The horizon is not so far as we can see, but as far as we can imagine

Trump Promises to Reduce Drug Prices

So, there was a lot of hoopla over Trump’s press conference, most of it concentrating on the release of the oppo research file on him, containing not one proven assertion.

I decided, once again, to read the actual transcript.  And found out that there was little coverage of something which should matter more to most Americans: Trump’s promise to lower Pharma prices.

We’ve got to get our drug industry back. Our drug industry has been disastrous. They’re leaving left and right. They supply our drugs, but they don’t make them here, to a large extent. And the other thing we have to do is create new bidding procedures for the drug industry because they’re getting away with murder.

Pharma has a lot of lobbies and a lot of lobbyists and a lot of power and there’s very little bidding on drugs. We’re the largest buyer of drugs in the world and yet we don’t bid properly and we’re going to start bidding and we’re going to save billions of dollars over a period of time.

The business press seem to be taking this seriously.

It is also, AGAIN, something which should have been tackled long ago. Obama deliberately refused to allow price negotiation with pharma and so did Bush. In both cases, they gave into the lobby. Insane.

Nor, as some say, will this mean that pharma prices will have to rise overseas. Pharma is a profitable industry which spends more on marketing and advertising than on drug research, which researches mostly the wrong drugs, and so on.  They can just make less money–high profits to Pharma are mis-allocated resources.

Next Trump talked about the F-35 (for those who don’t keep track, it basically can’t fly and is vastly over cost.)

And we’re going to do that with a lot of other industries. I’m very much involved with the generals and admirals on the airplane, the F-35, you’ve been reading about it. And it’s way, way behind schedule and many, many billions of dollars over budget. I don’t like that. And the admirals have been fantastic, the generals have been fantastic. I’ve really gotten to know them well. And we’re going to do some big things on the F-35 program…

AGAIN something which should have already been dealt with.

Trump thinks like a deal-maker and a business man, and what he sees is that the government is vastly over-paying for services and products, and he doesn’t like that. And what he sees is that Americans are overpaying as well, because the government refuses to act on their behalf.

I’m sorry, I’m very sorry. Trump will certainly do bad things, but if he follows through on these two things (especially pharma), he’ll be doing very good things that people like Obama would not do.

This is of a piece with Trump killing the Trans Pacific Partnership, while reports have regularly indicated that getting it passed was Obama’s most important legislative priority, likely for his entire Presidency.

Understand clearly that this is the sort of stuff that Trump was elected to do, along with bringing jobs back, curtailing immigration, and so on.

The next thing to watch will be what replaces the ACA (Obamacare). I am not optimistic, because health care accounts are a terrible idea.  But let’s see. (Or, alternatively, call your Congress critters and insist the ACA not be repealed. You might win.)

But right now, as I score it, Trump is more or less on track to do what he said he would do. I think his tax cuts will be disastrous, especially in the long run. I don’t like Obamacare, but I expect him to replace it with something worse. However, in a lot of areas, he’s talking about doing things that should have been done long ago.

When the people too many liberals think are “good” (like Obama), won’t do what everyone knows what must be done, they will eventually be done by people liberals consider “bad,” in ways liberals might not like.

There’s a lesson there.


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29 Comments

  1. Tom

    The F-35 should be just canceled as the skin can’t stand up to rain like the F-22 which was pulled from frontline duties due to those problems.

    Trump should just stick to proven and evolved F-15s, 16s, and 18s which with updates have more than held their own.

    As for Pharma, just nationalize them and direct the research to diseases such as aids, cancer, and flu. Also focus on eradicating Polio once and for all.

  2. different clue

    And save the A-10 wonder warthog.

  3. DMC

    Figures on big Pharma that are especially telling are research (14-16%) and advertising (28-30%) where the percentages indicate funds allocated per annum. It quickly puts the lie to the oft repeated cry of “But we need these insane profits for research!”. Yeah like they needed them for taxol, developed by the NIH, 100% taxpayer funded research. The manufacturer charged $10,000 a year for it.

