Trump's Big Week: Middle East Trip, China Deal, Pharma EO, "Big, Beautiful Bill" with Ben Shapiro

All-In Podcast with Ben Shapiro

Introduction and Topics Overview

• The episode features Ben Shapiro as a guest, discussing various topics including Trump's trip to the Middle East and an executive order on pharmaceutical benefits.

• Other subjects include the ban on mock meat in Montana and a critique of the tax bill supported by Republicans.

Daily Mail Commentary

• Discussion about the endless nature of Daily Mail articles, likening them to "click crack" due to their addictive content.

• The hosts humorously reflect on their experiences with Daily Mail, particularly how they get drawn into multiple stories through links and photos.

Apology Segment

• Jason Calacanis issues a formal apology to poker legend Phil Helmu for previous comments made about his relationship with actor Timothy Shalamé. This is framed as a commitment to journalistic integrity.

• The apology acknowledges inaccuracies regarding Mr. Helmu's connections within Hollywood, emphasizing his extensive celebrity friendships across various fields such as film and sports.

Personal Reflections on Friendship

• One host expresses personal affection for Phil Helmu, noting that their ribbing is meant in good fun but recognizes it may have hurt his feelings. They reaffirm their friendship and appreciation for him.

• Acknowledgment of Phil's contributions to the podcast community and relationships formed through him is highlighted as significant.

Future Events Announcement

Gambling and Las Vegas Plans

Discussion on Gambling

• The conversation begins with a light-hearted invitation to Ben to join in Las Vegas, highlighting his lack of experience with gambling.

• The host emphasizes the excitement of having a "virgin shooter" at the craps table, suggesting that beginners can often have unexpected success.

• A personal anecdote is shared about taking family members to Vegas, where a first-time dice roller had an impressive run, illustrating the thrill of gambling.

Invitation to Event

• The host insists on Ben attending an event in Las Vegas on November 22nd, promising a fun experience and participation in activities on stage.

• There’s humor regarding parenting advice being given during this trip, contrasting traditional responsibilities with spontaneous adventures.

Trump's Middle East Trip Analysis

Overview of Trump's Visit

• Ben Shapiro joins the podcast to discuss Trump’s recent trip to the Middle East, focusing on significant investments secured from Saudi Arabia totaling $600 billion.

• Notable figures from various industries accompanied Trump, including Elon Musk and Andy Jassy, indicating high-profile support for his initiatives.

Key Deals and Policies

• Trump announced major deals including a $200 billion agreement with Qatar for defense contracts involving Boeing aircraft.

• His speech emphasized moving away from past American interventionist policies towards fostering business relationships in the region.

Strategic Implications

• Shapiro notes Trump's comfort level with Middle Eastern leaders like NBS (Mohammed bin Salman), marking a shift from previous administrations' approaches focused on democracy promotion.

• The discussion highlights Trump's focus on commerce over chaos as a guiding principle for U.S. foreign policy in the region.

Concerns Regarding Qatar

Cautionary Notes

• Shapiro raises concerns about Qatar's complex relationship with terrorism funding while also engaging diplomatically with Western nations.

Al Sharai and U.S. Relations with Qatar

The Evolution of Al Sharai

• Discussion on the name change from Alalani to Al Sharai, highlighting his previous affiliations with groups like al-Qaeda and ISIS.

• Mention of Al Sharai's current alignment with Turkish interests and the implications for sanctions.

U.S.-Qatar Relations

• Inquiry into whether deep ties with Qatar are beneficial, considering its relationships with Hamas and the Muslim Brotherhood.

• Argument that the U.S. should leverage its position regarding Qatar’s air base to influence their actions towards Hamas.

Strategic Leverage Post-October 7th

• Suggestion that after significant events (e.g., October 7th), the U.S. should have demanded hostages' release in exchange for maintaining military presence in Qatar.

• Emphasis on a cautious approach ("trust but verify") rather than blind trust in diplomatic relations.

Business Collaborations Between Nations

• Overview of Trump's business dealings, including a controversial $400 million plane deal, raising questions about its relevance.

