Replace the ACA with single payer

[Onyx]

Form a community association to negotiate with healthcare service companies directly. Don't allow the state to become a public source of dependency.

 

[Dont Taz Me Bro]

I believe unregulated capitalism is evil...

Where on this planet does unregulated capitalism exist?

 

[frigidweirdo]

Form a community association to negotiate with healthcare service companies directly. Don't allow the state to become a public source of dependency.

Which just then gives more power to healthcare service companies.

 

[Onyx]

And when you look around the world, there isn't a single example where it is cheaper. The UK has a tax rate that is nearly double our tax rate, and their health care system is running out of money.... with nearly double our tax rate.

Nationalized single payer could technically be cheaper, since it is essentially a collective bargaining scheme that bypasses the need for insurance companies. The issue is that it is controlled by politicians, and the game of politics is about making special interest groups rich.

 

[Onyx]

Which just then gives more power to healthcare service companies.

Not anymore so than nationalized single payer or privatized insurance. This way citizens can drive down the costs of healthcare without the need for politicians or insurance companies. Eliminate the middleman and you save money.

 

[Andylusion]

So how is it that it works elsewhere?

What you're telling me is the US govt and state govts are inept and useless and don't work for the people at all, whereas they do in other countries.

I see you and other Liberals are still confused by the meaning of the word "Works".

I'm surprised you figured that out so quickly. Yes, the US Government, State Governments, and every Government in the world, are completely inept. Government has always been inept, is inept, and will always be inept. Even on the off chance one was not, the same person does not control the government permanently, at some point someone you don't like will control the government, and it'll be inept. One of the nearly infinite number of reasons the Liberal fantasy of the government controlling literally everything doesn't work. Ask Russia or Germany.

How many Canadians used to come to the US for healthcare?

You're saying it wouldn't be cheaper, but you're not providing any evidence.

The US healthcare system takes in the most amount of money of any system in the world per capita and you're telling me it wouldn't be cheaper.

How much money goes into corruption? The estimates are 3% of US GDP

https://www.hks.harvard.edu/fs/msparrow/documents--in use/Corruption in Health Care--The US Experience--TI Global Report on Corruption--2006--pp16-22.pdf

Healthcare expenditure "represents 15.3 per cent of the country’s GDP, up from 5.7 per cent in 1965, and 8.8 per cent in 1980."

"Despite the extraordinary level of spending, health care economists have traditionally paid very little attention to corruption, fraud, waste and abuse in the US health care delivery system. They do not factor it into their cost models, they say, because ‘there is no data on that’."

However what is not included in corruption are the legitimate ways of squeezing money out of the system.

Number one is insurance companies.

Do Dropped Patients Mean $$$ for Insurers?

"The nation's five largest for-profit insurers closed 2009 with a combined profit of $12.2 billion,"

Just five insurance companies had profits of $12.2 billion. In the UK this is simply not necessary. On top of the profits you have the workers who are paid, the overheads that are paid and all of it is for something completely unnecessary.

According to this, 7% of healthcare spending goes on insurance companies. Seeing as the government paid 64.3% of all healthcare, this 7% is actually far larger amount of private health insurance.

Here are other things which cost a lot, lot more.

The US spends 17.5% of GDP per year on healthcare.


United States GDP | 1960-2016 | Data | Chart | Calendar | Forecast | News

US GDP is $17,947 billion in 2015.
This means healthcare spending is $3140 billion a year.
This means healthcare insurance companies are wasting $219 billion a year on doing something that is completely unnecessary. The chart puts it at $190 billion a year.

Add up all these costs and you get $765 billion a year wasted.

Now, that's $2,550 per person per year. You have a family of four and they are, on average, paying $12,000 just for corruption in health. Woopie.

Now, UK GDP is $2.849 billion, and they spend 8.5% on healthcare, so that means they spend $2.42 billion on healthcare, which is $3,725 per person per year on healthcare. That's only slightly more than an American is paying for the cost of corruption.

How is the US not going to save money? Seriously if so much is going on corruption because of the system, then you can't lose.

Obamacare: Before and After - Discover the Networks
I read through that, like, three times. It told me absolutely nothing. The fact is that the government shouldn't be paying for any part of healthcare in general, that makes privatized healthcare inherently better for that reason alone. If state lines were opened, it would cost even less than it did previously for the people, and hey, you wouldn't be having your money stolen by the government to pay for it for random people. On top of that, the government would raise taxes to compensate for the extra cost, and plunge further into debt. We all already know this, Liberals just don't care because they prefer not to have jobs and pay for things themselves~

No, I'm someone who has USED some of these systems, I know they can work. What do you have? Nothing. You read through it three times and still you have nothing.

