Basically, Medicare and Medicaid are tired of getting screwed. When those programs were established, they were intentionally hobbled in negotiating prices with drug companies, hospitals, physicians, etc. Because, you know, it wouldn't be fair to providers.

As a result, Medicare and Medicaid often pay more than private insurance. In part, that's because their ranges for negotiation are pegged to list prices. And so providers inflate those list prices. And nobody, except for a few clueless patients, actually pays list price.

Anyway, good for Medicare and Medicaid!