• Notable investments between Saudi Arabia, UAE, and American companies indicating unprecedented collaboration.

Human Rights and Social Reforms

• Observations on social reforms in Saudi Arabia over recent years compared to historical progress on human rights issues.

Commercial Developments

• Announcement of a significant $1.7 billion AI inference deal aimed at building data centers in Saudi Arabia as part of growing commercial ties.

Military Gifts and Diplomatic Customs

• Clarification regarding a military plane gift from Qatar to the U.S., explaining it as part of customary diplomatic practices rather than corruption or graft concerns.

The Shift in Global Influence: America and China

America's Hegemony Post-World War II

• The speaker emphasizes that the United States has been a global hegemon since World War II but suggests that recent years have seen a decline in influence due to neglecting key global dynamics, particularly regarding China.

China's Belt and Road Initiative

• The Belt and Road Initiative (BRI) is highlighted as a strategic move by China to invest heavily in critical regions like Southeast Asia, the Middle East, and Africa, with significant investments totaling around $200 billion over 15 years.

Economic Cooperation with the Middle East

• The U.S. recently announced a $2 trillion investment from Middle Eastern countries into the U.S., indicating a shift towards economic cooperation and alignment between these nations and America.

Strategic Importance of Saudi Arabia

• Saudi Arabia's geographical significance is noted; it is located within a thousand-mile radius of 4 billion people, making it crucial for establishing regional cooperation and strategic alliances.

Trump's Impact on U.S.-Middle East Relations

• Trump’s administration is credited with redefining relationships in the Middle East by fostering an economic alliance that may be difficult for future administrations to dismantle, emphasizing his $2 trillion bet on partnerships with Saudi Arabia, Qatar, and UAE.

Narrative Shift in American Foreign Policy

• A notable change in narrative during Trump's speech reflects respect for different governance styles without imposing American ideals, contrasting past leadership approaches that viewed other systems as inferior.

Embracing Diverse Governance Models

• The speaker critiques the colonial mindset inherent in previous American foreign policy which insisted on promoting democracy as the only valid model. Instead, there’s an acknowledgment of multiple paths to governance that can coexist peacefully.

Moving Beyond Moral Absolutism

• There’s an assertion that America will no longer enforce its political framework globally but will seek partnerships based on mutual respect while addressing shared concerns like terrorism.

Republican Stance on Human Rights

Discussion on Modernization and Foreign Policy

Modernization in the UAE

• The speaker notes a shift in the UAE towards modernization, highlighting increased engagement with women in business, music, and dance, alongside the introduction of alcohol and casinos.

• This change reflects a strategy of less judgment and more engagement, suggesting positive outcomes for modernization efforts.

Misinterpretation of Trump's Foreign Policy

• The media presents a false binary regarding President Trump's foreign policy as either neoconservatism or isolationism; however, this oversimplifies the reality.

• Trump has rejected Wilsonian interventionism while actively engaging in international deals, indicating a realist approach rather than true isolationism.

Realist Approach to Foreign Relations

• Trump's foreign policy is characterized by realism—making beneficial deals for America rather than isolating from global affairs.

• Within Republican debates, there are differing views on realism: one hawkish (skeptical of foreign intentions) and one dovish (favoring no strings attached).

Implications of Economic Deals with Iran

• The discussion highlights that after Trump’s economic dealings with various countries, Iran appeared to capitulate quickly; this raises questions about future negotiations.

• Skepticism remains regarding Iran's negotiation tactics; they have historically been adept at leveraging negotiations without losing ground.

Trust Issues with Iran

• Concerns are raised about whether any new nuclear deal will truly prevent Iran from pursuing weapons development or terrorism funding.

• There is an emphasis on the need for Iran to earn trust before being allowed access to capital that could fund nefarious activities.

Future of Commerce in the Middle East

• Trump expressed interest in Saudi Arabia joining the Abraham Accords during his speech in Saudi Arabia, emphasizing commerce over ideological conflicts.