  4. Dilip G

    Is there a chance he’s using this as a shakedown tactic, so the various industries can now come lobby with him or his people instead of the legacy elite?

  5. No, he is robbing Peter to pay Paul. Large cities make drugs, therefore drugs being high is to their advantage. Away from large cities they have doctors to manage people cannot get drugs, therefore drugs are low in profits, but doctors are high in profits. So robbing Peter (drugs) to pay Paul (doctors) is the Republican way. The Democrats are not liberals, the conservatives from the cities; Republicans are conservatives from the rural areas.

    If you want actual left policies, the first thing you have to do is pick a party, and say “be liberal or else”.

  6. nihil obstet

    The Senate seems on the way to making a win for Trump very easy — last night they voted down an amendment to allow pharmacists to import drugs from Canada where they cost much less. Thirteen Democrats voted with the Republican majority. If the House goes along, Trump can rail against this ban to much popularity, and probably a few of the drug companies will make highly publicized price reductions. The price reductions will be miniscule, but like the Carrier deal, they’ll make Trump look good.

  7. Peter

    @DC

    Nuke the A-10 and save the whales says someone who has been mock targeted by these bad boys. I was driving my tractor in SE AZ that didn’t really resemble a tank when two of these A-10’s decided it was as close to a tank as they were likely to see that sunny day on their way to Fort Huachuca They blindsided me flying on the deck, about 50′, and wide open and although I was driving a diesel and had on ear protection the sonic/shock wave nearly blew me off the tractor and left my ears ringing.

    Because there aren’t many tank battles to disrupt today these hotshots are probably back at harassing farmers to get their kicks.

  8. realitychecker

    Take two aspirin, and don’t ever call me again.

  9. MeToo

    The ACA is a total disaster, speaking from personal experience (and not much else). It is not affordable, not even close. I know of nobody that likes it or finds it affordable either.

    Does not provide adequate coverage in critical areas. Has created gigantic backlogs for services.

    Government has no responsibility to ‘enforce’ this (mandatory provision) on everyone either.

    However, private care was also unaffordable to the uninsured, but still better (from my own experience).

    I do not have insurance now. Will not submit to the demands that I must either. Once I realized the cost (pure extortion), I told them to fuck off. We need something far better.

    Controlling ridiculous costs for starters. Cross either border to buy your pharmaceuticals and you will pay far, far less. Same with medical treatments. It’s not just the dollar rate of exchange either, not hard to factor it. It’s the underlying cost and how Medicine in Amerika is pure extortion now.

    The majority of bankruptcies today are the result of medical costs (look it up). Did not vote nor support Trump, but I hope he abolishes this American Disaster. Soon.

  10. “I won’t have anything so other people should not either.”

  11. Richard McGee

    One of the corporate giants Trump may want to make an example of is Time Warner (CNN’s parent company). A whisper in the ear of Jeff Bewkes: “It would be a real shame if the feds starting investigating municipal monopolies.” The pressure could easily be ratcheted up until they agree to pull the rug out from under CNN.

    The other MSM parent companies would cave like sand castles.

    This could actually happen very quickly. No coverage critical of Trump on TV. There will be ‘alternatives,’ but for the average schmuck who gets his news from the tube, the new reality will be the Trump version.

  12. realitychecker

    @ Richard McGee

    God forbid anything should disrupt the way the media whores do their corrupt business, amirite?

  13. Tom

    @McGee

    And the beauty of that approach is that it is simply unimpeachable without looking like hypocrites. MSMs are breaking the law by their business practices and getting bitchslapped would go over well, hell throwing several in prison would do some good so long as he gets the goods to do so up front first so everyone can’t decry it as its clear that the journalist broke a law.

