You Can’t Fix Healthcare Costs Without Talking About Pharma

I’m writing this from a buzzing hallway just outside the House Energy and Commerce hearing on insurance companies. You can practically feel the tension bouncing off the marble. The title of the hearing was An Examination of Health Insurance Affordability” and everyone took turns talking about premiums, copays, and deductibles. But I kept wondering, “why is no one talking about the price of prescription drugs?” But if Congress wants to fix what’s broken in our healthcare system, they can’t keep letting Big Pharma hide behind the curtain. 

 This hearing is supposed to be about “lowering healthcare costs,” but instead of asking why our drugs cost three times more than in other wealthy countries, lawmakers are busy grilling insurers about plan design. On average, Americans pay about 3x more for prescription drugs than people in other rich countries, and more than 4x more for brand name drugs. You cannot fix affordability while drug companies keep charging whatever they want and raising prices year after year.  

The People Behind the Prices  

Ordinary Americans are expected to cover out-of-pocket cost for cancer medication that can jumped from $70 to over $400 without notice because pharmaceutical companies can raise their prices anytime they want.

I met a few folks in line this morning waiting to get a seat inside. 

“There's a reality that I might very well have to treat a child that is dying from cancer and explain to his parents that his medication is hundreds of thousands of dollars. Knowing that their child will ultimately die because he is simply a victim of the system.

 — Andrew Geatz, a medical student.

Follow the Money  

While regular Americans cut back on their kids’ activities or skip their own prescriptions, drug companies spend billions on lobbying and TV ads. In 2024, Big Pharma spent over $10 billion advertising drugs directly to consumers, including more than $5 billion just on television. That’s about one out of every four commercials you see during the evening news. These same companies have spent over $6.3 billion over the past 30 years just lobbying Washington and ensuring they’re never too far from the ears of the people writing the laws.  

Let’s follow the money trail. Pharma’s profit margins hover around 23%, nearly ten times higher than every other part of the healthcare system.

Who sets the list price for your medication? Pharma.  

Who raises those prices year after year on hundreds of drugs at a time, including treatments for cancer, diabetes, and heart disease? Pharma.  

And who holds on to the lion’s share of profits across the entire drug supply chain? You guessed it again. Pharma!  

What Accountability Really Looks Like  

The crisis patients feel at the pharmacy counter isn’t an accident of “the system.” It’s the result of deliberate corporate strategies like patent games, market lockups, and pay-for-delay deals designed to protect profits, not people.  

America thrives on scientific innovation, but American families should not be paying two or three times more than people overseas for the very same pills just so profits can stay at record levels.  

 So, when I hear politicians talk about affordability but skip over the elephant in the room, I must ask, how serious are we about change?  Until Congress is willing to talk about the companies that set the prices, we’ll just keep chasing our tails, while hardworking Americans keep paying the price.