Chapter 600 - 279: Creating a Fait Accompli

He drew a heavy circle around the border of Pittsburgh.

The red circle was like a city wall, isolating the city from the outside world.

"I will make an announcement."

Leo’s voice was low.

"Starting tomorrow."

"Pittsburgh will become a special administrative zone for healthcare reform."

"Inside this circle."

"I will only recognize my Mutual Aid Card."

"Here, in this city of three hundred thousand people, I will first build an island—one independent of the United States’ healthcare system."

"I’m going to sear a steak right here."

"I want the aroma to drift to Philadelphia, to Harrisburg, to waft right under the noses of every American being tormented by high drug prices."

"I want them to watch us eat, to make their mouths water, to drive them mad."

Ethan didn’t understand why Leo had suddenly used the metaphor of searing a steak, but he understood what Leo meant.

"Leo, this is too risky."

Ethan said, "We haven’t reached a formal purchasing agreement with a single major pharmaceutical company."

"If we publicly commit to launching the Mutual Aid Alliance now, what happens when citizens take their cards to the pharmacy only to find they can’t buy the medicine at that low price? Or that the pharmacy won’t even honor it?"

"Our credibility will be ruined."

"That’s fraud, Leo."

Leo didn’t look up at Ethan’s pointed question.

"Ethan, you’re still stuck in the logic of business negotiations."

"You think that to force drug prices down, we first have to negotiate with the drug companies, right?"

"Isn’t that how it works?" Ethan retorted. "It’s basic supply and demand."

"Wrong."

Leo looked up.

"That’s a businessman’s logic. In politics, price is something you create."

Leo walked over to the whiteboard.

"We control the city’s finances. Before the bill passes, we’ll pay the subsidy ourselves."

Leo wrote a formula on the whiteboard: Market Price - Subsidy = Pittsburgh Price.

"We’ll use city funds to subsidize the pharmacies directly."

"The pharmacy’s acquisition cost is three hundred US dollars? No problem. We tell the pharmacy, ’If a citizen with a Red Card comes to buy, you charge them thirty-five US dollars. City Hall will cover the remaining two hundred and sixty-five.’"

"Even if we have to buy it at the full three hundred US dollars, I’m going to make sure our citizens only pay thirty-five."

Ethan’s eyes widened.

"You’re burning through money!"

"You can’t keep that up for long! The moment the funding dries up, the whole pricing system will collapse."

"I know,"

Leo said calmly.

"Of course we’re burning money. This completely defies the laws of economics."

"But it’s money we have to burn."

Leo looked at Ethan, his eyes turning sharp.

"Ethan, you need to understand what we’re up against."

"We’re fighting the entire United States healthcare-industrial complex. We’re fighting the bureaucrats in Harrisburg."

"The Medicine Benefits Transparency and Fairness Bill needs to pass in Pennsylvania’s Congress, and that requires immense public pressure."

"We need a victory."

"An immediate, undeniable victory that no one can argue with."

"This subsidy isn’t a waste."

"It’s an advertising expense."

"It’s the marketing cost we must pay to ignite public opinion across the entire state."

Leo picked up the bill.

"When the news reports come out, when the people of Pittsburgh are actually buying life-saving medicine for thirty-five dollars..."

"That story will spread like a virus."

"What will the people in Philadelphia think? What will the people in Scranton think?"

"They’ll see the massive price difference. They’ll see the people of Pittsburgh enjoying benefits they could only dream of."

"They’ll get jealous. They’ll get angry. They’ll go to their own representatives and ask, ’Why can Pittsburgh do this when we can’t?’"

"That pressure, from voters all across the state, will be the final push we need to break down the doors in Harrisburg."

"It will force the State Government to approve our bill, to grant us legitimate power to negotiate prices."

"At that point, with a market of millions in our hands, the drug companies will be on their knees, begging to work with us."

"And then, the prices will naturally come down."

"So, right now, we’re using money to buy time and to win the hearts and minds of the people."

"It’s a bargain."

Ethan stared at Leo, a chill running down his spine.

This young Mayor was governing the city with the reckless abandon of a gambler.

He was using tomorrow’s money to buy today’s support.

He was leveraging a fiscal deficit to gain political capital.

It was incredibly dangerous.

But a dangerous method like this was the only way to blast a hole in the ironclad healthcare system.

’Leo never intended to be a reformer who played by the rules.’

’He used the law as a smokescreen and procedure as a shield, but his core logic was always to create a fait accompli.’

’If he succeeded, any violation would become legitimate.’

’If he failed, playing by the rules would still lead to a dead end.’

"I understand."

Ethan took a deep breath.

He walked over and picked up the thick draft of the bill.

He locked it in the safe for which only he and Leo knew the combination.

"I’ll notify Sarah."

Ethan straightened his tie.

"For tomorrow’s press conference, we’ll make it a big show."

"We’ll let everyone in Pittsburgh know that better days are coming."

Leo nodded and sat back down in his chair.

The office fell silent again.

But he knew it was merely the calm before the storm.

Tomorrow, the moment he announced that decision, he would be formally declaring war on the entire United States healthcare-industrial complex.

This was no longer about slogans. No longer about a bill.

This was a war of cold, hard cash.

’Mr. President,’

Leo thought to himself.

’I’m going to cook this steak until the aroma is irresistible.’

"Of course."

Roosevelt’s voice held a hint of amusement.

"Don’t forget to add a little pepper."

"Make those greedy people sneeze a few times before they even get a whiff of that aroma."