Its a basic tenet of economics, cost shifting.
Say you are a multinational, a drug company, and lets just say you sell drugs to treat cancer.
That used to be very profitable, everywhere, but now, they say, one by one, their customers have started driving hard bargains with you. Squeezed in one area, you have to squeeze back somewhere else.
You might even have to cut research!
Thank God for America! Its the laststupid rich country left where they can charge "market rate" prices!
Well, if you look at a graph of the United States' generosity in health spending, relative to other nations its obvious what is going on. We are subsidizing drug research FOR THE WHOLE WORLD, (they say)
Those "free rider nations" like Canada decided over the last few decades to shift all of certain costs to USA. For example drug research costs, according the Pharma and the US government, are borne disproportionately by American taxpayers. (they say)