So I finally succumbed to Amazon’s pleas that I join A9, some kind of search engine that, if I use it a couple of times a week, will give me yet 1.57% more off my Amazon purchases.

I went to A9 and, to try it out, searched for a Sony BP-T24 replacement battery.

I had used Google to find it here for $9.95 plus $5.98 UPS shipping (total: $15.93), and here – a sponsored link – for $15.44 plus $4.24 Priority Mail shipping (total: $19.68).

The first of ‘about 985’ hits on the A9 list was here$1.99 plus $1.95 first class mail.

So the total was $3.94 instead of $15.93 or $19.68. And because the vendor takes PayPal, I didn’t even have to give them my credit card info, whoever they are.

I’m not saying this kind of price variation is typical, or the result of using A9 versus Google – just that, as always, it pays to shop around.

If only the Republicans had thought of that when they forbade Medicare from negotiating prices with the drug manufacturers. It’s one thing to overpay by $15 on a battery, another to overpay by $100 billion a year on prescription drugs.

Nor need the negotiation have been punitive to the drug companies. I’m out of my depth here, so you will correct me if this is stupid. But what if Medicaid were allowed to negotiate?

Rather than ultimate brinksmanship – where if a deal couldn’t be reached on some lifesaving drug the patients would just die – the dance could have gone this way:

‘Hey, this is a great drug!’ ‘Yes, isn’t it?’ ‘We want to buy 100 million of these pills a year.’ ‘Great. They’re $7 each.’ ‘Ouch!’ ‘Well, for you, and in quantity like that, maybe $6.’ ‘But you charge the Canadians $1.40, and your cost of production is only 7 cents.’ ‘That’s true, but it costs us billions to develop these drugs. We need to make a profit commensurate with our investment and our risk, or else why would we continue to advance the frontiers of medicine.’ ‘You have a good point. How about we pay double what the Canadians pay?’

‘Triple.’

‘Double.’

‘Triple.’

‘Double.’

At this point – and here’s where I was heading with this – there is an alternative if a compromise can’t be reached.

At least with some drugs, I should think, Medicare could say, ‘Well, look: if you make us pay triple instead of double, we’ll buy it – but with a high co-pay that discourages sales. We’ll probably need only 70 million pills.’

Or if it’s truly a life-saving drug with no alternative to prescribe, they could say, ‘Well, if you make us pay triple, we’ll do it – we have no choice. But if you let us pay double instead, we’ll commit to purchasing it for at least a year after an alternative therapy comes on the market.’

Or: ‘If you don’t cut us a better deal on this life-saving drug, we’ll beat you up harder on the statins, where there are lots of competitive drugs.’

My point isn’t to get the details right; only to suggest that there could be creative ways to negotiate, short of having to threaten to eschew a lifesaving drug altogether. (‘But if you don’t buy it, 50,000 people will die!’ ‘Well, that’s tough, but that’s our position. Do you want that on your head?’ ‘Do you want that on your head?’)

I have nothing whatever against the Canadians or the Brits or the Swiss – but maybe some of this would lead to their being charged a little more for drugs so that we can be charged a little less more.

And to think: all this started when my phone battery died.

Of course, it is just pie in the sky. The law, hard as the Democrats fought this part of it, specifically says Medicare may not negotiate on the price of drugs.

It is a good time to buy batteries in America, but it is a grand time to be rich and powerful.

Tomorrow: One More Movie (and a word about Bjorn Lomborg)

 And coming soon: Frozen Peas

 

Comments are closed.