President Biden instituted drug price controls in 2022 as a part of the Inflation Reduction Act. This legislation required pharmaceutical companies to accept fixed prices on ten drugs named by the federal government that are covered by government healthcare programs such as Medicare and Medicaid. If the drug companies didn’t accept the prices, they couldn’t sell the drugs to these programs.

This legislation by Biden has been referred to as the “Biden Pill Penalty” because its unintended consequence is to inhibit new drug research and innovation. I wrote about this in an earlier post called Biden’s Pill Penalty.

Now, President Trump is addressing concerns about rising drug prices with an executive order of his own. This order establishes a “most-favored nation” policy which stipulates that the federal government will only pay the same price here in the U.S. as charged by pharmaceutical companies in other “favored nations” for drugs covered by Medicare and Medicaid. In other words, he wants America to start paying the same price for drugs as other countries in Europe.

For decades, America has carried the burden of paying higher prices for drugs here than pharmaceutical companies charge in other countries. Price controls are common in Europe so drug companies make up the loss by charging Americans more.  As the economic leader in the world, America has been expected to pay more while others pay less. This means America has been subsidizing the cost of drugs in other countries.

How is this different from Biden’s Pill Penalty?

Trump is not arbitrarily setting the price of the drugs. His order simply forces the drug companies to level the playing field; charging the U.S. no more than they are charging the most expensive prices of other similar economic nations. That means the drug companies will probably have to raise prices on the other nations to avoid losing money. If they do that without a significant impact on their profits, then new drug innovation should not suffer. However, if raising prices in other nations leads to lower profits, then new drug innovation will be impacted.

Some say this is just price controls by a different method. Tevi Troy, writing in The Wall Street Journal, believes the impact of Trump’s order will be as bad as Biden’s Pill Penalty. Troy says, “Americans are understandably frustrated about high prices. But the alternative to expensive new products is a slowdown in biomedical innovation. At a time when artificial intelligence, informatics and the unlocking of the human genome could generate tremendous advances in life-changing pharmaceutical products, it’s a dangerous time to alienate the industry that brings those products to fruition.”

Perhaps he is right. Trump is understandably outraged at the way Americans have been treated by the drug companies. He said the U.S. is being “ripped off compared to the rest of the world.” This is consistent with his views of tariffs being charged by other countries for products made in America.

The question is how much more will other countries be willing to pay to purchase their drugs and will that be enough to sustain new drug research? It looks like we’re going to find out soon.

Medicaid has become the latest political football to be kicked around. The liberal media is complicit in promulgating the lie that Republicans are out to take Medicaid away from poor people with starving babies. These scare tactics obfuscate the truth, which is exactly what Democrats want to achieve.

They are responsible for expanding Medicaid far beyond its original intention and even farther beyond what Congress approved when the Democrats passed the Affordable Care Act (ObamaCare) in 2010. I have written about this in recent posts including Medicaid Costs Out of Control – Parts I, II, and III.

It’s time to reform Medicaid to rein in the spending which has driven the cost of Medicaid to nearly $900 Billion, outpacing even defense spending. But reforming Medicaid will not be for the timid. It will require determination and a willingness to fight back against the lies that will be told and the fake atrocities that will be prophesied.

Paul Winfree and Brian Blasé, writing in The Wall Street Journal, tell us there’s a lot at stake. They say, “Congress has an opportunity to reform Medicaid, the nation’s third-largest, and most flawed, entitlement program. Done right, reform could protect the vulnerable, promote private coverage and save hundreds of billions of dollars. Done wrong, it won’t reduce federal spending and will hurt Republicans at the ballot box by making more voters dependent on government welfare.”

They tell us Medicaid’s financing is fundamentally broken. Because of ObamaCare, the federal government pays $9 for every $1 of state spending on able-bodied working-age adults, compared with roughly $1.33 for pregnant women and disabled children. That incentive pushes states to favor healthy adults over the vulnerable in enrollment and access to providers and better services.

States also use mechanisms such as the Medicaid provider tax to distort federal-state fiscal responsibility. States tax hospitals and insurers, then use that revenue to increase Medicaid payments back to the same entities. These inflated payments trigger higher federal matching funds. The result: States recycle money through the system and extract substantial federal money with little real state contribution.

