Earlier this week, 20 U.S. Senators spoke out against an exorbitant price increase for EpiPens distributed by Mylan, a pharmaceutical company that raised the price from $100 (in 2008) to $600. In an effort to quell the following outrage, Mylan offered a generic version of its own product, a package of two EpiPens for $300, but the incident sparked a raging debate, reminiscent of reviled “Pharma Bro” Martin Shkreli raising the price of an AIDS drug by 5,000 percent back in November.

According to Medical Ethicist Art Caplan, there’s a larger issue here: as long as the pharmaceutical industry remains unregulated, companies like Mylan can continue to call the shots when it comes to prices for drugs and medical devices. “It’s easy to demonize [Mylan] and Shkreli and all this sort of thing, but it doesn’t get to the fundamental problem, which is, prices are too high for drugs and medical devices, and they have been for a long time,” Caplan said. “We’re paying more than other countries do all over the world, way more. We don’t negotiate prices across the board, and if the EpiPen had gone up 15 percent a year over ten years, we probably wouldn’t have noticed in the way that when they made a sudden ridiculous 1,500 percent price increase.”

According to Caplan, the public notices when drastic price increases occur suddenly, but there are more insidious cases to watch out for. “Prices creep along, even things like insulin and saline which has got nothing new, their prices are going up,” he said. “We need to get into a recognition that the free market doesn’t work to control prices, because it’s not a competitive marketplace.”

As far as the bipartisan show of outrage among senators, Caplan was not impressed. “It’s really cheap grandstanding, I think,” Caplan said. “Bipartisan grandstanding. What you’ve really got to do is say, we’re going to bargain prices in Medicare and Medicaid, and we’re going to make sure that everybody gets the same price.”

It’s because people have patents, they get monopolies, they pay for the generics to stay out, it’s called pay to play, you don’t let the generic in by buying them off, so you continue to have a monopoly. Drugs are monopolies. Unless you get into some rule for government in setting prices, like they do in Canada, like they do in Britain, like they do everywhere… this sort of little burst of anxiety over the EpiPen is not going to get the systematic solution done

Though pressure is mounting on the F.D.A. to regulate the market, Caplan says solving the problem is going to take more than offering up a $300 EpiPen package. “Drugs are monopolies. Unless you get into some rule for government in setting prices, like they do in Canada, like they do in Britain, like they do everywhere,” Caplan said, “this sort of little burst of anxiety over the EpiPen is not going to get the systematic solution done.”

Medical Ethicist Art Caplan is Head of the Division of Medical Ethics at NYU Langone Medical Center and the co-host of the Everyday Ethics podcast. To hear more of his interview with BPR, click on the audio link above.