Health care costs will only be contained if we become better shoppers.
One of the problems with third party payers, whether private or government, is that when someone else pays, only the best will do.
But we don’t all drive brand new Cadillacs. Some do but most of us make do with a less fancy, less safe, and less costly car. The same should be done in health care.
The proper competitor for the newest, whiz bang, cutting edge drug for gout is not an equally new, whiz bang, cutting edge gout drug from another manufacturer but rather the slightly older, but adequate off patent drug that can be had much cheaper. The cutting edge drug may work a bit faster, or require fewer doses per day, or have less annoying side effects, but the older drug is still good treatment, and the manufacturer of the newer drug will be forced to reduce his profit margin to compete.
Of course, the problem is the FDA, which has wrecked the generic drug market. Generics first became available early in my practice years. We were skeptical. But so long as the generics were properly tested for bioequivalence, they were a strong tool for competition in the marketplace.
But somewhere along the way, the FDA stopped simply testing for bioequivalence and started licensing generic suppliers. That’s why there are 132 suppliers of generic insulin in the world market, but only 3 licensed in the US, and why insulin costs 10 times what it did(real numbers) 30 years ago.