Letters from an American - August 15, 2024

Episode Date: August 16, 2024

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August 15, 2024. In 2021, a study by the RAND Corporation found that drug prices averaged 2.56 times higher in the U.S. than in 32 other countries. For brand name drugs, U.S. prices were 3.44 times those in comparable nations. Almost exactly two years ago, on August 16, 2022, President Joe Biden signed the Inflation Reduction Act into law. Among other things, that law permitted Medicare to negotiate drug prices, a provision about 83% of voters supported. Republicans opposed the measure, siding with drug company executives who insist that high prices are necessary to create an incentive for drug companies to innovate, as their investment in research and development depends on the revenue they expect from new drugs. Ultimately, not a single Republican voted for

the Inflation Reduction Act itself, and Vice President Kamala Harris cast the tie-breaking vote that gave the act the votes to go to the president's desk. About a year later, on August 29, 2023, the government announced the first 10 drugs over whose prices it would negotiate on behalf of about 65 million Medicare recipients. The 10 drugs are among those with the highest total spending in Medicare Part D, which is the Medicare plan that covers drugs administered at home. The original plan for Medicare and Medicaid in 1965 covered drugs administered in health care settings, but it was not until 2003, after almost 40 years of medical innovation had significantly changed our management of chronic illnesses, that Congress included those drugs someone takes at home. At the time, to get Republicans behind the bill, Congress explicitly prohibited the government from

negotiating the prices of medications. Today, the Biden-Harris administration announced it has reached agreements with pharmaceutical companies for those 10 drugs. The new prices offer discounts of from 38% to 79% off list prices. The new prices would have saved the government an estimated $6 billion last year if they had been in effect. About 9 million people take those drugs and will save about $1.5 billion out of pocket after the new prices go into effect on January 1, 2026. The Centers for Medicare and Medicaid Services expects to select the next 15 drugs for negotiation by February 1, 2025, although Trump and the Republicans have vowed to repeal the Inflation Reduction Act, conferring on the government the ability to negotiate drug prices.

So a Trump-Vance victory would presumably change that plan. Speaking together in Maryland today for the first time since Biden announced he would not accept the Democratic nomination for president and instead endorsed Vice President Harris, Biden and Harris praised the drug negotiations and each other. We're in a weird moment in which the press seems to be demanding detailed policy positions from Vice President Harris as she tries to win the presidency in 2024, while putting little comparable pressure on former President Donald Trump, who is the Republican presidential nominee. Yesterday, the Bureau of Labor Statistics reported that inflation had fallen below 3% for the past year, reported that inflation had fallen below 3% for the past year,

while economic growth continues strong and unemployment is low, putting us in what some call a Goldilocks economy, neither too hot nor too cold. Today, news broke that retail sales were up 1%, higher than expected, and the stock market rallied, with the Dow Jones Industrial Average ending the day over 40,000. There is every reason to think that a Harris presidency will continue the policies that put the U.S. in such an enviable position. Nonetheless, a reporter today asked President Biden, how much does it bother you that Vice President Harris might soon,

for political reasons, start to distance herself from your economic plan? Biden responded, she's not going to. Another asked, will Bidenomics continue under Vice President Harris? The president responded, it doesn't matter what the hell you call it, the economy is going to continue. With all the legislation we passed, it's working. In case you haven't noticed, it's working. In contrast, Trump has been unable to articulate any actual policies for an economic program. After yesterday's planned economic speech became a rant, he called reporters to his property in Bedminster, New Jersey today for what was billed as a press conference about the economy. He appeared before a table with containers of coffee and breakfast cereal,

but the reason for those props never became clear. He began the event by reading from a script that rehashed the greatest hits of the 1950s, saying, Kamala Harris is a radical California liberal who broke the economy, broke the border, and broke the world, frankly. He claimed that Harris has a very strong communist lean and is in favor of the death of the American dream. He predicted a stock market crash like that of 1929 and warned that you're all going to be thrown into a communist system where everybody gets health care. As he spoke on the Fox News channel, a stock ticker in the corner of the screen showed the stock market over 40,563.

