Democratic lawmakers who have spent decades devoted to health care reform are celebrating a relatively minor legislative victory of 2022, expecting it to pay big dividends down the line. The first year of the Biden administration was going to be when Medicare drug price negotiation finally happened. That didn’t happen in full, but Democrats succeeded in inserting a wedge and intend to keep pushing it until they break Big Pharma’s hold entire.
The Inflation Reduction Act includes that wedge, allowing Medicare to negotiate prices on a limited set of prescription drugs. It also caps the monthly cost of insulin for diabetic Medicare enrollees at $35. It’s not precedent setting—the Department of Veterans Affairs has been able to negotiate prices for its program for years, and has paid less than half what the Department of Health and Human Services (HHS) has for drugs in the Medicare system. But the patient pool in Medicare is much larger than in the Veterans Affairs department, and it’s a damned profitable pool for the pharmaceutical industry, so that’s a nut that Democrats hadn’t been able to crack until now after decades of hammering on it.
That’s just the beginning, Sen.-elect Peter Welch of Vermont promises. Welch has been a staunch advocate of reform in his 15 years in the House, and was the lead sponsor of this drug price effort. He definitely wanted more, as one of the primary advocates of a single-payer health system for the U.S. But he’s bullish on what they got, and is daring Republicans to try to take it away.
“The slippery slope is very powerful,” Welch told Politico. “If [negotiation] works in Medicare, it can work in the private market. Once you have the tool, and it gets implemented, and people get to experience lower rates, and it doesn’t harm health outcomes, it’s going to be really hard to reverse that.”
RELATED STORY: Republicans could have helped Democrats save the lives of diabetics. They refused
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Just as it’s been hard to reverse the Affordable Care Act (ACA), though Republicans spent a solid decade trying to do that. The public now both accepts and approves of the ACA. Not that Republicans necessarily learned from that experience, which was a series of midterm losses every time it looked like they made a concerted effort to repeal that law. Now they want to continue to carry Big Pharma’s water and try to repeal this, too.
It won’t succeed with a Democratic Senate and White House, but they’ll keep trying, with pathetic excuses. “I want drug prices to be lower but we have to do it in a way that doesn’t undermine the creation of new drugs,” said Sen. Marco Rubio, who is cosponsoring repeal legislation. “Companies are not going to invest in developing new treatments unless they believe they have a chance to make back their money with a profit.”
As if their profits haven’t been good enough and as if every American who takes a prescription drug didn’t know that. As if we weren’t aware that the money we pay in this country—250% more than other Organization for Economic Co-operation and Development (OECD) nations—is subsidizing the rest of the world’s pharmaceutical needs. As if there is a shred of sympathy for PhRMA outside of the industry, its investors, and its beneficiaries: GOP lawmakers.
Meanwhile, the GOP and pharmaceutical industry are not even trying to pretend that they want to nip this good thing for the American people in the bud, that they’re not evil. “Every year more drugs are added onto the negotiations, so the impact is going to increase over time,” Joe Grogan, a former pharmaceutical industry lobbyist, told Politico. He’s an adviser to GOP lawmakers on health care policy—perhaps more accurately, denying health care to people policy. “And now that you have demonstrated savings, Congress can expand the law to save more money in the future. So there’s no question it’s a slippery slope. It’s up to Republicans to try and arrest the slide down that slope.”
In other words, it’s up to the Republicans to keep prices as high has possible for consumers so pharmaceutical profits are as high as possible, a role they’re willingly accepting. They’re not even bothering to argue otherwise. Nor is the behemoth Pharmaceutical Research and Manufacturers of America, one of the most powerful industry lobbying groups outside of defense contractors. PhRMA will “keep working to mitigate the law’s harm and continue to push for real solutions that will bring financial relief for patients” spokesperson Sarah Ryan said. Because only in their world is having to pay no more than $35 a month for insulin not real financial relief.
They’re also going to try to pass the buck to other players in the system. “Any further attempt to lower what patients are paying for their medicines cannot ignore the role insurers and other middlemen play in the system,” she said.
Good luck with that. One of the most encouraging parts of this accomplishment is that now Democrats know they can do it. And they can do more. Sen. Raphael Warnock, for example, now has six years in office to work on his goal of capping the cost of insulin for everyone. “There are 20 states that already cap the cost of insulin. Many of them are red states,” he said. “So only politics can get in the way of us getting this done.”
