Now we really know how President looks at America's drug price problem

We know that because Republicans in Congress don't seem interested in taking up the cause at all.

President Trump met with big pharma CEOs on Tuesday, and in what should've been a clear threat to the profits of the American drug industry, he told them "you have to get your prices down."

Trump promised a relaxation of FDA regulations for drug approval – a classic capitalist move — and suggested that trade should be the centerpiece of lowering drug pricing, railing against the "global price controls" implemented by other countries.

This is Trump's trademarked line of economic victimhood – the part that sounds good to populists right off the bat, makes capitalists queasy, and puts our country at risk of a trade war.

It's becoming more and more clear that Trump sees making threats and starting fights with other countries as a form of fiscal policy.

And now it's coming to the drug game, a place where it definitely won't work.

Dude, youre not scaring anyone

After Trump's meeting with the pharma CEOs, t

More importantly, Roosevelt was willing to back up what he said with real legislation. His bark had bite.

All smiles

These CEOs don't care about Trump's bully pulpit. They walked into that meeting, smiled, nodded, talked about the jobs they were creating, heard that some deregulation was coming, and walked away smiling.

No other concrete policies for actually bringing down drug prices were actually discussed, and until that's on the table, they could lower prices 10% across the board just to make nice and it wouldn't mean much.

As for calling for the FDA to approve more drugs to spur competition – that's really great and all, until you actually think of what these companies have been doing. They've been accused of fixing prices.

Remember, that toward the end of the last year the Obama Justice Department went after around a dozen big pharmaceutical companies, including EpiPen-maker Mylan, for colluding to keep prices high.

The makers of insulin were just accused of doing the same thing in a class action lawsuit. This practice is rampant in the industry and Capitol Hill is just starting to wrap its mind around it.

You know what else drug companies have been doing that they FDA can't fix? Paying their way into your healthcare plan.

As we learned through our work looking into Valeant Pharmaceuticals, drug companies are more than willing to pay the companies that manage your healthcare plan to get on lists called formularies – formularies determine what drugs your insurance company will pay for.

That means a higher priced drug with cheaper competition can find its way on a list where it really doesn't belong.

It means drugs that should've been crushed by competition in a fair market don't actually die a natural death – they live on thanks to palms greased in the system.

And that's the problem – our system. Not another country's, not the FDA's, the American pharmaceutical industry's system. Looking at it any other way ensures you apply the wrong solutions on the wrong problem.

That's because the biggest problem with the industry is all its own, and it doesn't require regulation to fix either. It is the fact that our drug pricing system is incredibly opaque.

Try telling a pharmacy benefit manager (the people who manage the lists) to publish a clear list of how it prices everything, what cut it's taking, and who is paying for it. Tell drug companies to do the same.

Then watch them all have a panic attack.

It's the opacity of the market that allows it to price things the way it does. Imagine yourself turning on the light in the bathroom at a remote campsite in the middle of the night. Imagine that light hasn't been turned on in about 10 years. Imagine what you would see. It would be like that.

Just bullying, no pulpit

It's not how you get things done, it's how you get humiliated in public when the President of Mexico refuses to have a meeting with you. It's is how trade wars start.

Now to be clear, trade wars aren't good for the pharma industry either, they just might be better than lowering prices long term or enacting regulation that forces companies to come clean on how the sausage is made.

There's nothing scarier than having to show the American people the inside of the sausage.