特朗普处方药业务开业

我是凯瑟琳·本霍尔德，纽约时报每日通讯《世界》的主持人。

I'm Catherine Benhold, host of The World, a daily newsletter from The New York Times.

我曾用二十年时间在十多个国家进行报道，有一天我突然想到，我会想读什么样的通讯呢？

I spent twenty years reporting from more than a dozen countries, and it occurred to me one day, what kind of newsletter would I like to read?

我不住在美国。

I don't live in The US.

我想为全球读者打造一份特别的通讯。

I want something especially for a global audience.

世界正是如此。

The world is just that.

每个工作日早晨，我们会为您带来最重要的新闻、同事从现场发回的报道，以及一些附带视频的惊喜内容。

Each weekday morning, we bring you the biggest stories, dispatches from my colleagues on the ground, and a few surprises with video too.

《世界》通讯。

The World Newsletter.

阅读最新内容并前往 nytimes.com/theworld 订阅。

Read the latest and sign up at nytimes.com/theworld.

来自《纽约时报》，我是蕾切尔·阿布拉姆斯，这里是《每日新闻》。

From The New York Times, I'm Rachel Abrams, and this is The Daily.

女士们、先生们，美国总统。

Ladies and gentlemen, the president of The United States.

上周，特朗普总统推出了特朗普药房计划。

Last week, president Trump unveiled Trump Rx.

数十种最常用的处方药将通过一个新网站以大幅折扣向所有消费者提供。

Dozens of the most commonly used prescription drugs will be available at dramatic discounts for all consumers throughout a new website.

这个网站叫做 trumprx.gov。

It's called trumprx.gov.

这是政府应对处方药高价的方案。

The administration's answer to the high cost of prescription drugs.

此次推出标志着处方药价格有史以来最大幅度的下调，远超以往任何一次，差距之大难以想象。

This launch represents the largest reduction in prescription drug prices in history by many, many times, and it's not even close.

你将看到一些你不敢相信的数字。

You're gonna see numbers that you're not gonna believe.

总统将该网站称为一项变革性的医疗保健举措。

The president hailed the website as a, quote, transformative health care initiative.

恭喜你，为你省下的这笔钱。

Congratulations to you on all that money you're saving.

明白吗？

Okay?

谢谢。

Thank you.

非常感谢大家。

Thank you very much, everybody.

感谢。

Appreciate it.

今天，我的同事玛戈·桑格·卡茨将解释这个网站是如何运作的，以及它是否真的能为美国人省钱。

Today, my colleague, Margo Sanger Katz, explains how the site works and whether it will actually save Americans money.

今天是2月11日，星期三。

It's Wednesday, February 11.

玛戈，欢迎再次回到节目。

Margo, welcome back to the show.

能回来真好。

It's nice to be back.

我觉得我已经听人谈论这个特朗普处方药项目好几个月了，却一直不清楚它到底是什么。

I feel like I have been hearing about this Trump Rx thing for probably months now without having a good sense of what this thing actually was.

比如，我都不知道它是不是一个在线药房，也许是个打上特朗普品牌的在线药房。

Like, I didn't know if it was an online pharmacy, a Trump branded online pharmacy perhaps.

上周，这个网站终于正式发布了。

And last week, the website was actually unveiled.

所以，玛戈，先给我们讲讲特朗普处方药项目到底是什么。

So, Margo, start off by telling us what is Trump Rx.

所以，在某些方面，说清楚它不是什么可能更容易些。

So I think in some ways, it's easier to say what it's not.

它不是一个可以购买处方药的地方。

It's not a place that you can buy prescription drugs.

这并不是一家药房。

This is not a pharmacy.

它也不是由联邦政府运营的商店。

It is not a store that's run by the federal government.

相反，这是一个你可以前往的地方，如果你正在寻找购买某些处方药的话。

Instead, it's a place that you can go if you're looking to buy certain prescription drugs.

它会帮助你找到以折扣价获取这些药物的方法。

It will help you figure out how to get them at a discounted price.

是的。

Mhmm.

因此，这是联邦政府努力帮助你找到价格合理的药物，但并不直接向你销售药物。

So this is the federal government's effort to help you find drugs at a good price, but not to sell you drugs directly.

这非常有趣，因为我认为在我有生之年，几乎每一位总统候选人都曾以某种形式谈论过降低药价的问题。

Which is so interesting because I'm pretty sure that pretty much every presidential candidate in my lifetime has talked at some point and in some form about bringing down drug prices.

而这个网站，Trump Rx，似乎是在应对一个非常棘手的问题上迈出的不寻常一步。

And this website, Trump Rx, seems like an unusual step toward addressing a very intractable problem.

那么，总统是如何得出这个解决方案的呢？

So how did the president arrive as this as the solution right now?

我觉得有两方面原因。

So I think there's two things going on.

