Nobody pays that. It's a pre-negotiation price that exists as a factor of many other costs and payments to various stakeholders like PBMs.

“Nobody pays that”

I hate this so much. Nobody knows how much anything costs. What kind of market is this?

> Nobody knows how much anything costs.

Slightly off topic, but I have this exact feeling every time I visit the US and buy stuff in a store.

"Sorry, we don't include tax in the price that is displayed, so you'll need to either figure that out in your head or just pull the slot machine of what you are actually gonna pay at the register."

And don't give me the "taxes are different from place to place" cuz the store ain't gonna change place while I am in it. So much is just psychological warfare in the US, which just has no reason to be...

Sure that mildly annoys me but does it really matter? Everything in the store is taxed according to the relevant laws for the region. It's not as though this TV will have 10% tax but that TV will have 50% tax. They'll both be taxed according to the item category they fall under.

It's not as though most people are in a position to shop around when it comes to tax authorities.

It would be nice to know how much something costs before you pay.

Americans just do the quick math for their locale for taxes, not nearly the same thing as opaque medical fees.

I don’t think that it generally true. At least, I just wait to get to the register to discover how much I’ll be spending. I mean it is usually within 20% or so of the advertised cost.

It is a pretty stupid system.

It’s just dishonest, and it makes it difficult to guess how much you are spending before you get to the register.

>"Sorry, we don't include tax in the price that is displayed, so you'll need to either figure that out in your head or just pull the slot machine of what you are actually gonna pay at the register."

Canada, where I lived for years, has, or at least when I was there had, the same thing with taxes not being included in posted prices, and yes, it's annoying, i'll grant you that. I especially realized how annoying when I eventually moved to a country where all posted retail prices include all taxes. However, if you're in a supermarket with $150 in groceries in your cart and can't muster the neurons to roughly remember what sales taxes in your area are (their percentage is indeed often mentioned in price tags) and do the tiny bit of mental arithmetic necessary to know what 15% on $150 or etc is, you've got bigger problems than a specific grocery bill.

Health insurance in the US is specifically mostly not a market, because your employer picks your health insurance for you.

Also, markets are supposed to have associated prices. In US healthcare you learn the price later, sometimes weeks or months later, in the form of balance billing. For those not in the US -- you pay six ways:

1 - Premium

2 - Co-Pay

3 - Deductible

4 - Co-Insurance

5 - Balance Billing -- you dont learn the full cost until weeks/months later

6 - Non-covered items -- you dont learn the full cost until weeks/months later