On July 31 Secretary of Health and Humans Services Alex Azar announced a proposal that would allow US pharmacies, distributors, and states to import drugs from Canada that are sold there by US drug makers at prices well below the prices for which they are sold in the U.S. US pharmaceutical companies sell many of their products at much lower prices demanded by Canada’s central health ministry called Health Canada. The Secretary was authorized to implement this proposed policy by the Medicare Modernization Act of 2003.
This idea has been long opposed by US pharmaceutical companies. They argue that the Food and Drug Administration’s onerous regulatory requirements cause them to spend an average of 10 years and an estimated $2.6 billion in research and development costs to bring a new drug from initial discovery to market. The price controls imposed by Canada and other countries on their products prevent them from recouping enough of those costs to justify and sustain innovation. Therefore, they charge much higher prices to US consumers who, in effect, subsidize new drug development for patients in Canada and other countries.
The drug companies also warn that drugs imported from Canada and elsewhere may not be safe because they may not have been made using the same quality control measures employed by US factories. However, Health Canada (the Canadian counterpart of the FDA) monitors and sets safety standards for the manufacture and sale of drugs in that country, and the European Union has allowed the manufacture and sale of drugs approved by any member country to any other member country for decades without any major safety issues.
The FDA typically “does not object” when individual patients travel to Canada, Mexico, or other countries to purchase medications manufactured and sold in those countries, bringing them back to the US for personal use—a process called personal importation. Personal importation from online pharmacies in other countries is also permitted, subject to certain guidelines. Personal importation received further protection with passage last fall of HR 6 (the S.U.P.P.O.R.T. Act), a bill mainly focused on the opioid overdose crisis.
The current federal prohibition of the importation of FDA-approved drugs selling for lower prices in Canada is a form of pharmaceutical protectionism. It forces American consumers to subsidize medications consumed by Canadians, while infringing on the freedom to trade.
Critics of removing the trade barriers claim importing drugs from Canada amounts to importing Canadian price controls. But the pharmaceutical companies are not compelled to sell their products in Canada at prices demanded by its government. They can reduce the amount they sell there, or not sell at all. And while re-sale contracts are prohibited in the European Union, they are not prohibited in Canada—so companies marketing their drugs in Canada can enter into agreements that would prohibit low-cost buyers in Canada from reselling the product to high cost buyers in the US.
Large scale importation from Canada may lead US drug companies to limit sales to Canada unless they can negotiate better prices with Health Canada. A risk then arises that drug companies might successfully lobby Canadian officials to pass laws protecting the lower prices by prohibiting drug exports to the US. This is one reason why HHS should allow importation from a much greater number of countries, opening up more fronts on which US drug companies must battle. In this way market forces have a better chance of bringing into closer balance the prices for which the drugs are sold in other countries in comparison to the US.
Dropping trade barriers and allowing US consumers to purchase drugs at lower prices from other countries is no panacea to address skyrocketing drug prices. But it would help. The forces driving high pharmaceutical prices are multiple and complex and require FDA regulatory reform as well as patent law reform. A particularly powerful driver is the excessive presence of third parties in health care: drug prices are negotiated with deep-pocketed third party payers, not directly with consumers. Cato adjunct scholars Charles Silver and David Hyman dig into this area in great detail in their excellent book “Overcharged: Why Americans Pay Too Much For Health Care,” published by the Cato Institute last year.
It is also important to mention that Secretary Azar’s proposal takes only a small step toward dropping pharmaceutical trade barriers. The “Safe Importation Action Plan” calls only for time-limited demonstration projects wherein a state, wholesaler, or pharmacy must convince HHS how they plan to comply with "statutory safety and cost conditions," and requires reporting and renewal. Only certain drugs will be eligible for importation. Those drugs’ active pharmaceutical ingredients must be manufactured at plants that already manufacture the same active ingredients for the FDA-approved drug sold domestically—a requirement aimed at addressing safety concerns raised by critics of importation. Another avenue for importation provided in the HHS proposal is to allow makers of FDA-approved drugs that are completely manufactured and approved for sale in the US--but also sold in Canada at lower prices--to be reimported to the US from distributors in Canada at the lower Canadian price. HHS seems to believe many manufacturers would use this “pathway” because they wish to be able to sell the drugs in the US at lower prices but are “locked into contracts with other parties in the supply chain.”
