Xoomer - The hospital bill was $77.50, not the pharmaceutical companies or the pharmacies. Hospital inflate their bills, just like most industries that work with insurance companies ( ask some of our auto people here ), because the insurance company will reimburse at such a low rate, the hospital will lose money ( a large percentage, if not most, hospitals, especially public ones, work in the red )if they billed at the actual cost. The same reason pushes hospitals, and other health care providers, to bill non-insured people at a higher rate than they do the insurance companies. That person is basically covering the difference. OTOH, insurance companies and HMO's ( that was the main rational for HMO creations ) argue that they are only getting a discounted rate ( and if its an HMO and the health care provider/hospital is an in-network, than its a contracted amount ) because they are doing what we reefers call, " a group buy. "
Dom - Pharm representatives regularly take out doctors for lunches. They do a lot more than that too. A lot of little things like free pens, samples, notepads, and more valuable things like all expense paid conferences, etc. Chartered fishing trips are unheard of these days but there are other things that are done. The AMA actually set a guideline that states it is ethical for a doctor to accept a gift - from a patient or family, pharmaceutical rep, etc - for about up to $80 ( I have to check my notes for the exact amount ). There are many doctors who, as principle, won't accept anything for free, even a pen, because they feel it affects their integrity - in actuality or in the eyes of patients ( my dean is one ).
No one can deny that these products work. 
