Manchin and Sinema have agreed to let Medicare negotiate bulk purchases of some drugs.

This will be a signal victory if it gets passed into law, even though it is limited to only some drugs and some patients (those covered by Medicare), because it will break through the barrier that has held for 50 years. Extending the exception policy should be easier than creating it.

In more civilized countries, the national medical system provides all prescription drugs to patients. Italy's system, for example, distributes insulin gratis to all diabetics that need it.