This is, perhaps, one of the best arguments possible for single payer healthcare. If a pharma company can show that its price is justified and it is determined the product serves the public good it makes no real difference what it costs to the federal government. While insurance obviously has a vested interest in pharma costs as a “user” of the currency, the “issuer” of the currency has no such interest as long as long term benefits can be shown.

It is only when one confuses the roles of users and issuer of the currency and attempts to defend the “taxpayer’s” interest that efficiency becomes an issue. The issuer of the currency, however, is not revenue constrained and “never” uses revenue from any source to enable its spending. It has no need to borrow and only uses taxation and bonds as inflation control and to prevent extreme inequality. When properly viewed in correct context, taxation of business is also counterproductive.