You say the govt shouldn't pay. But we were talking about something else. You make silly claims, like it will be more expensive, I prove it won't be, then you say there is nothing.

Sorry, but your post is a waste of time with the usual "liberals this and liberals that" nonsense.

Apparently you haven't used the systems if you think they can work. History has proven that the government is totally incompetent, and common sense dictates that if a Business makes money off of you regardless of performance, and that if you have no other options, there's no incentive to work properly.

It WILL be more expensive, the other Nations implementing this failed system have higher taxes, faster growing debt, or both.

It's not nonsense if it's totally accurate.

What a ridiculous statement. You claim to be a 15 year old, so what's your experience exactly? You have the nerve to tell me that you know my experiences better than I know my own. Seriously, grow up.

Yeah, but he's basically right about that last statement.

When government is paying the bills, then you are not a customer. If you are not a customer, then you are nothing more than a problem. You are an annoyance to the employees.

And that's the way you are treated in many of these systems. I've seen it first hand. I went to a free-gov-care clinic years ago, and watched in horror as the nurse was absolutely a jerk to the people there. Then it occurred to me, she doesn't care if they stay or leave. The clinic is funded whether she has 20 patients, or sees zero. The doctor, was dressed in blue jeans and a sports cap. He looked like he was going to a football game, not to a doctor's office.

Even the very chair I was sitting on, started tilting on me, and I realized two of the legs were broken. Why didn't they fix it? Or replace the chair? Well why would they? They get paid, whether I'm comfortable, or sitting on the floor. They couldn't care less if I stayed or left. That's government care. I ended up waiting a full hour past the time that I was scheduled. Again, they don't care.

Now, when I go to my regular doctor, I am seen the moment I am supposed to be seen. The waiting room is clean, and comfortable. The doctor is dressed exactly as a doctor should, and the nurses are exceptionally nice.

But of course...... I'm paying them. I'm the customer. If they lose me, they lose my money. They lose too much money, they don't have jobs anymore.

Completely different system.

That's why you go to Canada and see people waiting 3 years to get basic treatment, and in most places in the US you wait 3 days.

The only places with long wait times in the US, are gov-funded care centers. The VA for example.

My bro-in-law is ex-military, and he waited so long for VA care, that he finally just saved up the money, and got instant treatment at a private clinic. He says he'll never wait for the VA again. He might be wrong, if you guys make all US care like the VA.

 

[frigidweirdo]

I believe unregulated capitalism is evil...

Where on this planet does unregulated capitalism exist?

I believe genocide of pygmies is evil, doesn't mean it exists right now.

 

[frigidweirdo]

Which just then gives more power to healthcare service companies.

Not anymore so than nationalized single payer or privatized insurance. This way citizens can drive down the costs of healthcare without the need for politicians or insurance companies. Eliminate the middleman and you save money.

The nationalized system is shown to have a lot more power, get cheaper drugs etc etc.

 

[Dubya Da Last Repug Prez]

I believe unregulated capitalism is evil...

Where on this planet does unregulated capitalism exist?

Basically Wall Street, dummy. Or do you not recall what happened in 2008?

Yeah, I know....."too much regulation" caused the 2008 crash. Whatever, lightweight.

 

[Dont Taz Me Bro]

I believe unregulated capitalism is evil...

Where on this planet does unregulated capitalism exist?

Basically Wall Street, dummy. Or do you not recall what happened in 2008?

Try again, tard. Unregulated capitalism has never existed at any time in world history. There has always existed some level of regulation in every capitalist economy on the planet.

 

[Onyx]

The nationalized system is shown to have a lot more power, get cheaper drugs etc etc.

Do you have any examples of a nationalized system relative to a private healthcare association?

Their function is the same, except one deals with politicians and the other through union representatives. The positive side for me is that a private healthcare association wouldn't force itself on citizens by establishing a monopoly or levying involuntary taxation.

 

[Dubya Da Last Repug Prez]

I believe unregulated capitalism is evil...

Where on this planet does unregulated capitalism exist?

Basically Wall Street, dummy. Or do you not recall what happened in 2008?

Try again, tard. Unregulated capitalism has never existed at any time in world history. There has always existed some level of regulation in every capitalist economy on the planet.

