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Comment by dmurray | Hacker News Reader

Another interpretation: the biggest beneficiaries of high list prices are the insurance companies. After all, they don't pay that price, and the higher the non-insured price, the more attractive it is to buy health insurance.

So perhaps the drug companies are just responding to demand from their biggest customers.

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Also remember that insurance companies make a profit on margins, so they are directly incentivized to make healthcare transactions larger.

Shouldn't this be illegal / isn't this already illegal?

Two companies reaching an agreement to supply products at reduced price, but not making the terms of that agreement available to a third entity (uninsured customers)?

It's definitely not illegal in general to charge different prices to different customers, or to keep the terms of your business agreements private.

As for "should it be illegal", most people seem to agree the healthcare industry should be regulated more tightly than commerce in general, but there's plenty of debate about exactly how far we should go.

If you carefully craft all incentives to create the strong impulse in all participants to do things everyone benefits from without actually phoning them up and saying (let's do it this way), it's not illegal. This describes the why for a lot that is wrong with the world.

Giving special discounts to preferred customers is a completely normal practice everywhere outside medicine/drugs.

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