What might be done is to have Medicare Part D plans buy on an all the doctors prescribe basis with typical co-pays 95+x% of the federal Medicare Part D subsidy amount, where x is insurer chosen. Plan buyers would pay the x% as a premium. The 5% would be insurer overhead and profit.
Not every drug or every drug class need be covered, but in practice there would be few exceptions.
No drug company would want to be left behind. No insurer would want gaps in its coverage.
Part B drug coverage would be eliminated in year 2 and the federal Part D subsidy increased to allow Part D coverage to be expanded.
This leaves price setting to the marketplace.
Do you realize how many people both Legal and Illegal are on Medicare or Medicaid. Tricare Prime/Life, and VA Care? Every one is a pre-negotiated price. Right down to hospital stays. Nursing Homes are the biggest drain. Besides the Fraud which if you add all of them up come to around $1 Trillion a year. That doesn’t even include private insurance. All of them cover less each year. Raise Co-pays, and flat won’t cover some medications.
Yet Pharma spent billions to invent a $2 Million a dose drug that treats about 1,000 patients. While Patients with Fibromyalgia have 12+ Million patients. Still not found a cure for Cancer, MD, MS and many more.
Zantac generic just was pulled as were more generic BP meds. If you find the Generic Zantac on the shelf notify the pharmacist. You might prevent someone’s chance of getting Cancer. The FDA will find more drugs with the same Cancer agent from China in generics of all types of medications. Know the difference in the Generic Nexium price over the Name Brand? $4-5.00.
I had SIBO 3 times 2018, each round of 14 days antibiotic generic was $1,550. SIBO is Painful and can kill. Small Bowel Infection Over Growth, when the 2 valves of the intestines separate it allows the bacteria of the Colon to get into the Small intestines. It was so expensive Tricare would only fill it at the Navy base or other Military base.
We are Medicare/Tricare Life, we are not allowed to use coupons, discounts, and we have no dental, vision or hearing coverage. Unless it’s a disease or a Service Injury. As the Spouse, you are SOL on coverage of many things. A Diabetic is covered for Neuropathy aids, a Neuropathy patient non Diabetic is NOT covered for. Welcome to Government 101 healthcare.