I know that, dim one. My point is that there are very few regulations governing Wall Street. The SEC is nothing more than a rubber stamp that looks the other way regarding all the shenanigans that go on. Wall Street is a criminal enterprise and that's no exaggeration.

 

[Onyx]

Most government regulations are a result of crony capitalism. Whenever a tycoon wants to eliminate new competition, they lobby for a new regulation.

 

[frigidweirdo]

So how is it that it works elsewhere?

What you're telling me is the US govt and state govts are inept and useless and don't work for the people at all, whereas they do in other countries.

I see you and other Liberals are still confused by the meaning of the word "Works".

I'm surprised you figured that out so quickly. Yes, the US Government, State Governments, and every Government in the world, are completely inept. Government has always been inept, is inept, and will always be inept. Even on the off chance one was not, the same person does not control the government permanently, at some point someone you don't like will control the government, and it'll be inept. One of the nearly infinite number of reasons the Liberal fantasy of the government controlling literally everything doesn't work. Ask Russia or Germany.

How many Canadians used to come to the US for healthcare?

You're saying it wouldn't be cheaper, but you're not providing any evidence.

The US healthcare system takes in the most amount of money of any system in the world per capita and you're telling me it wouldn't be cheaper.

How much money goes into corruption? The estimates are 3% of US GDP

https://www.hks.harvard.edu/fs/msparrow/documents--in use/Corruption in Health Care--The US Experience--TI Global Report on Corruption--2006--pp16-22.pdf

Healthcare expenditure "represents 15.3 per cent of the country’s GDP, up from 5.7 per cent in 1965, and 8.8 per cent in 1980."

"Despite the extraordinary level of spending, health care economists have traditionally paid very little attention to corruption, fraud, waste and abuse in the US health care delivery system. They do not factor it into their cost models, they say, because ‘there is no data on that’."

However what is not included in corruption are the legitimate ways of squeezing money out of the system.

Number one is insurance companies.

Do Dropped Patients Mean $$$ for Insurers?

"The nation's five largest for-profit insurers closed 2009 with a combined profit of $12.2 billion,"

Just five insurance companies had profits of $12.2 billion. In the UK this is simply not necessary. On top of the profits you have the workers who are paid, the overheads that are paid and all of it is for something completely unnecessary.

According to this, 7% of healthcare spending goes on insurance companies. Seeing as the government paid 64.3% of all healthcare, this 7% is actually far larger amount of private health insurance.

Here are other things which cost a lot, lot more.

The US spends 17.5% of GDP per year on healthcare.


United States GDP | 1960-2016 | Data | Chart | Calendar | Forecast | News

US GDP is $17,947 billion in 2015.
This means healthcare spending is $3140 billion a year.
This means healthcare insurance companies are wasting $219 billion a year on doing something that is completely unnecessary. The chart puts it at $190 billion a year.

Add up all these costs and you get $765 billion a year wasted.

Now, that's $2,550 per person per year. You have a family of four and they are, on average, paying $12,000 just for corruption in health. Woopie.

Now, UK GDP is $2.849 billion, and they spend 8.5% on healthcare, so that means they spend $2.42 billion on healthcare, which is $3,725 per person per year on healthcare. That's only slightly more than an American is paying for the cost of corruption.

How is the US not going to save money? Seriously if so much is going on corruption because of the system, then you can't lose.

Obamacare: Before and After - Discover the Networks
I read through that, like, three times. It told me absolutely nothing. The fact is that the government shouldn't be paying for any part of healthcare in general, that makes privatized healthcare inherently better for that reason alone. If state lines were opened, it would cost even less than it did previously for the people, and hey, you wouldn't be having your money stolen by the government to pay for it for random people. On top of that, the government would raise taxes to compensate for the extra cost, and plunge further into debt. We all already know this, Liberals just don't care because they prefer not to have jobs and pay for things themselves~

No, I'm someone who has USED some of these systems, I know they can work. What do you have? Nothing. You read through it three times and still you have nothing.

You say the govt shouldn't pay. But we were talking about something else. You make silly claims, like it will be more expensive, I prove it won't be, then you say there is nothing.

Sorry, but your post is a waste of time with the usual "liberals this and liberals that" nonsense.

Apparently you haven't used the systems if you think they can work. History has proven that the government is totally incompetent, and common sense dictates that if a Business makes money off of you regardless of performance, and that if you have no other options, there's no incentive to work properly.

