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Let Big Pharma Build the Wall

Allow me to present a modest proposal that should serve to resolve all this anxiety and confusion about where to get the money to build THE WALL along our southern border with Mexico: Let Big Pharma build THE WALL.

Seriously. This idea should make President Trump deliriously happy. It’s capitalism friendly. Everyone knows you can always trust business to do a better job than government (see Boeing 737 Max 8). Big Pharma has the money and none of the pesky budget problems that bog down our Democratic form of government. And they’ll have even more Benjamins if we follow up construction of a big beautiful wall with appropriate regulations to enable better management of cross border traffic. 

Here’s the thing. Walls serve two functions. Walls keep things/people out, and they keep things/people in. We already have 280 miles of vehicle fencing (that doesn’t stop people) and 374 miles of pedestrian fencing (that doesn’t stop determined people) along our 1,954 mile border with Mexico.

Our current border security practices and the existing sections of wall are failing to keep people out, but they fail even more miserably at the second function of walls: keeping people in. Big Pharma can’t be happy about that.

NPR cited a US government trade report that estimated nearly 1 million Californians travel to Mexico every year for healthcare services, including prescription drugs.

Reportedly 9,000 US citizens cross the border every day from Yuma, Arizona, to Algodones, Mexico, where there is a pharmacy, dentist or eye doctor on every corner. Most of them presumably are not there to enjoy the scenery, which differs far less from the desolate environment on the US side of the border than the drug prices do.

Obviously, when these unpatriotic Americans buy their prescriptions in Mexico they are paying much lower prices than they would have to in the US, and this costs Big Pharma big money. It would cost the government money too if Big Pharma paid their fair share of taxes. Oxfam estimated that four Big Pharma giants dodged $2.3 billion in US taxes from 2013 to 2015.

The insurer for 170,000 public employees of the State of Utah is now paying for patients using one of 13 targeted drugs to fly to San Diego (along with a companion of their choice!), get chauffeured back and forth across the border to buy a 90-day supply of drugs, and fly back to Utah. They’re also giving these volunteers a $500 incentive cash bonus for each trip, which has to happen four times a year for chronic users.

Why? Because even with the travel expenses, the state saves buckets of money on each patient. The cost differential between Mexico and the US can run to thousands of dollars per scrip per month. For instance, in the US a 28-day supply of the MS drug Avonex runs about $6,700, while in Tijuana it might cost approximately $2,200.

Even if you’re not from the enlightened State of Utah, you can save big by traveling to Mexico. Insulin prices have skyrocketed in recent years. A three-month supply of one type of insulin that might cost $3,700 here may be had for as little as $600 in Mexico. One 100 milligram Viagra dose that costs about $65 here can be had for about $5 in Mexico.

How about EpiPens? They cost north of $700 for two in the US (although a decade ago they were less than $100 for two). Reportedly you can get vials of epinephrine in Mexico for as little as $2. Pick up some syringes and safely inject yourself (with a little instruction) if you have to. (By the way, many other civilized countries will let you buy an EpiPen for about 10% of the cost in the US.)

You do the math. An estimated 1.25 million Americans have Type 1 Diabetes. They need insulin. An estimated 3.6 million Americans were prescribed an EpiPen in 2015. They need to carry one. Can’t say how many millions are taking Viagra, Cialis and other ED (erectile dysfunction) meds, but Viagra sales (even with the increased competition in recent years) are still running over $1 billion per annum. Big Pharma is losing big.

So let the FDA and Big Pharma do their own math (since they have such a close working relationship as to be almost indistinguishable anyway). They can set a percentage of all profits to be gained from stopping the bleeding caused by Mexican cross border drug purchases, which percentage shall be equivalent to the amount needed to build THE WALL and hire enough border agents to start conducting comprehensive pill searches of all US citizens re-entering the country from Mexico.

Talk about killing two birds (and God knows how many patients) with one stone. And if all those migratory drug users turn around and head north to try to operate the same scam up in Canada, just start building a wall along the Canadian border too. That’ll create a lot of good jobs. And anyway, are those Canadians and that Trudeau guy as reliable as they used to be?

After all, there’s nothing more important than your health, except your security, of course. There’s no problems the free market can’t fix. And there’s no good reason to leave the country for medical care, when we already have the finest health care system in the history of the world.
Problem solved. Let freedom (for corporations) reign.

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Jeff Sher is a journalist specializing in the health care industry. He lives in San Francisco.

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