“A Very Sweet Deal”: Prescription Drug Price-Gouging Enabled By Congress
Republicans and Democrats don’t agree on much. But one thing they would agree on if they knew the facts is that because of the cozy relationship big drug companies have with our lawmakers in Washington, Americans pay far more for their medications than people anywhere else on the planet.
As a consequence, our health insurance premiums are much higher than they should be. And our Medicare program is costing both taxpayers and beneficiaries billions of dollars more than necessary.
Americans who are uninsured are at an even greater disadvantage: many of them have no choice but to put their health at risk because they can’t afford the medications their doctors prescribe for them.
Drug makers have so much influence in Washington that they’ve been able to kill numerous proposals over the years that would enable the U.S. government to regulate drug prices like most other countries do. Between 1988 and 2012, the pharmaceutical industry spent more on lobbying than any other special interest, forking over a total of $2.6 billion on lobbying activities, according to OpenSecrets.org. That’s far more than even banks and oil and gas companies spent.
That money helped them get a very sweet deal when members of Congress were drafting legislation that would eventually be the Medicare Part D prescription drug program. Drug makers were able to get their friends in Congress to insert language in the Part D legislation that prohibits the federal government from seeking the best prices from pharmaceutical companies.
According to a recent analysis by Health Care for America Now (HCAN), an advocacy group, the 11 largest drug companies reported $711.4 billion in profits over the 10 years ending in 2012, much of it coming from the Medicare program. They reaped $76.3 billion in profits in 2006 alone, 34 percent more than in 2005, the year before the Part D program went into effect.
“Americans pay significantly more than any other country for the exact same drugs,” said HCAN Executive Director Ethan Rome.
How much more do we pay than residents of other countries? Here are a few examples of what we pay on average for six brand name drugs compared to what residents of other countries pay, according to the International Federation of Health Plans:
— Celebrex (for pain) – U.S.: $162; Canada: $53
— Cymbalta (for depression and anxiety) – U.S: $176; France: $47
— Lipitor (for high cholesterol) – U.S.: $124; New Zealand: $6
— Nasonex (for nasal allergies) – U.S: $108; U.K.: $12
— Vytorin (for high cholesterol) – U.S: $123; Argentina: $31
— Nexium (for acid reflux) – U.S.: $123; Spain: $18
The Congressional Budget Office says that if Medicare could get the same bulk purchasing discounts on prescription drugs as state Medicaid programs already get, the federal government would save at least $137 billion over 10 years.
In his proposed budget for 2014, President Obama is asking Congress to require drug companies to sell their medications to Medicare at the best price they offer private insurance companies, which is what they are required to do for Medicaid.
On April 16, several members of Congress, led by Sen. Jay Rockefeller (D-W.Va.) and Rep. Henry Waxman (D-Calif.), introduced legislation to require drug companies to provide rebates to the federal government on drugs used by people who are eligible for both Medicare and Medicaid. One of the cosponsors was Independent Sen. Angus King, the former governor of Maine. The lawmakers noted that with the exception of Medicare Part D, all large purchasers of prescription drugs negotiate better prices. Their bill, they say, would correct excessive payments to drug companies, while saving taxpayers and the federal government billions of dollars.
As you can imagine, the drug companies don’t like what President Obama and the lawmakers are proposing. You can expect them to mount a multi-million dollar PR and lobbying campaign over the coming months to protect both their sweet deal with Medicare and their Wall Street-pleasing profits.
By: Wendell Potter, Guest Contributor, Politix, April 23, 2013
“Bullet Backdrops”: Arkansas Republican “Most Likely Won’t Try To Kill” Lawmakers Who Support Medicaid Expansion
Arkansas may become the first red state to accept the Obamacare Medicaid expansion, which the Supreme Court made optional in its decision last year, if the Department of Health and Human Services accepts its privatized plan.
(Of course, the states turning down Medicaid expansion are generally the ones that need it most.)
The notion of expanding government to improve health care outcomes apparently drove Chris Nogy of the Benton County Republican Committee a little nutty. In a recent newsletter, he encouraged his fellow Republicans to seek “Second Amendment” solutions against those who had voted for the expansion, and expressed dismay that he can’t actually back up these threats:
We need to let those who will come in the future to represent us [know] that we are serious. The 2nd amendment means nothing unless those in power believe you would have no problem simply walking up and shooting them if they got too far out of line and stopped responding as representatives. It seems that we are unable to muster that belief in any of our representatives on a state or federal level, but we have to have something, something costly, something that they will fear that we will use if they step out of line. If we can’t shoot them, we have to at least be firm in our threat to take immediate action against them politically, socially, and civically if they screw up on something this big. Personally, I think a gun is quicker and more merciful, but hey, we can’t.
Nogy’s wife is the group’s secretary and she claims the article was placed in the newsletter without her husband’s approval.
