"I have a common but chronic ailment so all I had to do was re-route the phase-converter to the deflector shield and invert the chromaton particles in Shelk-Einstein space and we're done!"
:/
In this case, the patient (A) may be getting the drug from a pharmacy (B), and the pharmacy bought the drug from the manufacturer (C), but the patient's insurance (D) is paying part of the cost of the drug, but so is the manufacturer, and insurance is paid for partially by the patient, and partially by the employer (E). There may also be direct government subsidies, and there are certainly indirect subsidies as well. Of course none of the 5 parties can really know how much anything costs, or how to reduce costs. Not to mention all the extra labor involved in administration of this complex system.
This sounds like a nice, generous thing to do, but basically it means that the drug company is bribing the customer to force their insurance company to spend more money on their behalf.
So, imagine that a drug costs $1000 and the customer's copay is $200. The drug company can give the customer a $200 coupon to recover their copay and then raise the price of the drug to $1200. They've basically shifted the price from the customer (who decides whether or not to get the drug and is probably very sensitive to price) to the insurer. They make the same profit, but can probably sell to a lot more customers because it's "free". While they're at it, they could raise the price to $1500 or $2000, and it's still free to the customer.
I think this is a corrupt practice and it's crazy that it's even legal, but it's just one small part of the complexity and perverse incentives of our health care system.
It doesn't work like that unless you're the only drug in class. If there are alternatives, then you'll get kicked off the formulary for a 20% price increase.
Fun fact: A lot of the original Star Trek screenplays were written with [tech] everywhere and the science writers came in and tried to right some jargon that was believable.
In regards to health care, it's a mess. I spent years working in the industry and it's truly a little frightening. I've been in other country's systems before and recently put together a writeup on it:
http://fightthefuture.org/article/returning-to-america-and-t...
For reference, I pay about ~$200 Australian to my personal insurance, which is a pretty generous plan with lots of extras, basic health care such has visiting a doctor for prescriptions, etc... I haven't paid a dollar for in 3 years, before that I used to pay $20 for convenience of a clinic that was open late and they didn't bill the government for the entire cost, which is common, but almost always a reasonably small fee in the multiples of $20 depending on how long you spend with the doctor. I paid this when I was a government employee, a private employee contracted to the government, and I continued to pay it when I quit to become a freelance developer, my cover has nothing to do with my job and I cannot even fathom why in the most awful circles of hell I would want my health care tied to my job. Hence my trepidation at ever subjecting myself to the American health care system.
I know I might have good options for my therapy in US, but the risks are just too big and depending where you are the monthly expenses only for the insulin analogs might be just way too much in the worst case.
