The only way Medicare works is by cost shifting to non-Medicare patients. I've seen some of the allowed billing rates on Medicare and there is no way a garage could survive on those rates for mechanics repairing a car, much less working on people with expensive equipment. One I think of is $8 for an X-ray. You couldn't get a mechanic to roll in a piece of expensive diagnostic equipment and scan your car with it and then have the senior mechanic evaluate the result for $8. That only works if they charge non-Medicare patients $500 for the same X-ray.
No one left to shift the costs to and the whole house of cards falls apart.
These executive orders are long overdue. Two examples of drugs I get for my metastatic prostate cancer.
1. injection every three months; $5400 in the U.S. About $1250 for the exact same drug in Canada that is ship from the U.S.
2. Xtandi -Full retail in the U.S. is a bit over $10,000/month. The V.A. gets it for about $3,600. A Canadian pharma company said the could manufacture, distribute and sell the exact same drug for $360 per month. The FDA wouldn’t allow it even though the FDA paid the full cost of the research and trials for the drug. Instead, a pharma company was able to secure to patent for the drug. This is the only drug that pharma company manufactures and sells. That corrupt as hell.