After the proposal goes through the regulatory review process it could still take months to years before it gets implemented and will still only consist of time-limited pilot projects. Nevertheless, it is encouraging that a consensus might finally be starting to form around the need to eliminate trade barriers to patients consuming medications.
Huawei has been in the U.S. government’s crosshairs for over a decade. In 2008, U.S. policymakers convinced the Committee on Foreign Investment in the United States to block the Chinese technology firm’s acquisition of U.S. software company 3-Com on the grounds that the deal would threaten national security. For many years, I have suspected that the U.S. campaign against Huawei was motivated less by concern over specific security threats than by the desire to respond to China’s aggressive, discriminatory industrial policies in the technology space. If Beijing was going to subsidize indigenous innovation, favor companies that registered intellectual property in China, and encourage Chinese companies to “borrow” U.S. technology in a push to challenge American firms at the technological fore, then the U.S. response would be to inhibit the commercial success of the beneficiaries of those industrial policies. Huawei‘s emergence as a global competitor made it an obvious target.
Although it is certainly plausible that Huawei presents a security threat to the United States, that conclusion has never been demonstrated convincingly in any public forum by anyone with access to the information upon which such a conclusion should be based. There have been closed door hearings in which classified information was discussed and generated, which—if declassified and shared with the public—might convincingly corroborate these threat claims and maybe even justify the administration’s decision to put Huawei on the U.S. Commerce Department, Bureau of Industry and Security’s “Entity List,” a move that could starve Huawei of needed inputs from U.S. companies. But it shouldn’t come as a surprise that policymakers who sit on intelligence committees or who serve in security-oriented federal agencies are probably predisposed to see security threats where others don’t or to discern nefarious intentions where the evidence is benign or even to interpret the absence of evidence as proof of the perpetrators’ craftiness.
Then again, when the standard of proof is the precautionary principle, the evidentiary thresholds aren’t especially rigorous. A threat possibility, however remote, tends to suffice.
Protecting national security is a legitimate function of government. Fulfilling that responsibility sometimes requires that international trade and investment be restricted. Since determinations of threats to national security often are based on classified information, the public has to trust that policymakers have reached the right conclusions and that the prescribed remedies are necessary and appropriate.
It is difficult to trust the Trump administration in this regard, as it has already demonstrated itself an unreliable arbiter of national security threats. President Trump has made a frivolity of the national security rationale for restricting trade. Last year, Trump invoked threats to national security to justify his tariffs on steel and aluminum imports. This year he concluded that U.S. security is threatened by imports of automobiles and auto parts. In those cases, the data and analyses “supporting” the national security threat conclusion were not classified, but publicly available. And you can count on your fingers and toes the number of people convinced that steel, aluminum, and auto imports present such threats.
Based on information that the U.S. public hasn’t seen, the Trump administration has deemed Huawei a national security threat. That may well be the right conclusion, but the U.K., German, and other governments that the administration has been pressuring to purge their networks of Huawei gear, seem unconvinced, and have resisted.
The Trump administration’s latest move to blacklist Huawei escalates already rapidly escalating tensions in the U.S.-China relationship. Putting the company (and 68 affiliates) on the Entity List means that U.S. firms can no longer do business with Huawei without first obtaining a special license, which can only be done after overcoming “a presumption of denial.” Earlier today, Google, Intel, Qualcomm, and other prominent suppliers announced plans to discontinue their current commercial relationships with Huawei. It doesn’t take a creative imagination to foresee worsening troubles ahead for U.S. businesses operating in China and, well, a deepening process of economic disengagement.
