People in the United States pay the highest drug prices in the world. By far. But for many this situation seems to be totally normal and we’re just resigned to it. There are cracks in the windows of this perception with some people, myself included. Having had to purchase an expensive drug for asthma while in South Africa only to be gobsmacked by the fact that it was less than one tenth the American price, and from the same drug company, is one such crack. It begs the question: Why is it legal to literally steal money from customers with excessive profits—especially when this price gouging really amounts to extortion?

Lobbyists Made It Legal

Pharma lobbyists have flooded both sides of the political aisle with money and direct influence on legislation. As we are seeing today with Congress on the cusp of passing an infrastructure bill that would include a restoration of the right for Medicare to negotiate drug prices, a pharma influenced Senator is standing as a roadblock. But that is just today.

What created this problem? One key factor is the Medicare Modernization Act of 2003, signed into law by George W. Bush. This “modernization” of Medicare included the now infamous Part D drug “benefit.” A poison pill clause was slipped into this bill that prevented Medicare from wielding its massive negotiating power on behalf of 60 million people. The power to negotiate drug prices was assigned to Pharma Benefit Managers or PBMs. These are private, for-profit, companies that are supposed to negotiate prices on behalf of consumers.

Who are the PBMs? The top three are: CVS, Express Scripts (Cigna) and OptumRX (United Health). Can you say, “Conflict of interest?”

Remember always that these are for-profit companies. That means that their primary concern, making money for their shareholders, is in direct conflict with their purported job of negotiating better prices for consumers. And in a monumental, class-by-itself, grandstand of double dealing, the biggest PBM is CVS which is also a national pharmacy chain.

I wrote in another short piece some time back about getting an antibiotic prescription filled. CVS offered a “discounted” price of $125 for 7 pills of a generic antibiotic, Levequin. I ended up getting it for $21 from a small neighborhood pharmacy. And those folks made a profit. Multiply the massive excess profit CVS was trying to gouge on that one transaction by a million or so and you get the idea of the river of money being generated in this so-called middleman negotiating position.

That bottom line is the transfer of Medicare’s negotiating power to private interests was never in the public’s interest. This was foisted on us by lobbyists. Of course this was sold with the overused idea that “government is just not as efficient a private companies.” This is a constant chant from special interests that want to take over what they see as massively profitable sectors. “Why should the government do for free what we can make money on?” is the actual thought.

The result is the unrestrained greed of the American pharma cartels which has given us $600 EpiPens, $700 per month insulin prices, $54,000 Hep C treatments and the like.

The Vacuum Hose in the Cookie Jar

The pharma industry is by far the largest spender on lobbying both houses of Congress and on both sides of the aisle. And they have been very successful. The move to take Medicare’s job and give it to for-profit companies was a stroke of greed-genius that would have made Gordon Gecko giddy with pride. This gave these companies the ability to siphon money out of the pockets of literally any American in need of drugs to maintain or even save their lives.

The truly evil part of this situation is that there is no check or balance to how far these companies can go with their price gouging. Drug addicts hooked on opiates will commit all manner of crimes to get money for another dose to keep from feeling sick. What about the patients who are only addicted to staying alive? What will they do? To what lengths will they go to pay for their insulin? “Your Money or Your Life” is how this article starts and we are still there.

The $3.5 trillion infrastructure bill is being fought tooth and nail by vested interests in the Senate. (Let’s clarify that. Being fought by all Republicans and two corrupt Democrats, one of whom, Kyrsten Sinema, is a happy recipient of pharma lobby money.) Included in this bill is a restoration of the right to negotiate drug prices by Medicare. Everyone who has ever had to fill a prescription has a personal interest in seeing this make it through the gauntlet of lobbying hatchet men. Lives actually depend on it.

We need to prevail upon the elected officials involved that their Oath of Office binds them to honor their commitment to representation of their constituents, not the lobbyists that leave slug trails of money in their offices.