For months, the Trump administration has floated the idea of a formal investigation into foreign countries' unfair drug pricing practices -- an implicit threat intended to push our allies into proactively reforming those practices, without the need for overt pressure. But those allies haven't taken the hint. They're still continuing their decades-long mistreatment of American biotech companies and their millions of workers.
It's time to launch the investigation. Doing so would unlock a broader range of enforcement tools -- and give President Trump more leverage to lower prescription drug prices at home by ending foreign governments' freeloading for good.
Nearly all of America's trading partners use a variety of price controls and non-tariff trade barriers, such as deliberate bureaucratic delays and not-so-subtle threats to invalidate American companies' patent protections, to artificially suppress their spending on American-designed, American-made medicines.
Consider how multiple European Union members, as well as the United Kingdom, routinely impose mandatory rebates and revenue clawbacks to cap spending on new medicines. Countries such as Germany and France restrict coverage for more than half of newly-approved medicines by declaring they offer "no added benefit." Even when the European Medicines Agency -- the continental counterpart to the FDA -- approves new medicines for sale, European nations' government-run health systems frequently drag out coverage decisions for up to 700 days.
In other words, EU members block their citizens from accessing the latest medicines in practice, even if those drugs are "approved" in theory.
Outside Europe, the picture is no better. South Korea has not updated the cost-effectiveness threshold that bureaucrats use to set prices on new medicines since 2007, and the average delay between regulatory approval and insurance reimbursement decisions is nearly two years. In Japan, the government-run health system subjects even the most clinically effective patented drugs to annual price cuts.
All these practices disproportionately shift the burden of paying for the ludicrously expensive research and development needed to produce new drugs onto Americans. Drug companies earn about 75% of their global profits in the U.S. market, even though the United States accounts for only a quarter of the global economy.
President Trump is not the first to point out this imbalance. But he is the first to take meaningful steps to address it.
In December 2025, the administration announced a landmark deal with the United Kingdom. In order to avoid President Trump's threatened tariffs, UK officials agreed to raise the cost-effectiveness threshold they use when determining which new medicines to cover, reduce revenue clawbacks, and double spending on pharmaceuticals over the next decade.
The agreement will ensure that one of our wealthiest trading partners contributes its fair share toward the global R&D burden. That will relieve American patients and taxpayers while increasing American biotech companies' revenues by billions of dollars, spurring domestic research and manufacturing and creating new jobs at home.
Top administration officials, especially U.S. Trade Representative Jamieson Greer, have promised more such deals in the near future. But securing them will require substantial leverage.
A formal Section 301 investigation into foreign drug pricing practices would be enormously helpful. If such an investigation concluded that foreign governments are systematically underpaying for American-made medicines, it would empower officials to use targeted enforcement actions, such as tariffs, to bring trading partners to the negotiating table.
Successful negotiations would vastly improve the physical and financial health of patients and workers.
And that would be a far better solution than the alternative proposal that some Washington lawmakers are considering: mandating that all drugmakers sell their products at the same artificially low prices that foreign countries currently pay.
Importing these foreign price controls would dramatically weaken America's negotiating position. Foreign governments could refuse President Trump and Ambassador Greer's demands -- and then watch as Congress' policy automatically brings U.S. prices down to other countries' artificially low floor, rather than bringing other countries up towards America's standard. That'd crater domestic research and manufacturing investments.
Our trading partners have gotten away with freeloading for too long. By launching a Section 301 investigation into these longstanding abuses, administration officials can give President Trump the leverage he needs to end foreign freeriding once and for all.
Ambassador Jeffrey Gerrish served as the Deputy U.S. Trade Representative for Asia, Europe, the Middle East, and Industrial Competitiveness from 2018 to 2020.
According to the statement, USS Truxtun, USS Rafael Peralta and USS Mason were moving through the international waterway toward the Gulf of Oman when Iranian forces launched what CENTCOM described as “unprovoked” attacks.
CENTCOM said no US assets were struck and that American forces targeted Iranian missile and drone launch sites, command centers and intelligence infrastructure linked to the attacks.
The command added that it “does not seek escalation” but remains prepared to defend US personnel and assets in the region.
