WASHINGTON — President Donald Trump's long-promised plan to bring down drug prices, unveiled Friday, would mostly spare the pharmaceutical industry he previously accused of "getting away with murder." Instead he focuses on private competition and more openness to reduce America's prescription pain.
In Rose Garden remarks at the White House, Trump called his plan the "most sweeping action in history to lower the price of prescription drugs for the American people." But it does not include his campaign pledge to use the massive buying power of the government's Medicare program to directly negotiate lower prices for seniors.
That idea has long been supported by Democrats but is a non-starter for drugmakers and most Republicans in Congress. Democratic Rep. Lloyd Doggett of Texas dismissed Trump's plan as "a sugar-coated nothing pill."
The administration will pursue a raft of old and new measures intended to improve competition and transparency in the notoriously complex drug pricing system. But most of the measures could take months or years to implement, and none would stop drugmakers from setting sky-high initial prices.
"There are some things in this set of proposals that can move us in the direction of lower prices for some people," said David Mitchell, founder of Patients for Affordable Drugs. "At the same time, it is not clear at all how they are going to lower list prices."
Drugmakers generally can charge as much as the market will bear because the U.S. government doesn't regulate medicine prices, unlike most other developed countries.
Trump's list of 50 proposals, dubbed American Patients First, includes:
• A potential requirement for drugmakers to disclose the cost of their medicines in television advertisements.
• Banning a pharmacist "gag rule," which prevents druggists from telling customers when they can save money by paying cash instead of using their insurance.
• Speeding up the approval process for over-the-counter medications so people can buy more drugs without prescriptions.
• Reconsidering how Medicare pays for some high-priced drugs administered at doctors' offices.
Those ideas avoid a direct confrontation with the powerful pharmaceutical lobby, but they may also underwhelm Americans seeking relief from escalating prescription costs.
Democrats pounced on Trump for not pursuing direct Medicare negotiations, an idea he championed before reaching the White House.
"This weak plan abandons the millions of hard-working families struggling with the crisis of surging drug prices," said Democratic Leader Nancy Pelosi, in a statement.
Pharmaceutical investors and analysts expressed relief after the announcement, and shares of most top drugmakers rose Friday afternoon, including Pfizer, Johnson & Johnson and Eli Lilly.
"Trump had a choice today: to seek disruptive fundamental reform or to embrace more incremental steps," wrote Terry Haines, a financial analyst, in an investment note. "Trump chose the incremental over the disruptive."
Some parts of the plan were previously proposed in the president's budget proposal sent to Congress, including providing free generic drugs to low-income seniors and sharing rebates from drugmakers with Medicare patients. Other parts could be implemented directly by the administration.
A majority of Americans say passing laws to bring down prescription drug prices should be a top priority for Trump and Congress, according to recent polling by the Kaiser Family Foundation.
As a candidate, Trump railed against the pharmaceutical industry. But as president he has shied away from major changes and has staffed his administration with appointees who have deep ties to the industry. They include Health Secretary Alex Azar, a former top executive at Eli Lilly and Co., who joined Trump for Friday's announcement.
Azar and other Trump officials have hinted for weeks that the plan would, in part, "dismantle" the convoluted system of rebates between drugmakers and the health care middlemen known as pharmacy benefit managers, which negotiate price concessions for insurers, employers and other large customers.
Trump called out those companies in his speech: "Our plan will end the dishonest double-dealing that allows the middleman to pocket rebates and discounts that should be passed onto consumers and patients," Trump said.
Azar later told reporters that the administration would "seek input" on doing away with drug rebates in the Medicare system to encourage more direct discounts. He gave no timeframe for more concrete steps.
Public outrage over drug costs has been growing for years as Americans face pricing pressure from multiple sources: New medicines for life-threatening diseases often launch with prices exceeding $100,000 per year. And older drugs for common ailments like diabetes and asthma routinely see price hikes around 10 percent annually. Meanwhile Americans are paying more at the pharmacy counter due to health insurance plans that require them to shoulder more of their prescription costs.
America has the highest drug prices in the world.
The U.S. spent $1,162 per person on prescription drugs in 2015, according to the Organization for Economic Cooperation and Development. That's more than twice the $497 per person spent in the United Kingdom, which has a nationalized health care system.
More than 30,000 white balloons in all shapes and sizes filled the Delta Hotel by Marriott ballroom in South Sioux City Friday. A five-member team, led by Minneapolis-based artist and designer Carly Van Veldhuizen, arrived Thursday night to start crafting the installation for the Sioux City Art Center’s “Pop a Fundraiser.”
Volunteers assisted with blowing up the balloons, which ranged from nine inches all the way up to six-foot weather balloons. They will be illuminated with special colored lights to variously make the white balloons blue, green, yellow, orange, red and purple.
The fundraiser will be 6 to 10 p.m. Saturday.
