A Government for the People
President Trump closed out July by sending a letter to each of the CEOs of 17 major US Pharmaceutical companies as a follow up to his May 12 Executive order requiring that Americans are charged no more for drugs than the prices enjoyed by other developed nations. Americans are paying up to 3 times more than other nations for identical medicines and Trump made his position clear. “This unacceptable burden on hardworking American families ends with my Administration”.
Trump speaks with a clarity business leaders and others are unaccustomed to. Pharmaceutical executives have not had to contend with a President or Legislators who are working for the people in recent memory and Trump is undoubtedly a shock to their system. The pharmaceutical industry is number one in money spent lobbying elected officials and they have reaped the rewards. Open Secrets, a research and government transparency group that tracks money in politics and its effect on elections and policy, reported the pharmaceutical industry spent $388 million lobbying in 2024 with 55% of their lobbyists former government employees, hard evidence of the dirty revolving door of influence peddling that is a staple in our system of governance. According to Investopedia, a website that provides financial education and information focused on investing, the pharmaceutical industry spent $6.3 billion on lobbying between 1998 and mid-2025.
Trump gave the executives 60 days, until September 29 to implement what he calls Most Favored Nation (MFN) status by reducing drug prices to the lowest rates they sell to any developed nation for Medicaid and Medicare enrollees. Trump explained the need for this follow up letter. Since his Executive Order most of what he has heard from the industry executives has been blame shifting and requests for policy changes that would give billions in handouts to the industry. Trump made it clear the only response he will accept is relief for Americans and an end to the “free riding on American innovation” by other countries. (One of the excuses offered for the American pricing is the cost of research and innovation. Trump has taken the stand that other countries must share this cost just as they share its benefits). Showing no sympathy for this argument, Trump told the CEOs they are going to have to “negotiate harder with foreign freeloading nations” and further made it clear that any increased revenue from abroad must go to lowering prices for Americans. If this sounds harsh to anyone’s ears, make note of the fact that in the first 3 months of 2024 15 of the biggest pharmaceutical companies had $173 billion in revenue and 29 billion in net profit. Pharmaceutical companies are far more profitable than other industries and their CEO compensation is often between $20 and $30 million a year.
Specifically, Trump is demanding MFN status to Medicaid immediately and MFN status for newly launched drugs to Medicaid, Medicare and commercial payers at the time of the launch and going forward. Trump closed his letter with no ambiguity: “Make no mistake…if you refuse to step up we will deploy every tool in our arsenal to protect American families from continued abusive drug pricing practices”. “I look forward to your binding commitments to each of these goals by September 29”.
The first day of August brought more good news about the work the Trump Administration is doing on behalf of the American people. Frank Bisignano, Commissioner of the Social Security Administration (SSA), described his work as advancing Trump’s promise to protect and preserve Social Security for generations to come. Underscoring the fact that Social Security insolvency looming within 10 years will require long term solutions from Congress, he emphasized the work of his Agency in the short term is to change the paradigm that allowed for $18 billion in improper payments in recent years. His is a “control agenda” to eliminate waste, fraud and abuse and improve service. Bisignano is transforming the Agency by bringing in engineers from other industries and deploying state of the art technology. There are 300 million active social security cards which he stresses can be sources of identity theft and other fraudulent schemes that go far beyond improper payments from Social Security. There are many ways to traffic in stolen social security numbers. Locking down the rolls has strengthened the control environment.
Though Bisignano has been on the job less than 90 days, he hit the ground running with meaningful change. Prior to his arrival, the SSA website was down by design for 29 hours every week prior. That number is now zero. He made it clear that agency service hours must be 24/7. He is laser focused on a client first mindset throughout the Agency and is in a field office or regional office every week to emphasize the point that the employees of the SSA are “here to serve”. With 1.2 million transactions over the web every day, Bisignano knows he has a lot of work to do. Wait times for service have already been decreased from an average of 30 minutes to 5 minutes.
Another Commissioner, Marty Makary, who is running the Food and Drug Administration (FDA) was also out on the first day of August talking about some of his team’s priorities. They are in the process of removing toxic synthetic, petroleum-based food dyes from foods and replacing them with natural dyes. The push to replace ultra-processed foods with whole foods is in full swing and Makary says the major food companies are cooperating. Commissioner Makary calls the “Food Pyramid” “one of the greatest sources of misinformation in the history of health” and it came from the government.
Though eradicating conflicts of interest between the pharmaceutical industry and the FDA regulators is a priority of Secretary of Health and Human Services Bobby Kennedy and the Commissioner, Makary has an aggressive and optimistic plan of cooperation for the future. While adhering strictly to the best available science will be central to decision making, simultaneously addressing the obstacles in the system will also become a priority. It is not unusual to take more than 10 years for a new drug to come to market. Makary has his sights set on more cures and meaningful treatments to market within months by cutting red tape and creating new pathways, maintaining necessary rigor without unnecessary bureaucracy. He expects to work with the drug developers as partners, not adversaries.
These updates were shared with the public over the course of 3 days and are a tiny snapshot of the extensive work being done on behalf of the American people. The focus of this Administration is making real improvements in the lives of every American and the White House has to work very hard to get the word out. If members of the corrupt media have their way, the public will rarely hear about encouraging developments like these from their reporting. They are hellbent on seeing Trump fail and as they pursue this agenda with great determination, they drive themselves deeper into irrelevance.
Donald Trump has assembled an administrative team unlike anything we have seen. They are highly skilled, many political outsiders, fully aligned with the promises he made to the American people and undeterred by the obstacles thrown in their way every step of the way. Members of the old guard should fear them. Anyone who underestimates their ability to deliver, despite the evidence of a few short months, is a fool.
This is the America First agenda. This is the meaning of government for the people.