The bottom line is that when U.S. economic policy toward China could be successfully sequestered from the geopolitics, the relationship could be managed. Now our economic problems are viewed and magnified through a geopolitical prism and, for many, the calculations suggest that disengagement and decoupling is the optimum. But that, too, will be enormously costly.
To reiterate a conclusion from a recent op-ed:
By banning Huawei gear and putting pressure on third countries to do the same, the United States is effectively saying that a huge swath of 21st century trade—an estimated $12.3 trillion in sales activity across multiple industries involved in developing 5G infrastructure and producing 5G enabled products by 2035, according to the Congressional Research Service—will not be subject to the disciplines of the global trading system. If that doesn’t consign the WTO to insignificance, the ensuing race to carve up the world into spheres of influence based on competing 5G standards will.
In what will look like a replay of the Cold War, Beijing and Washington will compete for the loyalties of the rest of the world by offering carrots and threatening sticks to countries to adopt their respective 5G standards. Dividing the world into these technology blocs will deprive the technology ecosystem of global economies of scale and open the door to bloc-based tariffs and other forms of protectionism, making the world a poorer place. Creation of the open global trading system induced a steady climb in global exports from 4% of GDP in 1947 to 26% of GDP in 2015. Erecting tariffs and non-tariff barriers through that system would undoubtedly cause a decline in global trade and output.
The New York Times is reporting a major spike in aggressive cyber attacks by Iran and China against businesses and government agencies in the United States. “[S]ecurity experts believe,” the Times reports, that the renewed cyber attacks "have been energized by President Trump’s withdrawal from the Iran nuclear deal last year and his trade conflicts with China.”
Chinese cyberespionage cooled four years ago after President Barack Obama and President Xi Jinping of China reached a landmark deal to stop hacks meant to steal trade secrets.
But the 2015 agreement appears to have been unofficially canceled amid the continuing trade tension between the United States and China, the intelligence officials and private security researchers said. Chinese hacks have returned to earlier levels, although they are now stealthier and more sophisticated.
...Threats from China and Iran never stopped entirely, but Iranian hackers became much less active after the nuclear deal was signed in 2015. And for about 18 months, intelligence officials concluded, Beijing backed off its 10-year online effort to steal trade secrets.
But Chinese hackers have resumed carrying out commercially motivated attacks...
In other words, the United States has been the target of major cyber attacks from both Iran and China as a direct consequence of two Trump administration policies, neither of which were justified.
Last year, against the advice of his own top national security officials and the US intelligence community, as well as US allies, President Trump withdrew from the 2015 Iran nuclear deal (JCPOA). That deal rolled back Iran’s nuclear program and imposed strict limits on it for the foreseeable future. To this day, it remains one of the most robust non-proliferation agreements ever negotiated and Iran continues to comply with its stringent controls and invasive inspections regime. Trump’s withdrawal, which lacked a national security rationale (at least one that had any relation to reality) resulted in the automatic re-imposition of harsh economic sanctions against Iran. Although the sanctions have hurt the Iranian economy, the regime in Tehran has kept to its obligations anyway, even amid threatening and overtly hostile rhetoric from the Trump administration that strongly suggests it is seeking regime change.
Many predicted withdrawal from the JCPOA would pressure Iran to unburden itself from the deal’s restrictions and restart its nuclear enrichment program in earnest, the exact opposite of the White House's stated aim. Thankfully, this has not happened (yet). But what has happened is that Iran has ramped up aggressive cyber attacks against us.
Likewise, Trump’s determination to initiate a trade war with China, arguably America’s most important trade partner, cannot be justified on either economic or national security grounds. China’s immediate response was to retaliate with its own tariffs against US imports. Both the US and Chinese economies have consequently suffered an economic hit worth billions of dollars. We can add to these costs the apparent revocation of the arrangement Obama and Xi secured in 2015 not to engage in commercial cyber espionage.