Medicaid expansion will provide health insurance for up to 250,000 Arkansans, ultimately saving dozens if not hundreds of lives, while driving down the costs of the state’s insured — who already subsidize the uninsured through higher rates.
Most of Arkansas’ estimated uninsured 401,100 are working families who simply can’t afford coverage.
Several Arkansas Republicans made it clear that they were appalled by Nogy’s comments.
“I’m embarrassed for the Benton County Republican Committee for including this article in their newsletter,” said State Senator Jon Woods (R). “I would think the Benton County Committee would have better judgment and not allow this to be sent out.”
The Benton County Republican Committee offered a statement:
“The letter was not approved and Mr. Nogy had no authority to submit it through the newsletter. As a committee, we respect the right of our legislators to vote based on their knowledge and feedback from the voters they represent. We will discuss this issue further with our executive committee.”
Nogy later clarified his comments in a letter to KFSM News.
He explained why he is more angry at Republicans than Democrats:
I don’t feel the same way about the Democrats as bullet backstops as I do about the Republicans who joined them. The Democrats were doing what their party told them they had to do because they were elected to do that job.
He concluded by saying that his threats were only meant to attract attention and he “most likely” won’t kill those Republicans who supported the Obamacare provision. He simply thought it was important to put a face behind his threats so lawmakers will take him seriously:
And for the record, I didn’t advocate violence. I mentioned violence to get people’s attention, and it worked. I advocated a serious political and social stand, an assured and significant negative response to any politician who breaks a primary voter/elected official promise contract. We have only one mechanism to maintain the ‘government of the people, by the people, and for the people’, and that is to elect those who promise to do as we demand they do. If we cannot make these people understand that we will not tolerate this kind of breach of contract, then we lose our ability as the people to control the government. And in this age of death threats from nameless, faceless thugs, we need these folks to know that while we most likely won’t try to kill them or harm their families, they should be much more certain of our response than fearful of the actions of those who will not identify themselves.
The contentious battle over expansion has shown that Republicans are eager to take the federal funds without getting any Obama on them. Lawmakers are so afraid to be caught pandering to the president or “takers” that they’ve officially declared that Medicaid expansion is not an entitlement.
Mr. Nogy should be happy to know that another feature of Obamacare is mental health parity.
By: Jason Sattler, The National Memo, April 22, 2013
“Hell Bent On Destroying The Health Care System”: Mitch McConnell Has A Secret Plan For Obamacare
Republicans promised voters in 2012 that with public support, they would repeal the Affordable Care Act. Voters responded by electing Democrats, seemingly ending the debate.
Indeed, as recently as two months ago, there wasn’t much left to fight about. President Obama had won re-election; the health care law’s implementation would continue apace; many Republican governors started accepting the law’s provisions; House Speaker John Boehner called the Affordable Care Act “the law of the land”; and Larry Jacobs, director of the Center for the Study of Politics and Governance at the University of Minnesota, said, “The arc of partisan fever is beginning to recede, and pragmatism is beginning to come to the fore.”
That was late January. Now, congressional Republicans seem to vote uncontrollably on “Obamacare” repeal and National Journal reports that Senate Minority Leader Mitch McConnell (R-Ky.) has a “secret Republican plan” to destroy the law.
By Election Day, Senate Republicans were ready to, as McConnell put it, “take this monstrosity down.”
“We were prepared to do that had we had the votes to do it after the election. Well, the election didn’t turn out the way we wanted it to,” McConnell told National Journal in an interview. “The monstrosity has … begun to be implemented and we’re not giving up the fight.”
Sure, those darned voters got in the way of McConnell’s dreams, but the Republican senator apparently only sees that as a minor inconvenience that simply delays his plans.
The “secret Republican plan” really isn’t much of a secret. Hell, it’s not really much of a plan, either. McConnell’s idea is apparently to have Republicans win a bunch of elections and then destroy the law through the reconciliation process so Democrats can’t filibuster the GOP’s anti-Obamacare crusade.
That’s roughly the same plan Republicans came up with last year, right before the electorate re-elected President Obama and expanded the Democratic majority in the Senate.
But as is the case with so many issues — taxes, deficit reduction, Planned Parenthood, Paul Ryan’s budget, etc. — GOP officials are determined to pretend 2012 didn’t happen and the will of the voters is irrelevant.
What’s less clear is whether McConnell has actually thought through the consequences, or whether he’s so deep into his post-policy vision that he simply no longer cares.
How will he pay for Obamacare repeal, which would cost over $100 billion in the coming decade? What will he do for the millions of Americans who would lose the ability to see a doctor if Obamacare were destroyed? How will he reconcile eliminating Obamacare and Republican plans to rely on Obamacare to balance the federal budget?
