With drug plan, Trump tosses another nasty, disingenuous grenade into U.S.-Canada relations

OTTAWA—Blaming foreign “freeloaders” for the outrageous cost of pharmaceuticals in the United States, President Donald Trump has injected another potential irritant into his country’s vexed relations with Canada. The White House has been working on a proposal aimed at allowing American patients to import cheaper medications from outside the country, under the oversight of the U.S. Food and Drug Administration. The idea, announced in the summer, would be to allow states, wholesalers, and pharmacists to get FDA approval to import certain medications that are also available in the U.S. The overture is part of Trump’s manoeuvring in advance of the 2020 presidential election, when skyrocketing prescription drug prices may be a major issue. Aware that Americans are up in arms about these bankruptcy-inducing prices, Trump has promised to tackle the problem. But so far the administration’s actions have been limited and it’s unclear if the proposal to raid Canada’s medicine cabinet will ever be enacted. Still, the development drives home Trump’s willingness to scapegoat other countries when it comes to the U.S.’s own woes. With the usual breathtaking audacity and brazen disregard for the obvious truth, Trump proclaims that the problem is not the gouging of U.S. consumers perpetuated by big pharma—perhaps the most powerful of the many very powerful lobby groups in Washington. Instead, the issue from Trump’s viewpoint is that other countries are taking advantage of Americans by controlling pharmaceutical prices through publicly run health systems. That these systems are designed to serve the populations of countries like Canada by preventing drug companies from holding patients to ransom as they do in the privately controlled American system seems not to have registered with the U.S. president. “We’re taking aim at the global freeloading that forces American consumers to subsidize lower prices in foreign countries through higher prices in our country,” the president declared late last year. “For decades other countries have rigged the system so that American patients are charged much more—and in some cases much, much more—for the exact same drug. In other words, Americans pay more, so that other countries can pay less. Very simple. That’s exactly what it is. It’s wrong. It’s unfair. “The American middle class is effectively funding virtually all drug research and development for the entire planet. … Everybody else is benefitting. And they are paying nothing toward research and development.” As for Canada in particular, Trump has said Florida Governor Ron DeSantis told him the state could save 50 per cent on drug costs if they accessed them in Canada. “I said ‘Do it, do it,’” Trump proclaimed. Even leaving aside the untruth that no pharmaceutical research money is spent in other countries, this is Trump at his finest, encouraging Americans to feel like victims of some foreign plot rather than look at the problem that’s right in their faces—the deeply engrained and highly successful manipulation of the U.S. political machine by pharmaceutical companies for the deification of profit over any notion whatsoever of the public good. “If the U.S. was going to import anything from Canada,” University of British Columbia law professor Michael Law told a reporter, “it should import some controls over the prices of prescription drugs.” Americans’ growing interest in bringing in cheaper medications from Canada has already created concerns about shortages. Besides Florida, Maine and Vermont have passed laws to allow the imports, subject to the approval of U.S. authorities. “The Canadian medicine supply is not sufficient to support both Canadian and U.S. consumers,” health care groups said in a letter to Health Minister Ginette Petitpas Taylor several months ago. “The supply simply does not, and will not, exist within Canada to meet such demands.” Canadian officials weren’t consulted before the Trump administration floated its Buy Canadian proposal, but they say Ottawa has been in discussion with the U.S. about overall drug availability here. And Prime Minister Justin Trudeau has tried to dampen worries about the potential impact of Trump’s plan, saying Health Canada would continue to ensure that “Canadians have access to the medications they need at affordable prices.” Notwithstanding that reassurance, any extension of drug buying here by Americans beyond what is currently allowed for limited personal use would quickly turn the current drug shortage problem in Canada into an emergency. A U.S. government-facilitated run on Canadian formularies may never happen, owing to longstanding U.S. concerns about drug safety as well opposition from U.S. producers. Regardless, the whole episode is a reminder of Trump’s disdain for other countries, in particular for Canada and Canadians’ efforts to use the tools of government to ensure better socio-economic conditions for its citizens and avoid the ravages of unfettered capitalism. Whether it’s softwood lumber, bilateral procurement, steel and aluminum, or trade in general, it’s a lesson Canadians have learned all too well. Les Whittington is an Ottawa journalist and a regular contributor to The Hill Times. The Hill Times