negotiates a deal with pharmacos to supply the country and gets a good price.


Same as Clinton. Blackmail me into what is supposed to be the lesser of two evils. It is lesser, but its the same evil. I’m not going to deliver for Dems if they go down this road.

They screwed the pooch once. Do they have to do it twice before they get the message.


“Medicare For All is dead?” You know what’s really dead? We’re dead. You and me. There’s a day coming when we’ll all have to make a choice between paying for rent and paying for healthcare, and we’ll choose the rent. Then we’ll get sick, because none of us is getting any younger and sickness is what you get as you age. And that’s it – that’s all she wrote.

Thanks, Nancy. You’re very, very loyal to your wealthy corporate sponsors.

It’s almost like the current evolution of the political machine is oiled with money.

And those who live and die with the machine have a vested interest in seeing it continue to function.

So they seek out sources of sustenance for said machine, and fuck the little guy who can’t just pony up tons of $$$ to be relevant to the machine.

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Oh, Cory just knows that the Dems are useless and terrible. He’s not especially fact-based when it comes to the Democrats.

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okay AOC, now prove you are more than just a media darling with zero power

every interview you get, mention this, it’s literally the least you can do and then at least it will be on every major news network for weeks

This seems like the opposite is true.

I think private schools are almost always more expensive for value than most public school systems.

And when governments pay tuitions, the costs are usually much lower per capita…isn’t that right?


So… just going to point out that drug prices, while in marginal cases may be increasing 100%+ (diclofenac gel 3% by amneal for example went from $60/box to $1060/box this week), the average price paid for pharmaceuticals is actually decreasing or increasing much slower than inflation.

Consider this chart as well- why do you pay more out of pocket for drugs than you do for hospital stays, and yet we spend less than a third as much of drugs total than on hospital stays total?

I’m also thinking of Goods n Services.
When a business knows the government is
paying, (blindly in many cases) they freely
jack up the prices .
I can purchase a hammer for $10, but the gov.
will be charged $20.
(Remember the story years ago about the
$600 toilet).
That’s why there’s Medicare fraud.
Hospitals/Drs. can easily overcharge and there’s little to no oversight.
The bills are submitted and paid automatically.
Unless someone, somewhere, suspects
something is up, the fraud freely reigns.
The college’s have pumped up tuition, counting on student’s borrowing and many struggling to
pay back those loans…
some may never be able to.
In general, the purchasing power of “the government” should lower costs and it does,
but there’s also many times “the government”
is over charged/overpays.
There’s too many examples of both.

It’s just sad that those
marginal drugs
are life saving…*if" you can afford them.

I’m sure that it will be some fantastic motivating vision for healthcare.



There was never a $600 hammer or toilet seat cover. The famous story of the hammer was an accounting error, and the “toilet seat” story was a part designed for a P3 Orion submarine-hunting plane, not a consumer Walmart toilet ring.

This is a great example. When the money’s coming from a bunch of individual customers, who can’t negotiate, the price doesn’t go down compared to a government paying. It goes up, which is what I was saying.

You know when a private sector business jacks up prices? Every time they can. They don’t give sweeter deals to private citizens because they love private citizens.

Sometimes government gets charged less when it’s bulk, sometimes everyday people get hosed when they buy something from 7-11.

If the Pharma companies thought Medicare-for-all meant they could jack up their prices to a stupid government, then they wouldn’t be fighting it so hard. They like non-government prices better, because they’re making more money that way.


There are different ways government spends money. I think when the government administers programs (education, healthcare, etc.) those programs are delivered at lower cost than we could ever expect to have them delivered by the private sector.

But when the government buys things, kafkaesque procurement processes mean buying them from people who can navigate the process rather than people who are offering the best product at the lowest price. Basically the private sector is just trying to sell stuff, but they have to jack up the price a bunch because it takes so much more work to sell it to the government. Procurement processes are optimized to leave an auditable paper trail, not to get good value for money.

Finally there are private-public-partnerships where the government and the private sector agree to work on a thing together with some agreement about sharing costs and benefits. In these it seems like the private sector sees the government as an endless well of money and the government obliges. These just seem awful.


This is very dependent on the mechanics of what “paying for” means. It’s definitely not an absolute statement.

This is a great example of the different mechanics illustrating how they impact the cost.

A state run directly subsidized school providing education lowers costs to students. If the school is more or less expensive to run, is largely a function of the school itself and not the funding either way.

Students that are given cheap loans in abundance creating a glut of money to spend on college is a different mechanic. In this scenario, college prices do go up, as they seek to consume all that extra money that’s been added to the system. If the money given to the students was free, their costs would go down, but since it’s usually loans, their costs go up spread over time instead now. As also pointed out by @tuhu

That’s not just government either. The different requirements for what we think of as everyday items is always lost in these stories. That toilet on the P3 has different requirements than one in a house. I once saw a $150 electrical switch that needed to be installed in an industrial control panel. The catch was, the control panel was for a nuclear power plant, so it needed an extra $15,000 of QA testing for all kinds of extra scenarios it shouldn’t fail under.

We all assume this would be the government purchasing directly, using it’s size to negotiate a lower price, like it already does today but on a larger scale. That’s why they don’t want it.

If this was like the tuition example, the government would flood the market with extra cash for people to spend on their own independently. Removing the size and negotiating power, just adding extra funds. That would definitely raise prices, which is why nobody is suggesting this. :slight_smile: