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posted by martyb on Tuesday October 30 2018, @11:49AM   Printer-friendly
from the what-about-Canada? dept.

Amid a flurry of national proposals to bring exorbitant U.S. drug prices in line with other countries’ charges, one Utah insurer has a different option for patients:

Pay them to go to Mexico.

PEHP, which covers 160,000 public employees and family members, is offering plane tickets to San Diego, transportation to Tijuana, and a $500 cash payout to patients who need certain expensive drugs for multiple sclerosis, cancer and autoimmune disorders.

“That money is pretty small in comparison to the difference between U.S. prices and Mexico prices,” said Travis Tolley, clinical operations director for PEHP.

The insurer rolled out its “pharmacy tourism” option this fall in response to state legislation requiring state employees’ insurance plans to offer “savings rewards,” or cash incentives, to patients who choose cheaper providers.

PEHP is offering pharmacy tourism benefits for about a dozen drugs for which the price disparity between countries is vast. For example, Avonex, which treats MS, costs about $6,700 for a 28-day supply in the U.S., but about $2,200 through PEHP’s contracted clinic in Tijuana.

For three months’ supply — the maximum allowed under the program — the savings of $13,500 more than covers the $500 reward and transportation, typically less than $300 per person.

[...] Patients who participate will fly to San Diego, be driven through a priority lane at the border crossing and arrive at a clinic, which PEHP director Chet Loftis described as “top-notch,” comparable to a Mayo or Cleveland clinic in the United States.

Medical tourism is not new; PEHP itself has previously offered coverage for out-of-country medical procedures. But without the cash incentives, patients haven’t used that option, Loftis said. Now that clients are eligible for up to $3,900 a year in reward payments for trips to Tijuana for procedures and drugs, Loftis said he hopes more will participate.

Source: https://www.sltrib.com/news/2018/10/28/fight-high-drug-prices/


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  • (Score: 3, Insightful) by Anonymous Coward on Tuesday October 30 2018, @12:45PM (1 child)

    by Anonymous Coward on Tuesday October 30 2018, @12:45PM (#755609)

    if big companies can outsource to find cheaper employees then the consumer can find cheaper options too, right? Right?

    • (Score: 2) by Gaaark on Tuesday October 30 2018, @03:08PM

      by Gaaark (41) on Tuesday October 30 2018, @03:08PM (#755656) Journal

      It's a great idea, 'cause it seems that REAL competition is being eliminated in North America:
      huge corps allowed to merge to make mega corps, less competition means higher prices (as well as being incredibly STUPID!)

      More power to the people: glad to see there is some intelligence left in the world.

      --
      --- Please remind me if I haven't been civil to you: I'm channeling MDC. ---Gaaark 2.0 ---
  • (Score: 5, Touché) by Anonymous Coward on Tuesday October 30 2018, @12:46PM

    by Anonymous Coward on Tuesday October 30 2018, @12:46PM (#755610)

    What we need is more mexican drugs.

  • (Score: 1, Offtopic) by VLM on Tuesday October 30 2018, @01:10PM (2 children)

    by VLM (445) Subscriber Badge on Tuesday October 30 2018, @01:10PM (#755614)

    This will provide corporate motivation to invade Mexico to squeeze more money out of the remaining workers in the USA.

    I would be nervous if I were in the Mexican government. The narcos want you bribed, killed, or seemingly preferably both, the USA oil companies want what drippy trickle remains of nationalized Pemex, the invader army needs some kind of showy reaction, now big pharma wants to team up with the narcos and kill em all to keep medical costs high. If we could just convince our leaders in Israel to dislike Mexico, then we'd have M1A1 tanks in Mexico City in about five days.

    • (Score: 1, Touché) by Anonymous Coward on Tuesday October 30 2018, @09:32PM (1 child)

      by Anonymous Coward on Tuesday October 30 2018, @09:32PM (#755805)

      What you've just said is one of the most insanely idiotic things I have ever heard. At no point in your rambling, incoherent response were you even close to anything that could be considered a rational thought. Everyone in this room is now dumber for having listened to it. I award you no points, and may God have mercy on your soul.

      • (Score: 0) by Anonymous Coward on Tuesday October 30 2018, @09:49PM

        by Anonymous Coward on Tuesday October 30 2018, @09:49PM (#755818)

        'insane idioticy' works just fine within the today's corpocracy. It's unfair to blame the messenger for the world's insanity of the present.

        Want proof, you say? Read TFS again and assess if a state-sponsored healthcare tourism is not an admission of failure to protect the interest of the state's citizens.
        (don't get me started again on pointing to the fact US heathcare cost is 2 times higher than the next entry and over 3 times higher than the OECD average)

  • (Score: 5, Insightful) by fishybell on Tuesday October 30 2018, @01:14PM (1 child)

    by fishybell (3156) on Tuesday October 30 2018, @01:14PM (#755615)

    I don't always feel compelled to talk about Utah when it is mentioned here, but I did hear about this one on the radio, and do indeed feel compelled to comment.

    While the radio station I listen to — a very liberal station — thought this was a horrible idea, and instead we should have a single-payer health system, I disagree wholeheartedly. If the state of Utah had any ability to create a country-wide single-payer system, I think that that would be a better answer, but they don't. Other countries can negotiate lower drug prices because the whole country is a market or not based on the outcome of the negotiation. If Utah had a state-wide single-payer system, the market of Utah would pale in comparison to say, the country of Mexico or Canada.

    Some of the numbers they were quoting showed that the price of the flight (~$300), the cash to the patient ($500), and the cost of a 90-day supply of the drug — at a specifically licensed pharmacy in Tijuana — was often times a third what the insurer would pay here in Utah. While it may seem inconvenient to take a day off of work to fly out to San Diego, go through customs (practically non-existent going through the California/Mexico border to Mexico), drive to Tijuana, buy a drug at a specific pharmacy, drive back to San Diego going through what is definitely a pain in customs, and fly back to Utah, I would do it for $500 every 90 days. It would be like a little mini-vacation to a fun town full of fun things to do.

    That and the liquor in Utah is very expensive compared to what you could bring back from Tijuana.

    • (Score: 1, Funny) by Anonymous Coward on Tuesday October 30 2018, @06:59PM

      by Anonymous Coward on Tuesday October 30 2018, @06:59PM (#755743)

      Do you guys still have to put your bartenders behind a giant burka?

  • (Score: 3, Insightful) by urza9814 on Tuesday October 30 2018, @01:54PM (22 children)

    by urza9814 (3954) on Tuesday October 30 2018, @01:54PM (#755621) Journal

    If those exact drugs were approved for sale in the US, you wouldn't need to cross the border, you could just import them. But you can't do that because our legislators claim these may be different drugs, they aren't tested for US regulations, and therefore they aren't approved for sale.

    And yet...it's legal for a US insurance company to pay US patients to go purchase, import, and use these unapproved drugs? WTF?

    • (Score: 1, Insightful) by Anonymous Coward on Tuesday October 30 2018, @03:02PM

      by Anonymous Coward on Tuesday October 30 2018, @03:02PM (#755653)

      And yet...it's legal for a US insurance company to pay US patients to go purchase, import, and use these unapproved drugs? WTF?

      Don't worry, Trump will fix that loophole. The patients, I mean the smugglers, will be given life sentences, or whatever is left of their lives.

    • (Score: 3, Informative) by Anonymous Coward on Tuesday October 30 2018, @03:10PM (2 children)

      by Anonymous Coward on Tuesday October 30 2018, @03:10PM (#755659)

      Drugs in mexico are the exact same as in the USA. Not only chemically but in many times the brand name is the same as well.

      • (Score: 2) by urza9814 on Tuesday October 30 2018, @05:13PM

        by urza9814 (3954) on Tuesday October 30 2018, @05:13PM (#755713) Journal

        Yet according to the FDA it's still illegal to import them, even for personal use, because the FDA hasn't approved those specific pills. Even if it's the same brand and product.

        If it IS legal to do this, then why can't I just use one of the many websites which promise an online consultation with a foreign doctor who will then write a prescription for and mail me whatever meds I want? Why can't I just mail order Oxycontin from some random physician in India? The same drug is approved for sale in the US, right? And I've got a "valid prescription" from that foreign doctor, right?

        My understanding is that this is not legal in any way, but it's exploiting a bit of good will from the customs agents, who generally allow minor violations when people appear to be bringing a small supply for personal use. But it's one thing when it's a tourist bringing the drugs they need for their trip; it's quite another when it's a corporation paying people to do it in order to save that company money.

      • (Score: 0) by Anonymous Coward on Wednesday October 31 2018, @08:34PM

        by Anonymous Coward on Wednesday October 31 2018, @08:34PM (#756160)

        Right... Just like there is no fake Viagra... the brand name is the same so it's the same fucking drug right?

        You do not understand the only really objective piece of information a person has about a product they purchase is the fucking price. Because of this, things like drugs have a huge amount of beuracracy aroudn them to ensure quality control. Which results in huge price increases, but removes the chance you are given fake shit placebo.

        Now if Mexico also has similiar scheme ran by their government, and you trust it not to be corrupt, then great, you may save money. But you need to do research on your own to ensure this is the case, otherwise expect some fake shit made in China or elsewhere to be peddled to you at that price.

    • (Score: 3, Interesting) by Zanothis on Tuesday October 30 2018, @03:39PM (7 children)

      by Zanothis (3445) on Tuesday October 30 2018, @03:39PM (#755666)

      A quick search on Avonex, listed in TFA, indicates that it is manufactured by an American pharmaceutical company. I haven't been able to find where they manufacture this particular drug, but we'll assume for the sake of argument that it's manufactured in the USA. That would mean that the medications that people are traveling to Mexico to purchase were exported from the USA to Mexico, which makes the entire situation even more ridiculous (unless, of course, the manufacturing facility is not in the USA).

      Additionally, these medications ARE approved for sale in the USA, they just cost 3x as much because we have no bargaining power with which to stop outrageous drug price increases. If you recall, Australia had a similar problem with Adobe products, though at least Photoshop isn't required to treat debilitating medical conditions.

      I don't know about trying to import at scale, but for an individual crossing the border with a 3-month supply of the drug, it would be difficult to strip someone of a medication that they had a prescription for. We don't do that normally, why would we start for this specific instance? How would we determine that someone was doing that, anyway?

      • (Score: 2) by urza9814 on Tuesday October 30 2018, @04:09PM (6 children)

        by urza9814 (3954) on Tuesday October 30 2018, @04:09PM (#755693) Journal

        Additionally, these medications ARE approved for sale in the USA, they just cost 3x as much because we have no bargaining power with which to stop outrageous drug price increases. If you recall, Australia had a similar problem with Adobe products, though at least Photoshop isn't required to treat debilitating medical conditions.

        I think that's software is a perfect analogy, but I also don't think it's purely a matter of bargaining power. It's more basic supply and demand getting warped by low marginal costs. Development is expensive; each individual unit is cheap.

        In some countries like China, India, parts of eastern Europe, and many others you'll find very different designs for consumer electronics. You'll find tea kettles that could be sold at a dollar store here -- except for the fact that they violate a few dozen US safety regulations. But the quality that we require here would be prohibitively expensive over there, so they just get different (crappier) products. That doesn't really apply to software or drugs though. The expensive part is already paid; if you can sell it for a dollar a pill somewhere else then that's still almost a dollar of extra profit. But that only works if you can still charge a higher price somewhere else in order to make up the R&D costs.

        So...do we allow importing all drugs for everyone, and potentially price out poorer countries because the drugs will have to be sold at a single price globally? Do we crack down on all imports, even personal supplies? Or do we decouple research from production so that sale price only reflects production price and it can be sold the same as any other goods? Personally, I'm a fan of that last option...but it seems so far we've been going with the middle one, in which case the situation in TFA should definitely not be legal....

        I don't know about trying to import at scale, but for an individual crossing the border with a 3-month supply of the drug, it would be difficult to strip someone of a medication that they had a prescription for. We don't do that normally, why would we start for this specific instance? How would we determine that someone was doing that, anyway?

        You can find websites that will have a doctor in India or Mexico or wherever give you an online consultation via some web chat, write a prescription, and mail you the drugs through standard international post. If customs finds that package, they're gonna seize it, even though you've got a "valid prescription". Why should it be any different if you carry them across the border in person?

        Generally, customs *will* allow you to cross the border with a personal supply of medication; however according to the FDA website it is illegal to import any drugs into the US, even for personal use. So technically you aren't allowed to bring them at all, but they realize that this is a bit unreasonable and they give some flexibility. The insurance company in TFA is exploiting that in order to bypass regulations about importing foreign medication. They're using customers as drug mules; they're encouraging and sponsoring people to violate federal law en masse; and they ought to be prosecuted for that.

        • (Score: 2, Insightful) by Anonymous Coward on Tuesday October 30 2018, @05:10PM (1 child)

          by Anonymous Coward on Tuesday October 30 2018, @05:10PM (#755711)

          > But that only works if you can still charge a higher price somewhere else in order to make up the R&D costs.

          This has been the party line from Big Pharma for quite some time. I'm not sure I believe it anymore, at least not without questioning a few other things like excessive executive pay/perks/bonuses.

          • (Score: 2) by Mykl on Tuesday October 30 2018, @09:54PM

            by Mykl (1112) on Tuesday October 30 2018, @09:54PM (#755820)

            I agree.

            Big Pharma are not handing out lower prices in other countries because they are good guys. Rather, they are charging more than market price for drugs in the USA because they can, since all involved parties (insurers, pharma, hospitals, politicians) have created the conditions that make it so easy for them to charge what they want.

            I'm fully convinced that these companies could sell these drugs for the same price in the US that they sell them for overseas (e.g. the Mexico example in TFA) and still make a profit.

        • (Score: 5, Interesting) by sjames on Tuesday October 30 2018, @05:36PM (3 children)

          by sjames (2882) on Tuesday October 30 2018, @05:36PM (#755720) Journal

          They're playing a game of brinksmanship. Customs can't crack down too hard or the people in D.C. that want to kill the ACA and promote the "free" market would be forced to admit that they've done their damnedest to make the market non-free.

          It's popcorn time. Since we're talking about big bucks, this will NOT be the last insurance program to promote personal import. That is to say, this will not be the last too big to fail corporation to openly defy the law that was custom ordered by other too big to fail corporations.

          Meanwhile, the people will side with whoever provides their necessary health care the cheapest.

          The GOP might be best off joining hands with the DNC to promote single payer so the whole game can be swept under the rug before someone discovers the marked cards.

          Expect to see amazing contortions trying to avoid that.

          • (Score: 0) by Anonymous Coward on Tuesday October 30 2018, @07:06PM (2 children)

            by Anonymous Coward on Tuesday October 30 2018, @07:06PM (#755745)

            Yes, except that the DNC doesn't want single payer any more than the GOP does. That would definitely kill a very big golden goose. You people simply have to vote this shit out, starting next week!

            • (Score: 3, Informative) by sjames on Tuesday October 30 2018, @07:59PM (1 child)

              by sjames (2882) on Tuesday October 30 2018, @07:59PM (#755764) Journal

              Part of the DNC doesn't want it. art does. The part that doesn't got a slap to the back of the head and is widely seen to be the reason Trump won the election last time.

              • (Score: 0) by Anonymous Coward on Tuesday October 30 2018, @08:29PM

                by Anonymous Coward on Tuesday October 30 2018, @08:29PM (#755771)

                That is all irrelevant. What I am saying is that if you don't produce an alternative to the DNC/GOP monolith, you will get nowhere. You will be forever distracted with 'this part-that part' (good cop-bad cop).

    • (Score: 4, Insightful) by sjames on Tuesday October 30 2018, @05:09PM (9 children)

      by sjames (2882) on Tuesday October 30 2018, @05:09PM (#755710) Journal

      Except they are the same drugs. They probably came off of the same production line. This is just a way around the corruption between big pharma and the feds that is intended to trap U.S. citizens in a broken market.

      • (Score: 3, Insightful) by urza9814 on Tuesday October 30 2018, @05:50PM (8 children)

        by urza9814 (3954) on Tuesday October 30 2018, @05:50PM (#755724) Journal

        Sure, they're the same drugs, but they're still illegal to import. Doesn't matter if you're doing it personally, on behalf of a company, or a company importing in bulk. It's still illegal. And this company is paying people to violate that law.

        If the law is so goddamn broken, FIX IT instead of just looking the other way when certain privileged companies violate those laws for profit.

        • (Score: 3, Insightful) by sjames on Tuesday October 30 2018, @06:33PM (7 children)

          by sjames (2882) on Tuesday October 30 2018, @06:33PM (#755736) Journal

          See my comments about brinksmanship and our bought congress.

