After Trump, Can Congress Force PhRMA To Charge Americans Fair Prices For Medicine?

Tepid, establishment Democrats-- especially corporately financed ones like Chuck Schumer-- are still too cowardly to grab the healthcare bull by the horns, look it directly in the eyes and say "now's the time." Although 124 House Democrats are co-sponsoring Medicare-For-All and although the public overwhelmingly backs it, Democrats like Schumer have more in common with Republican officials than with normal Americans. The for-profit status quo is still Schumer's preferred outcome. He's too old, too rigid and living in another era. It's why people in Democratic leadership should not be allowed to go on forever and ever and instead need to make room for energetic and open-minded new leaders like Ro Khanna, Alexandria Ocasio-Cortez, Pramila Jayapal, Jeff Merkley, and others not wedded to old bugaboos from their teenage years.

Pressed by MSNBC's Chuck Todd on whether he thinks it's time for Democrats to unify around Medicare for All-- which has the backing of 84 percent of Democratic voters-- Schumer dodged, saying, "Look, Democrats are for universal access to healthcare, from one end of the party to the other."

"We want more people covered, everyone covered; we want better healthcare at a lower cost. People have different views as to how to get there. Many are for Medicare for All, some are for Medicare buy-in, some are Medicare over 55, some are Medicaid buy-in, some are public option," Schumer added. "I'm going to support a plan that can pass, and that can provide the best, cheapest healthcare for all Americans."

Schumer's refusal to back Medicare for All came just days after a federal judge deemed the Affordable Care Act unconstitutional-- a ruling many characterized as the latest sign that it's time for the U.S. to move beyond its overly complex, market-based status quo to a straightforward and popular system that guarantees healthcare to all as a right.

Progressive activists see the ruling as an opportunity to ditch ObamaCare (RomneyCare) to Medicare-For-All and they want to see candidates taking a strong position on it. As has been pointed out all over the media, Republicans are worried that the crackpot right-wing judge in Texas-- responding to a suit by extremist GOP Attorneys General-- put something on their plate that they can't handle and don't want to try handling. Drew Altman, of theKaiser Family Foundation wrote that "There is little hope of a deal with Democrats on health reform in a divided Congress if the decision is upheld. Democrats will now use the 2020 campaign to paint Republicans as threatening a host of popular provisions in the ACA. And here’s the kicker: protections for pre-existing conditions, the provision that played such a big role in the midterms, is not even the most popular one." According to the latest Kaiser tracking poll, these are the ObamaCare provisions-- in order of their popularity-- that voters don't want to see obliterated by the GOP:

• Young adults can remain on their parents' health insurance policies until age 26: 82% of the public supports this, including 66% of Republicans.
• Subsidies for lower and moderate income people: 81% support this, including 63% of Republicans.
• Closing the "donut hole" so there's no gap in Medicare prescription drug coverage: 81% like this, as do 80% of Republicans.
• Eliminating costs for many preventive services: 79% support this, as do 68% of Republicans.
• Medicaid expansion: 77% like it, as do 55% of Republicans.

The list goes on, but notably, further down but still very popular: 65% of the public supports protecting people with pre-existing conditions, as do 70% of Democrats, 66% of independents and 58% of Republicans. The fact the pre-existing conditions does not top the list shows how popular all of the other provisions are.

The Republican attorneys general brought their lawsuit in a different political environment, when Republicans held the House, Senate and the White House. If that had continued, they could have had reason to hope that a ruling in their favor, if upheld by higher courts, could have helped them achieve their goal of repeal and replace legislation.

The bottom line: Their world has changed politically, with Democrats preparing to take control of the House next year, and Republicans may have been better off settling for the repeal of the mandate penalty that Congress already passed. The mandate was by far the least popular part of the law and gave them something to crow about. Now, they may have bought more than they bargained for.

