> So a lot of people who take this drug in the US actually pay $0 because they sign up for this card.

They do not pay $0 because the insurance company raises the rates for all of their customers to cover the cost of all the red tape and time spent negotiating with drug companies over their bullshit. The insurance companies aren't eating those costs, they're profiting from them and it's us who end up footing the bill. By the time you factor in the unnecessary time, staff, record keeping, etc. the actual cost for the $20 drug will be even more than the $800 sticker price.

No matter how our crooked system twists things to make it look otherwise they always make you pay. One way or another.

Yep. And it's worse than that.

80% of prescriptions are controlled by 3 companies. You can look up the FTC report on it. All three of them own or are owned by insurance companies.

The insurance companies had their profit percentage capped, and so the only way they could increase profits was by increasing their share of the pie. So they bought medical providers and prescription companies.

Now the insurance company is both the buyer and the seller, but not the one who pays. We pay. So they raise the prices of the drug, raise the cost of insurance, and make a lot more money while staying in their profit percent cap.

All the way around, this is the opposite of a free market and the FTC should be breaking these companies up. And as everybody knows, all the way around, it is immoral, too.