A 2003 law passed by Big Pharma’s friends in Congress actually prohibits Medicare, which serves the elderly, from negotiating drug prices for the 52 million Americans in the program. Because of this cynical give-away to some important election funders, Americans pay an extra $16 billion a year more than is necessary for pharmaceuticals, whose cost, in America, is the highest in the world. Many of the poor elderly have to go without needed drugs as a result. The Veteran’s Administration and Medicaid (for the poor) already have the ability to negotiate with the drug companies, who still make a tidy profit out of it, but Medicare has to pay whatever the pharmaceutical companies say is the price.
As a former employee of a major pharmaceutical company I think that the huge amount of publicity given to their “high cost of research” is partly baloney. Half of all research costs are paid for out of taxes and carried out by the National Institutes of Health and universities. Margins, I can assure you from experience, are huge. Don’t cry for Big Pharma.
An Epicurean government (contradiction in terms!) would have a single payer system as in Europe and that single payer would negotiate prices – hard!