Pelosi's Drug Pricing Plan Is Weak And Likely To Get Weaker Before It Ever Passes... If It Ever Passes

Pelosi's long-awaited drug-pricing plan was finally made public yesterday. Key non-policy top-lines:

• Republicans immediately started calling it "socialist" before reading it
• Progressives have noted that it's quite a bit less than what was promised
• Moscow Mitch butt-boy John Thune (R-ND) said it will be dead on arrival if it passes the House this fall.

The fairly weak plan-- albeit just as hated by the GOP and Big Pharma as a real plan would be-- gives Medicare the job of negotiating prices on 25 (instead of 250) commonly used drugs. By targeting only the most commonly used drugs, Pelosi-- who should be fired by San Francisco voters in 2020-- is purposely leaving people who take less common drugs, out to dry, especially since those are the drugs that are usually prohibitively expensive. (McConnell said if Pelosi's plan passes the House he will refuse to allow a vote on it in the Senate. "Socialist price controls," he lisped, "will do a lot of left-wing damage to the healthcare system. And of course we’re not going to be calling up a bill like that.")

The corrupt conservative New Dems, who are in part financed by the pharmaceutical companies, are siding with Trump to water down all proposals as much as possible. That would have been a good reason to strat the process with a really strong proposal, like Lloyd Doggett's, rather than a sad little puny plan like Pelosi's. If if Republicans and their New Dem allies watered down Doggett's plan, it would probably still be better than the pablum Pelosi came up with. Pelosi put herself in a position where any compromises at all will result in a completely meaningless bill that does virtually nothing, the goal of the Republicans and Big PhRMA.

The main thrust of the plan will allow Medicare to negotiate lower prices on as many as 250 of the most expensive drugs, including insulin, per year and apply those discounts to private health plans across the U.S, according to a legislative summary distributed to lawmakers.

The plan will also establish an international pricing index that is supposed to bring drug prices in line with what other nations pay and penalize pharmaceuticals companies that refuse to negotiate with the government or fail to reach any drug pricing agreement. The penalty will start at 65% of the gross sales of the drug in question and increase by 10% each quarter the manufacturer doesn’t reach an agreement, according to the summary.

Pelosi’s proposal also will:

• penalize pharmaceutical companies that raise the price of their drugs faster than inflation
• create an out-of-pocket maximum of $2,000 for Medicare beneficiaries
• and reinvest savings from negotiated prices on finding new treatments at NIH.

Bernie's platform is what Congress should be looking at, rather than Pelosi's pre-compromised plan. Bernie:

The giant pharmaceutical and health insurance lobbies have spent billions of dollars over the past decades to ensure that their profits come before the health of the American people. We must defeat them, together. That means:

• Joining every other major country on Earth and guaranteeing health care to all people as a right, not a privilege, through a Medicare-for-all, single-payer program.

And to lower the prices of prescription drugs now, we need to:

• Allow Medicare to negotiate with the big drug companies to lower prescription drug prices with the Medicare Drug Price Negotiation Act.
• Allow patients, pharmacists, and wholesalers to buy low-cost prescription drugs from Canada and other industrialized countries with the Affordable and Safe Prescription Drug Importation Act.
• Cut prescription drug prices in half, with the Prescription Drug Price Relief Act, by pegging prices to the median drug price in five major countries: Canada, the United Kingdom, France, Germany, and Japan.

Why should Democrats in Congress compromise with the pharmaceutical industry, the way Pelosi is doing? On Wednesday, Oregon Senator Jeff Merkley made a case for giving them some rough treatment. "Purdue Pharma had a big plan," he wrote. Hook people on opioids like OxyContin. Lean on groups like the World Health Organization to look the other way. And then turn their backs on the victims when people became addicted and started dying. That's the opioid crisis in America and it's a signal that health care in our country is in grave danger." It's a multi-pronged assault:

• Companies like Purdue get people hooked on their drugs, then try to weasel out of responsibility for a crisis they helped cause.
• Other drug companies develop life-saving medications, but then jack up the prices and hold patients hostage to their profits.
• They bankroll Republican campaigns, funding people who promise to cut regulations on health care and protect Big Pharma.
• Industry executives, lobbyists, and insiders are appointed to major positions of power, who spend their days undermining our health care system.

"Americans can't afford for Big Pharma to call the shots anymore. I've proposed solutions like barring them from gouging Americans with prices far higher than they charge in other countries, and making them pay for an opioid treatment surge."

He then called on Americans to "help hold Big Pharma accountable for what they've done" and suggests electing Democrats in 2020 is how we do that. I understand where he's coming from, but electing Democrats who kowtow to Big Pharma and Wall Street doesn't sound like a very good idea to me. In his own state, one of the worst corporate whores in Congress, Blue Dog Kurt Schrader, is being challenged by Milwaukie mayor Mark Gamba. "The Pharmaceutical industry in America has been allowed prey on Americans for decades now," Gamba told us this morning. "This latest revelation regarding opioids, and the industry’s active participation in addicting Americans in their moment of suffering is in keeping with their long standing attitude of wringing as much profit out of people during their time of illness as possible. They do so, often, regardless of the actual efficacy or detrimental side effects involved. They also have no qualms about jacking up prices to bankruptcy inducing levels for critical life saving drugs. As Americans we pay dramatically higher prices for the same drug that people in other countries are using. Just google 'insulin price comparisons worldwide' if you want hard numbers. This means that often Americans go without their life saving drugs, and they die. When I’m elected, one of my top priorities will be to pass H.R. 1384 the House version of the Medicare for All act so that prescription drug prices are negotiated, just like they are in most of the rest of the world. It is high time that our entire medical system be focused on providing the best care possible, for all the people, at a reduced cost."