    Its how Erdogan broke the Turkish Deep State so thoroughly their last gasp to keep power spectacularly failed. With the new Constitution ready to be put to the people, Turks 18 years of age will be able to vote and run for national offices and the last vestiges of militarily imposed laws will be swept away to make way for a new Turkish Democratic Awaking.

    The key is to show the person broke a law, then arrest that person. Or in the case of the HDP, show they were abusing their parliamentary immunity to gun run for the PKK which is blowing people up and then revoke it by vote in Parliament, wait for HDP deputies to break the law again and then arrest them.

    No one can decry Erdogan’s arresting of HDP deputies for gun running and helping PKK kill Turkish Citizens without looking like a hypocrite.

    If Trump acts and does the Erdogan Way, he will go a long way towards breaking the Deep State and opening a way for either his sons, or his daughter and son-in-law to continue the assault on the US Deep State and break it.

  14. @Peter
    Sonic/shock wave? The A-10 has a top speed of 439 mph, which is barely over half the speed of sound. I lived just half a mile from Davis-Monthan AFB for quite a few years and A-10s are not particularly loud. The F-18s at Miramar where I live now puts them to shame in the noise department.

    Which is not to say the Warthog is not a great airplane; best close air support/ground attack weapon we have by a very large margin.

  15. Ché Pasa

    “Trump Promises”…

    Uh, yeah. He promises a lot of things, doesn’t he? And some people are really desperate to believe him, aren’t they?
    
    He satisfies a yearning in that regard, no doubt. But if I recall correctly, so did Obama, and when the reality of what he was doing started to hit, his defenders simply redoubled their defenses. They’re still doing it.

    In fact, his defenders have never acknowledged what Obama’s and Congressional policies have actually done in detail or aggregate (there is good and there is much bad), while his critics can’t for the life of them imagine him doing anything but bad.

    It exactly parallels the situation with Trump and his defenders and critics.

    It isn’t policy or governance, it’s politics.

    It’s how the game is played. It’s the deliberate and cynical creation of a false reality, one that is made to obscure what is really going on.

    Sure, you will hear lots of promises and lots of lies, and you’ll believe what you want to and need to, and that’s the point of the game.

    As long as you’re hearing and believing what you want, you’ll be tame, and that’s why there are so many lies and so many promises.

    When people break out of that framework and deal with the actual policies our rulers are imposing and their effects, it’s quite a different picture.

    Trump makes promises. Good to know. Better to know the actual policies and their effects.

    

  16. Hugh

    The F-35 is an example of how bloated, ineffective, insanely expensive gold-plated defense boondoggles not only aren’t smothered at birth but become politically untouchable. Basically, Lockheed Martin hired as many subcontractors in as many states and congressional districts as possible. The company was completely bipartisan in its largesse. Additionally, it could point to which bases in which states would have the plane. Lockheed Martin could go and cite “The F-35 means X number of jobs in your state or district. You gonna kill those jobs and make the US of A less safe?” People like me have been pointing out for years what a disaster the F-35 was. It had no effect. And how could we when Lockheed Martin had bought off even supposedly progressives politicians like Bernie Sanders? Yes, progressive Bernie against all that waste in government but a supporter of the trillion dollar F-35. His cut is that the Vermont Air National Guard in Burlington is supposed to get F-35s. So Trump might just have a lot of opposition from both sides of the aisle if he tries to do in a program that so richly deserves doing in.

    With regard to drug prices, Trump might also face headwinds from Congressional Republicans. It was they after all who pushed through Medicare Part D (which deals with drug prescriptions) and specifically banned Medicare from using its market share to negotiate prices.