Insights on U.S.-Saudi Relations and Regional Dynamics

The Role of the U.S. in Saudi Arabia's Economic Landscape

• Discussion on how the U.S. influences economic deals with Saudi Arabia, emphasizing President Trump's strategic approach to fostering business relationships.

• Highlights the importance of regional stability, noting threats from groups like the Muslim Brotherhood and Iran that could destabilize alliances in the Middle East.

Potential Outcomes of President Trump's Strategy

• Examination of two possible strategies: a bilateral approach with individual nations versus creating a more interdependent regional economic block through initiatives like the Abraham Accords.

• Questions raised about whether Saudi Arabia will join the Abraham Accords and what factors are delaying this decision.

Challenges Facing the Abraham Accords

• Analysis of obstacles to Saudi participation in the Abraham Accords, particularly focusing on ongoing conflicts such as the war in Gaza.

• Discussion on how Israel's military actions against Iranian proxies have shifted dynamics, potentially reducing incentives for Saudi-Israeli cooperation.

Implications of Military Sales to KSA

• Insight into President Trump’s military sales to Saudi Arabia as a defensive measure against Iran, suggesting it may impact future diplomatic agreements like the Abraham Accords.

Corruption Allegations and Their Impact on Policy

• Commentary on perceptions surrounding Qatar's financial dealings and their implications for U.S. politics, including concerns over optics related to accepting significant gifts.

Discussion on Trump's Public Image and Political Strategy

Impact of Allegations on Trump's Image

• The discussion revolves around whether allegations against Trump harm his public image or serve as a narrative for his political opponents, potentially benefiting him in the long run.

• Media coverage could have focused on positive aspects of Trump's dealings but instead became an unnecessary distraction, contributing to perceptions of impropriety among critics.

Economic Concerns and Corruption Allegations

• There is a sentiment that many people prioritize economic performance over corruption allegations; however, if economic indicators decline, scrutiny may increase.

• The analogy of a car crash illustrates how minor issues can become significant when larger problems arise, suggesting that losing midterms could lead to intensified investigations against Trump.

Trade Deals and Economic Implications

Recent Trade Developments

• A recent trade deal with China was announced, reducing tariffs significantly from 145% to 30%, which could be seen as a win for Trump.

• The market reacted positively to these developments despite some fluctuations in major indices like the Dow and NASDAQ.

Long-term Effects of Tariff Changes

• Discussion includes potential long-term impacts of tariff changes on U.S. businesses and the economy, questioning whether these deals will yield substantial revenue or merely serve as distractions.

Regulatory Parity in Trade Negotiations

Importance of Regulatory Fairness

• Emphasis is placed on regulatory parity as crucial for U.S. companies competing in foreign markets; this aspect often gets overshadowed by headline tariff numbers.

• Examples are provided regarding challenges faced by U.S. tech companies abroad due to fines and restrictions imposed by foreign governments.

Future Outlook on Trade Agreements

Negotiating Trade: Insights on Tariffs and Global Relations

The Role of Tariffs in U.S. Trade Strategy

• The discussion begins with the potential for tariffs to serve as a starting point for negotiations, suggesting that success for the Trump administration could be measured by how effectively these tariffs are utilized.

• The speaker compares U.S. trade strategy to China's Belt and Road Initiative, emphasizing the need for America to reclaim its influence globally while moving away from reliance on low-cost imports.

• A call is made for higher quality goods over quantity, advocating for bilateral agreements with various countries to strengthen American hegemony.

• The importance of negotiating with China is acknowledged, but there’s a warning against losing focus on broader strategic goals amidst globalist free trade ideologies.

• The speaker views current tariff discussions as an opportunity to reset America's position in global trade dynamics, likening it to a new phase of international relations.

Challenges and Opportunities in Consumer Behavior

• There’s recognition that consumer habits may need adjustment; Americans should consider the implications of their purchasing choices beyond just price.

• A prediction is made regarding tariffs generating significant revenue by 2025, though skepticism exists about measuring this impact accurately due to complexities in trade relationships.

• Questions arise about whether changing consumer preferences can shift away from cheap imports towards more sustainable options produced elsewhere.

