As long as it's left generic so it goes both ways. Currently it's usually the uninsured patients who are charged less (since they're paying the whole thing out of pocket instead of having insurance cover most or all of it), not the insured patients.
As long as it's left generic so it goes both ways. Currently it's usually the uninsured patients who are charged less (since they're paying the whole thing out of pocket instead of having insurance cover most or all of it), not the insured patients.
Hospitals and clinics offer a preferential rate to insurance companies as a sort of volume discount because insurance companies with thousands of patients have a lot more negotiating power than any individual patient who is uninsured or using an HSA.
It got even worse once health insurance companies started negotiating contracts with favored nations clauses requiring hospitals to bill then ~10-30% less than patients paying out of pocket. It's an oligopoly, but on the demand side: an oligopsony.