President Trump seems to be backing down on his famous campaign claim to curb drug companies — in 2016, then-candidate Trump said big pharma was “getting away with murder” by inflating drug prices and working with lobbyists. Two years later, his latest plan is a little less populist.

The White House’s new plan doesn’t challenge big players in the pharmaceutical industry and their role in pricing, a move that has drawn a lot of criticism, especially amid news that the drug company Novartis paid Trump’s personal attorney Michael Cohen more than $1 million to gain access to the Trump administration.

“There was an elephantine wind-up, and a mouse was born,” Medical Ethicist Art Caplan said during an interview with Boston Public Radio Tuesday. “Not much real action on price control here, despite all the hand-waving.”

Caplan did praise Trump for suggesting that the FDA rethink its relationship to pharmacy benefit management companies like Caremark and Express Scripts — ”middlemen” that often hike up the price of drugs.

“When a drug company has a drug, it makes it in a factory but it doesn’t ship it to the drug store, the middlemen do that,” Caplan said. “Watching over the prices of those drugs and bargaining for the prices are these for-profit companies, and I would say they have failed miserably to control costs of drugs. They’re making money hand over fist.”

According to Caplan, Trump should take the leap to entirely remove these industry middlemen from the process.

“They don’t do the job,” Caplan said. “Trump said maybe we could rethink how they get paid. I think we should be rethinking how to get rid of them because they’re just sucking huge resources out of healthcare.”

Art Caplan is the Drs. William F. and Virginia Connolly Mitty Chair, and director of the Division of Medical Ethics at NYU Langone Medical Center. He’s also the co-host of the Everyday Ethics Podcast. To hear his full segment, click on the audio player above.