The American Dilemma: Rent or Relief?

By Daniella Elie

Prescription drugs have become more than just a line item on a bill – they can be the difference between life and death. As drug prices grow, they have become not just an economic issue, but a daily burden for many Americans. An increasing number of Americans have been forced to choose between prescription drugs and things such as transportation, utilities, or even housing.  

The Inflation Reduction Act (IRA), passed in 2022, was a turning point in healthcare policy. The law capped out-of-pocket insulin costs for Medicare recipients at $35 a month and gave Medicare the power to negotiate prices for select medications [1, 2]. That’s progress. But to me, it feels more like a first step than a full solution. These changes won’t fully take effect until 2026, and they leave out nearly 180 million Americans with private insurance [3]. The urgency of the problem doesn’t match the timeline of the response. 

Too much of our healthcare system is still shaped by market forces and it’s not cutting it anymore. The IRA’s negotiation powers apply to a very limited list of drugs, and in the meantime, people battling chronic illnesses continue to battle impossible costs [4]. By focusing mainly on Medicare, the policy leaves behind a huge portion of the population. My friends –

college students with private insurance – are already struggling to afford basic medications.

Critics argue that regulating drug prices too heavily could hurt innovation and limiting profits would discourage investment in life-saving breakthroughs. Yet, I believe a solution exists where we can have both innovation and affordability, in which the government takes a more active role. The National Institutes of Health already funds much of the early research behind new drugs. In fact, NIH-funded work contributed to the development of 99 percent of new drugs approved between 2010 and 2019 [5]. If we’re publicly investing in breakthroughs, then we should ensure the public can afford them. 

So where do we go from here? 

First, drug price negotiations shouldn’t stop with Medicare. Expanding this authority to include the private insurance market would directly lower costs for millions more Americans [3, 6]. Right now, we’re reinforcing a two-tiered system where your ability to pay for medication depends entirely on your insurance card. That’s not equity, it’s exclusion. 

Second, the reforms promised by the IRA need to arrive faster. For patients managing chronic illness, every year without relief brings more financial strain and more health risks. Healthcare isn’t something you can delay. Accelerating the implementation of these reforms could mean fewer medical complications, lower household debt, and greater trust in the system [4, 6]. 

Lastly, we need to confront the outsized influence of pharmaceutical lobbying. Drug companies spent over $373 million lobbying Congress in 2022 which is more than any other industry [3]. That money has shaped laws, slowed reforms, and protected profits. Stricter lobbying regulations and fewer loopholes would help refocus policy on patient needs, not corporate margins. 

This isn’t just a policy issue, it’s a moral one. Every day we delay action, real people suffer. They ration pills. They skip appointments. They forgo treatment. The system asks the most of those with the least, and that’s not sustainable. Meaningful change in prescription drug pricing will take more than just promises. It will mean broadening the scope of drug price negotiations, speeding up the cost-saving measures, and curbing the influence of pharmaceutical giants. These aren’t extreme demands but more like practical steps toward a healthcare system that puts people first. But none of it will happen unless we speak up. No one should have to risk their health or give up their home just to afford the medicine they need.

Works Cited

1. Centers for Medicare & Medicaid Services (CMS). Inflation Reduction Act and Medicare. CMS.gov, 2023, https://www.cms.gov/inflation-reduction-act-and-medicare.
2. Kaiser Family Foundation (KFF). Explaining the Prescription Drug Provisions in the Inflation Reduction Act. KFF.org, 2023, https://www.kff.org/medicare/issue-brief/explaining-the-prescription-drug-provisions-in-t he-inflation-reduction-act. 
3. OpenSecrets. Pharmaceuticals/Health Products Lobbying Profile. OpenSecrets.org, 2023, https://www.opensecrets.org/federal-lobbying/industries/summary?id=H04.
4. Hopkins, Jared S. “Medicare Negotiated Lower Prices for These 10 Drugs.” The Wall Street Journal, 29 Aug. 2023, https://www.wsj.com/health/pharma/medicare-prescription-drugs-lower-prices-e8eceeb7. 
5. National Academies of Sciences, Engineering, and Medicine. The Role of NIH in Drug Development Innovation and Its Impact on Patient Access: Proceedings of a Workshop. 2020, https://www.ncbi.nlm.nih.gov/books/NBK553542/. 
6. Congressional Budget Office. Estimated Budgetary Effects of the Prescription Drug Provisions of the Inflation Reduction Act. CBO.gov, 2022, https://www.cbo.gov/publication/58455.

Photo Credit: “Health Insurance Policies” by sinclair.sharon28 is licensed under CC BY 2.0