The Most Fooled Nation

Trump waved MFN like a victory flag, reporters applauded, Americans hoped, but Pharma raised prices anyway, proving that bold words, chest-thumping, and headlines never buy actual leverage or relief.

Guest article by Michael Cohen. Remember to follow him on Substack for more by clicking here. Michael just hit 500,000 subscribers on YouTube! Subscribe today for free here and let’s keep the momentum going!

Photo credit: Joey Sussman / Shutterstock.com

It’s amazing how easy it is to talk tough—until the world reminds you, with interest, that words alone don’t pay the bills. Declarations are cheap. Headlines are cheaper. Promises? Free in Trump World. Chest-thumping counts as policy. Reality is optional. And yes, I’ve watched the applause section take it seriously.

Take Trump’s greatest hits on drug prices. Remember the rallies? The Oval Office meetings? The constant chest pounding? The line about Americans finally paying what “other countries pay”? Cue the applause, cue the flags, cue the big, shiny MFN sticker slapped across your brain: Most Favored Nation. Sounds like leverage. Patriotic. Tough. Elegant. All show, no reality.

In practice, it was just more branding masquerading as policy. Like a cologne ad that promises success but smells like desperation.

Trump claimed drug companies would be forced to give Americans the lowest prices in the world. What he never explained—because explaining it ruins the illusion—is that drug companies don’t respond to bluster. They respond to incentives. MFN? It handed Big Pharma a new buzzword while leaving their profit margins untouched. Genius, if your IQ is measured in applause points.

Now reality has arrived. And it brought the receipts.

As of yesterday, drugmakers are raising U.S. prices on at least 350 branded medications—up sharply from 250 last year. These aren’t obscure meds that only the government pharmacist knows. We’re talking COVID, RSV, and shingles vaccines. Blockbuster cancer drugs like Pfizer’s Ibrance. Everyday medications people actually need to survive. And survive means paying more, of course.

The median price hike? Around 4%, in line with 2025. Nothing changed—except the number of drugs climbing went up. Like inflation, but again, with more applause.

This is where Trump normally declares victory. He rolled out “deals” with 14 drugmakers—Pfizer, Sanofi, Novartis, GSK—for Medicaid pricing and some cash-pay arrangements. Press releases called them transformative. Headlines echoed the claim. Applause was manufactured. Real savings? Optional.

Except many of those same companies raised their prices starting on January 1, 2026.

Not a glitch. The system working exactly as designed. I mean, you really have to admire the consistency.

Here’s how it functions. List prices go up. Rebates and discounts are quietly negotiated with insurers, pharmacy benefit managers, and government programs. Numbers patients actually see? Still climbing. Pay cash? Often a third, higher number awaits. Think of it as a surprise fee. For breathing.

Three prices. Zero transparency. One predictable outcome. Pharma profits.

Dr. Benjamin Rome of Brigham and Women’s Hospital calls these deals “nibbling around the margins.” Translation: the real money stays with Big Pharma. Meanwhile, Americans still pay nearly three times more for prescription drugs than people in other wealthy nations. True before MFN. True after MFN. True until the end of time—unless someone actually enforces law instead of tweeting slogans.

Pfizer leads the pack this year, raising prices on around 80 drugs: cancer treatments, migraine meds, Paxlovid, hospital staples like morphine and hydromorphone. Some hikes below 10%, which the company would like you to applaud. Others higher. One COVID vaccine jumped 15%. Now, clap America for the Art of the Deal.

Pfizer claims these increases are “modest” and necessary to support innovation. That’s corporate PR masquerading as rationality. Translation: “We need more of your money so we can make more money for us.”

Drugmakers have scaled back the truly obscene hikes from a decade ago—mostly because Congress threatened penalties for Medicare prices rising faster than inflation. Behavior changes when there are consequences. Not speeches. Not press releases. Consequences. A radical idea, I know.

There were a few price cuts—around nine drugs total. Jardiance, a diabetes medication, saw a major reduction. Why? Because the government negotiated it directly for Medicare. Not because Trump pressured anyone. Because the law forced it. That’s what leverage actually looks like. Hint: it doesn’t involve press conferences or chest-thumping.

What Trump offered instead was dominance theater. Loud announcements. Big claims. Victory laps disconnected from math. Say it forcefully enough, and eventually someone will confuse volume with results. It’s amazing how frequently humans fall for that trick.

This was never a serious attempt to lower drug prices. It was a performance designed to look tough while leaving the underlying system intact. The industry understood that immediately. The lobbyists certainly did. The fact is, patients are the ones paying for the gap between rhetoric and truth.

In reality, Trump collected the applause while Americans are left paying the bill—fleeced by the same system he pretended to control. And that, in the end, is the most Trumpian outcome of all: bold promises, zero backbone, and Americans left holding the bill while being told they just won big. Most Favored Nation? No. Maybe, The Most Fooled Nation.

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