RUTHFULLY YOURS

I’m not as sorry as the editors to see the Trans-Pacific Partnership laid to rest. Because I agree with our editorial on a number of points, and because I fear that what I dislike about TPP is actually appealing to President Trump (and likely to recur in any bilateral deals his administration strikes), it is worth adding a few thoughts of my own.

1. The manner in which the Obama administration went about negotiating TPP has been wrongly maligned, undoubtedly because of (and contributing to) the distaste in which international trade is held these days. I have negotiated about a million plea agreements, some of them quite complicated. Had they been negotiated out in the open, with running commentary on the possible terms by non-parties or agencies whose interests might be affected, they would never have been consummated. The moving parts of an international trade deal — even a bilateral one — make it infinitely more complex than a plea deal.

While Congress has a critical constitutional role in reviewing international agreements, it is the president’s job to conduct international relations and make treaties. Eleven other countries cannot be expected to negotiate with 535 legislators plus the executive branch. Thus, the complaint about Obama’s having conducted secret negotiations with foreign governments in order to spring a damaging agreement on the United States was meritless in the case of TPP. (It is an apt complaint in the case of the Iran nuclear deal, which Obama never intended as a treaty.)

While TPP could have been damaging, that is because of its terms, not the secrecy in which they were negotiated. The question was not whether Congress should have had the opportunity to review aspects of the deal while it was being negotiated. (Lawmakers did in fact have that opportunity, under conditions of confidentiality that were appropriate no matter how much Congress complained about them.) The question was whether Congress was given an opportunity for meaningful review after the agreement was finalized by the countries taking part. There is no doubt that legislators had that opportunity — and, indeed, that TPP could not have been imposed on the U.S. without their consent.

2. Which brings us to Trade-Promotion Authority — the “TPA” that, regrettably, was conflated with TPP in the public debate. I continue to believe that TPA, which obliges Congress to give the president an up-or-down vote without amendments after the president has negotiated an international agreement, not only makes eminent sense but is the best way to avoid bad international agreements.

Remember when the media briefly decided that anyone who offends a Gold Star family was the worst human being in existence? Dissent is patriotic now. And how better to define dissent than spitting on Gold Star families?

Don’t worry, shortly Michael Moore will be on to explain that spitting on Gold Star families is truly the highest form of patriotism. And that their children died to protect the right of anti-Trump patriots to spit on them.

On Friday, Amy and I were assaulted by angry “protesters” outside the Renaissance Washington DC Hotel, where the American Legion hosted a tribute to Medal of Honor recipients at their Veterans Inaugural Ball. We were pushed by a man in a mask hiding his face. Our clothes were drawn on with permanent marker by other “protesters.” And we were called the most vile names I have ever heard as we entered and exited the venue.

What the individuals who assaulted us did not know is that I am the sister of Marine First Lt. Travis Manion, and Amy is the wife of Navy SEAL Lt. Brendan Looney, who gave their lives in Iraq and Afghanistan. Travis was killed in 2007, and Brendan in 2010.

I doubt very much that they would have cared. If anything, it would have only encouraged the anti-American left.

Looney and Manion were initially late to the ball because they couldn’t get through “an angry mob in the street that was burning trash cans and smashing windows,” Manion wrote on Facebook. When they eventually got near the entrance a group of around 75 people tried separating them from the ball. It was as the two women walked through the crowd that people began pushing them and yelling insults.

“We understand more than most how fortunate we are to live in a country where we can demonstrate and share our different beliefs,” Manion wrote. “But my question for those who chose to take this route Friday is this: Are you truly accomplishing anything by inciting hate?”

To control escalating U.S. drug prices that seem to be disconnected from research, development, and manufacturing costs, an array of politicians, policy wonks, and pundits have proposed a spectrum of government interventions. The Senate Special Committee on Aging is the latest to weigh in, with a report that makes various recommendations.

Characteristically, it focuses on high-profile abuses and proposes only tepid measures to “rein in price spikes in off-patent, decades-old drugs purchased by companies that did not bear the drugs’ research and development costs.”

The report urged, for example, that the Food and Drug Administration be given expanded authority to allow imports of medicines from countries with drug-safety standards similar to those in the United States, but only in narrowly defined circumstances, such as when consumers face sharp, sudden increases in the price of off-patent drugs that have no competition. (Regulators already have the ability to allow imports when there are acute critical shortages of approved drugs in this country.) But the Senate recommendations would require the imports to end “as soon as the monopoly was broken up.”

There is certainly sympathy from the incoming administration for reform of drug regulation. President Trump pledged during the campaign to “remove barriers to entry” of “imported safe and dependable drugs from overseas,” and he told Time magazine after the election: “I’m going to bring down drug prices. I don’t like what’s happened with drug prices.”

That’s a widely shared sentiment, but pharmaceutical pricing is neither simple nor transparent, not only because of global and national competition, but also because of inconsistent national laws, individual company practices, industry-wide insurance-company discounts, and government rules that require preferential pricing, rebates, and discounts. American politicians often cite foreign countries’ approaches to controlling prices, but their very different market and reimbursement systems make it difficult to judge the extent to which they are applicable to the United States.

Foreign governments’ cost savings arise from price controls and refusal to pay for drugs that do not show sufficient medical benefit to justify the cost. This sort of technology assessment is not done routinely in the United States. “If it’s an FDA-approved drug and prescribed by a duly licensed physician, Medicare will cover it,” notes Gail Wilensky, who ran U.S. Medicare and Medicaid reimbursement in the 1990s. Non-government insurers also often (but not always) cover approved drugs and medical devices.

Government-imposed price controls on a wide variety of goods have an extensive and unhappy history in the United States. At various times the federal government, states, and even localities have imposed price controls on items such as oil, electricity, apartment rents, food, and plane fares, but the benefits tend to be short-term at best, with unintended consequences including consumer dissatisfaction from shortages and curtailed industrial production, investment, and innovation.