Reflections on American Manufacturing and Consumerism

• Historical context is provided regarding past efforts to promote American-made products, highlighting challenges faced when domestic goods did not meet quality expectations compared to foreign alternatives.

• There's an acknowledgment that reshoring manufacturing entirely back to the U.S. may not be feasible; instead, production might shift to other countries like Vietnam or India.

Humor and Insight into Economic Policy

• A humorous anecdote illustrates the complexity of economic adjustments under Trump's policies, comparing it metaphorically to adding livestock into a household until realizing less is more.

Understanding Investor Sentiment and Economic Policy

The Role of Uncertainty in Investment Decisions

• Investors face uncertainty regarding future economic policies, particularly concerning pharmaceutical executive orders and tax negotiations.

• Saudi Arabia's stability as a wealthy kingdom contributes to investor confidence, as it does not have the same electoral pressures that influence other nations.

Impact of Political Stability on Market Confidence

• The unpredictability of U.S. policy under President Trump creates challenges for businesses, especially in e-commerce, leading to anticipated layoffs.

• Companies struggle with hiring and advertising due to market uncertainties; advertisers may pause spending if consumer demand is unclear.

Legislative Developments: The Big Beautiful Bill

• Republicans are pushing a significant bill through reconciliation to avoid Senate filibuster, aiming for 51 votes instead of the usual 60.

• Key components include extending tax cuts from the 2017 Tax Cuts and Jobs Act until 2034 and various campaign promises related to taxation.

Financial Implications of Proposed Tax Cuts

• The Tax Foundation estimates that proposed tax cuts could reduce federal revenue by $4.1 trillion over ten years while also aiming for $1.5 trillion in spending cuts.

• Notable proposed cuts include stricter SNAP rules and tighter Medicaid caps, reflecting ongoing debates about fiscal responsibility.

Concerns Over National Debt and Fiscal Responsibility

• There is significant concern regarding the national debt; critics argue that current proposals do not adequately address fiscal emergencies.

• Projections indicate annual deficits could reach $2.5 trillion, exacerbating existing debt levels significantly.

Understanding Rising Interest Rates

• Interest rates are increasing due to market perceptions of potential U.S. default on debt payments; this reflects broader fiscal instability.

Budget Cuts and Fiscal Responsibility

Guiding Principles for Budget Management

• The speaker emphasizes that any ongoing programs should have their budgets cut back to pre-COVID levels, specifically 2019 levels, to improve the fiscal situation.

• A call is made to refrain from adding new programs at this time, highlighting concerns over increased costs in the current budget proposal.

SNAP Program Changes

• Notable cuts are proposed for the Supplemental Nutrition Assistance Program (SNAP), which has seen its budget grow from $60 billion in 2019 to $120 billion today.

• The proposed budget aims to reduce SNAP funding by approximately $30 billion, bringing it down to $90 billion—still significantly higher than pre-COVID levels.

Taxation and Spending Concerns

• The speaker advocates for tax cuts but stresses that spending must not exceed revenue; otherwise, it leads to unsustainable financial practices.

• There are concerns about potential loopholes arising from tips and overtime exclusions in contracts, which could lead to exploitative practices.

Debt Crisis Insights

• Current interest on national debt amounts to $1.9 trillion annually, representing 7% of GDP—indicating a severe fiscal crisis as funds are diverted from productive use.

• Senator Paul and Senator Ron Johnson are acknowledged for criticizing the inadequate spending cuts proposed in the bill.

Historical Context of U.S. Debt

• The speaker compares current debt levels with historical data during Clinton's presidency when budgets were balanced versus recent administrations' deficits.

• Current deficit projections suggest an alarming trend similar to Argentina's economic issues, with a deficit-to-GDP ratio reaching around 8%.

Political Dynamics and Future Implications

• There's concern over Congress members prioritizing local funding requests over sustainable fiscal policies, leading to a lack of necessary tough conversations about budgeting.

Fiscal Challenges and Political Will

The Role of the Republican Party in Fiscal Policy

• Discussion on Paul Ryan's alignment with fiscal responsibility, particularly regarding government overspending linked to Obamacare.