一方面，特朗普现在面临着巨大的压力，必须采取措施解决药品可负担性问题，尤其是医疗保健的可负担性问题。

One is that Trump is obviously under a lot of pressure right now to do something about affordability, and particularly about the affordability of health care.

民主党人一直在猛烈抨击特朗普政府在这方面的表现，许多美国人也对医疗保健费用高昂且持续上涨感到担忧。

Democrats have just been hammering the Trump administration on this, and a lot of Americans are concerned about high and rising costs for health care.

是的。

Mhmm.

另一方面，药品价格一直是特朗普的执念。

The other thing is that drug prices have sort of been an obsession of Trump's.

甚至从2015年他刚开始竞选总统时，他就经常在竞选活动中谈论这个问题。

Even from the time he started running for president in 2015, this was something that he would talk about on the campaign trail a lot.

他在这一议题上的表态，听起来有点像伯尼·桑德斯。

Almost He sounded a little bit like Bernie Sanders on this issue.

他总是抱怨美国人支付着全球最高的药品价格，这一点确实如此。

He was always complaining that Americans pay the highest prices for drugs in the world, which is true.

平均而言，我们为处方药支付的价格是其他富裕国家的三倍左右。

On average, we pay about three times as much as what other rich countries pay for prescription drugs.

在他的第一个任期内，他曾试图采取一些措施来解决这个问题，但效果并不理想。

And in his first term, he tried to take some actions to do something about it, but they didn't really work out.

你能提醒我们一下吗，玛戈特，为什么美国人支付的药品价格比其他国家高？

And can you just remind us, Margot, why do Americans pay more than other countries for drugs?

答案有点复杂，但我觉得最简单的解释是，大多数其他国家的政府会直接与制药公司进行谈判。

So the answer is a little bit complicated, but I think the simplest way to answer it is that most other countries, the government of that country negotiates directly with pharmaceutical companies.

他们会说：如果你想把你的药卖给全国所有患者，就必须给我们一个合理的价格。

And they say, if you wanna sell your drug to all of the patients in my country, you need to give us a good price.

是的。

Mhmm.

而美国并没有这样的制度。

We don't have a system like that in The United States.

政府通常不参与药品价格的设定。

The government in general is not involved in setting the price for drugs.

相反，我们有众多不同的保险公司，各自为不同客户群体单独谈判价格。

Instead, we have lots of different insurance companies that are making separate deals for different groups of customers.

另一个区别是，在许多其他国家，如果制药公司推出一种疗效显著但价格昂贵的新药，这些国家会明确表示：如果你不把价格降得足够低，我们宁愿放弃谈判。

The other difference is that in a lot of other countries, if a drugmaker has a new drug that's really great but really expensive, those countries are willing to say, if you don't bring the price down enough, we are willing to walk away from the negotiating table.

而在美国，我认为我们有一种文化、政治氛围和预期：如果一种新药有效，我们就希望能让本国患者用上。

Whereas in The United States, I think we have a culture and a politics and an expectation that if a new drug works, that we wanna be able to offer it to patients here.

因此，政府在一定程度上参与其中，所有这些独立的保险公司也都缺乏足够的议价能力来压低价格。

And so that means that the government, to the degree it's involved, and all of those individual insurance companies just have a little bit less leverage to pull the price down.

因为它们无法退出谈判，制药公司在这里就拥有更大的权力，可以随意设定药品价格。

Because they can't walk away from the table, the drug companies have a lot more power here to set whatever price they want for those drugs.

如果你仔细想想，这意味着我们美国在某种程度上为其他国家的药品成本提供了补贴。

Which if you think about it, means that we, as The United States, are in some ways underwriting the cost of drugs for other countries.

对吧？

Right?

因为我们的国家愿意支付任何价格。

Because our country is willing to pay kind of whatever.

这可能让制药公司更容易去法国、英国或其他任何地方说：当然可以。

That probably makes it easier for drug companies to go to France or The United Kingdom or wherever else and say, sure.

好的。

Fine.

我们会接受你们对这种药物提出的任何要求。

We'll take whatever you're demanding we take for this drug.

我认为这完全正确。

I think that's absolutely true.

美国市场对制药行业来说至关重要。

The United States market is incredibly important to the pharmaceutical industry.

我们支付这些极高的价格。

We pay these super high prices.

而且我们还是一个非常大的国家，因此许多商业模式都基于这样一个理念：制药公司几乎所有的利润都来自美国市场，而从其他国家获得的收入则完全是额外的收益。

Also, we're just a really big country, And so a lot of the business model is sort of predicated on the idea that the drug company is gonna make almost all of its money on a new drug in The United States market, and then anything that they get from these other countries is kind of gravy.

对。

Right.

所以，好吧。

So okay.

所以你之前说特朗普在第一个任期内没能降低药价。

So you said Trump couldn't bring down the drug prices in his first term.

