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Comment by jmcgough | Hacker News Reader

The government is better able to negotiate with pharmaceutical companies because of its size, which is part of why medicare pays them less than even private insurance companies do. Individuals, in comparison, often don't have time to do research or compare prices when they have an emergency, so the healthcare industry takes advantage of that weakness.

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I think you actually have this kind of backwards. For example, when I broke my toe last year I had to wear a boot for 6 weeks. I didn't really have a choice but to let my Dr give me one, given my inability to walk without crutches or a plaster cast otherwise. I received a bill from them for $384 a couple weeks later. It was the first bill I disputed with my insurance company, using the fact that I could buy the identical product on Amazon (and a number of other online retailers) for <$80. Aetna was just "tough luck" and paid ~$200 of it, leaving me to pay the other ~$200. Things like this happening are just plain stupid.

I'm missing your point I think - how does jmcgough have things backwards? It sounds like you had issues with a private company? In a country with a socialised healthcare system you wouldn't get a bill and the company selling the moon boot wouldn't get paid nearly as much.

No, Medicare is specifically prohibited by law from negotiating drug prices. They can and do negotiate prices with hospitals and doctors, but not drug companies.

Interesting - the TPPA which is being imposed on New Zealand is very specifically anti our national purchasing of drugs. This existing regime has been a very good bulk purchaser for 3+ million people and has kept prices down.

I've looked but can't find the rationale behind that law. I know the real reason was to keep drug prices high but how was this sold to the American people?

Just the usual story of corrupt congressmen and a Republican in the White House: https://en.wikipedia.org/wiki/Medicare_Part_D#Criticisms

The doesn't really answer my question and from what I can tell the measure was rather bipartisan.

The fear is the "bargaining power" that will be used is "give it to us or we invalidate your patent." And the fear is valid, because that's how most other countries' governments negotiate.

Thank you, that was what I was looking for.

Epipens are not bought during an emergency. The point is to buy them in advance in order to have them at hand in an emergency.

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