• Critique of current Republican focus on waste, fraud, and abuse rather than addressing systemic issues within programs like Medicare, Medicaid, and Social Security.

Addiction to Government Support

• Assertion that Americans are reliant on government assistance; the top quintile pays all net taxes while lower quintiles receive more from the government than they contribute.

• Prediction of future economic outcomes: either significant inflation or severe austerity measures due to unsustainable fiscal practices.

Proposed Solutions and Political Resistance

• Examination of proposed work requirements for Medicaid recipients as insufficient to address deeper fiscal issues.

• Challenge for President Trump: balancing tax cuts with necessary spending cuts amidst pushback from moderate Republicans concerned about losing their seats.

Urgency of Addressing Deficit Spending

• Emphasis on the critical nature of $2.5 trillion deficit spending against a $28 trillion GDP; historical context provided regarding similar situations during wartime.

• Discussion on de-dollarization and its implications for U.S. debt obligations; concerns over rising interest rates leading to a "debt death spiral."

Revenue Generation vs. Fiscal Responsibility

• Mention of cabinet members discussing new revenue sources but stressing the need for immediate spending cuts before any revenue can be effectively utilized.

• Call for modest austerity measures including potential military spending cuts as part of broader fiscal reforms.

Taxation Insights

Economic Perspectives on Austerity and America's Financial Strategy

The Context of Austerity Measures

• Discussion on the difference in facing austerity measures between Italy and the United States, highlighting that Americans have not experienced such measures in their lifetime.

• Emphasis on the need to find nuance when comparing economic situations across countries, suggesting that America holds a unique position globally.

America's Unique Position

• Assertion that the U.S. is "the shining city on a hill," indicating its perceived superiority and importance compared to other nations.

• Analogy about debt: owing a million dollars is a personal problem, but owing a billion shifts the burden, illustrating America's significant role in global finance.

Proposed Solutions for Economic Stability

• Warning against panic-driven decisions like aggressive entitlement cuts, which could harm American prosperity and hinder problem-solving.

• Proposal to monetize America's balance sheet, emphasizing that citizens collectively own substantial assets valued at $100 trillion to $150 trillion.

Asset Valuation and Government Control

• Explanation of federal land ownership: 500 million acres directly owned by the government with control over 3.2 billion acres in offshore areas.

• Mention of potential resource value beneath these lands, including oil and minerals, which could be monetized through partnerships with private companies.

Balancing Debt and Revenue Generation

• Argument that U.S. debt ($33 trillion) is as much an issue for creditors as it is for Americans; interdependencies exist where foreign governments rely on U.S. success.

• Call for simultaneous actions: monetizing assets while enforcing strict spending limits to create meaningful revenue inflows without overspending.

Vision for Economic Growth

• Introduction of Scott Besson's 333 plan (3% inflation, GDP growth, and deficit), positing it as a mathematical renaissance for the U.S. economy if implemented effectively.

• Urging swift action from government officials to begin monetizing assets aggressively while maintaining fiscal discipline.

Resource Utilization Insights

• Inquiry into what resources lie beneath U.S. land and ocean floors; discussion includes various minerals essential for manufacturing.

Entitlement Programs and Economic Strategies

Discussion on Entitlement Programs

• The speaker suggests that entitlement programs should be made more efficient, proposing to reset other programs to pre-COVID levels and eliminate new ones.

Personal Anecdote

• A personal story is shared about a recent argument with the speaker's wife, highlighting the dynamics of their relationship and communication.

Observations on Relationships

• The speaker reflects on how relationships can involve serious discussions, comparing it to observing a couple speaking in an unfamiliar language at a café.

Relationship Dynamics

• The speaker humorously describes a lengthy fight with his partner followed by reconciliation and sharing food, illustrating the complexities of romantic relationships.

Environmental Concerns vs. Economic Needs

• A critical question is posed regarding the environmental implications of extracting resources from Alaska versus maintaining economic stability through austerity measures.

