<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>wahern</author><text>Drug coupons are common in the United States. AFAIU, they&amp;#x27;re issued by the pharmaceutical companies, but as few people know about them (or how the pricing system is structured in general) it&amp;#x27;s often doctors and pharmacies that seem to help broker their distribution. The coupon system permits pharmaceuticals and friendly politicians to deflect criticism about drug pricing strategies by providing plausible deniability regarding costs to the uninsured and underinsured.&lt;p&gt;I remember reading several years ago reports that drug companies were favoring coupon distribution to doctors according to how often doctors prescribed the issuer&amp;#x27;s name-brand drugs instead of generics. That is, a doctor who prescribed a designer expensive drug, Foo, more often might get more coupons for name-brand but boring drug, Bar, for distribution to the doctor&amp;#x27;s indigent patients. I don&amp;#x27;t remember, however, if or which reforms were enacted as a result. Also, I&amp;#x27;m not sure if it was nearly as big of an issue as actual kick-backs in the form of vacations, etc, which (AFAIU) were made illegal years ago. The opacity and overall baroqueness of the coupon system is precisely why there&amp;#x27;s not much opportunity for doctors to &lt;i&gt;personally&lt;/i&gt; benefit from the scheme, yet why it works well as a tool for pharmaceutical companies to maximize profits while staving off political reforms.&lt;p&gt;See &lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;en.wikipedia.org&amp;#x2F;wiki&amp;#x2F;Drug_coupon&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;en.wikipedia.org&amp;#x2F;wiki&amp;#x2F;Drug_coupon&lt;/a&gt;</text><parent_chain><item><author>Consultant32452</author><text>My kid recently needed a script. We had to go through a specialty pharmacy that ships directly to home because it apparently wasn&amp;#x27;t carried in the pharmacies like CVS. The script was over $400.&lt;p&gt;Insurance denied the claim.&lt;p&gt;They &amp;quot;applied a coupon&amp;quot; and the price magically became $35.&lt;p&gt;In this one transaction there&amp;#x27;s multiple layers of corruption most likely starting with the prescribing doctor.</text></item><item><author>tempestn</author><text>I expect the main difficulty this presents to hospitals isn&amp;#x27;t that their customers will be informed, or even that their competitors will be advantaged, but that they will be unable to engage in price discrimination (charging different amounts to different customers, based on their willingness and ability to pay).  Or at least, they&amp;#x27;ll need to do so transparently.</text></item></parent_chain></comment><story><title>Hospitals still not fully complying with federal price-disclosure rules</title><url>https://www.wsj.com/articles/hospital-price-public-biden-11640882507</url></story>
<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>heavyset_go</author><text>The scary truth is that the prescribing doctor probably prescribed what they thought would best treat their patient&amp;#x27;s condition, and access to that medication requires hundreds of dollars because the manufacturer can simply charge that much, so why not? Your insurer denied you, again, because they can, so why not? Manufacturers give coupons that bring down the cost of their medications by hundreds, even thousands of dollars, so they have something to point to when they&amp;#x27;re accused of profiteering and exploitation. Your life and the lives of your family members depend on this system not fucking any of you over for a buck, despite fucking you over for a buck every step of the way.</text><parent_chain><item><author>Consultant32452</author><text>My kid recently needed a script. We had to go through a specialty pharmacy that ships directly to home because it apparently wasn&amp;#x27;t carried in the pharmacies like CVS. The script was over $400.&lt;p&gt;Insurance denied the claim.&lt;p&gt;They &amp;quot;applied a coupon&amp;quot; and the price magically became $35.&lt;p&gt;In this one transaction there&amp;#x27;s multiple layers of corruption most likely starting with the prescribing doctor.</text></item><item><author>tempestn</author><text>I expect the main difficulty this presents to hospitals isn&amp;#x27;t that their customers will be informed, or even that their competitors will be advantaged, but that they will be unable to engage in price discrimination (charging different amounts to different customers, based on their willingness and ability to pay).  Or at least, they&amp;#x27;ll need to do so transparently.</text></item></parent_chain></comment><story><title>Hospitals still not fully complying with federal price-disclosure rules</title><url>https://www.wsj.com/articles/hospital-price-public-biden-11640882507</url></story>