Hey, Denmark: I want you to know that millions of Americans think you’re a pretty swell place overall, and that if Donald Trump denounces you or bullies you or even God forbid invades you, we’ll be here to lend you a sympathetic ear.
Consider, my fellow Americans. For a country of a mere 5.9 million people, with a gross domestic product not much bigger than the state of Missouri’s, the place has some remarkable accomplishments to boast about. We can thank Jens and Lars Rasmussen for Google Maps. It was a Danish mycologist who developed the yeast that made beer drinkable (incidentally, this chap also translated Darwin into Danish). And of course, they gave the world Lego, which will sell you a Star Wars Death Star for a mere $3,250.
But here’s the interesting Danish fact that really caught my eye over the weekend as I was reading about Trump’s obsession with Greenland. Denmark doesn’t export a whole lot of things to the United States. But it does produce two products that Americans are gaga over: Ozempic and Wegovy. That’s right—the insanely popular diabetes and weight-loss drugs are Danish in origin, from the big pharmaceutical company Novo Nordisk.
Wait a second. This doesn’t make any sense. Because you see, Denmark has socialized medicine; they subsidize it with taxes. Most health care is provided free of charge. So you see the source of my confusion. Because we in America have been told for decades by Republican politicians, a small handful of Democratic ones, and the pharmaceutical industry that if we went to a system like that, we’d kill off the innovation that makes the American system the envy of the world.
But now, lo and behold, we’re not the envy of the world. Denmark is! They’ve somehow managed to overcome the suffocating weight of socialism to innovate their way to two of the most popular products in the world. According to the Bible of American free enterprise, that isn’t supposed to happen.
I joke—a little. The Danish government does not set prices for prescription drugs. However, manufacturers do have to notify the Danish Medicines Agency of proposed price changes every 14 days. Also, by law, prescription drugs are sold for the same price at every pharmacy in the country. Oh, and this too—pharmaceutical manufacturers aren’t allowed to advertise directly to consumers; only to health care professionals. That cuts costs by many billions right there. In the United States, of course, half the advertising on television is for prescription drugs. (The other half is for online gambling apps.)
I don’t have a strong position on Trump’s Greenland ploy. Part of me has to admit that it makes a certain sense, assuming we accept the idea that the planet is warming. If those northern waters become navigable, I guess it’ll be good for the United States to have control over them—at least in the few short years that humanity will, in those circumstances, have left. Of course, Trump doesn’t accept the idea that the planet is warming, although maybe this is proof that deep down he does. And maybe he’s thinking that the capital city of Nuuk, like the Gaza City of Trump’s imaginings, might be a beachfront playground for the rich someday and a nice home for a future Trump hotel and casino.
My guess is that Trump just likes the idea because he looks at a map and sees that Greenland is so yuge. I wonder if anyone has explained to him that maps have been drawn since the 1700s in something called the Mercator projection, which converts the actual Earth’s curved lines into straight lines so they’re easier to read, but which exaggerates the size of land bodies near the poles. In real life, Greenland is larger than Libya but smaller than Algeria. On the other hand, Trump doesn’t care much about reality. He cares about how things look. So as long as Greenland looks massive, it’s all good.
The more important illusion here in my book is the bill of goods Americans have been sold for decades about how medical innovation would be utterly impossible if we had a more heavily regulated health care system. It’s just bosh. As the Democrats claw their way out of the wreckage of the election and toward a more viable future, I hope they take a minute to think about how the Danish health care system managed to give us Ozempic.
Indeed, Ozempic and Wegovy may well be in the news in the coming months—if Trump imposes the massive tariffs on Denmark that he has threatened over Greenland, the prices of the two drugs may well be raised.
Mind you, they’re already sky-high—here at home anyway. My admiration for Novo Nordisk and its innovative prowess is tempered by a quick look at the prices the company charges across the world. A four-week supply of Ozempic in the U.S. is about $1,000. In Denmark itself, it’s $122. It’s about $150 in Canada and $59 in Germany. Wegovy costs $1,349 here but $186 in Denmark and $92 in the U.K.
Bernie Sanders launched an investigation into Novo Nordisk last year and grilled its CEO in a hearing. The CEO said that rebates, discounts, and fees make the actual prices of the drugs substantially lower than the list prices and that pharmacy benefit managers sometimes exclude the drugs when prices are lowered because PBMs profit from the rebates. Joe Biden’s Federal Trade Commission, under Lina Khan, sued the three largest PBMs, alleging that they excluded covering lower-priced insulin providers in favor of higher-priced ones that offer higher rebates. That suit, we can assume, will not be of much interest to a Trump administration.
So while Trump spends his pre-inaugural days spinning these woolly Lebensraum fantasies, there is still good reason for Americans to be paying attention to Denmark: The private sector produced these two wonder drugs, and the government managed to make them affordable. That’s something that will actually impact people’s lives. But in Trump’s America, that isn’t how things are going to work.