    For anyone interested, here is my entry on Medicare Part D from my old Bush Scandals List:

    In an effort to spike a Democratic issue and protect the interests of drug and insurance companies, Republicans came up with their version of a Medicare drug prescription bill (Medicare Part D). The fix as they say was very much in. Representative Billy Tauzin (R-LA) Chairman of the Commerce Committee was listed as the principal “author” of the bill which was largely written by industry lobbyists. Shortly after its passage, Tauzin announced his retirement and swung a deal to become a lobbyist at $2.5 million/year with the Pharmaceutical Research and Manufacturers of America (PhRMA), Big Pharma’s trade group. Thomas Scully who headed Medicare at the time lied to Congress about the program’s expected costs, understating them by $139 billion ($395 billion vs $534 billion), and then threatened the program’s chief actuary Richard Foster with firing if he told Congress the truth. He too quickly returned to the private sector and a law firm Alston & Bird lobbying for the healthcare industry.

    The bill came up for a vote in the House at about 3 AM on November 22, 2003. Votes are usually held open for 15 minutes. After 45 minutes, the bill was failing 215-219. Speaker of the House Dennis Hastert and House Majority Leader Tom Delay spent the next few hours engaged in arm twisting and, in the case of Nick Smith (R-MI), bribery. They were successful. The vote was closed at 5:53 AM after nearly 3 hours, and the bill passed the House 220-215. It passed 54-44 in the Senate 3 days later on November 25, was signed into law December 8, 2003, and, after a signup period, went into effect January 1, 2006.

    The bill prohibited Medicare from using its market share to negotiate with drug companies for lower prices and forced enrolling seniors into private insurance plans. It presented them with multiple and confusing plans which might cover some but not other of their prescriptions. On top of this, most plans had various co-pays and deductibles further complicating the situation. And it had its famous donut-hole, which was introduced to meet the Administration’s fake cost estimates. Prescriptions would be covered up to a certain amount and then not covered until a higher threshold had been reached. Senator Dick Durbin (D-IL) described the program succinctly as “somewhere between a bureaucratic nightmare and elder abuse.”

  17. Nancy

    If Trump really wanted to accomplish something spectacular that would help the American people, he would push for a single-payer system like every other civilized country in the world has. This could take the form of Medicare for all. Hell, he could call it TrumpCare. Think of it like a Nixon goes to China move.

    Of course, rich people would turn their noses up at “healhcare for all”, but they could subscribe to their own “Concierge Medical Care”. That way they wouldn’t have to rub shoulders with the common rabble.

  18. Nancy

    If Trump really wanted to accomplish something spectacular that would help the American people, he would push for a single-payer system like every other civilized country in the world has. This could take the form of Medicare for all. Hell, he could call it TrumpCare. Think of it like a Nixon goes to China move.

    Of course, rich people would turn their noses up at “healhcare for all”, but they could subscribe to their own “Concierge Medical Care”. That way they wouldn’t have to rub shoulders with the common rabble.

  19. BlizzardOfOz

    The health/insurance system in the USA is a criminal racket. How do they get away with it? Incredible. For people with asthma, if you cross the southern border you can buy inhalers for something like 1/20th of the price. The manufacturers will periodically patent some useless “improvement” so that they can maintain the exorbitant price. If you can afford it, you have no choice but to pay, otherwise it just gets billed to the American taxpayer, and added to the $20 trillion-and-counting national debt.

    Obama and the Democrats with their supermajority in both houses, spent two years on “healthcare reform” and didn’t touch the fundamentals of the racket? In a healthy country Obama, Pelosi and Reid would be tried for treason.

    I’ll be really impressed if Trump can actually improve the system, but I’m extremely doubtful. He was obviously out to sea in the debates on the topic, and just kept muttering something about “selling across state lines”. Is it even possible to do something quickly, or will it consume 2 years and his entire political capital, as the ACA monstrosity did for Obama?

    I do think that some kind of free-market type reform could work (Singapore style?). What if hospitals actually had to quote a price for routine procedures and compete with each other? This goes back to the New Freedom vs New Nationalism debate of the Wilson-FDR era. Is it better to break up the oligopolies and enforce a fair free market, or allow the de-facto monopolies but control them in the public interest?

