You can believe whatever you want, but the facts are pretty clear.
It's not the entire reason, but when America pays 2-3x more for the same drug, it can blow out.
Reading the source I attached helps. "In 2022, U.S. prices across all drugs (brands and generics) were nearly 2.78 times as high as prices in the comparison countries. U.S. prices for brand drugs were at least 3.22 times as high as prices in the comparison countries, even after adjustments for estimated U.S. rebates."
I accept that the US pays over the odds for drugs. I don't accept that's the driving force behind overall health care costs - as 2.78x cost for something that's only 10% of overall costs doesn't get you to doubling the overall spend. ( If overall cost is 100 - then a 2.78 increase in 10% of that is = (10 * 2.78) + 90 = 117.8
That's a long way from double the cost - ie 200.
My contention is that the higher drug prices are a symptom, not a cause - and that's important to understand if you want a cure. Simply targeting drug pricing alone is an exercise in whack-a-mole.
The problem with insurance systems in markets that aren't operating properly is that it's actually in the insurance companies interests to increases costs.
Why? Because in the absence of proper competition in the market, insurance companies profits scale with the size of the thing they are insuring against as margins are % based.
So I would argue there is indirect collusions between all the parties involved ( insurance companies, doctors, hospitals, middlemen, pharma etc ) to escalate costs to increase the money flow they are all feeding on.
The idea of free markets driving ruthless competition is fine on paper - however in the real world there are all sorts of reasons why they don't happen in practice - so they have to be actively managed or in some cases acknowledge it's just not the best way - but that's a much longer post.
It's not the entire reason, but when America pays 2-3x more for the same drug, it can blow out.
Reading the source I attached helps. "In 2022, U.S. prices across all drugs (brands and generics) were nearly 2.78 times as high as prices in the comparison countries. U.S. prices for brand drugs were at least 3.22 times as high as prices in the comparison countries, even after adjustments for estimated U.S. rebates."