After tough talk, Trump is poised to deliver for the drug industry

Image: US President Trump leads listening session on human trafficking
President Donald J. Trump speaks during a listening session on domestic and international human trafficking in the Roosevelt Room of the White House in Washington, DC, USA, 23 February 2017. 

One of the few key areas on which Donald Trump broke with Republican Party orthodoxy was lowering prices on prescription drugs. In fact, shortly before taking office, he complained bitterly about the pharmaceutical industry's powerful lobbyists, and said drug companies are "getting away with murder."

For some on the left, this offered at least some hope that the Trump administration would be progressive on the issue, though those hopes faded soon after the president took office. In late January, Trump reversed course, saying he no longer wanted to use the government's buying power to lower costs, denouncing such a policy as "price fixing."

Vox explained at the time that the White House's approach appeared to amount to little more than "lowering taxes" and "getting rid of regulations."

That turned out to be exactly right. Five months later, the New York Times reports on a draft of an executive order the president intends to sign on drug prices that "appears to give the pharmaceutical industry much of what it has asked for."

The draft, which The New York Times obtained on Tuesday, is light on specifics but clear on philosophy: Easing regulatory hurdles for the drug industry is the best way to get prices down.The proposals identify some issues that have stoked public outrage -- such as the high out-of-pocket costs for medicines -- but it largely leaves the drug industry unscathed. In fact, the four-page document contains several proposals that have long been championed by the industry, including strengthening drugmakers' monopoly power overseas and scaling back a federal program that requires pharmaceutical companies to give discounts to hospitals and clinics that serve low-income patients.

This is entirely in line with a Politico report from last week, which said Trump's approach to drug prices would be "industry friendly," and the White House does not intend to push the idea of using federal leverage to negotiate lower prices -- which is what the president vowed to do before he was elected.

Before you ask me why I'd be surprised by any of this, I'm not. But sometimes, developments can be predictable and disheartening at the same time.

Indeed, the salient question is no longer whether Trump is ignoring his health care promises, but rather, just how many promises he's choosing to break. He promised to create a system that covers "everybody"; he swore he wouldn't cut Medicaid; he vowed to lower deductibles; he "guaranteed" protections for Americans with pre-existing conditions; he said he'd lower the cost of prescription drugs; and on and on.

The president played those who trusted his promises for fools.