When I was five years old, my family fled communist Cuba. We left behind a regime built on government decrees, central planning, and the false promise that state mandates could magically cure economic pain. I learned a lesson early in life that has stayed with me ever since: government can order a price to be lower on paper, but it cannot order a scientist to discover a cure, an entrepreneur to risk capital, or a business to survive in a broken or fixed market.
That history drives my work today. At Latinos for Tennessee, our advocacy is rooted in free enterprise and free-market principles—limited government, fiscal responsibility, and individual liberty. When we talk about healthcare affordability, we have to be careful. Well-intentioned policy ideas can easily destroy the very engine of scientific progress that makes American medicine the best in the world.
One proposal gaining traction in federal debates is the “Most Favored Nation” (MFN) drug pricing scheme. The concept sounds simple enough: force American prescription prices to match artificial price caps set by foreign governments. But tying our economy to price controls imposed by socialized healthcare systems gets the problem entirely backward.
In a free market, prices attract investment toward high-risk, high-reward breakthroughs. Developing a new drug takes years and billions of dollars with no guarantee of success. Importing foreign price caps artificially starves the research budgets that fund tomorrow’s cures. When government price controls choke off innovation, the real victims are families waiting on the next treatment for cancer, Alzheimer’s, ALS, or rare diseases.
The fact is these European price controls actually delay access to new and innovative treatments and cures. European patient access lags that of the American healthcare system. If anything, our government should be asking Europe to pay more of their fair share, not importing their socialistic price controls.
The problem in Washington isn’t a lack of desire to help families—it’s that policy proposals keep hitting the wrong target. MFN assumes drug prices are set by manufacturers in a vacuum. In reality, our healthcare marketplace is clogged up by corporate intermediaries: insurance companies and Pharmacy Benefit Managers (PBMs).
According to research from KFF, PBMs manage prescription benefits for roughly 270 million Americans, operating as middlemen between drug makers, health plans, and local pharmacies. PBMs negotiate massive rebates from manufacturers, but those savings rarely trickle down to families at the checkout counter. Studies from the National Institutes of Health even show that as manufacturer rebates have grown, out-of-pocket costs for patients have actually gone up.
This is where the market is broken. MFN is like arguing over the sticker price on a car while the dealership quietly tacks on thousands in mystery fees. The mystery fees are the PBM markups, and MFN leaves them completely untouched.
If a federal rule lowers a price benchmark on paper, but your insurer and PBM pocket the difference in the middle, what changes for a working family at the pharmacy? Nothing. Your copay stays the exact same – or even increases – while corporate middlemen manage new layers of paperwork.
If we want real affordability, we have to stop chasing foreign price benchmarks and start following the money right here at home. Rather than copying foreign price controls that threaten life-saving research, we need conservative, market-based reform: total transparency and direct pass-through savings.
Any rebate or discount negotiated in the healthcare system should immediately lower what the patient pays at the register. Disclose the hidden fees, pull back the curtain on PBM rebates, and pass those savings directly to families. And, the same thing goes for the 340B prescription drug pricing program.
When hard-working Tennesseans go to the pharmacy, they care about one thing: the total on their receipt. Imagine a store offering a discount on paper, but the cashier refuses to apply it to your bill. That is how drug pricing works today. MFN doesn’t fix that fundamental disconnect—transparency, accountability, and real market competition do.
Let’s protect American innovation while fixing the middleman system that burdens our families.
 – – –
Raul Lopez is the co-founder and chairman of Latinos for Tennessee.