          In particular talk to the congress critters that don't want single payer or the ACA because "free market" and then don't want the free market either because.....well, they've carefully avoided actually answering that question.

          Basically, we have a congress that wants to give us the worst possible solution and since it is unwilling to bend on the issue we are now seeing open defiance.

          • (Score: 3, Insightful) by urza9814 on Tuesday October 30 2018, @06:49PM (1 child)

            by urza9814 (3954) on Tuesday October 30 2018, @06:49PM (#755741) Journal

            Basically, we have a congress that wants to give us the worst possible solution and since it is unwilling to bend on the issue we are now seeing open defiance.

            I'd feel a lot better about that if it wasn't large corporations bribing individual citizens to be the ones doing the defiance. If something goes wrong it's not going to be the CEO responsible for this decision who ends up in prison -- it's going to be the individual citizens they paid off as drug mules. If the company wants to defy an unjust law they should do it themselves.

            These insurance companies are no better than our "bought congress" (in fact, they're often the ones doing the buying), and I don't expect their actions to fix anything other than their own profit margins...

            • (Score: 3, Interesting) by sjames on Tuesday October 30 2018, @07:15PM

              by sjames (2882) on Tuesday October 30 2018, @07:15PM (#755752) Journal

              I doubt any individual is going to have any problems here. The last thing the GOP wants is to shine a bright light on this issue. Also, this is the insurance plan provided as a benefit to Utah State employees and it has the backing of the state government. So any light that shines there would also obliquely bring state's rights into the picture. It's a political powder keg and nobody wants to risk lighting a match within a thousand miles of it.

              I would prefer to see a sane actual solution to the cost of healthcare come out of the federal government but they have made it perfectly clear that they would rather we die than do that. So here we are.

          • (Score: 0) by Anonymous Coward on Tuesday October 30 2018, @07:09PM (4 children)

            by Anonymous Coward on Tuesday October 30 2018, @07:09PM (#755747)

            You have the congress that you voted for! Don't forget that as you reelect 95% of them every time the opportunity to fix the problem comes around.

            • (Score: 2) by sjames on Tuesday October 30 2018, @08:01PM (3 children)

              by sjames (2882) on Tuesday October 30 2018, @08:01PM (#755765) Journal

              You are aware that I don't get to vote for all of them, arent you? I voted for the ones that support single payer.

              • (Score: 0) by Anonymous Coward on Wednesday October 31 2018, @12:01AM (2 children)

                by Anonymous Coward on Wednesday October 31 2018, @12:01AM (#755858)

                You are aware that you are a collective, and as a collective, the failure is yours, not the system, or anything else.

                • (Score: 3, Informative) by sjames on Wednesday October 31 2018, @01:43AM (1 child)

                  by sjames (2882) on Wednesday October 31 2018, @01:43AM (#755898) Journal

                  Other than as a collection of various single cells, I am but one individual with one vote. Voting helps, but there most certainly ARE systemic issues. It's not a coincidence that the leading candidates for a given office are generally a rogue's gallery of more of the same. It's not random chance that potential candidates who aren't part of the rogue's gallery couldn't get air time if they killed someone on camera.

                  • (Score: 0) by Anonymous Coward on Wednesday October 31 2018, @04:12AM

                    by Anonymous Coward on Wednesday October 31 2018, @04:12AM (#755924)

                    Free choice, real or myth? That's all I want to know...

  • (Score: 3, Interesting) by Anonymous Coward on Tuesday October 30 2018, @02:25PM (4 children)

    by Anonymous Coward on Tuesday October 30 2018, @02:25PM (#755631)

    My employer's health plan has a different solution this year that I hadn't seen before. For expensive long term use drugs they will give them to you for free if you don't mind them being imported from overseas and waiting for shipping (so you need to get an extra prescription in advance). They say they only use "Tier 1 counties" for sourcing these which have "regulations similar to the FDA" and list UK, New Zeland, Canada, and Australia as T1. Supposedly these are just as good and since they are much much cheaper than buying them in the US they give them for free as it's saves them money in the long run and encourages signups.

