Capitalists hate capitalism
As the Marxist agitator Adam Smith once said, “People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the public, or in some contrivance to raise prices.”
Smith understood that capitalists hate capitalism. They don’t want to compete with one another, because that would interfere with their ability to raise the prices their customers pay and reduce the wages they pay their workers. Thus Peter Thiel’s anticapitalist rallying cry, “competition is for losers,” or Warren Buffett’s extreme horniness for businesses with “wide, sustainable moats.”
These anti-capitalist capitalists love big government. They love no-bid military contracts, they love ACA subsidies for health insurance companies, they love Farm Bill cash for Cargill and Monsanto. What they don’t love is markets.
Case in point: pharma giant Merck. The Inflation Reduction Act (IRA) includes a provision that allows Medicare to (finally) start (weakly) negotiating the prices it pays for (a tiny handful of) drugs. If you’re scratching your head and wondering if you understood that correctly, let me assure you, you did: the US government is currently prohibited from negotiating drug prices when it bargains with pharma companies.
In other words: Medicare simply pays a pharma companies — whose products build on billions in publicly funded basic research, whose taxes are reduced by billions in research credits, whose patents are backstopped by billions in enforcement — whatever it demands.
To do otherwise, you see, would be socialism. Markets are “efficient” because they “discover prices” through bidding and selling. In the case of publicly purchased drugs, the price that Uncle Sucker “discovers” is inevitably “a titanic sum” or possibly “add a couple more zeroes, wouldya?”
Enter the IRA. Starting in 2026, Medicare will be permitted to negotiate the price of ten (10) drugs. The negotiations will use the prices of other drugs from the dysfunctional, monopolized market as a starting point and go up from there. The negotiations go on for three years, and there are multiple stages where pharma companies can…