President Donald Trump's new push to allow the importation of lower-priced prescription drugs isn't a cure-all for high prices, but it might help some Americans struggling to afford their medications. That's if — and this is a big if — the proposal becomes a reality.

Skepticism is merited about this well-intentioned plan's implementation. Trump and his administration have floated a number of good ideas to hold down drug costs. The trouble is that the follow-up leap from talking point to actual policy has fallen short.

On the campaign trail, Trump called for allowing Medicare, the government's health insurance program for seniors, to wield its vast purchasing might to negotiate lower prices. This is a sensible, run-the-government-like-a-business strategy, one that the Star Tribune Editorial Board and many other health care advocates support. But it's now 2019, and this reform hasn't happened.

Another smart idea was shelved recently: a proposal from Health and Human Services Secretary Alex Azar to shield Medicare seniors from drug-price hikes. Conservative health care wonk Avik Roy, writing in Forbes, said the setback "does not bode well" for the administration's other drug cost initiatives. The stumbling block that drug importation and other reforms face should come as no surprise. Drug manufacturers are among the nation's most powerful special interests, spending $284 million on lobbying in 2018.

The industry doesn't sit idly by when reforms threaten its bottom line. The drug importation plan, if implemented, would do just that by allowing Americans to buy medications at lower prices charged internationally. Drugs elsewhere generally cost less due to government price-regulation. The U.S. is the only industrialized country that doesn't have national drug-price controls.

Minnesotans have seen close up how vigorously the pharmaceutical industry will fight even smaller-scale threats to profits. The 2017 death of Alec Smith, who died after rationing insulin, spurred outrage. Yet the Legislature this year couldn't even pass an insulin assistance bill, one that tapped the industry for a modest contribution, after lobbyists swarmed the scene.

It's foolish to imagine that Trump's new drug importation plan will be met with anything less than gale-force opposition from industry. The fine print of the proposal also generates skepticism about its success, even if implemented. The reason: It depends on drugmakers' goodwill. The amount of drugs that the U.S. would need to import would far outstrip Canada's current supply. Manufacturers weren't cooperative in the early 2000s, when a previous effort to import drugs from north of the border gathered steam.

"Pharmaceutical manufacturers did everything they could to prevent the Canadian internet pharmacies from buying drugs," said Cody Wiberg, the Minnesota Board of Pharmacy's executive director.

Another prong of the Trump plan would rely on manufacturers to "seek to import into the U.S. versions of these drugs they sell in foreign countries." This pathway would likely allow the importation of insulin, the drug that has spurred Minnesotans to travel to Canada in "caravans." Why would manufacturers do this extra work to sell their product at a lower price?

For all the caveats, the Trump plan is worth trying. Everyone should hope it succeeds. At the same time, recognize its limitations. This is simply a workaround — not a solution. Bigger, bolder proposals are still urgently needed.