On Monday, President Donald J. Trump flew into Mankato Airport for a rally. In attendance were some of Minnesota’s most fiscally-minded Republicans – like Tom Emmer who repeatedly votes against most spending bills complaining of the cost to taxpayers. The president’s visit to Mankato included an advance team that reportedly was 70 strong including a large transport plane which arrived at Mankato airport on Friday with motorcade vehicles for the presidential visit, even though he was just a “fly in and fly out” … plus the City of Mankato is looking at a $50,000 bill for its law enforcement personnel.
The Trump speech was genius level in terms of appealing to voters fears but balanced by revelations of how good things are and will be only better in Trump’s second, third or fourth term (yep, you had to hear him mention his willingness to serve again and again and again.) Trump praised himself as an environmentalist for signing The Great America Outdoor Act (hmm, somebody should ask Jim Hagedorn and Tom Emmer why they voted NO.) Dairy operations heard that they should be prepared for a 50% increase in shipments to Canada and miners learned that wages have increased up to 50%. And warnings of the evils that “Sleepy Joe” would cause … but not if we re-elected the man who received “Michigan’s Man of the Year” long before he was President.
There were a lot of statements that were made that … let’s be kind and just say “misleading” but one area of his speech will not get enough attention — prescription drug pricing.
According to Trump, his Executive Orders regarding “favored-nation” clause for drugs sold to the U.S. government; granting exemptions to States to allow importation of drugs from Canada; and addressing rebates that drug manufacturers give to pharmacy benefit managers … all to make the issue another “Mission Accomplished” from his 2016 campaign promise to bring pharmaceutical companies under control.
Invoking the “favored nation” clause would essentially secure the lowest possible prices on the market—or so he says. Of course, when you read the Executive Order one key thing missing is a start date … Trump actually asked the industry to propose an alternate system to the international pricing index (IPI).
To no one’s surprise, the industry is balking.
The industry’s largest lobbying group, the Pharmaceutical Research and Manufacturers of America issued a statement saying the group is “steadfastly opposed to policies that would allow foreign governments to set prices for medicines in the United States.“
Pfizer’s Albert Bourla said Trump’s Executive Order “pose enormous distraction” to the biopharma industry as it fights COVID-19. “We have plans to invest in both R&D and manufacturing in the United States,” Bourla said. “If finalized, these new executive orders could force us to rethink those plans, consider job reductions and add to the economic and health anxiety already widely felt in our country.” Gosh, looks like somebody is taking a lesson from the Medical Device industry.
Sanofi CEO Paul Hudson said he’s “not expecting any impact from these conversations this year” and that the IPI is a “very convenient subject matter” right before the election.
The use of importing drugs from Canada is not new … something that Minnesota’s First District constituents have heard about for over a decade … anyone else remember the unlikely duo of Gil Gutknect and Rahm Emanuel fighting the Bush Administration on this ? For that matter, there is a bill pending in Congress H.R. 478 Safe and Affordable Drugs from Canada Act of 2019 — which is sponsored by Angie Craig but not Jim Hagedorn, Tom Emmer or Pete Stauber. (Side note – neither Jason Lewis or Tom Emmer sponsored the 2017 proposal.)
What Trump has done is to allow some States, after getting legislative approval, an exemption to import drugs from Canada … he mentioned Florida which he granted the exemption in July … but it is expected to take several months, at least, before consumers would see less expensive medications. The order must be carried out by the federal bureaucracy and could face court challenges and the Pharmaceutical Research and Manufacturers of America called the Florida plan a “reckless policy” that could have a “devastating impact on patient safety” by introducing counterfeit drugs into the market.
OK … so those are hardly fait accompli … in fact, shouldn’t the question be asked … WHY didn’t President Trump start these actions in 2017 ?
The last major “accomplishment” that Trump boosted was his Executive Order on rebates. Sorta, funny because the Trump Administration actually proposed making changes in February 2019 but later withdrew it. Turns out that both the Congressional Budget Office and the Centers for Medicare & Medicaid Services Office of the Actuary found that it would increase federal spending “by $196 billion over the 10-year period, while average beneficiary costs and manufacturer concessions would decrease,” per the CMS actuary report. The latest Trump Executive Order instructs the HHS secretary to make sure whatever action is taken doesn’t increase federal spending, Medicare premiums or total out-of-pocket costs … good luck with that.
Which brings this discussion to First District Congressman Jim Hagedorn who has been praising Trump’s action and promoting his own idea “One pill, one price”. Ignoring that this sounds like installing socialist price controls into America’s healthcare system, the immediate concern should be is that all that Hagedorn has is an idea … he has not proposed a formal bill. Congressman Hagedorn did sponsor H.R. 19 Lower Costs, More Cures Act which would require manufacturers to provide both notification of and an explanation for list price hikes that exceed 10 percent in a single year or 25 percent within three years (Section 111). So in Hagedorn’s mind, unchecked price increases are okay as long as other countries are paying higher prices too ?
Yep, it was a massive rally (I have been to farm auctions with bigger crowds) to the fact that Donald Trump (and Jim Hagedorn) have done little during their time in office to improve the lives of Americans but maybe in the next four, eight or twelve years they might.