现在他显然又回到了办公室。

Now he's obviously back in office.

有什么变化吗？

What has changed?

有一件事没变，就是他仍然认为这是一个非常重要的问题，但这里有一些不同的地方。

So one thing that hasn't changed is he's continued to think that this is a really important issue, but here are a few things that are different.

一是药品市场发生了一些变化。

One is that the market for drugs has changed a little bit.

治疗肥胖的GLP-1药物激增，导致更多消费者直接购买药物，绕过他们的医疗保险。

The explosion of these GLP one drugs that treat obesity has led to many more consumers buying drugs directly and going around their health insurance.

所以，这是一个以前不存在的新型药品消费市场。

So that's kind of a new consumer market for drugs that didn't exist before.

另一点是特朗普面临的医疗可负担性方面的政治压力，美国人觉得医疗太贵了。

And the other thing is the political pressures around health care affordability that Trump is facing, that Americans feel like health care is too expensive.

是的。

Mhmm.

例如，他曾有一个重大的竞选承诺，说自己将成为辅助生殖技术之父，帮助许多不孕不育的夫妇让试管婴儿更便宜。

For example, he had this big campaign promise that he was gonna be the father of IVF, and he was gonna help a lot of couples that were having trouble with fertility, make IVF more affordable.

是的。

Mhmm.

此外，国会还通过其大型税收法案，大幅削减了为大量低收入人群提供保险的州医疗补助计划。

And then on top of that, the congress, as part of its big tax bill, made major cuts to state Medicaid programs that provide insurance to lots of low income people.

去年年底，国会让帮助数百万美国人购买奥巴马医改保险计划的补贴到期了。

And at the end of last year, congress allowed subsidies to expire that help millions of Americans buy Obamacare health insurance plans.

因此，这导致购买这类保险的人保费上涨，同时没有保险的人数也在增加。

And so that's increasing the premiums for people who buy that kind of insurance and increasing the number of people who don't have coverage.

是的

Mhmm.

我认为所有这些都在对他施加压力，迫使他开始寻找解决医疗成本上升的办法。

I think all of this is creating pressure for him to try to start to find solutions around rising health care costs.

关于处方药，有这么一件事。

And here's the thing about prescription drugs.

它们并不是医疗支出的最大原因。

They are not the largest cause of health care spending.

我们大部分的医疗支出都用于支付住院和医生诊疗费用。

Most of our health care spending goes to pay for hospitalization and doctor's visits.

但我认为，对很多人来说，药费特别突出，因为这是人们每个月都要面对的唯一一项医疗开支。

But I think that drug costs are particularly salient for a lot of people because it's the one health care cost that people kinda deal with every single month.

因此，特朗普决定将重点放在制药公司及其在系统中的作用上，并直接对这些公司施加压力。

And so Trump decides that he wants to focus on the pharmaceutical companies and their role in the system, and he begins a pressure campaign on these companies directly.

那意味着什么？

What does that mean?

我的意思是，他到底开始做什么了？

Like, what does he actually start doing?

于是他让他的贸易官员展开调查，并决定对药品征收高额关税。

So he has his trade officials do an investigation and determine that they can impose major tariffs on pharmaceutical products.

然后他亲自去找各个制药公司的首席执行官。

And then he goes to the CEOs of individual pharmaceutical companies.

他基本上对他们说：听着，我可以给你们加一大笔关税。

And he basically said to them, like, look, I could put a big tariff on you.

我可以让你们在这个国家继续做生意变得极其困难。

I could make it really hard for you to continue to do business in this country.

我真的很需要你们和我达成一项协议。

I really need you to make me a deal.

于是他开始一家一家地与这些制药公司谈判，并公开把他们请出来，在镜头前宣布达成的协议。

So he starts negotiating with all these drug companies one at a time, and he begins hauling them out in public in front of the cameras to announce deals.

我认为这是本办公室有史以来最重要的医疗公告之一，因为我们谈论的是

I think this is one of the biggest medical announcements that this office has ever made because we're talking about

所以他先从制药公司辉瑞开始。

So he starts with the drug company Pfizer.

辉瑞同意以大幅折扣的价格向所有消费者提供其一些最畅销的现有药品。

Pfizer has agreed to provide some of their most popular current medications to all consumers at heavily discounted prices of

他与这家公司的首席执行官举行了新闻发布会。

And he has this press conference with the CEO of that company.

总统先生，能来到这里真是荣幸。

Mister president, what what an honor to be here.

这场新闻发布会带有一点人质视频的感觉。

And the press conference, like, has a little bit of, like, a hostage video kind of feel to it.

他有一个漂亮的办公室，但椭圆形办公室最酷。

He has a beautiful office, but the Oval is the coolest.

对吧？

Right?

你觉得呢？

What do you think?

我觉得到目前为止是这样。

I I think by far.

