>

I'd argue thats just an extra step, that takes more of your time and resources, and still often leaves you with some amount of extra bill left.
The U.S. Department of Health and Human Services' Office of Inspector General in 2020 concluded that the proposal could violate the kickback law by inducing patients to buy Pfizer's drug while leaving taxpayers to bear the costs.
Pfizer sued the department to challenge its determination. The Manhattan-based 2nd U.S. Court of Appeals last July ruled in favor of the government, rejecting Pfizer's argument that a subsidy program would violate the anti-kickback law only if it were administered with corrupt intent.

An interesting case for sure. Basically Pfizer offering to pay for the copay component of the treatment will saddle Medicare with the rest of the costs. Since more patients will presumably be then induced to take the drug, Pfizer is effectively increasing its addressable market into low income families but shifting the cost of the drug into the government. >

The whole 'charge what the market will bear' idea, central to Capitalism, can work - but, this is a case of the market not being able to bear the asking price, and Pfizer basically saying: 
'Nah... this is how much money we WILL get, and it's up to you poor fools to figure out how you're going to give it to us!' >

That concept only works as well when you’re dealing with something where consumer and seller have approximately equal power in the system. Medication frequently does not fit that situation. Cancer drug X which is your best chance for survival, just for example, is a situation where the seller inherently has you over a barrel. >

There's multiple levels of hidden power - Cancer drug X might work best for you in your situation, but your doctor (or their practice) may be incentivized to prescribe drug Y. Or, your insurance may not cover drug X, or it might be part of the formulary where you have to pay a much higher copay. Maybe the manufacturer of drug X has a consumer rebate program, maybe not - almost certainly the doctor doesn't know, and the insurance company surely doesn't. (I've been told that insurance companies do factor in consumer rebate programs in creating their formularies; I don't know if that's true, but at that point it becomes your responsibility to research medication rebates, as well as dealing with your cancer diagnosis.)
But if you're American, your insurance is probably through your work, which means your insurance coverage was selected by your employer's HR department, and you got little if any say in what plan you got.
A few years ago, the company I worked for changed their insurance provider to Kaiser Permanente. Kaiser is an HMO, which means you only get to go to their doctors. So, people who've been seeing the same family doctor, OB/GYN, pediatrician, etc, for years, suddenly had to drop everything and find a new set of doctors. And, they sprung it on us so late in the year that people's spouses' open enrollments had already ended, so married employees didn't have the option of switching to their spouses' coverage, and keeping their same doctors. They did this because Kaiser needed them to hit certain threshold of enrollment, and if people left, it would be less profitable for them. >

Sounds like an interesting case of productivity dropping by 50% while people find new doctors and having to work around the new insurance. It's a lot of work to find a doctor who gets you. >

That might literally kill me.  I have several chronic illnesses and I'm on 15 prescription meds written by 4 doctors.  I would have to scramble just to keep all my meds active and not get serious complications/discontinuation syndrome from some. >

Pfizer could simply lower the cost of the drug instead of this weird rebate system. >

They make the system as labyrinthine and inconvenient as possible in hopes that poor patients will just give up and pay anyway. One of my nerve medications used to be like that, until their patent expired and a generic came onto the market. >

You couldn't design a stupider system if you wanted to. Every other major world power has figured out healthcare to a somewhat workable system and we have this outrageous system where getting sick can financially cripple you. >

Something like over half of the personal bankruptcies in the US are due to medical debt.
I remember years ago when a doctor suggested I should get a blood test, I asked them how much would it cost.
They said they had no idea, but that "it shouldn't be much".
3 weeks after the blood test, I get a +$500 bill in the mail. Oh, and insurance refused to cover it.
Imagine if buying a car or a house meant that you couldn't see the pricing until after you agreed to pay for it... >

And then you get a second bill for what the insurance didn't agree to pay, do you get a forced surprise second mortgage. >

No, you get forced arbitration. I have to go often enough that I know the first names of most of the firms arbiters.