Each Thanksgiving, Americans gather to give thanks for all that we are and have. This year, I will add one more item to our long list of blessings: that the world's wealthiest countries should be grateful to America for keeping their drugs affordable.
Nations with socialist modeled healthcare systems incessantly praise themselves for providing price-fixed and capped medicines. They constantly lecture us about "equity," "fair pricing," and "universal care," but their self-righteous leaders of these allegedly saintly healthcare systems are only able to negotiate bargain basement pricing because Big Pharma makes so much money from American families.
It is now time they told the truth about why they are able to enjoy champagne healthcare on a generic beer budget.
Americans pay the highest drug prices in the developed world: three times as much as those in 33 other wealthy OECD nations. The U.S. is also the world's top drug research nation – doing the heavy lifting while others coast on our investments. Meanwhile, foreign countries get discounted rates while Americans are ripped off on an annual basis.
To be brutally honest, if Thanksgiving had a kids' table for freeloaders, half of Europe would be sitting at it, swinging their legs and asking for seconds.
These nations arrive empty-handed and leave with all the leftovers, preaching moral superiority about "free healthcare," and then quietly helping themselves to the medicines we paid to bring to the rest of the world. We are not expecting the E.U. to send us a turkey to show their appreciation for our work and spending. But a little gratitude would be appreciated.
The reason for this price imbalance is not mysterious. It is baked into the global system. While foreign governments haggle down drug prices to politically acceptable levels, American patients are left paying market rates that absorb the cost of innovation.
President Donald Trump understands this problem and deserves our thanks for taking on Big Pharma. He recently unveiled an agreement to slash U.S. prices on top-selling drugs, including diabetes and obesity medications like Ozempic and Wegovy, from around $1,000 per month to roughly $350. He also struck deals to tie future U.S. drug prices to the lowest prices offered abroad pursuant to "Most Favored Nation" policy pricing and demanded companies invest billions in U.S. manufacturing.
The president knows America bankrolls the research, the science, and the breakthroughs, while our risk-averse and mooching allies enjoy access to world-class medicines they never would have paid to discover themselves. The U.S. accounts for less than five percent of the world's population, yet generates roughly 75 percent of global pharmaceutical profits. The industry benefits from huge subsidies, but instead of passing savings on to American consumers, it lowers prices overseas and funds this expansion through high prices on the home front.
Meanwhile, companies headquartered in the U.S. invest 34 percent of revenue back into R&D – a significantly higher figure than Europe (22 percent) and the Asia/Pacific region (20 percent).
In total, American-based firms spent $187 billion on R&D between 2010 and 2019, prompting the Institute for New Economic Thinking to warn that taxpayer dollars basically paid for every new pharmaceutical approved during that decade. We paid for the research and then got taxed for it, like inventors whose ideas are stolen and sold back to them at a massive markup.
As it continues to rack up further riches on the backs of sick Americans, Big Pharma talks endlessly about "affordability" but never acknowledges the global pricing imbalance that keeps American bills so high. If pharmaceutical companies truly wanted lower prices for U.S. patients, they'd stop enabling an international system that depends on foreign governments siphoning off American R&D spending. Why is this imbalance allowed to continue? Because it is profitable. And they don't think we notice.
Meanwhile, families across the country pay a hidden foreign tax on drugs that strain household budgets, inflate medical debt, and directly impact their health.
We are told that those inflated prices bankroll the research, clinical trials, and regulatory approvals that bring new medicines to market. But we all know that is not the entire truth.
Reconfiguring the market is not complicated. That is why Trump has been able to make such amazing progress so quickly. He is forcing Big Pharma to stop pretending this lopsided arrangement is anything other than deliberate. Their greed is hurting too many families for "business as usual" to continue.
This Thanksgiving, Americans deserve recognition from every country that benefits from discount drugs made possible by our taxpayers' investment in research. Until the freeloading ends, Americans will keep carrying much more than their fair share.
And maybe – just maybe – it is time America stopped being so polite about it.
Timothy W. Jones is a former Missouri legislator who served as the state's House Majority Leader and Speaker. He remains active in the freedom and liberty world of politics and public policy while hosting a daily drive-time radio show on St. Louis-based NewsTalk STL and serving as the State Director of the Missouri Freedom Caucus.