Federal and state politicians are puzzled as to why COVID vaccination rates in the U.S. are so low compared to other countries. Their puzzlement suggest that they might be in the wrong business. Nonetheless, Americans are not getting on the vaccination train to the same extent as their counterparts in other countries due to an inherent skepticism of the healthcare system.
That skepticism is part and parcel of a general distrust of government. Elsewhere in the world, people believe that their governments would never do anything that wasn’t in their best interests. If the government says a vaccine is necessary, people line up to get it.
We Americans don’t think the same way. That is not to say our attitude is right or wrong. In fact, determining the government’s trustworthiness boils down to personal opinions and beliefs. Still, it cannot be denied that we Americans are terribly skeptical of our leaders. And because the government influences healthcare to the degree that it does, people are skeptical of it, too.
Drug Prices Say It All
If you don’t draw a correlation between healthcare and government skepticism, perhaps looking at U.S. drug prices will make it clear. They say it all. Drug prices in this country are higher than most other countries around the world. Is it because our system is privately run? No. It is because we are trying to mix private and public policies in ways that do not work.
If you have a prescription drug plan as part of your health insurance, you get no say in how much you pay for medications. Your co-pay is what it is. Your health insurance company picks up the rest of the cost based on prices set by pharmacy benefit managers (PBMs).
If you don’t have a prescription plan, you pay cash for your medications. Now you have a say. You can shop around for the best price by calling different pharmacies. You can shop around by using a coupon program. You can even buy Canadian drugs online from a company like Canada Pharmacy. You ultimately decide what you will pay by shopping around to find the best deal.
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Prices Vary Greatly
Shopping for medications is educational in the sense that it reveals significant price differences between pharmacies. The price for a single drug can vary anywhere from a few dollars to several hundred. Why such disparities? Because our health insurance system allows PBMs to set the prices. PBMs work with drug companies to artificially set prices.
In any other industry, this would be illegal. It is called price-fixing, and it’s a violation of antitrust regulations. But the insurance industry was given an exemption in 1947 by an act of Congress. Some parts of the exemption were stripped by legislation signed into law by President Trump. But because other parts of the exemption remain intact, PBMs and manufacturers will continue to set prices as they see fit.
American consumers understand this, at least in terms of retail prices. Though they may not know the mechanisms behind high prices, they still know that medicine costs a lot more here than many other places. They also know the Affordable Care Act is not the fix they were promised. They know politicians have been debating healthcare costs for decades without ever solving the problem.
This is why Americans are so skeptical of the U.S. healthcare system. They have come to understand that just because a politician or healthcare expert says something is true doesn’t make it so. A growing number of us are no longer willing to take their word for it.