As I see it, we can draw two lessons from this. First, countries are likely to retaliate if we punish them for engaging in cooperative diplomacy with us. Second, Trump’s policies have made America less safe.
For those who think the proper response to intensified Iranian and Chinese cyber attacks is to adopt a more aggressive, offensive cyber posture (in retaliation for the retaliation), I recommend reading this Cato Policy Analysis we published last month which demonstrates the dangers, and low utility, of such a path.
“Where do we have tariffs?” President Trump asked yesterday. One obvious answer is on imported clothing and footwear, where tariffs are both substantial and hit low-income consumers hard.
The United States raised $33.1 billion in tariff revenue in 2017, but $14 billion of that came from tariffs on apparel and footwear alone. These items account for 4.6 percent of the value of U.S. imports, but 42 percent of duties paid. That means while the average effective tariff rate for U.S. imports overall is just over 1.4 percent, rates for apparel and footwear are 13.7 percent and 11.3 percent, respectively.[i]
My colleague Daniel Ikenson has previously examined the evolution of clothing and textile protectionism. He concludes that such high tariffs do not protect domestic apparel manufacturing. Data from the U.S. Trade Representative shows that 91 percent of manufactured apparel goods and 96.5 percent of footwear are imported.
Why then are such highly regressive tariffs imposed? The answer appears to be the lobbying efforts of the capital-intensive U.S. textile industry. Textiles are the major input for labor-intensive apparel production, which largely occurs overseas. To quote Ikenson directly:
The U.S. textile industry insists on preserving those tariffs as leverage to compel foreign apparel producers to purchase their inputs. Preferential access [to U.S. markets] is conditioned on use of U.S. textiles. The high rates of duty apply, generally, to all “normal trade relations” partners. But those duties are much lower or excused entirely for trade agreement partners, provided that the finished garment comprises of textiles made in countries that are signatories to the agreement.
U.S. consumers pay the price of this protectionism, and poorer consumers especially. In 2016, the average household in the bottom income quintile spent $860 on apparel and footwear, or 3.4 percent of overall spending—the highest proportion of any income quintile. The average single-parent household put 4.5 percent of total expenditure toward these goods. The poor spend a disproportionate amount on clothing and footwear, and family structures most likely to be recipients of means-tested welfare programs (single-parent households) spend most of all.
But this protectionism is not just regressive because of relative spending patterns. Edward Gresser’s work has shown how, often, luxury clothes and shoes face lower tariff rates than inexpensive products.
Consider Table 3 from my report below (an updated version of Gresser’s work.) Where duties are applicable, a pure cashmere sweater import incurs a 4 percent tariff, a wool sweater a 16 percent tariff, and an acrylic sweater a whopping 32 percent. Men’s silk shirts see a 0.9 percent tariff, cotton shirts a 19.7 percent tariff, and cheaper polyester shirts a 32 percent tariff. Leather dress shoes have an 8.5 percent tariff, whereas cheap sneakers would see a 43 percent tariff. Windbreakers, leggings, tank tops, and other clothes made cheaply from synthetic fabrics face a 32 percent tariff if sourced from countries that the United States does not have a free-trade agreement with. Assuming poorer households tend to buy cheaper products, these differential tariffs have perniciously regressive effects.
The true overall cost of all this to poorer families is difficult to calculate. To get an accurate estimate would require detailed information on the effect on domestic substitute goods' prices, knowledge of products bought by poor families and their propensity to import in the absence of protectionism.
Nevertheless, we can develop cautious lower-bound estimates. The average household in the poorest income quintile spends $655 on apparel and $206 on footwear per year. Assuming the import propensities for the population as a whole apply to poorer people implies $595 of apparel spending and $199 of footwear spending is on imported goods. Taking average effective tariff rates for apparel and footwear for this spending (13.7 and 11.3 percent) implies a combined direct tariff cost of $92 per year for the average household in the poorest income quintile, or $204 per year for the average single-parent household.