你看到辉瑞的首席执行官在镜头前侃侃而谈，表示非常高兴能为他们的产品提供大幅折扣。

You see the CEO of Pfizer get up in front of the camera and talk about how delighted he is to offer these big discounts on his products.

现在我们清楚了美国药品定价的框架是什么。

Now we have clarity about what is the framework for The US pricing.

当然，他们以前根本不会愿意这么做。

Which, of course, they never would have wanted to do before.

今后，美国和海外的药品定价都将按照这种方式进行。

And going forward, this is how things will be priced in The US and abroad.

正是在那次新闻发布会上，特朗普提到了这个‘特朗普处方药’网站的想法。

And it's at that press conference that Trump mentioned the idea of this Trump Rx website.

药品将通过一个由联邦政府运营的网站直接在线购买，

Drugs will be available for direct purchase online at a website operated by the federal government where

所有这些协议都将集中到该网站上，并向美国民众公开。

Where all of these deals are gonna be pulled together and made public for the American people to find.

在接下来的几周和几个月里，一家接一家

And then over the next weeks and months, one by one

所以，特朗普总统，再次见到您真的非常高兴，自从

So president Trump, it is really a pleasure to see you again since

他们带来了多家制药公司的高管。

They have executives from numerous drug companies.

总统先生，谢谢您。

Mister president, thank you.

谢谢您，总统先生。

Thank you, mister president.

能来到这里真是莫大的荣幸。

It's a true honor to be here.

来参加这些新闻发布会。

Come out for these press conferences.

我们将大幅降低他们所依赖药品的价格。

We're gonna be significantly lowering the cost of the medicines they rely on.

宣布这些协议，并称它们将为美国消费者提供更优惠的价格。

Announce these deals and say that they're gonna be offering much better pricing to American consumers.

这相当于降价70%。

And that's a 70% price reduction.

这些优惠也将适用于Trump Rx。

And that also will be available on Trump Rx.

我们还将在每一次新闻发布会上

We're also very And at each one of these press conferences

现在你将看到一些令人难以置信的数字。

Now you're gonna see numbers that nobody would believe possible.

想想看。

Think of this.

特朗普正在使用极其夸张的语言来描述这些协议的优惠力度。

Trump is using this incredibly hyperbolic language to describe the kinds of deals that are being offered.

500%、600%、700%、800%。

500, 600, seven hundred, eight hundred percent.

他说，你知道，这些不是50%或80%的折扣，而是700%、800%、1000%的折扣。

Saying, you know, these are not discounts of 50 or 80%, but they are 700, 800, 1000% discounts.

在某些情况下，你谈论的是1400%、1500%、1600%的降价。

You're talking about fourteen, fifteen, 1600% reductions in some cases.

这些折扣在数学上是不可能的。

Discounts that are mathematically not possible.

我认为基于这一点，我今天甚至不会回答任何问题，因为没有任何问题能与你刚才所见的相提并论。

And I think based on that, I won't even take questions today because there's no way I can take questions that are anywhere comparable to what you just witnessed.

你刚刚见证了药物价格将以从未想象过的幅度下降，马蒂。

You just witnessed drug prices that will go down at levels never thought even possible, Marty.

所以，当这个网站上周上线时，已经连续举办了多场新闻发布会。

So by the time this website rolls out last week, there's been this drumbeat of press conference after press conference.

我认为这造就了一种预期，即这将是一个巨大的突破，药物将出现各种美妙的折扣。

And I think it's led to this expectation that it's going to be this huge deal, and there are gonna be all of these wonderful discounts on drugs.

但如果你仔细查看这些实际协议的细节，现实与那种预期截然不同。

But if you look at the details of these actual deals, the reality is very different than that.

我们马上回来。

We'll be right back.

我叫丹·鲍威尔。

My name is Dan Powell.

我是玛丽昂·洛扎诺。

I'm Marion Lozano.

我们是《纽约时报》的作曲家。

We are composers at the New York Times.

我们为《每日新闻》创作大量音乐。

And we write a lot of music for the daily.

我目前正在创作一首名为《几何》的作品。

I'm currently working on a piece called Geometry.

这是一段音乐性的沉思时刻，帮助听众消化故事内容。

It's a musical moment of reflection to help the listener digest the story.

这首作品是为一篇太空主题的报道创作的。

This piece is for a space episode.

我想让听众直接置身于太空的深邃黑暗中。

I wanna put the listener right into the deep darkness of space.

对于这段音乐，制作人希望我们创作出能唤起七十年代末感觉的作品。

For this cue, the producers wanted us to write something that would evoke the late seventies.

我先从贝斯线开始，然后加了一些鼓点。

I started with a baseline, and then I added some drums to it.

他说，你能给这段音乐多加20%到30%的放克元素吗？

He said, can you, like, add 20 or 30% more funk to this?

