Anybody else notice this latest Trump policy flip flop?
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Today's NYTimes reports Trump's intention to impose tariffs on meds manufactured overseas (almost all of them, considering they're mostly manufactured - piecemeal - in several countries apiece).
As someone who takes a fair number of prescriptions (the most expensive ones being ordered from Canada), that made my heart sink.
But, hey! What IS going on? Does anyone besides me remember his announcing not long ago that he was going to sock it to Big Pharma for charging Americans multiples of the prices other countries charge for the same medications? (Why? Because other countries are able to put pressure on American companies by forced negotiations, so their citizens can get them at a mere fraction of what we pay). Old news, but fabulous that Trump was finally going to make it right.
I cheered (even my sons sent me happy "about time" messages) - and indeed it would have been. (I guess everyone knows how we're gouged in med prices, rationalized as needed to pay for R&D because our insurance companies aren't allowed to negotiate price so patients everywhere would divide that expense. (Except - for some reason - MEDICAID is allowed to negotiate.).
It's been a scandal forever and a day.Or did I hallucinate that whole make-it-right pronouncement??
Because it doesn't jibe with this newest announcement about imposing tariffs on medications coming from overseas. Or can both policies somehow go together?
I guess it's laughable to question Trump's flip flopping on an issue, but it really DID seem that (for once) a policy change benefiting consumers fit in with his "America First" dogma.
Anybody else notice this and have comments?
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You’re not hallucinating. I actually freaked out about the news you were excited about. (And if anyone thinks they take a lot of medications, hold my beer…)
I agree of course that the imbalance whereby we subsidize drug development and the rest of the world pays something related to marginal cost is unfair and unsustainable. But like any large international imbalance it needs to be fixed very deliberately over time and would involve negotiations with other first world countries (most of us wouldn’t have an issue with very poor countries continuing to pay marginal cost I assume).
Anyway, ‘deliberate’, ‘negotiations with allies’, and ‘over time’ are not in Trump’s vocabulary so it would have been a shit show and therapeutic development would have been the immediate casualty.
If you want to make sense out of the two policies they are consistent from Trump’s viewpoint that the US gets ‘ripped off’ in international trade. He sees imports as us getting taken, and (far more rationally) sees us paying 5x what Europe pays for pharmaceuticals as us getting taken. It’s not really about lowering prices per se.
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@ Daniel
"It's complicated". Has to do with it's being a state's issue, with many separate arrangements which amount to significantly lower medication prices through Medicaid.
However, you're right strictly speaking. Those mechanisms aren't negotiations per se on a broad federal level.
(quote from Perplexity)
WHAT?
I can't cut and paste it - must be some kind of copyright limitation.Here's a link.
https://www.perplexity.ai/search/can-medicaid-negotiate-medicat-6pPD5c4dTwyxm6MOW4aaFg -
@ Daniel
"It's complicated". Has to do with it's being a state's issue, with many separate arrangements which amount to significantly lower medication prices through Medicaid.
However, you're right strictly speaking. Those mechanisms aren't negotiations per se on a broad federal level.
(quote from Perplexity)
WHAT?
I can't cut and paste it - must be some kind of copyright limitation.Here's a link.
https://www.perplexity.ai/search/can-medicaid-negotiate-medicat-6pPD5c4dTwyxm6MOW4aaFg@Amanda said in Anybody else notice this latest Trump policy flip flop?:
WHAT?
I can't cut and paste it - must be some kind of copyright limitation.
Here's a link.
https://www.perplexity.ai/search/can-medicaid-negotiate-medicat-6pPD5c4dTwyxm6MOW4aaFgWhen I click on the link, itomes up with a message of "This Thread is Private Sign in if you are the owner of this thread, or to request access"
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@Amanda Well, it's a joint Federal/ States program. The states actually run it by subcontracting it to private insurance companies (classic neoliberalism).
It has been my understanding that Medicare and Medicaid, are under the same bureaucratic Federal umbrella (there's a name for that agency).
Any negotiation on price is truly piecemeal and kind of a joke compared to what real negotiation across the board would be.
Florida's Medicaid program pays 100% retail for drugs, but only offers generic, and denies authorization for some (many?) drugs.
The elephant (sic) in the room is that drug companies were exempted from Federal anti-trust law in the '40's and nothing has been done about it.
There are huge disadvantages to Medicaid in Florida. PCPs have a heavy disincentive to make specialist recommendations. You'd practically have to fall down in front of a PCP and break an arm or a leg to get one.
Florida pays for Medicaid prescriptions on the assumption that almost all Medicaid receipts have literally no money.
Of course, we'll have to see, if we live long enough, what effects Trump cutting almost $1 trillion from Medicare, Medicaid, and the ACA will have in the immediate and long term.
I think it's a two party set up (I'm cynical that way) but I confess Trump II has been a wrecking ball the likes of which I did not predict.