Energy Production and Environmental Impact

Global Energy Demand

• The discussion emphasizes that global energy demand is increasing regardless of U.S. involvement, questioning whether America should participate in this market.

Methane as an Energy Source

• Methane is presented as a cleaner alternative for electricity production compared to oil or coal, noting its lower carbon emissions when burned.

Risks Associated with Methane Extraction

• While methane has advantages, it poses risks due to potential leaks which are significantly more harmful than CO2; thus, extraction systems must be tightly regulated.

U.S. Position in Energy Market

• The argument supports the idea that if the U.S. can produce cleaner energy efficiently, it should become a leader in liquefied natural gas (LNG) exports.

Economic Priorities and National Strategy

Need for Revenue Generation

• There’s an urgent call for monetizing national assets to generate revenue quickly amidst concerns over national debt and economic stability.

Critique of Incremental Tax Increases

• Responding to audience suggestions about raising taxes on wealthy individuals and cutting military spending, it's argued that such measures alone won't sufficiently address national debt issues.

Military Budget Considerations

Understanding U.S. Influence in the Middle East

The Role of American Power

• The existence of the United States is crucial for the stability of nations like Saudi Arabia, Qatar, and the UAE; without it, these monarchies might not survive in their current forms.

• American soft power is often backed by hard power; this dynamic is evident in geopolitical tensions such as those involving Taiwan.

Economic Competitiveness and Energy Production

• The U.S. must enhance its naval capabilities and energy production to remain competitive against China, especially regarding AI advancements.

• There are concerns that even with increased energy production, it may not be sufficient to offset deficits quickly enough.

Fiscal Responsibility and Spending Cuts

• A call for a structured approach to fiscal responsibility: avoid adding new programs, revert to pre-COVID spending levels before addressing entitlements.

• Political cycles could hinder consistent financial strategies; if Democrats regain power, they may block monetization efforts.

Historical Context on Spending Habits

• Drawing parallels with the 16th-century Spanish Empire's downfall due to excessive spending despite newfound wealth; warns against overspending regardless of asset increases.

• Emphasizes that Americans need to adjust their mindset about spending habits—overreliance on social programs could lead to bankruptcy.

Prioritizing National Challenges

• Advocates for a collective maturity in prioritizing national issues rather than reacting disproportionately to every challenge presented.

Discussion on Cellular Meat Bans

Overview of Recent Legislative Actions

• The conversation begins with a mention of various states, including Florida, Alabama, Mississippi, and Indiana, that have enacted laws banning cellular meat. Governor DeSantis is highlighted as a key figure in this movement.

• Montana's Governor Greg Gianforte recently signed House Bill 401 to ban cellular meat, effective October 1st. The speaker draws parallels between this ban and potential bans on other technologies like AI.

Economic Implications of Banning Cellular Meat

• The discussion emphasizes the economic consequences of such bans, noting that while some states restrict cellular meat to protect local ranchers, countries like China and those in Europe are advancing their cellular meat industries.

• It is argued that these innovations can lower food costs and create new industries. The speaker advocates for consumer choice in a free market rather than government-imposed restrictions.

Critique of Protectionism

• The speaker criticizes the rationale behind banning cellular meat as economic protectionism for ranchers. They compare it to banning Uber to protect taxi drivers, suggesting that such measures stifle innovation.

• Each state should be allowed to make its own decisions regarding regulations; however, the speaker believes consumers should ultimately decide what products succeed based on quality.

Consumer Preferences and Market Dynamics

• A significant point raised is that if cellular meat were genuinely appealing to consumers (i.e., "delicious"), it would naturally gain popularity without needing legislative support.

• The speaker expresses skepticism about the quality of current cellular meat products and suggests that poor taste may contribute to their lack of market success.

Regulatory Capture and Innovation Stifling

• There’s concern over regulatory capture where small interest groups influence legislation against emerging technologies. This could hinder progress similar to how some regions initially banned Uber before recognizing its value.

• The dialogue highlights the importance of allowing early-stage technologies like cellular meat a chance to prove themselves in the market without premature bans.