是的。

Yeah.

我们

We

我们创作音乐是为了突出某个时刻，让你沉浸于故事中，而不直接告诉你该有什么感受。

write music to highlight a moment, to draw you into the story without telling you how to feel.

是的。

Yeah.

这始终是一个需要解决的谜题。

It's always the puzzle to solve.

所以，如果你喜欢《每日新闻》并希望我们继续为这个节目制作富有反思性、宇宙感、有时带点律动但始终低调的音乐，请通过订阅《纽约时报》来支持我们。

So So if you love The Daily and you want us to keep making reflective, cosmic, sometimes groovy, but always subtle music for the show, support us by subscribing to The New York Times.

所以，玛戈，你在广告前提到，特朗普此前对这个网站的言论设定了很高的期望，但当你实际查看该网站上所代表的交易时，这些期望并未完全实现。

So, Margo, you said before the break that the way that Trump had been talking about this website had set up huge expectations that weren't necessarily met when you actually looked at the deals represented on this site.

所以请你再多讲讲，当你进一步调查时发现了什么。

So tell us a little bit more about what you found when you looked into this more.

当你查看这个网站时，它根本没能让大多数美国人服用的药物价格发生革命性变化。

So when you look at this website, it is absolutely not revolutionizing the price of most drugs that most Americans take.

首先，这个网站上只有43种药物。

First of all, there are only 43 drugs on this website.

而处方药有成千上万种。

There are thousands and thousands of prescription drugs.

所以，这仅仅是人们所需药物中极其微小的一部分。

So this is this tiny, tiny little fraction of the drugs that people need.

对。

Right.

这在药物市场中占比很小。

That is not a lot of the drug market.

是的。

Yeah.

对于有保险的人群——占所有美国人的85%——这个网站并没有提供比他们现有价格更好的优惠。

And for people who have insurance, which is 85% of all Americans, this website is really not offering them a better price than what they already have.

但有两类药物的优惠实际上相当不错。

But there are two categories of drugs where the deals are actually pretty good.

那就是不孕症和肥胖症的药物。

Those are drugs for infertility and for obesity.

我觉得我们应该一起看看这个网站，实际走一遍你能看到什么。

I think we should take a look at this website together and just kinda like walk through what you might actually see.

对。

Yeah.

我们来吧。

Let's do it.

那我去找 trumprx.gov。

So I'm gonna go to trumprx.gov.

对吧？

Right?

这就是那个网站吗？

That's the website?

我也去那里。

I'm going there too.

好的。

Alright.

所以我第一眼看到的是，大字写着：找到处方药的世界最低价。

So the first thing that I see is in big letters, it says, find the world's lowest prices on prescription drugs.

而且在‘drugs’这个词后面，有一个小药丸符号代替了句号。

And there's like a little pill instead of a period after the word drugs.

有一个小药瓶悬浮在‘价格’这个词上方。

There's a vial kind of hovering over the word prices.

我们来看看。

And let's see.

你可以向下滚动。

You can scroll down.

我们看到了美国和加拿大的对比。

We see comparisons between The USA and Canada.

好的。

Okay.

不过继续吧，因为这是我最喜欢的部分。

So keep going, though, because this is my favorite part.

有一个旋转的地球仪，美国部分用金色显示。

There's a spinning globe with The United States in gold.

非常引人注目。

It's very catching.

并且它说，得益于特朗普总统，大型制药公司抬高价格的时代已经结束。

And it says, thanks to president Trump, the days of big pharma price gouging are over.

通过动用美利坚合众国的全部力量和影响力，总统确保了每个美国人都能享受到发达国家中最低的处方药价格。

Leveraging the full weight and power of The United States Of America, the president has ensured every American gets the lowest prices on prescription medications in the developed world.

你知道，我觉得这个网站非常漂亮。

You know, I think it's a very beautiful website.

设计非常简洁。

The design is very clean.

使用起来很愉快。

It's enjoyable.

很容易理解。

It's easy to understand.

但它仍在不断做出这些夸张到根本无法兑现的承诺。

But it is continuing to make these very hyperbolic hyperbolic promises that it really just doesn't deliver on.

好的。

Okay.

那我们来看看实际的药物。

So let's look at the actual drugs.

我往下滚动，找一种药物。

I'm gonna scroll down until I find a drug.

好的。

Okay.

这里列出的第一种药物是Wegovy，一种减肥药。

So the first drug listed here is Wegovy, a weight loss medication.

对吧？

Right?

玛戈，告诉我我们现在看的是什么。

Margo, tell me what we are looking at.

Wegovy是一种GLP-1类药物。

So Wegovy, this is one of these GLP one drugs.

这是一种用于治疗肥胖的药物。

This is a drug that is used to treat obesity.

并且它显示Wegovy笔，折扣74%到85%。

And it says Wegovy Pen, 74 to 85% off.