A hospital in Santa Clara, Calif., has confirmed at least 18 cases related to Legionella bacteria, which can cause Legionnaires’ disease, a severe form of pneumonia, or a milder illness called Pontiac fever.
After detecting the bacteria during routine internal monitoring, Kaiser Permanente Santa Clara Medical Center has reported 18 cases to Santa Clara public health officials, according to several news outlets. The hospital is operating normally as it implements water treatment measures, as Legionella naturally occurs in water.
Most of the affected individuals are recovering at home, according to a Kaiser Permanente spokesperson.
Legionnaires’ disease has a 10% fatality rate, but that figure rises to 25% for healthcare-associated infections, according to CDC data. Legionella bacteria can also cause a milder infection called Pontiac fever in which hospitalization is uncommon.
The types of infection detected at Santa Clara Medical Center are unknown, as well as whether the cases were detected among patients, visitors or staff.
Hospital leaders told CBS News they are working with public health authorities to identify the source of contamination.
The medical center is part of Oakland, Calif.-based Kaiser Permanente, which operates 40 hospitals and more than 600 medical offices.
Two separate federal policy decisions within days of each other are simultaneously boosting the pipeline of foreign-born physicians through travel-ban policy changes while straining the pipeline of some domestic clinical workers through student loan caps.
The Department of Homeland Security quietly changed its travel-ban policy to no longer subject physicians to the processing hold. The department confirmed to The New York Times that it will resume processing visas and work permits for medical physicians — freeing them from the visa renewal limbo they have faced for months.
At the same time this change could alleviate stressors on the foreign-born physician pipeline at U.S. hospitals, a new rule could hinder the domestic pipeline of clinical workers. The Department of Education finalized a rule April 30 implementing sweeping changes to federal student loans, limiting how much some healthcare students can borrow. Industry leaders argue the rule could restrict access to education and worsen workforce shortages in nursing, physician assistant and physical therapy programs.
The visa reversal addresses an immediate problem. The U.S. Citizenship and Immigration Services updated its website to indicate physicians are no longer subject to a processing hold imposed under travel restrictions, which froze decisions on visa extensions, work permits and green cards for citizens of 39 countries. While the ban did not apply to visa holders already in the U.S., USCIS paused visa renewals and updates for individuals from those countries. The pause affected more than 10,000 physician H-1B visa holders and 17,000 J-1 holders, as well as thousands of nurses, lab technicians and other healthcare workers. Many physicians were placed on administrative leave by hospitals while awaiting renewal.
The Department of Education rule moves in the other direction. The agency released final regulations April 30 implementing the student loan provisions of the Working Families Tax Cuts Act, which President Donald Trump signed into law July 4. The act caps federal loans for graduate and professional students, creating a $20,500 annual borrowing limit for graduate students and a $50,000 annual limit for professional students. The rule establishes a formal definition for “graduate student” and “professional student,” which determines eligibility for higher federal loan limits. Under the rule’s framework, some healthcare fields — including physician assistant programs and certain advanced practice nursing pathways — are treated as graduate programs rather than professional ones. Students in those programs will be placed in the lower borrowing tier, limiting annual federal loans to $20,500 beginning July 1.
Healthcare professional groups protested the exclusion of major fields throughout the public comment period and after it was finalized. The American Nurses Association said the rule “will be felt in real communities, for example, in rural areas where nurse practitioners, midwives and nurse anesthesiologists are often the only providers of core care services.” The American Academy of Physician Associates and the PA Education Association said they will challenge the rule in court.
The two policies describe two different theories of how the U.S. clinical workforce should be supplied. The visa reversal reflects a near-term operational reality, while the loan caps reflect a longer-term policy choice that the federal student loan program should not finance graduate borrowing to the extent it has been — even in fields where industry groups say shortages are documented and worsening.
For health system leaders, the changes signal an opportunity for a stronger pipeline of foreign-trained physicians, though that pipeline remains tethered to immigration policy that has shifted multiple times over the past year. The systems best-positioned for what comes next may be the ones building durable internal pipelines — residency partnerships with nursing and PA schools, employer-sponsored tuition support for graduate-level licensure, in-house upskilling programs — rather than relying on either federal lever to hold steady.
