Rob, it's interesting that you think it's OK to give away penicillin and make it up somewhere else. Do you suppose Publix charges an extra $10 on the cough syrup that goes with it? Within a couple of months after Walmart announced their $4 rx plan, a woman came to my 24 hr Walgreen with 9 rx's in hand. She was visibly upset. Dr told her she would have to purchase the 9 rx's & bring them to hospital before he would discharge her husband. She called Walmart for quotes which included 3 of the $4 rx's. She scraped up the $131 total Walmart quoted, but when she got to the pharmacy, it had closed 20 minutes early & employees ignored her banging at the window. She provided me the quote list from Walmart and I proceed to fill the rx's at Walgreens retail prices which came to $124. She was delighted with her $7 savings and her pleasant late night experience. She remains a Walgreens customer today, and we have always worked with her to provide value. That was not the norm. Walgreens overall is higher than Walmart, but not as much higher as some people (yourself for instance) think. The $4 plan is just part of the smoke & mirrors that many retailers use to create an image of value. Most frequently that image is one that the retailer does not truely live up to.
Your 7 points to control health care costs are truly the daydreams of an uninformed consumer (or possibly an informed one who prefers to mislead). Regarding point (1), the idea of putting all US citizens into a risk pool is a marxist idea. If a US citizen does not wish to be part of the risk pool, no one has the right to force him. Not even President Obama who has been known to utter the same nonsense. Regarding point (2), it is private insurance that put us in the position of high cost healthcare to begin with. Back in the early 70's the United Auto Workers coerced the automakers Ford, GM & Chrysler into providing Rx drug insurance. At that time the average cost of a prescription was about $3.50 at the pharmacy I worked. Branded oral contraceptives were 99 cents. Brand Lanoxin was 99 cents for a month supply. The pharmaceutical mfrs association took out ads in monthly magazines in which they took pride that rx drugs had experienced zero inflation in the past 30 years. Then came the insurance experience. Doctors wrote the most expensive meds because their patient no longer had to pay the bill. Patients demanded brand name because they didn't have to pay the bill. Pharmacist dispensed brand name to appease the patient because the insurance company would pay them a higher profit for brand. They were paying full AWP back then and most pharmacies bought at an 8-10% discount. Insurance companies didn't care how much they were billed because drugs were cheap compared to other health care costs and anyway it was easy to raise the price to Ford, GM & Chrysler. Drug companies learned that no one cared that there was no inflation in Rx drugs, so they started increasing prices by 5...10...often 15% annually. Some even increase more than once a year. Every time research developed a new drug it was priced higher than any drug had ever been before. Still no one cared. By the time the world woke up to what was happening, virtually all employers had begun purchasing rx drug insurance for their employees and paying through the nose for it. Manufacturers charged as much as they could for drugs & devices. Insurance companies would make token complaints about rising health care costs, but they enjoyed knowing that rising costs actually were necessary to assure their survival. Insurance companies were seen as fighting rising costs, but their fight began too late and never in earnest. By suggesting that insurance companies are the cure to high health care costs, you play right into the script they have written.