Using goodRX has really opened my eyes to the shady practices of drug pricing. The same drug with or without insurance at different pharmacies can range in price by 80+% (often with the higher rate "discounted" for insurance). The drug companies are willing to be this flexible with the prices when dealing with retailers. In the case of a Wal-Mart or Costco the negotiations don't sound so different. So what's the difference with what's happening with the government? It's on public record not in a private corporate meeting room. The business side of Healthcare in this country follows protection racket economics and it doesn't look like this is going to change any time soon.