Trump’s bitter pill

Of all of Donald Trump’s applause lines on the campaign trail, one stood out for its striking common sense: Give senior citizens a break by bargaining down the price of prescription drugs using the massive purchasing power of the federal government’s $700 billion Medicare insurance program.

Here was the man who promised to un-rig the economy demonstrating how the art of the deal could help ordinary Americans, and, bonus, flying in the face of overly rigid conservative Republican free-market orthodoxy.

The U.S. could “save $300 billion a year,” he told a MSNBC town hall. (Far more than the government spends on drugs, but OK.) Making it happen was “one of my greatest priorities.” Since Medicare limits drug benefits, seniors would see out-of-pocket savings, too.

File this one with the border wall Mexico is going to pay for any day now, because boy did Trump deliver a different bottle of goods Friday.

With fanfare in the Rose Garden, Trump and Health and Human Services Secretary Alex Azar announced they would, get this, press to raise prices for prescription drugs in many countries that do more or less what Trump had said he would do for ours: wield the brawn of their government health insurance programs to drive down prescription drug prices.

The concept for prescription-drug savings Trump once promised as America’s rescue from queasily high pharmaceutical prices he now condemns as “global freeloading”: “It’s unfair, it’s ridiculous, and it’s not going to happen any longer.”

And, promising on a drug reaction that economists think is highly unlikely to materialize, the President swears that pushing other nations to lift their price caps will someday, somehow, spur drugmakers to lower exorbitant prices in the U.S.

If you felt a rumble Friday, it was the laughter of Big Pharma raking in big gains on Wall Street.

Trump also targets middlemen, known as pharmacy benefit managers, who negotiate lower drug prices for insurers and keep a cut for themselves, and related rebates that may have the unintended effect of raising list prices on drugs.

Since those are already savings schemes, it’s hard to see how altering them will wring massive new savings.

So how about those savings for seniors? Vague proposals to make it easier for private health insurers who work with Medicare to more easily bargain with drug-makers could bear fruit, but nothing like the bounty of savings Trump promised from the stump.

Did we mention that drug maker Novartis paid Trump’s personal lawyer, Michael Cohen, $1.2 million to help navigate the administration?

Thursday, CEO Vasant Narasimham told employees “we made a mistake” in inking the Cohen contract.

After Trump’s announcement Friday, he might want to rethink that assessment.