These figures likely underestimate the true burden, because they only represent the direct cost from current spending on imported goods. They assume tariffs do not raise domestically produced goods prices, though in reality the anti-competitive effect of the tariffs would be expected to raise prices here too. It also assumes the same effective tariff rates for apparel and footwear apply for the poorest households as for the whole population, but we have seen that products that the poor are more likely to buy tend to face higher tariff rates. Consumer welfare losses from tariffs, of course, are higher than the implied costs here, since tariffs make consumers less willing to buy imported products that they would otherwise prefer.
In short, next time the President asks where tariffs are applied, someone shout "apparel and footwear." They are both large and regressive.
[i] U.S. International Trade Commission, “Interactive Tariff and Trade DataWeb,” at http://dataweb.usitc.gov. Data for imports for consumption, and effective rates calculated using “customs value” and “calculated duties” for 2017.
“[T]here came another folly of government intervention in 1930 transcending all the rest in significance. In a world staggering under a load of international debt which could be carried only if countries under pressure could produce goods and export them to their creditors, we, the great creditor nation of the world, with tariffs already far too high, raised our tariffs again. The Hawley-Smoot Tariff Act of June 1930 was the crowning folly of the who period from 1920 to 1933. . ..
Protectionism ran wild all over the world. Markets were cut off. Trade lines were narrowed. Unemployment in the export industries all over the world grew with great rapidity, and the prices of export commodities, notably farm commodities in the United States, dropped with ominous rapidity. . ..
The dangers of this measure were so well understood in financial circles that, up to the very last, the New York financial district retained hope the President Hoover would veto the tariff bill. But late on Sunday, June 15, it was announced that he would sign the bill. This was headline news Monday morning. The stock market broke twelve points in the New York Time averages that day and the industrials broke nearly twenty points. The market, not the President, was right.”
-- Dr. Benjamin M. Anderson [chief economist at Chase National Bank 1920-39], Economics and the Public Welfare: A Financial and Economic History of the United States, 1914-1946 (Indianapolis, Liberty Press, 1979, pp. 229-230)
If 2017 was the year of fiery trade talk, 2018 has been the year of provocative trade actions. During the first four months, President Trump imposed or announced intentions to impose tariffs on thousands of products stemming from five investigations conducted under three different, seldom-used laws. Talk of trade war is rampant and, as May begins, the troops are in formation—a circular formation, but a formation nonetheless! By Memorial Day, it should become much clearer whether their orders will be to shoot, hold fire, or demobilize.
What follows is a brief recap of the relevant trade policy actions of 2018 that have taken us to the present situation.
In January, the president imposed “safeguard” restrictions following two separate investigations of imports of large washers and solar cells, under Section 201 of the Trade Act of 1974. Tariffs and tariff rate quotas, respectively, were imposed for a period of four years in both cases against imports from most countries. These safeguard measures are absolutely stupid as a matter of economics, but relatively trivial as far as the impact on U.S.-China relations and the prospects for trade war are concerned.
In March, under the guise of acting to protect national security, Trump invoked Section 232 of the Trade Expansion Act of 1962 to impose tariffs on imported steel and aluminum from all countries. Soon after the announcement and before the tariffs took effect, Trump offered temporary exemptions to several trading partners to “encourage” them to play nice: buy more U.S. stuff; sell Americans less foreign stuff; increase NATO spending (EU countries); agree to U.S. terms on various aspects of the NAFTA renegotiations (Canada, Mexico); agree to export quotas (South Korea) and the temporary exemptions will be made permanent. Well, as the temporary exemption period was about to expire on May 1, the president extended the deadline to June 1. Presumably, if the NAFTA negotiations wrap up this month (apparently, a real possibility) and Trump gets what he wants, Canada and Mexico will be permanently exempted from the steel and aluminum tariffs. Congrats! It’s much less clear that the Europeans are willing to submit to these tactics. They’ve crafted a retaliation list and seem likely to go that route. The Chinese, whose steel and aluminum exports have been subject to the tariff since March 23, have already retaliated against a list of 128 U.S. products (amounting to about $3 billion in U.S. exports), including ethanol, wine, nuts, fruit, and a few other commodities.