NORTH SIOUX CITY -- Three days after a state rule change gave him a chance to compete, Freddie Linden has been picked for the Dakota Valley High School competitive girls dance team.
Linden's mother, Stephanie Linden, on Friday enthusiastically reported her son was among the members selected for the 2018-19 team following tryouts Thursday.
"He made the team!!" Stephanie Linden shared in a text message to The Journal.
As a freshman this season, he served as team manager because of a rule that forbid mixed gender teams in state-sanctioned tournaments. The family sued the South Dakota High School Activities Association to overturn the prohibition.
The SDHSAA on Tuesday voted 7-0 to allow both boys and girls to participate in the sport of competitive dance during the 2018-19 season.
SDHSAA Executive Director Dan Swartos said the change is a "fair compromise, in that it allows participation for next school year, while also directing action through the established process for rule changes that already exists."
Stephanie Linden on Tuesday said she was pleased with the rule change, saying the timing of the decision was fortunate, with Dakota Valley team tryouts happening this week.
Freddie Linden, 15, started training in a dance studio in first grade and practices about 14 hours per week. He is highly talented, as evidenced by awards he has received.
He is the only male dancer at the studio in South Dakota, while many female studio dancers from that studio are members of the Dakota Valley team.
In an April interview, Freddie Linden said he first learned he couldn't be on the Dakota Valley dance team in eighth grade, when an email went out telling girls they could sign up for the 2017-18 team. He went to the dance coach and asked, "Why does it say girls only?"
"I had to sit and watch, and play the music, as dance manager. I'd like to be the one dancing," said Freddie Linden, who will be a sophomore this fall.
SIOUX CITY -- The Sioux City School Board is scheduled to vote Monday on new contracts with all four unions representing district employees.
Board vice president Mike McTaggart said Friday he's pleased to have "challenging" negotiations with the groups now complete. McTaggart said it was hard to juggle the board's goals to keep property taxes low, avoid cutting programs and instructors while still giving employees a pay raise. That was mainly due to the state's supplemental aid to public school districts rising by just 1 percent.
"We would want to do better for employees, but we have (financial) constraints...We just don't have the money to do it," he said.
Of the four employee groups, the most contentious bargaining took place with the Sioux City Education Association, which represents more than 1,000 teachers. It was the first such talks since state lawmakers in 2017 approved a sweeping rewrite of Iowa's 40-year-old collective bargaining law. The changes limited mandatory items of negotiation to primarily base salaries for non-public safety employees.
Since Wednesday, SCEA members have been voting on a tentative three-year agreement with the district.
In a summary of the deal, a union leader said Thursday the package amounted to a 0.55 increase in pay for instructors in the next academic year. Brenda Zahner, director of the Siouxland UniServ group of the Iowa State Education Association, categorized it as the smallest single year raise for district teachers in at least 20 years, based on her research.
District leaders pushed back on that figure on Friday, pointing out it includes the elimination of $4,792 in annual pay for nearly 300 middle and high school teachers, starting next year. The extra pay was meant to compensate those teachers for covering an additional period in an eight-period schedule spread over two days.
The district proposed doing away with the so-called "6-period pay" to help close a projected budget deficit, as well as put middle and high school teachers on an equal footing with elementary instructors, who do not receive the same compensation for the normal school day.
Under the proposed contract settlement, the base salary for teachers will rise by $196 annually and longevity pay will increase by $300. Excluding the reductions in the 6-period pay, average teacher pay will rise by 2.2 percent, or $1,401, according to the district. The average annual teacher salary will go from $63,637 this year to $65,038 in 2018-19.
McTaggart said individual teachers will see pay raises between 0.94 percent and 4.2 percent, depending on factors such as their tenure and educational levels.
In its opening proposal, the SCEA called for raising base salaries to $35,564, up 3.5 percent, for 2018-19. The district countered with an opening offer of a $100 increase in base pay.
The tentative three-year contract, which would take effect July 1, includes a provision that would allow the teachers' union to renegotiate base pay after the first year.
The new collective bargaining law removed health insurance and other employee benefits from the list of mandatory items of negotiation for non-public safety employees.
McTaggart pointed out the district next year will add a new health insurance tiered plan for employees with children. The option will save those families nearly $10,000 a year in premiums, compared to a family policy that also would cover an employee's spouse.
The lowest-priced insurance package for district employees will rise by $32 per month, from $760 to $792. Under its benefits plan, the district provides provides employees with $1,275 per month in cafeteria cash to offset the cost of premiums for medical, dental and life insurance.
The district also has reached agreements with three other unionized employee groups.
The board on Monday will consider approval of packages for the 400-member Sioux City Educational Support Personnel Association, which represents paraprofessional associates, secretaries and bus assistants, the Sioux City Community School District Bus Drivers Association and the Operations & Maintenance Employees International Union of Operating Engineers (IUOE) Local 234.
Monday's meeting will begin at 6 p.m. in the Educational Service Center.