The crisis of confidence in the pharmaceutical industry remains one of the least well-reported elements of contemporary politics. And despite numerous scandals surrounding mismanagement and price gouging by Pharma companies, the proverbial big Kahuna of the industry’s scandals is undoubtedly the developing Opioid crisis. As documented in a recent story from the Washington Post, Pharma paid doctors more than $46 million as an incentive to push painkillers between 2013 and 2015, a scandalous push that arguably gave birth to the crisis as it presently stands. At least one state has already sued a pharmaceutical company over this, and more political remedies are likely to come down the pike. President Trump himself has vowed to tackle the crisis, and it appears that he is likely to declare a state of emergency over it.
The President deserves a great deal of credit for that, as far as it goes. But declaring a state of emergency only goes so far. It is imperative that the White House not follow the script that it seemed to be leaning toward before Trump’s “emergency” comments. Indeed, its initial approach seemed to let the pharmaceutical industry completely off the hook. Unlike even other Republicans, such as Ohio Attorney General Mike DeWine, who courageously pushed the ball into pharma’s court, so far Trump’s advisers seem to be advising solely that the President crack down on illegal purchases of drugs, rather than legal but unethical approaches to getting people hooked on them in the first place. This approach likely was not imagined by the President himself, who has previously shown no qualms about attacking pharmaceutical companies, but instead by members of his administration brought in to turn the Trump White House into a bastion of the policy preferences of Conservatism, Inc.
Not only does the reflexively pro-business, Conservatism, Inc.-favored approach utterly fail to respond to the needs of President Trump’s base, but it sometimes ends up being more pro-Pharma than even Pharma wants, as in the case of the proposed changes to the 340B drug pricing program issued by the Centers for Medicare & Medicaid Services (CMS). But even more worrisome than this is the fact that it’s not clear that Conservatism, Inc. has a good answer to how to solve the opioid crisis at all. For example, a Heritage Foundation article on the crisis offers little in the way of solutions other than cutting money for drug treatment programs, vague hints about prevention, and, of course, increasing the enforcement of the war on drugs. These range from tone deaf (cutting funding) to actively counterproductive (the War on Drugs has been a failure for decades). There is no acknowledgement of the elephant in the room — namely, the already established role that pharmaceutical companies played in getting people addicted to the opioids in the first place.
Moreover, it is easy to see why standard conservative dogma would militate against acknowledging such facts: because they cut against the lobbyist-driven view on the Right that all business is good business, and because they are easily appropriated to form a case for regulation. The same ideological paralysis prevailed in response to the financial crisis of 2008.
As that crisis showed, however, what this kind of shut-your-eyes-and-it’ll-go-away mindset produces is a monopoly by progressives on solutions for a genuine crisis, which in turns drives the terms of debate over such issues intrinsically Leftward. Surely it is better for conservatives to acknowledge the need for action and produce the least intrusive regulatory or legal remedies possible than it is for them to let progressives pick up the bloody shirt of the victims of opioid abuse. Moreover, even President Trump acknowledged that for every two regulations his administration repudiates, one new one could theoretically be appropriate. The actual ratio under the Trump administration is more like 16 repealed for every one passed. That leaves plenty of room for action in response to this issue, even by the 2-for-1 standard. At the very least, conservatives could rein in the massive amounts of corporate welfare the government grants Pharma, thus eliminating Washington’s complicity with such noxious programs. Particularly when you consider that without such action, the very people who voted for Trump will likely become even less inclined to trust that conservatives have answers to their problems.
However, so long as the capture of Trump’s White House by reflexively pro-Pharma forces remains in effect, such answers are not likely to be forthcoming. After all, those very forces made sure that the problem was allowed to exist in the first place. The President knows better, and one hopes he will rein in the members of his staff who have subjected the very real concerns of his base to the outmoded litmus tests of Conservatism, Inc. If not, progressivism is likely to continue to profit just as unjustly from the pain caused by this crisis as the pharmaceutical companies did from the suffering patients on whom they pushed painkillers.
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