    • (Score: 2) by urza9814 on Tuesday October 30 2018, @06:02PM (3 children)

      by urza9814 (3954) on Tuesday October 30 2018, @06:02PM (#755728) Journal

      My employer's health plan has a different solution this year that I hadn't seen before. For expensive long term use drugs they will give them to you for free if you don't mind them being imported from overseas and waiting for shipping (so you need to get an extra prescription in advance). They say they only use "Tier 1 counties" for sourcing these which have "regulations similar to the FDA" and list UK, New Zeland, Canada, and Australia as T1. Supposedly these are just as good and since they are much much cheaper than buying them in the US they give them for free as it's saves them money in the long run and encourages signups.

      The FDA is pretty clear that this is not legal.

      From https://www.fda.gov/forindustry/importprogram/ucm173751.htm [fda.gov] [emphasis added]:

      It must be emphasized that the intent of the personal use importation guidance is to save FDA resources and to generally permit, through the exercise of enforcement discretion, medical treatments sought by individuals that are not otherwise available in the United States (where such treatments are not promoted/commercialized in the U.S.). Thus, foreign-made chemical versions of drugs available in the U.S. are not intended to be covered by the policy. For example, a person may decide that his or her FDA approved heart medication is cheaper in Mexico, and attempt to import the unapproved version of the drug from Mexico. FDA cannot assure that such products have been properly manufactured and are effective; therefore, given that such products are available in the U.S., their use would present an unreasonable risk and the guidance would not apply (unless the person seeking their importation could establish that the drugs were needed to refill a prescription while traveling or were otherwise needed while traveling).

      • (Score: 1, Funny) by Anonymous Coward on Tuesday October 30 2018, @07:03PM

        by Anonymous Coward on Tuesday October 30 2018, @07:03PM (#755744)

        (unless the person seeking their importation could establish that the drugs were needed to refill a prescription while traveling or were otherwise needed while traveling)

        It's really annoying how my prescriptions always run out whenever I'm visiting Mexico!

      • (Score: 2) by coolgopher on Wednesday October 31 2018, @12:22AM

        by coolgopher (1157) on Wednesday October 31 2018, @12:22AM (#755863)

        foreign-made

        Didn't someone above just point out that at least one of the drugs was in fact manufactured in the US? Clearly it can't be foreign-made from a US perspective in that case...

      • (Score: 2) by legont on Wednesday October 31 2018, @12:39AM

        by legont (4179) on Wednesday October 31 2018, @12:39AM (#755872)

        My company insurance explicitly prohibits buying foreign drugs with an intent to bring them to the US. They pay for drugs abroad if I need them abroad and have even foreign doctor prescriptions while I am on vacation or something and I guess I can bring unused back, but I can not do it with an intent to supply myself.

        Perhaps local authorities started to fight the law guerilla style similarly to marijuana movement.

        --
        "Wealth is the relentless enemy of understanding" - John Kenneth Galbraith.
  • (Score: 0) by Anonymous Coward on Tuesday October 30 2018, @08:36PM (2 children)

    by Anonymous Coward on Tuesday October 30 2018, @08:36PM (#755777)

    I would love to see a poll taken by the general American public that asks if they consider equivalent foreign pharmaceuticals "dangerous" compared to what you buy in the US. Hell, when I look at where my "American" drugs were made, frequently it says "India" or "Mexico" !

    LET'S CUT OUT THE MIDDLEMAN.

    • (Score: 1, Insightful) by Anonymous Coward on Tuesday October 30 2018, @10:01PM

      by Anonymous Coward on Tuesday October 30 2018, @10:01PM (#755824)

      LET'S CUT OUT THE MIDDLEMAN.

      You're too lenient. Don't just cut him out, rip his chest open and tear out his heart; eviscerate him slowly... you get the idea.

    • (Score: 0) by Anonymous Coward on Tuesday October 30 2018, @11:23PM

      by Anonymous Coward on Tuesday October 30 2018, @11:23PM (#755849)

      But the flow of money is from government printing press to pharma company. YOU are the middleman in this scenario and I'm sure both the others would be glad to get rid of you if they could.

  • (Score: 0) by Anonymous Coward on Wednesday October 31 2018, @02:23AM

    by Anonymous Coward on Wednesday October 31 2018, @02:23AM (#755908)

    It is against the law to personally import pharmaceuticals for the same reason that DVDs had region codes: market segmentation enforced by law!
    It doesn't get less "free market" than this.

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