Medicaid isn’t merely a federal health program. It’s also a political machine. Studies show Medicaid enrollment boosts voter turnout, especially in Democratic areas. Enrolling in Medicaid traps recipients in a welfare program, links them to nonprofits offering voter registration, and places them squarely in the sights of campaigns’ get-out-the-vote efforts. Leftists are so reliant on welfare spending for electoral success that they oppose policies that lift people out of poverty. Expanding Medicaid using federal funds—even to noncitizens through creative financing—can have significant political consequences that Republicans shouldn’t underestimate.

The authors say Congressional Republicans should tackle the core reasons for Medicaid’s growth. They should start by eliminating Medicaid’s discrimination against the most vulnerable and lowering ObamaCare’s 90% reimbursement rate for able-bodied adults. Then they should follow Joe Biden’s advice and eliminate the Medicaid provider-tax scam. These reforms would generate significant savings that could be redirected to vulnerable patients or rural providers.

They say if Congress doesn’t enact these structural reforms, the Medicaid-industrial complex will collude with the states for richer payments funded through higher debt, inflation and taxes. In some states, Medicaid payments to hospitals now approach or exceed twice the Medicare rate, which could threaten seniors’ care. And without reform, states will continue to prioritize healthy working-age adults ahead of children and the disabled. Meanwhile, Republicans will have missed an opportunity to restore Medicaid’s core mission: providing a safety net for the vulnerable, not corporate welfare for the healthcare industry.

The authors say, “Republicans who ran on reining in Washington’s excesses and defending the needy shouldn’t preserve Medicaid’s financing inequities and money-laundering schemes. Fix the incentives now or watch federal spending—and Democratic turnout—soar on the back of a program conservatives failed to reform when they had the chance.”

This explains why Democrats are howling so much about any proposed cuts to Medicaid spending. They’re not worried about the poor needing healthcare as much as they are worried about the impact on Democratic voter turnout.

According to the National Assessment of Educational Progress (NAEP), the 2024 Report Card says only 30% of eighth grade students performed at or above NAEP Proficient standards. This reflected little change form 2022, but was lower compared to 2019. You may be familiar with these numbers since they have been reported widely in the media. They reflect the growing concern with our educational system.

But what may be news to you is many of these same deficient readers are getting into college! Patrick Keeney, PhD, tells us about this in an article published in The Epoch Times. Keeney refers to an essay called “The Average College Student is Illiterate” by Hilarius Bookbinder.

Here’s what Keeney has to say: “It is a sobering account. Bookbinder (a pseudonym) teaches in the humanities and draws upon years of classroom experience. He observes that many of his students are functionally illiterate in that they are unable to engage with serious adult literature, and often find the very act of reading tedious. As a result, they avoid it whenever possible. This aversion manifests in predictable ways: skimming texts without comprehension, failing to identify key arguments, and struggling with exam questions simply because they haven’t read them carefully.”

Keeney goes on to say his reflections provide a sobering glimpse into the current state of liberal learning and the formidable challenge educators face in fostering genuine intellectual engagement. Bookbinder places the blame squarely on society. “I don’t blame K–12 teachers,” he writes. “This is not an educational system problem. This is a societal problem.”

Keeney thinks this overlooks the significant failures within the K-12 system itself – failures that have deprioritized foundational literacy, neglected intellectual rigor, and left student unprepared for the demands of higher education.

Over the past several decades, elementary and secondary schools have increasingly adopted a pedagogical model that prioritizes technological fluency and emotional well-being over the development of serious intellectual habits. As one parent noted in response to Bookbinder’s piece, children are now “pushed into technology (computers, iPads) as early as kindergarten” and “are not required to read entire books, let alone write about them.”

Keeney says, “But this is not merely an educational failure. It is a moral one. Literacy is not simply a technical skill—it is a form of ethical and intellectual development. It requires cultivating patience, empathy, and sound judgment. It demands that we sit still and listen attentively to the minds and voices of others. If students cannot do this, then we are not educating them. At best, we are merely credentialing them.”

Reading has played a critical role in my life and continues to do so. Good reading skills were crucial to my success in graduating from college and medical school and no amount of technical skills with a computer could have replaced them. Though I use a computer every day in my life now, I also continue to read voraciously, averaging three or more books per month for the last 25 years!

It has been suggested by some that medical students today need not learn the foundational facts of our profession but only need to know how to find those facts on their computers or cell phones as needed. Please! I hope that when I find myself in the emergency room fighting for my life, the E.R. doctor isn’t spending time on his or her computer trying to figure out how to save me!

Reading is essential to a successful life and it’s about time our educational system figured out how to get back to the basics – reading, writing, and arithmetic.