然后还有一个小图表，显示你购买不同剂量的药物时对应的价格。

And then there's this little chart that shows you depending on what dose of the drug you're gonna buy, what is the price.

这种药物的标价每月超过1000美元。

So the list price for this drug is more than $1,000 a month.

在这个网站上，它显示原价为1349.02美元。

On this website, it says original price, $1,349.02.

这是你在药房需要支付的价格。

That is what you would have to pay at the pharmacy.

嗯。

Mhmm.

每月13.50美元。

$13.50 a month.

而根据特朗普处方定价，他们展示的是最高剂量药物的价格仅为349美元。

And with the Trump Rx pricing, what they are showing you is for the highest dose of the drug, the price is only $349.

所以对于那些没有保险覆盖、需要自费购买这种药物的人来说，这是一笔相当可观的节省。

So this is some really significant savings for people who take this drug, don't have insurance coverage for it, and are paying with their own money out

自费。

of pocket.

我想看看这个网站上的其他一些药物，因为我注意到这43种药物中有很多是生育药物，而这些药物人们通常需要自费购买。

I wanna look at some of the other drugs on this website because I noticed that a lot of the drugs listed of these 43 are fertility drugs, which are drugs that people often have to pay for out of pocket.

我实际上请一位最近刚经历试管婴儿的朋友发给我她最近从在线药房自费购买的药物清单，我想对比一下她支付的价格和Trump Rx上宣传的价格。

And I'd actually asked a girlfriend of mine who recently went through IVF to send me the list of drugs she had to purchase out of pocket from an online pharmacy recently because I wanted to compare the prices that she paid to the prices being advertised on Trump Rx.

我的朋友花了大约300美元。

My friend paid about $300 for it.

如果我们直接在Trump Rx上输入这种药，可以看到它从她所用的相同剂量开始，价格是168美元。

And if we just type it into Trump Rx, we can see that it starts at the same dosage that she had for a $168.

所以这是一个相当大的折扣。

So that's a significant discount.

是的。

Yeah.

我觉得你朋友的价格很有代表性。

I think your friend's price is kind of illustrative.

对吧？

Right?

Trump Rx 网站称，原价是 966 美元。

The Trump Rx website is saying that the original price was $966.

你朋友当时支付了大约 300 美元。

Your friend was paying around $300.

所以这是一笔不小的节省。

So this is a big savings.

168 美元比 300 美元还低。

A $168 is less than $300.

我认为，对于这些不孕药物来说，这又是特朗普政府谈判出比以往更好折扣的另一个例子。

I think for these fertility drugs, it's another example where the Trump administration did negotiate better discounts than were available before.

我认为，这些不孕药物成本的降低确实会让需要这些治疗的女性负担得起，但实际降幅并没有网站宣传的那么大。

And I do think that the reduced cost of some of these infertility drugs is going to make these treatments more affordable for women who need them, but it is not quite as big as what the website is promising.

所以如果你想想减肥药和不孕药，这两个例子正是Trump Rx真正下功夫的地方。

So if you think about obesity drugs and infertility drugs, these two examples are the places where Trump Rx is actually doing the most work.

好的。

Okay.

减肥药、试管婴儿药物。

Weight loss drugs, IVF drugs.

明白了。

Got it.

但其他所有药物呢？

But what about literally everything else?

至于其他所有药物，情况就有点令人失望了，原因如下。

So the literally everything else is a little bit more disappointing, and here's why.

这些其他药物主要是治疗常见疾病，比如哮喘、高胆固醇、糖尿病。

These other drugs are the kinds of drugs that treat more common conditions like asthma, high cholesterol, diabetes.

这些药物几乎都被所有保险计划很好地覆盖。

These are the kinds of drugs that almost everyone's insurance covers really well.

所以如果你有保险，你就不用支付全价。

And so if you have insurance, then you're not paying the full price.

你只需要支付共付额，在很多情况下每月大约是25美元。

You're paying a co payment, which in many cases could be like $25 a month.

这几乎肯定比特朗普医疗计划对所有这些药物的定价更划算。

That's pretty much gonna beat the Trump Rx price for all of these drugs.

百分之八十五的美国人有涵盖其药物的保险。

And eighty five percent of Americans have insurance coverage that covers their drugs.

所以这实际上涵盖了绝大多数人。

So that really is most people.

是的。

Mhmm.

即使你考虑那些没有保险、必须自费购药的人，我的同事丽贝卡·罗宾斯和我仔细研究了这份药物清单。

Then even if you're thinking about the people who don't have insurance and who have to pay for their drugs directly with cash, my colleague Rebecca Robbins and I went through this list of drugs.

在43种药物中，我们发现大约有一半已经有了上市的仿制药，价格比特朗普医疗计划提供的价格更低。

And of the 43 drugs, we found that about half of them already have generics that are on the market that are cheaper than the prices that are being offered on Trump Rx.