Although the “national security” restrictions on steel and aluminum are a more significant irritant than the safeguard restrictions on washers and solar cells, they still only amount to a flea bite on an elephant’s hide relative to Trump’s most recent, most provocative, and—some would argue—most justifiable action so far. At the beginning of April, Trump announced his intention to impose tariffs on 1,300 Chinese products accounting for about $50 billion of exports to the United States, as a result of an investigation into Chinese intellectual property and forced technology transfer policies, under Section 301 of the Trade Act of 1974. The “remedy” also includes instructions for the Treasury Department to publish new investment rules that will make it harder for Chinese companies to purchase U.S. technology and U.S. tech companies. Within a few hours of the U.S. announcement, China published a list of U.S. products, amounting to about $50 billion of exports to China (farm products, airplanes, autos, etc.), that it would subject to retaliatory duties of 25 percent should the U.S. measures take effect.
As of that point, between the 232 and the 301 cases, $106 billion of U.S.-China trade was in the crosshairs (about 15% of two-way trade). Then in reaction to China’s retaliation threat, Trump raised the stakes by instructing the USTR to identify another $100 billion of Chinese products to assess with tariffs. That list has not yet been published, but if it is and China responds commensurately (by targeting another $100 billion of U.S. exports), its list would have to include ALL U.S. exports to China because total U.S. goods exports to China in 2017 amounted to $130 billion. (Services exports add another $50 billion, but they’re not easy to hit with tariffs). The next likely target would be U.S. companies operating in China—discriminatory taxes, regulations, restrictions, etc. In any event, the amount of trade subject to tariffs ($306 billion) would begin to approach half the value of the two-way trade—a decidedly cataclysmic outcome.
President Trump seems to be aware of the stakes. Last month he tweeted that trade wars can be good and are winnable. He cites the bilateral U.S. trade deficit as evidence that China needs us more than we need them. Hopefully, he’s rational enough to realize that his avoidable actions would trigger a massive global economic contraction which, even if the United States is less hurt than others, history would not look kindly upon.
The month of May offers some opportunities to ratchet down the tensions and, even, find some solutions. The Trump administration’s trade policy team—USTR Robert Lighthizer, Commerce Secretary Wilbur Ross, Treasury Secretary Steven Mnuchin, National Economic Council Director Larry Kudlow, and National Trade Council Director Peter Navarro—is in Beijing this week, presumably to get China to commit to certain actions that would enable tensions to be dialed down. Mid-month, the USTR is holding a hearing for the public airing of views about the Section 301 remedies, where it will be impressed upon the administration how costly a trade war would be. And, presumably, toward the end of the month is the momentous Korean Summit. If the president gets the results he’s looking for (whatever they may be) and Beijing is perceived as having played an important role in reaching that outcome, that could give Trump the cover he probably needs to put his pistols back in their holsters and focus on an effective, comprehensive U.S.-China free trade agreement. That should be the primary goal of U.S. trade policy during the Trump administration.
Cato trade policy analyst Colin Grabow explains the sordid details in today's Wall Street Journal:
America’s Finest, a brand-new 264-foot fishing trawler, ought to be the pride of the fleet. As a newspaper in its birthplace of Anacortes, Wash., explained, the ship features an “on-board mechanized factory, fuel-efficient hull, and worker safety improvements”—priceless features for fishermen operating in the treacherous seas off Alaska. The ship is also said to have a smaller carbon footprint than any other fishing vessel in its region. According to Fishermen’s Finest, the company that ordered the ship, it would be the first new trawler purpose-built for the Pacific Northwest since 1989.
Sadly, it seems increasingly doubtful that the ship will ever ply its trade in U.S. waters. That’s because it contravenes the Jones Act, the 1920 law mandating, among other things, that ships carrying cargo between U.S. ports be domestically built