Everyone Wants to Reduce Drug Prices. So Why Can’t We Do It?

The pharmaceutical and health products industries spent $145 million on lobbying for the first half of 2017, according to the Center for Responsive Politics.

Drug makers gave $4.5 million to congressional campaigns in that period, including six-figure donations to House Speaker Paul Ryan; Representative Greg Walden, a Republican of Oregon who heads the House Energy and Commerce Committee; and Senator Orrin Hatch, Republican of Utah and chairman of the Senate Finance Committee, a Kaiser Health News analysis found.

The drug lobby has spent $28 million so far this year to air six ads depicting heroic researchers about 4,600 times on national TV, according to iSpot.tv, an ad tracker.

The industry hired the former F.B.I. director Louis Freeh to study the impact of importation. He concluded that it would “leave the safety of the U.S. prescription drug supply vulnerable to criminals seeking to harm patients.” Import proponents argue the Food and Drug Administration could easily ensure safety by licensing and inspecting Canadian suppliers.

.. Mr. Trump’s feud with congressional Republicans, especially the Senate majority leader, Mitch McConnell, means “you’re not going to get any strong direction or leadership out of the White House” on drug prices

Pharma Gets Roped Into the Trumpcare Maelstrom

With this change, insurers would still offer such benefits, letting consumers choose which ones they want. But insurers would likely charge substantially more for them than for bare-bones plans, which would appeal mainly to young and healthy people.

.. sicker people will gravitate toward the more-generous coverage, making it even more expensive and further stratifying the market.

Prescription-drug coverage could get caught on the wrong side of this divide, becoming ever more expensive and causing healthier people to skip it.

.. This could force the industry to reckon on a deeper level with the way it prices drugs.

.. So many medicines carry massive price tags because most patients typically pay just a small fraction of those list prices, while insurers handle the rest. That generous coverage is possible partly because everyone with insurance pays for it; healthy 27-year-olds help insure older diabetics.

.. Exposing more patients to high prices will crush demand, hurting sales. And the political pressure drugmakers already feel over prices will only intensify. The more Americans have to pay the actual list prices of drugs, the harder those prices will be to defend.

How America Made Donald Trump Unstoppable

Before the speech, the PA announcer had told us not to “touch or harm” any protesters, but to instead just surround them and chant, “Trump! Trump! Trump!” until security can arrive (and presumably do the touching and/or harming).

.. The same way Sarah Palin can see Russia from her house, Donald on the stump can see his future. The pundits don’t want to admit it, but it’s sitting there in plain view, 12 moves ahead, like a chess game already won:

President Donald Trump.

.. It’s been well-documented that Trump surged last summer when he openly embraced the ugly race politics that, according to the Beltway custom of 50-plus years, is supposed to stay at the dog-whistle level. No doubt, that’s been a huge factor in his rise.

.. That put him in position to understand that the presidential election campaign is really just a badly acted, billion-dollar TV show whose production costs ludicrously include the political disenfranchisement of its audience.

.. Trump’s basic argument is the same one every successful authoritarian movement in recent Western history has made: that the regular guy has been screwed by a conspiracy of incestuous elites.

.. What Trump understands better than his opponents is that NASCAR America, WWE America, always loves seeing the preening self-proclaimed good guy get whacked with a chair.

.. rump had said things that were true and that no other Republican would dare to say. And yet the press congratulated the candidate stuffed with more than $100 million in donor cash who really did take five whole days last year to figure out his position on his own brother’s invasion of Iraq.

.. Why do the media hate Trump? Progressive reporters will say it’s because of things like his being crazy and the next Hitler, while the Fox types insist it’s because he’s “not conservative.” But reporters mostly loathe Trump because he regularly craps on other reporters.

.. Reporters have focused quite a lot on the crazy/race-baiting/nativist themes in Trump’s campaign, but these comprise a very small part of his usual presentation. His speeches increasingly are strikingly populist in their content.

.. His pitch is: He’s rich, he won’t owe anyone anything upon election, and therefore he won’t do what both Democratic and Republican politicians unfailingly do upon taking office, i.e., approve rotten/regressive policies that screw ordinary people.

.. He talks, for instance, about the anti-trust exemption enjoyed by insurance companies, an atrocity dating back more than half a century, to the McCarran-Ferguson Act of 1945. This law, sponsored by one of the most notorious legislators in our history (Nevada Sen. Pat McCarran was thought to be the inspiration for the corrupt Sen. Pat Geary in The Godfather II), allows insurance companies to share information and collude to divvy up markets.

.. Neither the Republicans nor the Democrats made a serious effort to overturn this indefensible loophole during the debate over the Affordable Care Act.
.. Trump isn’t lying about any of this. Nor is he lying when he mentions that the big-pharma companies have such a stranglehold on both parties that they’ve managed to get the federal government to bar itself from negotiating Medicare prescription-drug prices in bulk.

.. He claims (and with Trump we always have to use words like “claims”) how it was these very big-pharma donors, “fat cats,” sitting in the front row of the debate the night before. He steams ahead even more with this tidbit: Woody Johnson, one of the heirs of drug giant Johnson & Johnson ..  .. is the finance chief for the campaign of whipping boy Jeb Bush.

.. Trump, incidentally, will someday be in the Twitter Hall of Fame

.. But that wasn’t because of the principle itself, but because it was always coupled with the more effective politics of resentment: Big-government liberals are to blame for your problems.

.. Elections, like criminal trials, are ultimately always about assigning blame. For a generation, conservative intellectuals have successfully pointed the finger at big-government-loving, whale-hugging liberals as the culprits behind American decline.

.. No one should be surprised that he’s tearing through the Republican primaries, because everything he’s saying about his GOP opponents is true. They really are all stooges on the take, unable to stand up to Trump because they’re not even people, but are, like Jeb and Rubio, just robo-babbling representatives of unseen donors.

.. Patinkin believed Cruz didn’t do that line because Cruz is himself in the revenge business, promising to “carpet-bomb [ISIS] into oblivion” and wondering if “sand can glow.”

 

 

America’s Stacked Deck

But when societies face economic pain, they sometimes turn to reforms, and other times to scapegoats (like refugees this year). So the historic question for 2016 is which direction the popular revolt among American voters will ultimately take. A President Trump or President Cruz would build walls and waterboard suspected terrorists, a President Clinton or President Sanders would raise the minimum wage and invest in at-risk children.

.. After a characteristically brilliant speech by Adlai Stevenson, the Democratic nominee for president in 1952 and 1956, a supporter is said to have bellowed, “Every thinking American will vote for you!”

Legend has it that Stevenson shouted back: “That’s not enough. I need a majority!”

.. The pharmaceutical industry, for example, has used its lobbying heft — it spent $272,000 in campaign donations per member of Congress last year, and it has more lobbyists than there are members of Congress — to bar the government from bargaining for drug prices in Medicare. That amounts to a $50 billion annual gift to pharmaceutical companies.