  20. Peter

    @BillH

    Go stand at the end of the runway when an A-10 lifts off and listen to that sound of freedom. The AF have to follow all kinds of silly noise rules when operating around delicate city folks. Their not allowed to do mock strafing runs in the burbs at 50′ off the ground at only 500mph, your number is in knots.

  21. Willy

    So what was going through Obama’s head – his primary influences? Are the lobbyists that persuasive? Do they threaten family member wackings by goombahs? There has to be a way for the truth to pierce all the noise.

  22. Nancy

    @BlizzardOfOz

    “In a healthy country Obama, Pelosi and Reid would be tried for treason.” Really?!?

    I think I would reserve that option for Presidents/Vice-Presidents who lie us into unfunded Middle East wars that add trillions to the debt and needlessly kill hundreds of thousands of non-combatants. Not to mention breaking the region for the foreseeable future.

    I don’t believe that quality, cost-effective healthcare is best served by the Ayn Rand approach. If every other 1st world country can provide healthcare for its citizens, I am puzzled why the “greatest and richest nation in the world” is unable or unwilling to do so.

  23. Willy

    Ayn Rand ignored the power game, who plays it, who usually wins it, what it does to people… They’re good at playing the game, not much else. You get rid of big gubmint and those players go elsewhere to stink up those joints. All we have left is checks and balances. And genetic engineering. But good luck with the meek inheriting that one. A POTUS license? An NFL-style combine for power candidates? A sociopath who actually talked to me once told he their kind controls everything, and it was they who instinctively engineered all us meek folk. Domesticated for our labor. Why the occasional meek folk stampedes can’t have a more rational direction…

    My angry fingers are taking on a mind of their own. I’ll quit for now…

  24. Willy

    “told me”

  25. different clue

    @Peter,

    It is never good that pilots of any kind of plane would harass a tractor driver or any other non-combatant on the ground for any reason, least of all for the natural fun of it.

    But should we blame the plane for that? Do the low-and-slow-flying capabilities of the A-10 present such an irresistable occasion to sin that the plane itself should be banned to pre-empt the possibility of weak pilots being led into flying astray? One wishes there were disciplinary pathways available to stop this sort of A-10 abuse without having to ban the plane itself.

    The A-10 Wonder Warthog.

    A-10 – – -> https://en.wikipedia.org/wiki/Fairchild_Republic_A-10_Thunderbolt_II

    Wonder Warthog – – – >https://images.search.yahoo.com/search/images;_ylt=AwrBT_34J3lYvhMAgn9XNyoA;_ylu=X3oDMTEyNGJsOGU5BGNvbG8DYmYxBHBvcwMxBHZ0aWQDQjMxMTNfMQRzZWMDc2M-?p=Wonder+Wart-hog&fr=sfp

  26. BlizzardOfOz

    @Nancy,

    I agree on Bush/Cheney. There’s a quality to the past few Presidents that seems Caracalla-like: men who ascend to the throne of a global empire, and the national interest just doesn’t seem to enter their thinking. One reason I like Trump is that he hearkens back to an earlier era — you might violently disagree with his policies, but at least his patriotism is not in question.

    By the way, not all countries have a single-payer system. As I understand it Switzerland has a private system but heavily regulated (set prices, etc). Singapore has a free-market system with a single-payer system as a safety net. Australia has taxpayer-provided basic insurance, and you can pay for improved private insurance. All these systems have better outcomes than ours for less than half the cost. That’s why the D’s botching the reform is such a scandal — there were models they could have copied, but the graft was more important to them.

  27. Peter

    I’m still unable to find anything in Trump’s statement about a promise to lower retail drug prices. He addressed lowering wholesale costs paid by the government due to restrictions on bidding and he mentioned the idea of returning drug manufacturing to the US but neither of these ideas would lower retail drug prices.

  28. Well, it only took two weeks to walk back that promise. That was disappointing 🙁

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