Let’s say we do this, and you create a state funded company that creates cheap insulin, let’s say they can sell it for 25$ in Walmart. What then happens is that to sell that drug to the insurance companies they negotiate with the Phamacy Benefits Managers they will say to them:”We want a 66% rebate!!” They’ll say errr? At what price? The PBM will say:”we don’t care, insurance covers the price”. So that company ends up putting a list price at 74 but providing a 66% rebate to the PBM so they still get their profit... but then the next year the PBM comes back saying “well, we are going to need a bigger rebate because the competitors where willing to raise their prices even more and thus giving us bigger rebates”

You essentially have a party who’s getting every company to compete on who is willing to sell at the highest list price who’s driving negotiations against the producers who only stand to gain by higher prices.

The American system is rotten to the core.