Of the parts of the world, other than the US, that I'm most familiar with, Japan and Western Europe, they control drug prices - and keep them low.

I've had a theory for a while that the way world drug companies make up for low profitability in those markets is in gouging in the US where it's a free-for-all and one should grab for as much as one can get.

The totality of US healthcare is a big, complicated $3+ trn/yr pie but there's flagrant abuse all over the system (and a variety of intl players, profitably for them, contribute) and pharmaceutical companies are eager to be in on the game.

I wonder what would happen to healthcare globally if the US were able to downsize its 20%-of-gdp system to something on the order of Western Europe or Japan which is to say 10% of gdp? That is, the revenue the system generates would drop by half.

Needless to say, there'd be resistance tantamount to, let's call it, institutional violence. US doctors' earnings cut in half? You've got to be kidding.