A Moving Experience: Italy vs. the US in the healthcare shell game

5 min readMay 15
by Paul Brennan from Pixabay

A shell game always involves deception or fraud. You’ll find plenty of online videos to show you the tricks in a street game with shells and peas. But what about the game with bigger stakes — the health of a person . . . or a country? Let’s look at the “guess what I cost” game in the US and compare it with Italy.

1. Keep your eye on the shell, er, pill.

How can one pill, one boring Tier One (Medicarespeak for cheap and easy to produce) pill vacillate so much in price? I needed a refill for such a pill, so ubiquitous that 23 million Americans take it, and as accessible as aspirin, right?

Wrong. I asked the doctor to send the prescription to a new pharmacy because the posted price of various prescription drugs in that pharmacy seemed very competitive, and I am always happy to thwart the profit margins of Big Pharma.

But when I came to pick up this particular item (let’s call it T), I encountered a bait-and-switch. The posted price was $10, which I assumed was for a 90-day supply of T, since that is what my prescription called for. “Sorry,” said the pharmacist. “That is our price for a 30-day supply.”

It was useless to recall that I had been paying € 2 in Italy for a month’s supply. Such prices belonged to rational, civilized health care systems, not the clown show found in the US. I knew that T was available in pharmacies nearer to me for half the price, or less. So I declined to pick up my order and requested that my primary care physician send another RX to a close-by pharmacy.

Before picking up, I checked online with GoodRX and found a price of $12.99 for a 90-day supply. Great. Showed up at the counter and the pharmacist informed me that their price was $23.20. Sure, cheaper than Pharmacy #1 but $10 more than the online quote from GoodRX.

“Here’s my coupon from GoodRX,” I waved my digital coupon at the pharmacist.

“How much was that? 12.99? We can do better. How about $9.97?”

A three-dollar savings? Fine with me. But what happened to the $23.20? It just disappeared into thin air? If I hadn’t asked, that is presumably what I would have paid. So buying medicine for health in America is like buying carpets for…


writer, PR professional, mother, dog-lover, traveler. See more at www.paroleanima.com