所以，即使对于那些没有保险的人，通过这个系统购买药物也不会更划算。

So even for those people who don't have insurance, they would not be better off buying the drugs through this system.

他们更好的选择是去药房，直接购买便宜的仿制药。

They would be better off going to their pharmacy and just paying for a generic.

人们会清楚地知道，这个网站可能并不能为他们找到最划算的药品吗？

Is it gonna be clear to people that this website might not give them the best deal for the drug that they're looking for?

这个网站上有一些免责声明。

The website has some disclaimers on it.

当你进入每个单独的页面时，你会看到免责声明，例如提醒你检查自己是否有保险。

When you go on each individual page, you will see that there is a disclaimer, for example, that you should check and see if you have insurance.

通过共付额支付可能会更便宜。

It might be cheaper with a co payment.

因此，这并不是一个一站式购物平台，就连设计这个特朗普处方药网站的人也承认这一点，并明确告知消费者。

So this is not a one stop shop for people, and even the people who have designed this Trump Rx website acknowledge that and are telling consumers that.

但与此同时，我们也要坦诚地面对人们在调查自身医疗保健时所耗费的时间和资源。

At the same time, though, let's just be honest about the amount of time and resources people have to investigate their own health care.

比如，如果你全职工作，或者你是照顾者，或者你同时打几份工，你花时间去研究如何找到最便宜的药——比如查网站、看保险信息等等——很可能非常有限。

Like, if you are working full time, if you are a caregiver, if you are working multiple jobs, the amount of time that you're likely to invest in whether you can get the cheapest drug by, like, looking this up, looking at your insurance, etcetera, etcetera, is probably kinda limited.

所以，如果你从我们之前提到的新闻发布会或其他渠道得到的印象是，这个网站能让你以最便宜的方式买到药，你可能会直接使用Trump Rx，即使它实际上并不是最划算的选择。

So if you have the general impression from the press conferences we talked about or others that this is gonna be the cheapest version of the way that you get your drugs, you might just end up using Trump Rx, right, even if it's not actually the best deal.

有可能。

You might.

但我认为大多数美国人已经习惯用保险来买药了。

But I think that most Americans actually are used to using their insurance for drugs.

他们不习惯直接用现金支付，也不习惯像这个网站所鼓励的那样货比三家来寻找最低价。

They're not used to paying directly with cash and shopping around for the best price in the way that this website is encouraging them to do.

但我们采访的一些人表示，他们担心人们会误以为Trump Rx提供的是最优惠的价格，因而不会去考虑其他选择，最终为药品支付了过高的费用。

But some people that we talked to said that they're worried people are going to think that Trump Rx is offering them the best deal, and they are not going to look into these other options, and they're gonna end up overpaying for drugs.

所以，从你所说的一切来看，关键在于：如果你在美国难以负担处方药的费用，这个网站很可能无法解决这个问题。

So the bottom line here, it seems, from everything you've said, is that if you have trouble paying for your prescription drugs in The United States, this website is probably not gonna fix that problem.

是的。

Yeah.

这个网站对于大多数在处方药费用上挣扎的美国人来说，实际上并没有提供多少帮助。

This website just isn't really doing very much for most Americans who struggle with their prescription drug prices.

例如，目前市场上一些最昂贵的药物，也是美国人和保险公司难以负担的药物，是治疗癌症的药物。

For example, some of the most expensive drugs on the market right now and the ones that Americans and insurance companies struggle to pay for are drugs for cancer.

这个网站上没有任何治疗癌症的药物。

There are not any drugs for cancer on this website.

值得注意的是，这仅仅是开始。

And it's worth noting that this is just the beginning.

未来预计会有更多药物被添加到这个网站上。

More drugs are expected to be added to this website over time.

但就目前而言，很明显，这并不是解决美国高昂处方药费用问题的方案。

But for right now, it's very clear that this is not the solution to the problem of high prescription drug costs in America.

所以，玛戈，如果这个网站真的只对那些想减肥或多生孩子的人有帮助，那我就不得不怀疑，为什么一开始要聚焦在这两个群体上，尤其是因为特朗普候选人把促进美国家庭增长作为他竞选的核心内容之一。

So, Margo, if this website is really only going to help people who either wanna lose weight or have more children, it does make me wonder about the decision to focus on those two groups to begin with, especially because candidate Trump made growing the American family such a big part of his campaign.

你认为这个Trump Rx项目更多是出于意识形态和竞选承诺，而不是真正希望改善药物的可负担性吗？

Do you think that this Trump Rx program is motivated more by ideology and perhaps campaign promises than by a desire to truly improve affordability?

我不觉得是这样。

I don't really think it is.

