Hacker News Reader

Comment by refurb | Hacker News Reader

There is evidence that this would actually increase prices across the board. How do we know? Such a system already exists.

The price that Medicaid plans pay is either 23% less than the average price paid or the “best price” (if lower).

When this was instituted, drug companies actually pulled back on their discounts to non-Medicaid accounts, so as to not trigger the “best price”.

View on HN

Right now there's likely to be 100 different prices for almost any medicine or procedure - it depends on who's paying. I think one of the frustrating aspects is that if you are uninsured, you are likely to pay the HIGHEST rate - even though you are likely to be the least able to afford it.

I agree that on non-generic drugs that the price would likely remain high - however if everyone paid the same rate (low or high) then it would at least discourage some of the type of pricing we see now where a procedure is provided below cost to a specific group of users to make sure those members (i.e. customers of specific insurance companies) are able to be kept "in network", while charging much, much higher rates to others to make up the difference.

Another part of this is the rise of 'rebates' for PBM's and insurance companies, that does not change the price paid for the drug.

Except Medicaid is contaminated by rebates from the drug companies to the states. That's one of the things that needs to be banned.

Reply on news.ycombinator.com