McConnell doesn’t seem to have answers for any of this. In fact, I’m not altogether sure why, exactly, McConnell hates the Affordable Care Act as much as he thinks he does, or whether this posturing is intended to placate the far-right wing of his party in advance of his 2014 campaign.
But the bottom line remains effectively the same: whereas Republicans were prepared two months ago to move on to other fights, GOP leaders are now back to their preoccupation with, in Paul Ryan’s words, “destroying the health care system for the American people.”
By: Steve Benen, The Maddow Blog, March 28, 2013
“A New Round Of Shame”: Michele Bachmann’s Confusion Bubbles Over
Dorsey Shaw noted late yesterday that Rep. Michele Bachmann (R-Minn.) has had a “horrible, no good, very bad week.” It’s true — even by Bachmann’s awful standards, the ignominious congresswoman has had it rough lately.
Her CPAC speech was ridiculous, and left in tatters by fact-checkers. Asked for an explanation, Bachmann literally fled from a reporter confronting her with her own words. Bill O’Reilly invited her on to get back on track, but when Bachmann refused, he turned on her.
This, however, was the moment that arguably mattered most.
“Let’s repeal this failure before it literally kills women, kills children, kills senior citizens,” Bachmann said on the House floor. “Let’s not do that. Let’s love people. Let’s care about people. Let’s repeal it now while we can.”
I’m sure this probably makes some sense to Bachmann, but for those of us living in reality, it’s just crazy.
She went on to say, “What [President Obama] demanded and insisted upon is that the government have 100 percent control over health care,” Bachmann said. “100 percent control? The American people lose control? What did they get? They get health care — health insurance, I should say — that is more expensive than anything they’ve ever paid for before. And they get less for it. Well what a deal, Mr. President, Mr. Speaker. What a deal.”
For anyone with a rudimentary understanding of the issue, this is complete gibberish. Under current law, government doesn’t have “100 percent control over health care,” but rather, private insurers have a key role providing coverage for tens of millions of people. What’s more, consumer costs are lower, not higher, and they have more expansive coverage, not less.
It’s almost as if Michele Bachmann, after having been caught saying ridiculously untrue things, has no qualms about making matters worse, bringing a new round of shame to her and her constituents.
Of course, she can at least take some comfort in the fact that the House Republican leadership kept her on the House Intelligence Committee, inexplicably giving this deeply strange and unhinged lawmaker access to the nation’s most sensitive, highly-classified secrets.
By: Steve Benen, The Maddow Blog, March 22, 2013
“Doing Nothing Was Not An Option”: Obamacare Is Lowering Some Health Care Costs
The snippy tone of the letter from my health insurance company really threw me for a minute. Very officious, very much this-is-totally-not-our-fault-the-bad-government-made-us-do-it, the letter informed me that because of the Affordable Care Act, my premium might change. Under the law, as of this year, insurance carriers would no longer be allowed to differentiate (or discriminate) on the basis of gender, and this, I was informed in a letter dripping with derision, might end up affecting how much I have to pay for my individual insurance each month.
Well, it did. My premiums are now 7 percent lower than they were.
Yes, that’s lower. Despite the fact that foes of Obamacare are screaming about how the law will bankrupt families and small businesses (the impact on buyers of individual policies never seems to come up), despite all the pols showing that Americans are terrified that their health care costs will grow, my premium went down. This will not be true for everyone—it was women who were routinely charged more for insurance for no other reason than their gender. That includes, incidentally, the handful of states in which it was perfectly legal for insurance companies to deem victims of domestic violence as having a “pre-existing condition.” But it’s reason to believe that the worry—verging on hysteria—over the law might be a bit much.
Health care costs are absurdly high in this country, and they must be reined in. And it’s not because we have the best health care in the world; we don’t. If you need a heart transplant, yes, this is where you want to be. But for most of the health care most of us will need in our lives, we are simply not getting the bang for our buck.
Health care premiums may indeed go up for many people, but they were going up before Obamacare was passed. That was the point of trying to do health care reform. That was the point during the Nixon administration, when both parties worried about the social and financial impact of the uninsured. It was the point in 1992, when Bill Clinton was running for president, and at nearly every campaign stop, someone told a sad story of a child with leukemia, and an insurance company refusing to pay for the treatments, or of someone who got laid off and couldn’t get a job because he had a “pre-existing condition” the new employer would find too expensive to cover through its insurance. The problem has merely gotten worse every single time Congress and the White House built the momentum to do something and came close but ultimately failed.
Is Obamacare the cure? The reality is, three years after the law was passed, is that we simply don’t know. House Democratic Leader Nancy Pelosi was criticized for saying we don’t know what the law will do until it’s in place, but she was right. That’s true of a lot of sweeping legislation (No Child Left Behind being the best recent example). The idea is to give it a shot, and then tweak it where necessary.
One thing is clear—doing nothing, yet again, was not an option.
By: Susan Milligan, U. S. News and World Report, March 22, 2013
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