The cruel irony is that we’re living through a golden age of medicine. A decade ago, a hepatitis C diagnosis might have led to liver disease, cirrhosis, or death. Today, breakthrough treatments have cured hundreds of thousands of people. Miraculous drugs have vastly extended the life expectancy for people with Hodgkin’s lymphoma and cystic fibrosis, protected us from many viruses and cancers, and put us within reach of ending the AIDS epidemic.

CAMPAIGNING RECENTLY IN Berlin, N.H., I met a man who described being in line behind a woman at the pharmacy who was five dollars short to buy her prescription drugs. He spotted her the five dollars. But he told me, “I’m just worried about what’s going to happen to her next time.” That shouldn’t be possible in this country. And yet we know that even for people who have insurance, the cost of health care and prescription drugs is out of control.


Although our tax dollars have funded many of those breakthroughs, too many Americans are denied access to these life-saving medicines. Drugs in the United States are more expensive than anywhere else in the world. The same vial of insulin that costs up to $300 here costs $30 in Canada and is free in Italy. As a result, nearly one in four Americans struggles to pay for medication. Three in 10 Americans skip doses or forgo filling prescriptions due to costs.

Families across the country are forced to choose: medicine or child care for my two-year-old? Medicine or making rent on time? One medicine to treat my diabetes or another to control my cholesterol?

Meanwhile, pharmaceutical companies are making tens of billions in profits while gouging Americans. All while politicians in Washington have repeatedly sided with the pharmaceutical industry over the American people.


It’s time for a new era of leadership in Washington, one ready to put American lives ahead of pharmaceutical profits. That’s why I’m proposing some of the boldest measures of any presidential candidate — not just in this election, but at any time — to lower costs for all Americans and to compel pharmaceutical companies to act responsibly.

This starts by ensuring that every American has access to my Medicare for All Who Want It plan, which will offer affordable prescription drugs and cap monthly out-of-pocket drug spending to under $250. Under my health care proposal, we’ll offer every American the choice of keeping his or her private plan or getting coverage through our affordable and comprehensive new public plan. If private insurers are unable or unwilling to offer better plans than they do today, competition from this public plan will naturally lead to Medicare for All.

By empowering the federal government to negotiate drug prices on behalf of Medicare and our public plan, we will dramatically bring down the cost of drugs. These lower rates will be available to Medicaid and private plans. The federal government has the power to claim the patent for any drug funded with taxpayer money. So we’ll use it.

“Worst offender” drug companies that refuse to price responsibly; or pursue other activities that restrict access to essential drugs that, for example, could help end public health emergencies — such as the opioid epidemic; or continue to refuse to negotiate reasonable prices in good faith, will risk having their patent withdrawn and given to a company that will act responsibly.


We’ll also ensure fairer prices by deterring drug companies from aggressively increasing prices. During the first half of this year, companies raised prices for 3,400 drugs by an average of 10.5 percent — five times the rate of inflation — including an 879 percent increase for the depression drug Prozac. To stop this trend, we’ll rein in outrageous price increases by penalizing companies that raise prices by more than the rate of inflation.

To ensure these savings are passed onto Americans, we’ll cap monthly out-of-pocket drug costs at $200 a month for seniors on Medicare. People on our public plan will also have a monthly drug spending cap. Americans with low incomes on Medicare, the public plan, and Medicaid will pay $0 co-pays for all generic drugs.

At the same time, our plan will invest in developing new and safer medicines. That means providing companies tax incentives to explore novel manufacturing methods, including 3D printing. It means strengthening our national security by developing drugs to prevent pandemics, and weaning ourselves off of drugs manufactured in China, which controls most global medicine production. It also means supporting states as they explore new ways to make drugs more affordable.

With bold policies like these, by the end of my first term, we can cut in half what Americans on Medicare spend out-of-pocket on prescription drugs. We can help end the opioid epidemic by dramatically reducing the cost of Naloxone and other medicines used to treat substance abuse. We can guarantee that in the richest nation in the world, no one living with diabetes will die from rationing insulin.


I believe our country is full of people who would reach into our pockets to find five dollars for somebody in distress in line at the pharmacy. But we’re also a country that shouldn’t allow that to happen to anyone in the first place. When I’m president, we won’t.

Pete Buttigieg, mayor of South Bend, Ind., is a Democratic candidate for president.