It WILL be more expensive, the other Nations implementing this failed system have higher taxes, faster growing debt, or both.

It's not nonsense if it's totally accurate.

What a ridiculous statement. You claim to be a 15 year old, so what's your experience exactly? You have the nerve to tell me that you know my experiences better than I know my own. Seriously, grow up.

Yeah, but he's basically right about that last statement.

When government is paying the bills, then you are not a customer. If you are not a customer, then you are nothing more than a problem. You are an annoyance to the employees.

And that's the way you are treated in many of these systems. I've seen it first hand. I went to a free-gov-care clinic years ago, and watched in horror as the nurse was absolutely a jerk to the people there. Then it occurred to me, she doesn't care if they stay or leave. The clinic is funded whether she has 20 patients, or sees zero. The doctor, was dressed in blue jeans and a sports cap. He looked like he was going to a football game, not to a doctor's office.

Even the very chair I was sitting on, started tilting on me, and I realized two of the legs were broken. Why didn't they fix it? Or replace the chair? Well why would they? They get paid, whether I'm comfortable, or sitting on the floor. They couldn't care less if I stayed or left. That's government care. I ended up waiting a full hour past the time that I was scheduled. Again, they don't care.

Now, when I go to my regular doctor, I am seen the moment I am supposed to be seen. The waiting room is clean, and comfortable. The doctor is dressed exactly as a doctor should, and the nurses are exceptionally nice.

But of course...... I'm paying them. I'm the customer. If they lose me, they lose my money. They lose too much money, they don't have jobs anymore.

Completely different system.

That's why you go to Canada and see people waiting 3 years to get basic treatment, and in most places in the US you wait 3 days.

The only places with long wait times in the US, are gov-funded care centers. The VA for example.

My bro-in-law is ex-military, and he waited so long for VA care, that he finally just saved up the money, and got instant treatment at a private clinic. He says he'll never wait for the VA again. He might be wrong, if you guys make all US care like the VA.

Yes, when the govt is paying the bills, you aren't a customer. When insurance companies are paying the bills, you aren't a customer either.

Like I said, in the US under insurance companies you're spending, on average per person, $2,500 on corruption alone. In the UK on average per person the health system costs $3,700. So, when insurance companies get in on it, they're not seeing you as a customer but as a cow to milked the whole damn way.

When doctors are handing out the pills, are they thinking about the customer's pocket or their own pocket? They make you pay, they hand them out, is this better care than not being given drugs?

What healthcare system works whereby the person is actually a customer who needs to be give the right care? I'd say my experience of a nationalized healthcare system is far closer to this than a privatized one.
I cut part of my finger off with a pair of scissors and was told that I'd need to spend THREE WEEKS in a hospital bed. I told them to get lost and was back at work a few hours later. Why did they want me to spend 3 weeks in hospital? Well, profit of course. I've also had a lung problem (still don't know what it actually was, no one would tell me) but I needed to get a scan of my lungs. Went to one hospital and they said I would have to come back in 4 days to do it, and it would cost waaaaay to much (this wasn't the USA), went to another hospital and they did it that day for 1/3rd of the cost.

My experience of nationalized hospitals are that they can be good or they can be not so good, and it often depends on whether the govt is left wing or right wing, the latter wants to destroy nationalized healthcare and so spends less money on it and lets it rot while saying how great they are for reducing taxes.

I was more a customer in the nationalized system, and more the cow in the private system.

As for free govt care hospitals, perhaps the private system makes those not in the private system not work so hard, like I said, you can get good or bad, it all depends on how things are done.

The biggest problem is the can't do attitude in the US.

 

[CowboyTed]

Replace the ACA with single payer the rest of the civilized world enjoys. Lets not be left out in the cold!!!!

-It would be cheaper
-Moral

Only rich can afford what the ryans of this world want. That is wrong.

Only an idiot like you would want the Govt. in charge of HC for three hundred million Americans.

The Govt. that has never done anything cheaply or well.

The Govt. that turns into mountains of paperwork, red tape and long waits.

The Govt. has no business in HC at all and anyone who thinks they do is one dumb fuck.

I have argued before on this....

All the best value systems in the world are Single Payer... People can buy insurance to go on top of that... I pay about $100 a month in Ireland to get a full choice of doctor and care I want. No government control.

But I do get medicines at a far reduced cost compared to America.

