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I thought this sort of thing is what insurance companies are expected to handle: to advise on cost-effective alternatives for standard diagnosis codes.


The article talks about Medicare, and how it's forbidden by Congress from negotiating prices, among other things.

I'll give you one guess on which industry lobbied for that restriction.


The gov't sure as hell negotiates other price concessions from pharma companies:

1. Medicare only pays "average selling price" which includes all discounts offered to physicians

2. Medicare demands pharma pay 50% of the donut hole gap which is several billion each year

3. Medicaid automatically gets a 23% discount on all drugs

4. DOD, VA and other gov't organizations do negotiation drug prices and they get a 24% discount on top of that

There is plenty of price negotiations on the gov't side.




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