This is a story of cause and effect — a tale of repeated and calculated public policy decisions that have now led to a predictable outcome.

This story begins twenty-five years ago, when the Clinton administration rescinded a rule that required pharmaceutical companies to charge Americans reasonable prices for medicines developed at government expense. Some progressive lawmakers tried to reinstate the rule, but Republicans and Democrats joined together to halt those initiatives.

In the ensuing years, the Obama administration refused Democratic lawmakers’ demand to invoke existing federal laws to force down the price of critical medicines. Meanwhile, the GOP also blocked legislation to let Medicare use its purchasing power to negotiate lower prices for prescription drugs.