For those legislators who are working on healthcare legislation right now , here are some suggestions : 1. For intercompany medical charges, require them to be priced at Medicare rates. Ends gaming of MLRs 2. Require all insurance plans to apply any cash purchase against your deductible. Let plan holders shop. 3. Require all pharmacy purchases by a plan holder to be charged at net price after rebates. Right now YOU pay full retail price for branded meds in your deductible phase. You can think your insurance company PBM for lying to you when they say they negotiate better prices. They obviously suck at their jobs if the best they can do is get you retail price ! 4. Require wholesale pharmacy pricing to be at net. This may seem like price controls. It’s not. The wholesaler buys at retail, gets a prompt pay/data discount of 5 pct from the manufacturer , then has the pharmacy buy from them at retail price minus a small discount. Which reimburses the wholesaler. Wholesalers complain then don’t make money on brands. Indie pharmacies get crushed on brands. Manufactures don’t make more money this way either. Why ? Because they write HUGE rebate checks to the PBM! Require pricing to be at net, and you improve cash flow and reduce reimbursement risk for indie pharmacies. Patients can naturally pay lower cash prices for brands because pharmacies will pay much less. The only loser in this ? The PBMs every one else gains 5. Create a moratorium on all acquisitions by ins carriers 6. If a medical provider of any kind, hospital , clinic , whatever , acquires another provider , they must retain the pricing ( pre any price increases meant to game this rule ) , for a period of 5 or 10 yrs allowing only for cpi increases 7. Investigate the acquisitions of providers by pharmacy wholesalers. 8. Allow doctors to own hospitals 9. Standardize contracts by insurance carriers by provider type. Every one contract with every hospital should have the same fill on the blanks with minimal variance. This will cut administration costs dramatically I can go on for days. This is a start(Mark Cuban)