President Trump could not have been more clear.
"The drug companies, frankly, are getting away with murder," he said in mid-October. He had used the same "getting away with murder" line previously, adding that "pharma has a lot of lobbies and a lot of lobbyists and a lot of power."
Yet just four weeks later, Trump nominated the former president of Eli Lilly's U.S. business to run the Department of Health and Human Services. If drug companies are murderers, Alex Azar is the guy with the rusty hatchet.
Azar was deputy secretary at HHS during the George W. Bush administration before he cashed out and made millions at Lilly while the company's prices for insulin and other drugs soared. Now he's taking another spin through the revolving door — nominated by a phony populist who had promised to drain the swamp but is instead handing over the government to corporations and the treasury to the rich.
The Senate will probably confirm him. This Senate would confirm Mr. Fox as secretary of henhouse security. But even a couple of the Republicans at Azar's first confirmation hearing Wednesday were squeamish about the spectacle of a Big Pharma executive being installed as the ultimate policeman of drug prices.
"You've got some convincing to make me believe that you're going to represent the American people and not Big Pharma," said Sen. Rand Paul (R-Ky.). "And I know that's insulting . . . but we all have our doubts, because Big Pharma manipulates the system to keep prices high."
And that was restrained compared with the Democrats' treatment of Azar.
"Your resume reads like a how-to manual for profiting from government service," said Sen. Elizabeth Warren (D-Mass.), noting the $3.5 million payout Azar got last year from Eli Lilly. "I think the American people have a right to know that the person running HHS is looking out for them and not for their own bank account or for the profitability of their former and maybe future employers."
Azar offered little beyond an acknowledgment that "drug prices are too high." When it came to reducing prices, he tossed out the usual objections offered by the pharmaceutical lobby — for example, that we can't reimport drugs from the European Union, where prices are lower, because the medicines wouldn't be "reliable and safe."
"It's a canard," Paul said. "That's BS, and the American people think it's BS."
If the "forgotten" man and woman were thinking Trump was really going to lower their drug prices — well, they can forget about it.
They certainly shouldn't be surprised. They've already seen Trump stock his administration with corporate titans and billionaires and begin to dismantle the Consumer Financial Protection Bureau. Nor should they be shocked to discover that they aren't getting that big, beautiful tax cut Trump promised. The Tax Policy Center projects that under the "cut," the wealthiest 1 percent of Americans will get 62 percent of the benefit in 2027, while the bottom 95 percent will see no real change.
Tax distribution analysis is hard to understand. Putting a drug executive in charge of drug pricing is easy. Sen. Lamar Alexander (R-Tenn.), chairman of the committee holding Wednesday's hearing, tried to inoculate Azar against the inevitable accusations of plutocracy. "What do you say to the skeptics," he asked at the start, "who question the increase in insulin prices while you were a leader at Eli Lilly?"
Azar explained that his knowledge of "how the money flows" would be an asset — in much the way Trump said that his experience gaming the tax system qualified him to fix it.
Sen. Patty Murray (Wash.), the ranking Democrat, asked how he would reduce prices. Azar spoke about the need to stop "gaming in the system" of patents.
Paul asked him to acknowledge Big Pharma's role in manipulating patents. Azar repeated that there are abuses "in the system."
Sen. Tammy Baldwin (D-Wis.) asked Azar how he would explain the tripling of insulin prices during his tenure at Eli Lilly to a father of diabetics.
Azar explained, once more, that "the problem is that system."
"The system?" Baldwin asked. "So I should just tell them it's the system?"
Warren asked Azar whether the $515 million criminal fine Lilly paid in 2009 was "adequate accountability" — even though the company made billions from the illegal marketing. Azar said it was. Asked whether Lilly's CEO should have been held personally responsible, Azar merely replied, "I'm satisfied with our discussion."
The plutocrat was not helping matters. Sen. Johnny Isakson (R-Ga.) tossed Azar a lifeline. Would he do some "homework" and "come back to us in six months" with recommendations to end the "gaming of the system"?
"Absolutely. Absolutely. Yeah," the nominee replied.