Ethical Considerations Around Cellular Meat Production

• An interesting ethical question arises regarding whether lab-grown pork could be considered kosher if it does not come from an actual pig. This reflects broader discussions about food production methods and dietary laws.

Memorial Day Promo and Drug Pricing Discussion

Memorial Day Promo and Personal Preferences

• A discussion about a Memorial Day promo code offering 10% off at Long Hill Wagyu, highlighting personal preferences for different cuts of steak.

• Mention of the location of Long Hill Wagyu in Austin, Texas, noted for its exceptional quality.

Executive Order on Drug Prices

• Trump signed an executive order aimed at reducing drug prices by 30 to 80%, introducing the concept of Most Favored Nation (MFN) status.

• MFN allows the U.S. to pay the same price as the country with the lowest cost for specific drugs, potentially eliminating middlemen like Pharmacy Benefit Managers (PBMs).

Pharmaceutical Industry Insights

• RFK Jr. comments on Congress being influenced by pharmaceutical industry donations and lobbyists, indicating a long-standing issue in politics.

• The executive order is linked to international reference pricing; a detailed study from the National Bureau of Economic Research supports this approach.

Impact on Drug Prices and R&D

• Study findings indicate that using international reference pricing could lead to varying impacts on profitability for pharmaceutical companies.

• Clinical trial enrollments in China have surged due to regulatory reforms, now matching or exceeding those in the U.S., raising concerns about innovation competition.

Broader Implications for Pharma Profitability

• The last decade has seen declining returns for Western pharmaceutical companies; average ROI was only 1.5% as of 2022.

• Trump's actions may politically benefit him by adopting a Democratic platform while complicating future domestic R&D viability due to potential profit reductions.

Conclusion on Healthcare Spending Issues

Pharmaceutical Pricing and Market Dynamics

Overview of Treatment Costs and Value Chain

• Discussion on the significant portion of healthcare costs attributed to fraud and abuse, estimated at 10%, highlighting inefficiencies in the value chain before funds reach pharmaceutical companies.

• Emphasis on Pharmacy Benefit Managers (PBMs) as major players that impact drug pricing, suggesting a need for scrutiny regarding their role.

Policy Perspectives on Drug Pricing

• Ben expresses skepticism towards policies favored by Bernie Sanders, indicating a general opposition to such approaches.

• Critique of using Most Favored Nation (MFN) status as proposed by President Trump; suggests it may unfairly pressure U.S. pharmaceuticals while neglecting international pricing disparities.

Implications for Pharmaceutical Availability

• Concerns raised about potential consequences of MFN status leading to reduced availability of drugs through Medicaid, pushing patients toward more expensive private sector options.

• Warning against artificially lowering drug prices which could stifle research and development (R&D), comparing it to gambling where only successful outcomes are visible.

Rising Costs in Clinical Trials

• Notable increase in clinical trial costs from $250 million in the early '90s to $2.3 billion projected for 2025 due to regulatory burdens increasing from 1,000 to 150,000 regulations.

• Suggestion that reducing regulatory hurdles could help lower trial costs and improve market dynamics.

Federal Government's Role in Drug Pricing

• Analysis of how federal government involvement inflates drug prices due to lack of competitive pressure; likened to education and housing markets influenced by government funding.

• Argument that if individuals were responsible for their own drug payments rather than relying on federal programs, a more dynamic marketplace would emerge.

The Impact of Pharmacy Benefit Managers (PBMs)

• Examination of PBMs' influence on drug pricing; they reportedly earn approximately $3 per prescription claim processed through markups.

The Role of PBMs and Government in Drug Pricing

The Impact of Pharmacy Benefit Managers (PBMs)

• Discussion on the ownership of drug manufacturers by payers, highlighting concerns about obfuscation of true drug costs.

• Mention of significant markups and spread taking in the pharmaceutical market, suggesting that removing PBMs could alleviate some issues.

• Emphasis on the distortion created when the federal government acts as a payer in market-based systems, leading to inefficiencies.

Closing Remarks

• Acknowledgment from Ben Shapiro regarding the implications of government involvement in markets, reinforcing earlier points made about efficiency.