American Consequences - August 2017

Angeles and ditched his Bentley curbside for the valet. The station had called to ask him to do a spot on Express Scripts. We rode the elevator to a silent floor, where the receptionist clocked him as he entered. “Hey, Andy.” Desks sat empty; the morning crew was here to shoot the 9:30 spots for the New York market, but in Los Angeles the day hadn’t started. A tech came out to lead us to the studio. He was a gentle man in middle age, soft-featured, wearing cargo pants and thick black sneakers, a big brown mustache, warm eyes. He knew Left from the Valeant short and liked to watch him stick it to the Wall Street bosses. All day, people came through the studio rattling off finance acronyms, EBITDA this and GAAP that. Left spoke English. The tech set Left up on a director’s chair. A screen behind his head projected a slightly more outdated version of the skyline than was visible through the floor-to-ceiling windows off-camera to the left and right. Left opened his notes and put his earpiece in. A few seconds into the interview, the anchor fell into a trap. “How much do you think Express Scripts makes off rebates off a high-priced drug?” he asked. “It’s amazing,” Left said. “Why would I have to answer that question? Isn’t it something they should answer?” Left was rolling now. “If a company does not disclose something, there’s a reason they do not disclose it.” He said: “There’s a machine.” He said: “$40,000 a vial.” He said: “Two words. Express. Scripts. They are the gatekeeper to high-priced pharmaceuticals in this country.”

He asked the anchor to look at Express Scripts’ profits. “The amount of money they make, it is obscene,” he said. “The money is being made on rebates. And before you defend it, any of the analysts, or the company, come out and give actual numbers .” The interview concluded. The tech was looking at Left. “You’re our best guest,” he said. “Our most controversial guest.” apologized. On-screen, the anchors moved on to the morning’s next story, the appointment to the Trump administration of the president of Goldman Sachs. Left rode the elevator down to the lobby and slipped outside, where the blue glass tower dwarfed him. One thing Left shares with the financiers he routinely assails is a certain ambivalence about Trump. During the campaign, Trump repelled Wall Street – with some exceptions – for the fact that he introduced an element of unpredictability that is anathema to long-term investing. One contradiction of his young presidency, then, has been the eagerness with which the same people who saw the apocalypse in his ascent are now watching as the Dow Jones industrial average breaks records. Though Trump has not accomplished much of substance, like tax reform or an infrastructure bill, he has nevertheless made good on promises to limit crucial government functions. A threatened change to the fiduciary rule, for example, would make it legal for personal financial advisers to operate against the interests “But not the handsomest,” Left said. “We’re in West Hollywood,” the tech

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