Is America back in business with Mike Johnson — or is it business as usual?

The concerted media assault on Mike Johnson as soon as he became speaker of the House — against all odds — was as predictable as it was hackneyed.

Every Republican, it seems, must be portrayed as an “ultra-MAGA” extremist. Although, to be fair, journalists and progressives aren't quite sure what concerns them more: Johnson's fondness for Trump or his faith in God.

One crusty leftist talking head labeled Johnson’s declaration that anyone who wanted to know his philosophy should “go pick up a Bible off your shelf and read it” as “the most terrifying words in the 21st century.”

That's a pretty low threshold for terror.

The truth is that many Republicans and conservatives are encouraged by Johnson’s first moves as House speaker — although the vast majority of Americans of all stripes are still getting to know him and thus haven't formed a strong opinion.

One thing is for sure: Johnson will have to navigate some exceptionally choppy waters and will face constant and seductive demands and entreaties from lobbyists and establishment operators that will make serving the American people and the national interest tricky to say the least.

Most Americans know that much congressional legislation is effectively written by lobbyists, and it is designed to give well-connected, deep-pocketed industry players legal and commercial advantages over their competitors — or, indeed, to stifle that competition altogether. It’s a time-honored Washington tradition. Most of the time, Democratic and Republican members of Congress play directly into lobbyists’ hands.

For example, legislation is now percolating in multiple House and Senate committees that would promote “delinking” in the compensation of obscure health care entities known as “pharmacy benefit managers.”

PBMs are retained voluntarily by health insurance plans, self-insured businesses, state and local governments, and unions to negotiate with wholesalers of pharmaceuticals for better prices, which sometimes can mean discounts and rebates. By one estimate, PBMs save the average American around $1,000 a year.

But who in their right mind would want to pay less for medications? This, in any case, is the attitude taken by Big Pharma and its pet lobbyists, who want to kneecap PBMs via legislated “delinking” and thus force them into a rigid fee-for-service business model instead of a value-based model. And, sure as clockwork, studies have shown that downplaying “value” results in higher costs overall. In short, everyone loses — employed Americans with health care insurance, seniors on Medicare, taxpayers, and naturally PBMs and their thousands of employees. Everyone, that is, except for the pharmaceutical industry itself, which stands to make billions in extra profits. And all because Congress passes a law.

Why would Congress even consider such misguided, counterintuitive legislation? The answer is obvious: The objective of most House members and senators is not necessarily to serve the national interest and to govern based on common sense. It is to win re-election, which is expensive and can only be accomplished if one cozies up to the special interests that are handing out campaign contributions most generously. I scratch your back and you scratch mine.

Needless to say, Big Pharma has been scratching a lot of backs in recent years. It plowed millions into the effort to elect Joe Biden in 2020, and it has redoubled its self-interested efforts since then. Big Pharma, in fact, is the leading lobbying industry in America.

The cynical talking heads are right about one thing. Winning the speakership was, perversely, the easy part for Johnson. Holding his caucus together and governing in a way that recognizably advances the interests and respects the values of the American people will be monstrously difficult. Whether Johnson and other House GOP leaders have the courage to stand up to special interests remains to be seen.

The temptation to embrace “crony capitalism” — and thus to reward donors with favorable if deeply irresponsible legislation — may increase in the years ahead. Because Congress’ other standard operating procedure, namely throwing money in all directions to placate constituents and lobbyists, is becoming less feasible as the national debt tops $34 trillion and rising interest rates make adding to the deficit prohibitively expensive.

Mike Johnson faces a terrible test in the weeks and months ahead as he leads the “People’s House.” If he is committed to serving God and the American people first, as opposed to mammon in the form of Big Pharma, then our country should be very grateful that a leader of his caliber appeared at such a critical juncture.