This article names the right problem. The TrumpRx site covers a handful of drugs, excludes the ones most Americans actually take, and does nothing for the 92% who have insurance and never touch out-of-pocket pricing sites anyway. That framing matters.
One layer I would add from the employer side of this: the conversation about international price comparisons tends to focus on what consumers pay at the pharmacy counter. But for the roughly 100 million Americans covered by self-funded employer plans, the pricing problem is not just what the drug costs. It is what happens between the manufacturer's price and the plan's final cost.
PBMs negotiate rebates on brand-name drugs, and those rebates are often framed as savings passed back to the plan. In practice, the rebate structure can incentivize higher-cost drugs over lower-cost alternatives because the rebate percentage on an expensive brand generates more revenue than a lower-cost option with no rebate at all. The plan pays more. The PBM earns more. The member sees the same copay either way. Germany does not just negotiate lower prices. They also eliminate the intermediary incentive to steer toward higher-cost products.
The point about "cutting out the middleman" in the article is exactly right, but it applies closer to home than most people realize. Self-funded employers are already paying for drug benefits directly. They are just doing it through a contracting structure that obscures where the money goes. Most employers we work with have never seen a side-by-side comparison of what their plan paid for a drug versus what the pharmacy actually received.
The gap between those two numbers is not theoretical. It is contractual. And unlike international pricing policy, it is something employers can address right now through their PBM contracts.
1. Please mention that everything on Trump RX is available on GoodRX for the same price. At first glance it looks like there are a few drugs on the Trump site that aren’t GoodRX, but if you click those links they go to the manufacturer site (which existed before TrumpRX) where you can apply for financial assistance.
2. When the best capitalism can do for the health care industry is a clunky awkward privately owned socialism based model (which is what the insurance industry is), it’s time to just socialize it for real already.
It is a standard trope that the idiotic health-care system we are beholden to is because Americans insist on Capitalism, and are totally opposed to anything smacking of Socialism. Not so. The health-care business is NOT capitalistic. Capitalism presupposes a few things, one of which is: the consumer can freely choose among the available options, including the option of taking none of them. This assumption is FALSE when you require health care. The American health-care system takes advantage of the fact that when you are in a health crisis, you are in no position to negotiate prices, or decline health-care altogether.
This Easter season, light a candle and consecrate it in the name of Blessed St. Mangioni, patron saint of US healthcare insurance victims. Go, thou, and do likewise.
Ta, Robyn. How is there always enough money for a war and never enough to put roofs over the heads of those without, pay for medical, dental, and vision care for everyone, and pay off student debt? I'm stymied.
Isn't Trump going to lean on Germany to raise their domestic drug prices, the same way he said he leaned on France by threatening to tariff their wines? What's he going to tariff this time, German beer?
Seriously, where TF did he get that story about France? It's pure fantasy, and a weird fantasy at that, even for him. Why would he give a shit about French drug prices?
60 to 70% of our healthcare is already funded by taxes, half of the rest by employers (in the form of foregone wages for employees) and the other half of the rest directly out-of-pocket. In every country, including outs and even those evil socialist ones, all healthcare is essentially coming from funds out of our pockets, this is the simple truth no matter how you try to paint it otherwise.
It won't be long before the standard crew of any ambulance will include an AI driver, two actual human medical technicians and an insurance specialist who can answer questions about which ERs are in your network and which are not.
Don’t be silly. The AI will handle the insurance claims, too. And once xAI perfects the robomedic 3000, we’ll be able to get rid of those pesky human medical technicians, too.
This article names the right problem. The TrumpRx site covers a handful of drugs, excludes the ones most Americans actually take, and does nothing for the 92% who have insurance and never touch out-of-pocket pricing sites anyway. That framing matters.
One layer I would add from the employer side of this: the conversation about international price comparisons tends to focus on what consumers pay at the pharmacy counter. But for the roughly 100 million Americans covered by self-funded employer plans, the pricing problem is not just what the drug costs. It is what happens between the manufacturer's price and the plan's final cost.
PBMs negotiate rebates on brand-name drugs, and those rebates are often framed as savings passed back to the plan. In practice, the rebate structure can incentivize higher-cost drugs over lower-cost alternatives because the rebate percentage on an expensive brand generates more revenue than a lower-cost option with no rebate at all. The plan pays more. The PBM earns more. The member sees the same copay either way. Germany does not just negotiate lower prices. They also eliminate the intermediary incentive to steer toward higher-cost products.
The point about "cutting out the middleman" in the article is exactly right, but it applies closer to home than most people realize. Self-funded employers are already paying for drug benefits directly. They are just doing it through a contracting structure that obscures where the money goes. Most employers we work with have never seen a side-by-side comparison of what their plan paid for a drug versus what the pharmacy actually received.
The gap between those two numbers is not theoretical. It is contractual. And unlike international pricing policy, it is something employers can address right now through their PBM contracts.
dump came in on promising low drug prices the first time , he lied then and he is lying now.
1. Please mention that everything on Trump RX is available on GoodRX for the same price. At first glance it looks like there are a few drugs on the Trump site that aren’t GoodRX, but if you click those links they go to the manufacturer site (which existed before TrumpRX) where you can apply for financial assistance.
2. When the best capitalism can do for the health care industry is a clunky awkward privately owned socialism based model (which is what the insurance industry is), it’s time to just socialize it for real already.
R'amen!
It is a standard trope that the idiotic health-care system we are beholden to is because Americans insist on Capitalism, and are totally opposed to anything smacking of Socialism. Not so. The health-care business is NOT capitalistic. Capitalism presupposes a few things, one of which is: the consumer can freely choose among the available options, including the option of taking none of them. This assumption is FALSE when you require health care. The American health-care system takes advantage of the fact that when you are in a health crisis, you are in no position to negotiate prices, or decline health-care altogether.
This Easter season, light a candle and consecrate it in the name of Blessed St. Mangioni, patron saint of US healthcare insurance victims. Go, thou, and do likewise.
Ta, Robyn. How is there always enough money for a war and never enough to put roofs over the heads of those without, pay for medical, dental, and vision care for everyone, and pay off student debt? I'm stymied.
You mean Trump lied? I'm shocked.
Isn't Trump going to lean on Germany to raise their domestic drug prices, the same way he said he leaned on France by threatening to tariff their wines? What's he going to tariff this time, German beer?
Seriously, where TF did he get that story about France? It's pure fantasy, and a weird fantasy at that, even for him. Why would he give a shit about French drug prices?
Wait, so it wasn’t 1500% off?
Just a reminder that Michael Moore's documentary 𝘚𝘪𝘤𝘬𝘰 was released in 2007. Nearly 20 years ago.
Spoiler : Cuba had better healthcare
The capitalist solution to healthcare is to let anyone who can’t pay die.
My co-pay for Trulicity went from $47 to $171, the retail only went up $100. Hecka of a job, tRump.
60 to 70% of our healthcare is already funded by taxes, half of the rest by employers (in the form of foregone wages for employees) and the other half of the rest directly out-of-pocket. In every country, including outs and even those evil socialist ones, all healthcare is essentially coming from funds out of our pockets, this is the simple truth no matter how you try to paint it otherwise.
are we paying less for fentanyl, oxy, ivermectin, ecstasy, alcohol, caffeine, & nicotine ? … you know the important stuff …
It won't be long before the standard crew of any ambulance will include an AI driver, two actual human medical technicians and an insurance specialist who can answer questions about which ERs are in your network and which are not.
Don’t be silly. The AI will handle the insurance claims, too. And once xAI perfects the robomedic 3000, we’ll be able to get rid of those pesky human medical technicians, too.