Fantasia in D

Paul Krugman's blog
NYT

Nowhere was the contrast in views over health care stronger than on drugs. Obama called for using Medicare’s purchasing power to reduce drug costs; Paul Ryan, in his hissy fit response, held Medicare Part D — which specifically denies Medicare the ability to bargain — as an example of the cost savings that can be achieved through privatization (although he didn’t call it that.)

Bad move.

It’s true that Part D has so far come in substantially cheaper than was predicted in 2003, when the Medicare Modernization Act was passed. That’s because overall spending on prescription drugs has risen much more slowly than expected, mainly thanks to relatively few new drugs being introduced and greater use of generics:

What you really want is a comparison of costs with what happens when the government is able to bargain; and Austin Frakt has the goods [see below]: the VA pays 40 percent less than Medicare Part D. This comes at the cost of somewhat restricted choices — but if you’re looking for a way to save money, you want to move away from the part D model, not towards it.