Trump's team calls this 'America First' — but here’s what it really means

Thom Hartmann
02 August
President Donald Trump holds a Cabinet meeting, Wednesday, April 30, 2025, in the Cabinet Room. (Official White House Photo by Molly Riley)

Americans pay more for medications than anybody else in the world. We’re the planet’s suckers: although everybody uses, by and large, the same meds, the drugs that carry the highest prices are — you guessed it — ours, the ones sold here in the USA.

And Donald Trump is committed to making it even worse. He’s barely been back in the White House six months and he’s already lobbed a grenade straight into America’s medicine cabinet, and he was grinning when he pulled the pin.

Not only that, he’s doing it in violation of the Constitution, which gives the sole power to impose tariffs to Congress. Trump’s claiming emergency powers to override Congress’ authority, but there is no emergency. He’s simply breaking the law, and nobody is holding him to account.

His administration’s newly announced 15 percent tariff on branded European pharmaceuticals — a framework unveiled just days ago — is already sending shock-waves through the healthcare system. And it will jack up the price of lifesaving medicines for millions of Americans.

Europe supplies roughly 60 percent of all U.S. pharmaceutical imports by value. That’s about $127 billion a year worth of medicines Americans depend on, out of a total $212.7 billion in U.S. pharmaceutical imports last year. These aren’t obscure treatments; they’re the drugs routinely found in bathroom cabinets across America:

  • Ozempic and Wegovy for diabetes and weight loss, manufactured in Denmark and Belgium
  • Humira and Stelara for Crohn’s, arthritis, and psoriasis, produced in Ireland
  • Keytruda, a breakthrough cancer drug used every single day in hospitals
  • And yes, even Botox and Viagra, the favorites of the Mar-a-Lago donor class

Trump’s tariffs hit them all. Pharmaceutical companies will not quietly absorb the cost. They’ll pass it on to you, one way or another. Expect higher out-of-pocket costs at the pharmacy, higher insurance premiums, and bigger taxpayer burdens as Medicare and Medicaid — already in Republican crosshairs — are forced to foot the bill.

Trump loves to boast about “lowering drug prices,” but his second-term policies are doing the exact opposite. Analysts estimate this tariff scheme could add $13–$19 billion in annual costs to America’s healthcare system. That’s billions ripped out of ordinary Americans’ pockets to prop up a political stunt dressed up as economic nationalism. All to stroke his ego, forcing foreign leaders to come groveling to him in public.

And the consequences are deadly. When drug prices rise, patients start cutting doses, skipping refills, or walking away from the pharmacy altogether. If you’re diabetic and can’t afford your insulin, you could die. If you’re fighting cancer and can’t afford Keytruda, you could die. If your child needs Humira and you can’t pay the new price, they could end up in the ER, or worse.

This is the pattern of Trump’s second term so far: policy as punishment. He’s attacked reproductive rights, gutted environmental protections, and is now turning medicine into a bargaining chip. And it’s all happening with lightning speed while Congress and the Courts seem oblivious to his flipping his middle finger at our Constitution.

Even the pharmaceutical industry — yes, the same industry infamous for gouging insulin prices — warned Trump’s administration in May not to do this. They told the Commerce Department tariffs would backfire, raise costs, and harm patients.

Trump ignored them because this was never about making Americans’ lives better. Instead, it’s all about his ego and his brand: bluster, short-term optics, and making sure the people who can least afford it always take the hit.

But this moment is also about more than tariffs and Trump’s naked violation of our Constitution’s having granted tariff power exclusively to Congress. It’s also, in a big way, about the fact that America is the only developed country without guaranteed healthcare for all.

In nations with universal systems, a politician couldn’t weaponize trade policy against patients because the government itself — not the for-profit insurers — would negotiate and protect prices. If we had Medicare for All or another form of guaranteed care, we wouldn’t have to watch Big Pharma and politicians turn our health into a bargaining chip. Until we build that system, every American’s life will remain hostage to policies like this one.

Trump’s team calls this “America First,” but here’s what it really means:

  • You pay more at the pharmacy.
  • You pay more in premiums and taxes.
  • You get fewer options and longer waits for new therapies.
  • And Trump gets to brag at rallies about being “tough on Europe” while he makes a mockery of our constitutional form of government.

He’s counting on us not noticing until our pharmacy bills double or our insurance companies announce another crushing premium hike. And by then? He’ll blame someone else. Democrats. Immigrants. Whoever’s convenient. Meanwhile, Big Pharma will quietly thank him for padding their profits while passing the tariff costs along to you and me.

And so the most expensive prescriptions in the world will continue to be, uniquely, ours.The ones Big Pharma sells to us, here, even though people in other countries pay a fraction of what we do.

Don’t fall for it. Trump’s second term is already proving to be a wrecking ball aimed at the foundations of our Constitution and your care. This tariff plan, justified by a non-existent “emergency,” is just the latest swing. If he keeps going unchecked, expect more of the same: higher costs, less coverage, and more Americans dying because they couldn’t afford the medication they needed.

Trump calls that “America First.” We should call it what it is: America last, with Trump and his big business buddies first.

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