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his article is excerpted from LiberatED, a weekly email newsletter where FEE Senior Education Fellow Kerry McDonald brings you news and analysis on current education topics. Click here to sign up.

While the past two years have been characterized in many ways by top-down policy approaches and greater centralization of power, there have also been positive signs of decentralization and bottom-up solutions. This has been particularly true in education, as parents seek new learning options for their kids and entrepreneurial educators create a variety of new models.

A decentralized education ecosystem is characterized by diversity of options. Rather than parents being forced to send their child to an assigned district school with a standardized curriculum, they now have increasingly greater opportunities to access a charter school, low-cost private school or microschool, learning pod, homeschooling center or co-op, or virtual learning platform. 

The more robust the education marketplace, the more choices there will be for parents. The more choices that are available, the more likely it will be …

I saw your post on the new bill, and I actually think the healthcare components of it might be worse than the rest of it.

The bill has a provision that allows the government to “negotiate” prices for drugs that are among the top 10-20 by spend in Medicare Part B (physician administered, usually IV infusions) and Part D. Since drugs that are selected in one year are not eligible for inclusion in subsequent years, this will capture more and more drugs over time. The negotiation of course happens with a gun to the head—the bill sets statutory minimum discounts of anywhere between 25-60%, depending how long the drug in question has been on market.

The biggest issue with the bill is that it makes small molecule drugs eligible 9 years after approval, while biologic drugs are eligible after 13 years. This is based on some silly misconception that small molecule drugs are quicker and cheaper to develop and therefore have shorter payback periods. That may have been true when we were tackling relatively low-hanging fruit like high cholesterol, but small molecule drugs that tackle unmet needs today are nothing less than miracles. An oral pill that treats cystic fibrosis, like Vertex’s Trikafta, or sickle-cell disease, like Global Blood Therapeutics’ Oxbryta, is incredibly challenging to develop.

This is going to hurt returns for small molecule drugs and skew R&D efforts away from them to biologics. Biologics like monoclonal antibodies are great, but many of them carry substantial administration costs or suffer from worse compliance/adherence because they are IV infusions that require patients to go into a care setting periodically to receive their next dose. But the real issue is they do not go generic the way small-molecule drugs do. Generics for small-molecule drugs are relatively cheap to develop, benefit from a streamlined approval process, and can be substituted for the branded drug at the …