It isn't surprising that Amy Rosenthal, the executive director of Health Care for All, wants to rein in the cost of prescription drugs. She's been quite clear that breakthrough drugs don't have much of an impact if people can't afford them.

But her talk of shared responsibility on the Health or Consequences Codcast with Paul Hattis and John McDonough took the debate in a new direction. She said she has made the rounds with all of the players in the Massachusetts health care system and discovered a shared pride in all that has been accomplished in terms of near-universal coverage and moderating prices. Each of the players has contributed.

"Individuals were required to start buying health insurance, the individual mandate," she said. "Employers had an employer assessment. Hospitals and insurers have to go before the Health Policy Commission. All of these things were not easy. People had to put some serious skin in the game. And all we're saying at this point is that it's time for pharma to do their part in this."