Americans pay more for our prescription drugs than other people do — half again as much as Canadians or Germans, more than twice as much as Greeks or Italians.

In recent years, those costs have become a major issue in the political debate over health care. Proposals to address drug prices range from allowing Americans to buy their drugs from abroad, to allowing government health programs like Medicare to directly negotiate lower prices, to having the government itself manufacture generic drugs.

One suggestion I don’t see very often is reconsidering the authority of the US Food and Drug Administration to bar drugs from sale in the US until they’ve passed an expensive and time-consuming regulatory approval process.

In the late 1950s and early 1960s, tens of thousands of babies  were born worldwide with birth defects. Only a few of the afflicted children were born in the US, because the  FDA hadn’t approved thalidomide (some American women received it through a testing program; others used it abroad).

But then a strange thing happened. Instead of congratulating FDA on the save, Congress expanded its authority even further. Oddly, regulatory agencies tend to ask for, and get, more power every time they succeed … and every time they fail.

This expanded authority made it more difficult and expensive to get new drugs approved for sale in the US. And Congress’s mistake has cost Americans not just money but lives.

Tens of thousands of patients died of second strokes and heart attacks while FDA dragged its heels on the approval of the beta blocker propranolol.

It took decades to get a now common (and sometimes lifesaving) substance — cyanoacrylate, aka “human body glue” — approved. During those decades, it was sold cheaply on store shelves under various “super glue” labels while patients bled out and died of traumatic injuries or internal ulcers it could have been used to seal.

No, we don’t want more patient deaths and injuries. But it’s not clear what a true balance sheet would say about how many lives FDA has saved versus how many Americans its regulations have killed.

Lately,  FDA seems more interested in feeding a moral panic over “e-cigarettes” to expand its power even further than in executing its supposed mission of “protecting the public health.”

I am not suggesting that there are no dangerous drugs. Of course there are dangerous drugs. And some of those dangerous drugs are approved by the FDA and the dangers only discovered later.

An FDA with only advisory powers would still be able to monitor the public health and warn doctors and patients about dangerous drugs.

But actual testing of drugs to determine their safety and efficacy is better left to an Underwriters Laboratories type non-profit financed by insurers whose costs go up and profits wane when they pay high prices for bad drugs that hurt their customers — the patients.

Unfortunately, American politicians seem more interested in empowering themselves and the regulatory agencies they oversee than in actually addressing the high costs of prescription drugs.

Thomas L. Knapp (Twitter: @thomaslknapp) is director and senior news analyst at the William Lloyd Garrison Center for Libertarian Advocacy Journalism (thegarrisoncenter.org). He lives and works in north central Florida.

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Politicians are people with jobs and with bosses.

On its face that seems like a relatively uncontroversial statement, but I’m always surprised at how much time people spend looking for high principle in the decisions politicians make instead of considering the mundane dynamics of political employment.

In a recent column, I pointed out that Speaker Nancy Pelosi (D-CA) finally opened a formal impeachment inquiry versus President Donald Trump because she’s good at counting votes, not because  she’s personally keen on the idea. Pelosi wants to keep her party’s top job in the US House of Representatives. Sometimes keeping that job involves running to the front of parades she didn’t plan.

When I write things like this, some accuse me of being overly cynical. Agree or disagree with a particular politician on a particular issue, they’re convinced that politicians in general are more like painters or musicians who create art for the sake of art than like fry cooks or janitors who work for paychecks and in hope of promotion.

I don’t think I’m too cynical. I’m not saying that politicians lack principles or beliefs. I’m not saying they never act on their principles or beliefs. But they’re people with jobs and with bosses.

Many people seek particular jobs out of what we might consider selfless, or at least highly principled, motives.

A kid dreams of becoming a veterinarian because he or she loves animals.

Decades  later, is that kid still spaying, neutering, smooshing stool samples, etc., solely from pure love of animals, or does paying the mortgage and building a profitable practice (or remaining employed in one) perhaps also play a role?

The average elected official probably answers to more  bosses than the average American worker. Voters. Campaign contributors. Party officials. Fellow politicians up and down the ladder of power.

Those bosses have conflicting goals and priorities, which means conflicting pressures on the politician. Pressure to move slowly on something he supports. Pressure to move fast on something she has doubts about. Pressure to sacrifice his goals to the group’s goals, just for now, we’ll get to your thing soon, pinky promise.

Politicians aren’t ethereal creatures of pure principle, operating on a higher moral plane than the rest of us. They’re people with jobs and with bosses, just LIKE the rest of us. And that’s more than sufficient reason to not give them much power OVER the rest of us.

Thomas L. Knapp (Twitter: @thomaslknapp) is director and senior news analyst at the William Lloyd Garrison Center for Libertarian Advocacy Journalism (thegarrisoncenter.org). He lives and works in north central Florida.

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On September 24, House Speaker Nancy Pelosi (D-CA) elbowed her way to the front of a parade she’d been trying to disperse since early 2017. “Today ,” she said, “I’m announcing the House of Representatives is moving forward with an official impeachment inquiry and directing our six committees to proceed with their investigation under that umbrella of impeachment inquiry.”

Pelosi’s announcement doesn’t reflect a personal change of mind. It reflects recognition of political reality. She’s for impeachment after being against it because she believes it’s going to happen with or without her.

If there’s one thing Pelosi’s good at, it’s counting votes. As the Democratic Party’s leader in the House since 2003, that’s her job: Building and herding majorities to achieve her party’s legislative goals, blocking minorities whose plans don’t serve those goals or aren’t ready for prime time.

She’s gone from “block” mode to “herd” mode. QED, a House majority for impeachment is inevitable, if not already in the bag. She can either lead the parade or get left behind by it. She’s choosing to lead it.

It’s not a job she really wants. Her prior political instinct seems to have been that impeachment will hurt rather than help the Democratic Party going into the 2020 elections. That instinct was probably correct, and turning the situation around will be difficult.

In order for the Democrats to make political hay with impeachment in the absence of a likely conviction, instead of losing congressional seats and the next presidential election (as Republicans did after their ill-fated impeachment of Bill Clinton), at least two things need to happen.

One is that Joe Biden has to get thrown under the bus. Immediately. His own perceived (and, yes, GOP-promoted) abuse of power / “quid pro quo” problem with Ukraine has already cost him the 2020 Democratic presidential nomination. The longer other Democrats pretend otherwise and continue to defend him, the more it will cost them as well.

The other is that the impeachment allegations need to be exceedingly narrow so that when Republicans vote against conviction, there can be no wiggle room, no reasonable doubt to be raised: They voted in favor of corruption and against presidential accountability.

Donald Trump abused his presidential power to pressure a foreign government to investigate a political opponent, then tried to hide what he’d done. That’s indisputable.

More importantly, it’s enough. “Quid pro quo” in the form of foreign aid or not, and any other extant allegations aside, these are acts most Americans understand as corrupt.

“I could stand in the middle of Fifth Avenue and shoot somebody and I wouldn’t lose any voters,” Donald Trump bragged a year before his inauguration. Among the general electorate, that remains to be seen, but where the US Senate is concerned, he could probably do exactly that and not lose the 20 Republican votes required to convict him following impeachment.

The voters will likely remove Trump from office next November in the usual way. The impeachment prize is convincing voters that politicians who take Trump’s side aren’t taking THEIR side.

Thomas L. Knapp (Twitter: @thomaslknapp) is director and senior news analyst at the William Lloyd Garrison Center for Libertarian Advocacy Journalism (thegarrisoncenter.org). He lives and works in north central Florida.

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