Trump spoke nonstop for an hour, essentially garnering free press coverage by advertising that he would take questions before taking questions for another hour during which he said of his strategy, all we have to do is define our opponent as being a communist or a socialist or somebody that's going to destroy our country. He never got around to talking about the coffee and breakfast cereal.

CNN fact checker Daniel Dale called it a whole bunch of nonsense. In Pittsburgh, Pennsylvania, earlier today, Republican vice presidential candidate Senator J.D. Vance, a Republican of Ohio, said, we actually have the plans, we have the policies to accomplish this stuff. That's a big thing that sets us apart from Kamala Harris and Tim Walz. In fact, the Republican Party platform lists things like, in all caps, end inflation and make America affordable again. But Trump's promises to deport more than 10 million migrants and to put a tariff wall around the country are both highly inflationary measures. Sixteen economists, who have won Nobel Prizes, said in June that Trump's policies would fuel inflation. They lauded the Biden-Harris administration's policies and wrote,

They lauded the Biden-Harris administration's policies and wrote, To the degree there is an actual set of policies in place on the Republican side, more evidence appeared today to suggest those policies are those set by the 2025 project, no matter how strongly Trump has tried to distance himself from it. Two men associated with the British non-profit Center for Climate Reporting secretly video recorded one of the key authors of Project 2025, Christian nationalist Russell Vogt, director of the Office of Management and Budget under Trump and the budget director for the extremist Republican Study Committee. In the recording released today, Vogt assured the men, who he thought might donate to the cause, that he and his Center for Renewing America were secretly writing a blueprint of executive orders, memos,

and regulations that Trump could enact immediately upon taking office a second time. Vogt assured the men that Trump was only disavowing Project 2025 for political reasons. In reality, Vogt said, Trump is very supportive of what we do. Vogt also said that he does not believe the president is bound by the Posse Comitatus Act, an 1878 law that prohibits the use of federal troops for law enforcement purposes against U.S. citizens. The president has, you know, the ability both along the border and elsewhere to maintain law and order with the military, Vogt said. And that's something that, you know, it's going to be important for him to remember and his lawyers to affirm. In summer 2020, defense officials stopped Trump from mobilizing active duty troops against protesters.

from mobilizing active duty troops against protesters. Project 2025 calls for gutting the nonpartisan civil service and replacing it with people loyal to a strong president and making the Department of Justice and the Department of Defense loyal to the president. With the power concentrated in the president, the government would enforce strict Christian nationalist ideals, revoking the rights of lgbtq plus people women and immigrants and racial minorities yesterday jill lawrence of the bulwark noted that trump and his allies don't even need to enact all of project 2025

simply gutting the nonpartisan civil service and filling almost 2 million government jobs with those who are loyal to Trump, above even laws, courts, security, liberty, the general welfare, and the rest of the Constitution, would be enough to destroy the country as we know it. Think Eileen Cannon, the Trump-appointed judge who dismissed the federal case charging Trump for retaining classified documents. Or House Speaker Mike Johnson, who killed a bipartisan border security bill because Trump wanted to keep the issue of immigration open so he could campaign on it. Trump could install into official positions doctors who endorse quack health remedies or officials who nod as Trump changes the trajectory of a tropical storm

with a sharpie. Personnel is policy, Project 2025's authors say, and, if elected, Trump has vowed to have his own loyalists take over the United States government. But Americans largely oppose Project 2025 and the Trump agenda, even in its vague state. In his appearance in Maryland today, Biden mocked Trump and added, you may have heard about the MAGA Republican Project 2025 plan. They want to repeal Medicare's power to negotiate drug prices. repeal Medicare's power to negotiate drug prices. Let big pharma get back to charging whatever they want. Let me tell you what our Project 2025 is. Beat the hell out of them.

Letters from an American was produced at Soundscape Productions, Dedham, Massachusetts. Recorded with music composed by Michael Moss.