The US is paying 17.1% of GDP on Healthcare, the EU is spending 10%:
France spends 11.5%, rated as the best in the world.
Health expenditure, total (% of GDP) | Data

France has better results on child mortality, Cancer survival, live longer,.......
ALL CANCERS DEATH RATE BY COUNTRY

I could go on for hours on why...

In the first world the more public spending healthcare the better the results... I have proven that well in the past...

Compare the administration costs of Medicare compared to a regular Insurance companies...
It is 1.4% compared to 20%+...

Important: What are Medicare’s true administrative costs? - PNHP's Official Blog
Health insurance companies are doomed. Here's why.

And it still gets worse... EU drastically reduces costs in bulk negotiating on the price of drugs with Pharma and Medical device companies...
Why the U.S. Pays More Than Other Countries for Drugs

Is it perfect in EU? No, but it looks a lot better by the numbers...

Certain places Private is great, Basic Healthcare insurance is not one of them...

 

[frigidweirdo]

The nationalized system is shown to have a lot more power, get cheaper drugs etc etc.

Do you have any examples of a nationalized system relative to a private healthcare association?

Their function is the same, except one deals with politicians and the other through union representatives. The positive side for me is that a private healthcare association wouldn't force itself on citizens by establishing a monopoly or levying involuntary taxation.

Well what do you mean by "private healthcare association" here?

 

[Andylusion]

And when you look around the world, there isn't a single example where it is cheaper. The UK has a tax rate that is nearly double our tax rate, and their health care system is running out of money.... with nearly double our tax rate.

Nationalized single payer could technically be cheaper, since it is essentially a collective bargaining scheme that bypasses the need for insurance companies. The issue is that it is controlled by politicians, and the game of politics is about making special interest groups rich.

Nah. First, there has never been an example where single payer has been cheaper.

Here's the problem with your theory.....

You are assuming that if government is the sole buyer, that they will have bargaining power over the seller.

Now in a private market system, you would be right. For example, Apple purchased most of the CPU chips for their computers from Motorola. Since only Apple bought those particular CPUs, Motorola cut them a pretty good deal, to keep that business.

However, the problem is, this isn't a private market transaction. This is a government transaction.

When government is the sole buyer, and supplier of the product to the public...... that actually places all the power in the hands of the companies.... not the government.

If you are like most, you don't believe that. You think I'm talking crazy.

But think about it. All the company has to do, is say the price is too low, and suddenly the entire country has a massive shortage of medications for example.

The government has no ability to 'force' people to work for the good of the state. If the company refuses to sell in the US, there is nothing the US government can do.

So when the shortages cross the country, who will get blamed by the public? The US government..... and the companies all know this.

So all the bargaining power is in the hands of the companies, if the government becomes the sole buyer.

You stay you still don't believe me? You want examples?

Venezuela. Chavez tried to demand lower prices for all sorts of goods and food products. The companies pulled out. Massive shortages across the country.

Need a better example?

Romney Care. MassHealth in Massachusetts, tried to do exactly the same thing. They tried to use collective bargaining on the medications for their universal health care system. If you don't remember, all the companies announced plans to leave the state.

Well of course, if Mitt Romney's policy suddenly caused all drugs to disappear from the state, he would have been fried up on a platter, and certainly wouldn't have been a runner for president. So the government immediately reversed course, and signed a more lucrative contract.

Again, trying to do single-payer never reduces cost. They either have shortages like Hugo Chavez, or they pay out lucrative government contracts. I have yet to see any example anywhere, from any country, where they actually made whatever it was, cheaper.

The mass transit line in Greece was so expensive, that they found they could buy each rider their own privately run taxi ride, cheaper than how much the government was paying to run the trains.

Where is the example of government being cheaper? I have yet to see a single example.

 

[Onyx]

Nah. First, there has never been an example where single payer has been cheaper.

I never said there was

Here's the problem with your theory.....

I am not even going to bother reading your ridiculous wall, which is an obvious attempt at overcompensating.

You don't even know what my theory was. I never advocated for nationalized single payer. You are an intellectually dishonest idiot that is engaging in strawman fallacy.

 

[Onyx]

Well what do you mean by "private healthcare association" here?

Replicate the single payer model, but make it voluntary and independent of politicians. Have individuals that want to participate pay into it in order to drive down costs, and leave out those that do not want to participate.

You also do not cause collateral damage under this solution. Looking at the NHS in the UK, some individuals end up paying more in taxes than they save on healthcare. Even if they are a minority, they do not deserve to be forced into a system that hurts them financially.