我认为这更像是一种偶然的幸运，因为这些药物正好能让他声称自己降低了价格，这与他在不孕问题上的竞选承诺相呼应，而在减肥药方面则非常受欢迎。

I think it's more of a happy accident that these are drugs that Trump would love to take credit for lowering the price of because they connect to his campaign promises in the case of infertility, and they're really popular in the case of weight loss drugs.

但还有一些药物，制药公司原本就有很大的动力提供折扣，因为已经有很多人自费购买这些药，而特朗普处方计划的发布带来的宣传效应，可能会为他们带来更多客户，从而弥补低价带来的损失。

But there are also drugs where the drug company already had a pretty big incentive to offer a discount, that there is this big market of people who are already paying for it with their own money, and the publicity of the Trump Rx launch might help bring them more customers that will compensate for the lower prices.

但我认为，整个举措非常符合我们对特朗普那种推销风格的预期。

But the whole exercise, I think, very much fits into the kind of salesmanship that we expect from Trump.

他并没有真正解决医疗费用负担这一更广泛的问题。

He does not really have a solution to the broader question of health care affordability.

他也没有制定全面的计划来降低医院、医生或其他大多数美国人面临最大账单的地方的医疗成本。

He does not have a comprehensive plan to lower health care costs at the hospital or at doctors or any of the other places where most Americans are faced with the biggest bills.

而且不仅如此，他的政府还采取了某些措施，导致许多美国人的医疗成本上升，可能使数百万美国人失去医疗保险。

And even more than that, his administration has taken actions that are raising the cost of health care for a lot of Americans that could cause millions of Americans to lose their health insurance.

所以这不仅仅是一个小方案，而是在特朗普执政期间问题日益恶化的情况下，一个微不足道的解决方案。

So this is not just a small solution, but it is a small solution to a problem that is getting worse on Trump's watch.

玛戈·辛格·卡茨，再次感谢您今天与我们同行。

Margo Singer Katz, thank you again for being with us today.

很高兴能来这里。

It's nice to be here.

我们马上回来。

We'll be right back.

以下是今天您需要了解的其他内容。

Here's what else you need to know today.

在周二的国会听证会上，代理移民与海关执法局局长托德·莱恩斯拒绝透露，上个月一名ICE特工在明尼苏达州开枪打死雷娜·古德后，是否有人被解雇。

During a congressional hearing on Tuesday, Todd Lyons, the acting ICE director, refused to say whether anyone had been fired after an ICE agent shot and killed Renee Good in Minnesota last month.

您能告诉我们，至少——天啊，我希望至少有一个人因为这些行动中的行为被解雇了吗？

Can you tell us if at least god, I hope at least one person has been fired for their conduct since these operations have begun.

您是在告诉我们，您甚至不能确认有一个人被解雇了吗？

Are you are you telling us you can't even say one person's been fired?

先生，我不会谈论这个。

Sir, I'm not gonna talk

关于个人行为，我们稍后会回复您。

about personal actions, but we will get back to you.

特朗普政府在古德去世后立即将她定性为国内恐怖分子。

The Trump administration had labeled Good a domestic terrorist in the immediate aftermath of her death.

当被追问时，莱昂斯拒绝为这一标签道歉，也拒绝对其真实性作出回应。

When pressed, Lyons refused to apologize for the label and declined to answer whether it was true.

一名枪手在加拿大东北部不列颠哥伦比亚省的一个偏远小镇开枪，造成九人死亡、二十五人受伤，这是加拿大历史上第三致命的枪击事件。

And a shooter killed nine people and injured 25 others in a remote town in Northeastern British Columbia, the third deadliest shooting in Canada's history.

在腾博里奇中学发现了七具尸体，其中包括一名据信是枪手的人，其死因似乎是自伤。

Seven people were found dead in Tumbler Ridge Secondary School, including a person believed to be the shooter who died from what appeared to be a self inflicted injury.

另有两人在一处当地住宅内被发现死亡，另一人在送往医院途中死亡。

Two other people were found dead in a local residence while another person died while being transported to a hospital.

此次袭击的动机尚未明确，当局也未公布关于枪手的任何细节。

A motive for the attack was not immediately clear, and authorities have not released details about the shooter.

本期节目由亚历克斯·斯特恩、罗布·齐普科、安娜·福利和黛安娜·温制作。

Today's episode was produced by Alex Stern, Rob Zipko, Anna Foley, and Diana Wynn.

本集由刁丽茜和MJ·戴维斯·林恩剪辑。

It was edited by Lexi Diao and MJ Davis Lynn.

音乐由玛丽安·洛萨诺和王黛安提供，音频工程由克里斯·伍德负责。

Contains music by Marian Lozano and Diane Wong and was engineered by Chris Wood.

以上就是《每日新闻》的全部内容。

That's it for The Daily.

我是蕾切尔·阿布拉姆斯。

I'm Rachel Abrams.

明天见。

See you tomorrow.