Politics and lots and lots of money to Republican politicians. Oh, and a certain newly declared independent senator from Arizona who happens to be a favorite of pharmaceutical companies.
The Inflation Reduction Act includes that wedge, allowing Medicare to negotiate prices on a limited set of prescription drugs. It also caps the monthly cost of insulin for diabetic Medicare enrollees at $35. It’s not precedent setting—the Department of Veterans Affairs has been able to negotiate prices for its program for years, and has paid less than half what the Department of Health and Human Services (HHS) has for drugs in the Medicare system. But the patient pool in Medicare is much larger than in the Veterans Affairs department, and it’s a damned profitable pool for the pharmaceutical industry, so that’s a nut that Democrats hadn’t been able to crack until now after decades of hammering on it.
That’s just the beginning, Sen.-elect Peter Welch of Vermont promises. Welch has been a staunch advocate of reform in his 15 years in the House, and was the lead sponsor of this drug price effort. He definitely wanted more, as one of the primary advocates of a single-payer health system for the U.S. But he’s bullish on what they got, and is daring Republicans to try to take it away.
“The slippery slope is very powerful,” Welch told Politico. “If [negotiation] works in Medicare, it can work in the private market. Once you have the tool, and it gets implemented, and people get to experience lower rates, and it doesn’t harm health outcomes, it’s going to be really hard to reverse that.”
RELATED STORY: Republicans could have helped Democrats save the lives of diabetics. They refused
Campaign Action
Just as it’s been hard to reverse the Affordable Care Act (ACA), though Republicans spent a solid decade trying to do that. The public now both accepts and approves of the ACA. Not that Republicans necessarily learned from that experience, which was a series of midterm losses every time it looked like they made a concerted effort to repeal that law. Now they want to continue to carry Big Pharma’s water and try to repeal this, too.
It won’t succeed with a Democratic Senate and White House, but they’ll keep trying, with pathetic excuses. “I want drug prices to be lower but we have to do it in a way that doesn’t undermine the creation of new drugs,” said Sen. Marco Rubio, who is cosponsoring repeal legislation. “Companies are not going to invest in developing new treatments unless they believe they have a chance to make back their money with a profit.”
As if their profits haven’t been good enough and as if every American who takes a prescription drug didn’t know that. As if we weren’t aware that the money we pay in this country—250% more than other Organization for Economic Co-operation and Development (OECD) nations—is subsidizing the rest of the world’s pharmaceutical needs. As if there is a shred of sympathy for PhRMA outside of the industry, its investors, and its beneficiaries: GOP lawmakers.
Meanwhile, the GOP and pharmaceutical industry are not even trying to pretend that they want to nip this good thing for the American people in the bud, that they’re not evil. “Every year more drugs are added onto the negotiations, so the impact is going to increase over time,” Joe Grogan, a former pharmaceutical industry lobbyist, told Politico. He’s an adviser to GOP lawmakers on health care policy—perhaps more accurately, denying health care to people policy. “And now that you have demonstrated savings, Congress can expand the law to save more money in the future. So there’s no question it’s a slippery slope. It’s up to Republicans to try and arrest the slide down that slope.”
In other words, it’s up to the Republicans to keep prices as high has possible for consumers so pharmaceutical profits are as high as possible, a role they’re willingly accepting. They’re not even bothering to argue otherwise. Nor is the behemoth Pharmaceutical Research and Manufacturers of America, one of the most powerful industry lobbying groups outside of defense contractors. PhRMA will “keep working to mitigate the law’s harm and continue to push for real solutions that will bring financial relief for patients” spokesperson Sarah Ryan said. Because only in their world is having to pay no more than $35 a month for insulin not real financial relief.
They’re also going to try to pass the buck to other players in the system. “Any further attempt to lower what patients are paying for their medicines cannot ignore the role insurers and other middlemen play in the system,” she said.
Good luck with that. One of the most encouraging parts of this accomplishment is that now Democrats know they can do it. And they can do more. Sen. Raphael Warnock, for example, now has six years in office to work on his goal of capping the cost of insulin for everyone. “There are 20 states that already cap the cost of insulin. Many of them are red states,” he said. “So only politics can get in the way of us getting this done.”
Politics and lots and lots of money to Republican politicians. Oh, and a certain newly declared independent senator from Arizona who happens to be a favorite of pharmaceutical companies.