Tuesday, Elizabeth Warren wrote an OpEd for the Washington Post that captures progressive thought on how to move forward on healthcare now. She draw heavily on Bernie's proposals put forward in the past several years. She begins by making sure readers know that "Forty-seven states and the Justice Department are investigating a price-fixing conspiracy that's driving up the cost of generic drugs in the United States. One investigator called it 'most likely the largest cartel in the history of the United States.' This crisis calls for action. That is why I'm introducing legislation to authorize the public manufacture of generic drugs wherever drug companies have warped markets to drive up prices.

Drug companies use the "free market" as a shield against any effort to reduce prices for families. But they're not operating in a free market; they're operating in a market that's rigged to line their pockets and limit competition. The entire pharmaceutical industry in reality runs on government-granted monopolies, mostly in the form of long-term patent protections.

This system, intended to compensate drug companies for innovation costs, should be closely scrutinized. One of its few remaining virtues is supposed to be that when these exclusive monopolies run out, market competition kicks in to produce cheap, generic versions for consumers. Sounds great-- but it isn't working.

Antibiotics, steroids, heart medications, thyroid pills-- nearly 90 percent of American prescriptions are written for generics. But the generic drug market is fundamentally broken.

Today, 40 percent of generic drugs are made by a single company, and the majority are manufactured by only one or two companies . With so little competition for generics, drug makers can push up prices and squeeze consumers without consequence. As a result, prescription drug prices are crushing families. Millions of Americans are skipping required doses and putting their health at risk because they can't afford to renew their prescriptions.

Promoting competition used to be a central goal of economic policymaking. Today, in market after market, competition is dying as a handful of giant companies gain more and more market share. And as these companies get bigger, they create a vicious cycle, spending millions more on politics and lobbying to rig the rules, crushing potential competitors and further insulating themselves from legal or market accountability.

It doesn't have to be this way. Aggressive enforcement of laws protecting competition is just the beginning. In the prescription drug market, the next step should be public manufacturing.

The Affordable Drug Manufacturing Act would allow the Department of Health and Human Services to step in where the market has failed. HHS would manufacture or contract for the manufacture of generic drugs in cases in which no company is manufacturing a drug, when only one or two companies manufacture a drug and its price has spiked, when the drug is in shortage, or when a medicine listed as essential by the World Health Organization faces limited competition and high prices.

Public manufacturing will be used to fix markets, not replace them. The Affordable Drug Manufacturing Act would allow the government to manufacture generic drugs at lower costs or contract with manufacturers to produce the drugs at competitive prices. And if a potential manufacturer thinks it can do better, the bill provides that the license to manufacture the drug is continually offered for sale, with the only condition being that the buyer would agree to keep selling the product to consumers at competitive prices.

Sound radical? It isn't. The federal government already contracts with private manufacturers to produce stockpiles of drugs critical to protecting and treating Americans in the event of a biological, chemical or nuclear attack. My proposal would use similar tools to address the public health crisis resulting from unaffordable medicines.

There's more to do to bring down high drug prices. Medicare should aggressively negotiate with drug companies. We should crack down on rampant abuse of the patent and regulatory system. We should import drugs from countries that sell the same medicines, with the same safety standards, but that charge their citizens a fraction of our costs. And I've already introduced legislation to make sure that no family will ever pay out of pocket more than a modest amount per month to fill its prescriptions. But in the battle for sustainable, affordable medicines, public manufacturing of generic drugs can be a critical tool.

The giant drug companies fighting to protect and expand their monopoly handouts will hate this idea. But Congress doesn't work for them. And so long as these companies continue to game the system, we should insist on competitive markets that actually work for consumers.

On a personal note, this morning, I woke up and started my regimen of prescription drugs, all of which-- despite (or because of) Medicare Part D (Republican Medicare)-- are drugs I bought at pharmacies in Thailand, France and Turkey at incredibly cheaper prices than they sell in the U.S. even with the crap Medicare Part D "insurance," which seems to insure pharmaceutical companies, not consumers. One example, a $70.00 inhaler in the U.S. costs around $6.00 in Thailand. When I first bought it, I asked my doctor to check it out and it said it was exactly the same.