 

[Andylusion]

Replace the ACA with single payer the rest of the civilized world enjoys. Lets not be left out in the cold!!!!

-It would be cheaper
-Moral

Only rich can afford what the ryans of this world want. That is wrong.

Only an idiot like you would want the Govt. in charge of HC for three hundred million Americans.

The Govt. that has never done anything cheaply or well.

The Govt. that turns into mountains of paperwork, red tape and long waits.

The Govt. has no business in HC at all and anyone who thinks they do is one dumb fuck.

I have argued before on this....

All the best value systems in the world are Single Payer... People can buy insurance to go on top of that... I pay about $100 a month in Ireland to get a full choice of doctor and care I want. No government control.

But I do get medicines at a far reduced cost compared to America.

The US is paying 17.1% of GDP on Healthcare, the EU is spending 10%:
France spends 11.5%, rated as the best in the world.
Health expenditure, total (% of GDP) | Data

France has better results on child mortality, Cancer survival, live longer,.......
ALL CANCERS DEATH RATE BY COUNTRY

I could go on for hours on why...

In the first world the more public spending healthcare the better the results... I have proven that well in the past...

Compare the administration costs of Medicare compared to a regular Insurance companies...
It is 1.4% compared to 20%+...

Important: What are Medicare’s true administrative costs? - PNHP's Official Blog
Health insurance companies are doomed. Here's why.

And it still gets worse... EU drastically reduces costs in bulk negotiating on the price of drugs with Pharma and Medical device companies...
Why the U.S. Pays More Than Other Countries for Drugs

Is it perfect in EU? No, but it looks a lot better by the numbers...

Certain places Private is great, Basic Healthcare insurance is not one of them...

First your own link, on cancer death rates, shows that France has a higher death rate, than the US.

France 146 die, per 100,000
US 130 die, per 100,000.

So, you are citing statistics that would seem to indicate our system is better.

Further you mention cancer survival rates.

I don't know where you got the idea that survival rates were better in France, or anywhere. It certainly hasn't been in any research I have ever looked at in the past 20 years. The US always.... consistently... has the best survival rates in the world. If you get nearly any form of cancer, you have a better chance of being cured, and surviving it in the US, more than any other country.

The Medicare administrative costs per user, is higher than any insurance company.

The myth of low administration costs, is that they compared administration cost, with their outlays.

The outlays for Medicare are really high, because it covers people who are older, and thus naturally have more health expenses.

Alternatively, private insurance has low outlays, because they cover everyone else, like myself for example, who hasn't been to a hospital in years.

But if you compared administrative costs on a per individual user basis, Medicare costs tons more in administrative costs, per individual user. Medicare is hideously expensive per person.

The EU pays lower costs on some drugs, and others they simply don't offer.

Now in some EU countries like France for example, the companies routinely simply don't offer the drug. There are numerous situations where French people discover a medication that could really help them, go to their doctor and ask 'why didn't you tell me about drug x?' and the doctor tell them it isn't offered in France.

Well of course you can reduce the cost of health care, when you simply.... don't provide care.

Alternatively, there are cases where they offer the same drug, at a lower price in Europe, and there is a very different reason why.

Let's say you make a fruit drink, that is horribly expensive to create, but once you came up with the fruit drink, it's really cheap to mass produce.

Now you have to make the millions back that you spent creating this drink. So your core market is a place with 300 million people, and they are willing to pay for your drink.

You make a price that is enough, you can get back all the money you spent, and then make a profit.

Now, you are doing this, and this little island country of 5 million, wants your fruit drink, but they don't want to pay the price you offer it in your main market. You can refuse and earn nothing from them, and still make the money back that you need to turn a profit from your primary market. Or you can cut them a deal, after all it's only a small little market of 5 million people, and make a tiny modest little profit from it.

So you do it. You'll still earn back the millions you invested from your primary market, so this is just a little bonus money.

That's how it works for little countries like Norway. The drug makers can afford to sell at a discount there, because they are making the billions of dollars they spent creating the drug in the US.... from the US market.

That's why when we try to do the same thing, they don't offer a discount, they just stop selling.

When Mitt Romney tried to get a discount for MassHealth, the drug makers said, no. And just planned to shut down operations in Massachusetts. They spend billions making these drugs. They have got to turn a profit, and that means selling at a good price. If they can't earn their money back... then they won't sell at all.