The thermometer above is for 2020 congressional candidates-- like Mark Gamba-- who are running Medicare-For-All-powered election campaigns, campaigns that aren't just passively in support of single payer but are actively talking with voters about it. Please click on it and give what you can.

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.

Day 5: Catching up with Mike Doonesbury's mom's War on Death Panels

"Don't worry, when it's my time, I'll drive into the sea."

-- Daisy Doonesbury, to her son Mike in Tuesday's strip

As regular Doonesbury readers know, Daisy Doonesbury's "golden years" (am I the only one who didn't know the Widow Doonesbury's first name till yesterday?) haven't been easy. Now, in angry revolt against "death panels," which Mike tries to assure her don't exist, and all "government-run health programs," she's prepared to burn her once-treasured Medicare card.

Don't forget to click on each strip to enlarge. And check here for tomorrow's end-of-week installment -- and for every day's Doonesbury "Daily Dose." -- Ken

DOONESBURY Monday, Sept. 21

DOONESBURY Tuesday, Sept. 22

DOONESBURY Wednesday, Sept. 23

DOONESBURY Thursday, Sept. 24

DOONESBURY Friday, Sept. 25


COMING UP (at 6pm PT): What the "death panel" lies have "protected" us from discussing about end-of-life care

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Public Option Rides Again

Yesterday we launched a campaign to thank the 65 Democrats who are standing up for working families-- standing up despite Big Insurance's big bucks, standing up despite a campaign of Republican lies and thuggery, standing up even despite corporate shills in their own party, from Blues Dogs to DLC corruptionists like Ben Nelson, Max Baucus and Blanche Lincoln... and perhaps even standing up despite the hard-to-get-a-handle-on maneuverings from the White House. In the 24 hours since we launched the campaign an incredible 1450 1500 donors contributed close to over $100,000 to these 65 courageous Democrats.

Last night Rachel Maddow dedicated the intro to her show to "Democrats drawing a line in the sand" and featured Jane Hamsher (see video below). This came right on the heels of a dial-in weekly Democratic House caucus meeting that reiterated that the House Democrats were stronger than ever behind health care reform with a public option-- regardless of what time of the day it is and where Obama happens to say he stands at the moment.

Not a single member spoke up on behalf of co-ops, according to both people on the call and people briefed on it... In the face of White House backsliding Monday, Pelosi reiterated that a public option is essential to reform. Pelosi gave the caucus a "pep talk," one attendee said, pushing the party to keep pressing the message. She assured an ultimate victory.

"Everyone has said on the record that they would support [the public option]. But there is a concern that the conference report would give them an out," said an aide briefed on the call by his boss. "Some people spoke up and said, 'We can't give in on the conference report.'"

I'm guessing none of the Blue Dogs called in. Maybe they had all passed around Digby's post from Monday explaining that sabotaging health care reform would probably cost lots of Democratic seats, almost all of them red state Blue Dogs... and that that could actually be a seen as a good thing! "And," writes the always startlingly perceptive Digby, "if it happens because [Obama] rammed through meaningful health care reform instead of some watered down bucket of warm spit and the administration managed to get unemployment down, I think he will very likely have Morning in America in 2012. To hell with Rahm and his appease the Blue Dogs at all costs strategy. What good is it if the president fails in 2012? If [Charlie] Cook is right and the Dems maintain their majority while losing a bunch of these reactionary wingnuts, I couldn't be happier. And the Democrats should be happy too because it means they can pass successful legislation for a change."

Late last night Carl Hulse and Jeff Zeleny had a piece published by the NY Times implying that Obama has gotten his mojo back and that he's ready to push through the health care reform he campaigned on and won the election on and that he would do it in the face of lockstep GOP obstructionism. Although Republican obstructionism prevented Harry Truman from passing health care reform, on July 30, 1965 LBJ signed two amendments to the Social Security Act into law that created Medicare and Medicaid. The year before Republicans lost 36 seats in the House and 2 seats in the Senate-- leaving them with a puny and powerless 32 member caucus in the Senate-- and giving the Democrats overwhelming majorities. So even with dogged obstructionism and Republicans screaming "socialism," and rending their clothes (although without Fox News), the amendments passed 307-116 in the House and 70-24 in the Senate. But even without Limbaugh, conservative opposition was fierce and dire. In 1961 Ronald Reagan warned “[I]f you don’t [stop Medicare] and I don’t do it, one of these days you and I are going to spend our sunset years telling our children and our children’s children what it once was like in America when men were free." Sound familiar? Barry Goldwater, who had just been defeated in the biggest presidential landslide in contemporary memory, didn't let that stop him from also warning about the slippery slope of socialism: “Having given our pensioners their medical care in kind, why not food baskets, why not public housing accommodations, why not vacation resorts, why not a ration of cigarettes for those who smoke and of beer for those who drink.” Equating beer and cigarettes with health care is quite the stretch... unless you're a rightist whose only goal is maintaining the status quo for the powerful elites whose interests you represent.

Recognizing that the only effort the GOP is willing to expend is work they think will guarantee that the Obama presidency is a failure, and that they are not negotiating in good faith, word from Democrats last night was that "their go-it-alone view was being shaped by what they saw as Republicans’ purposely strident tone against health care legislation during this month’s Congressional recess, as well as remarks by leading Republicans that current proposals were flawed beyond repair."

Leaving the obstructionists out of the equation, Democrats have the opportunity to come up with a bill that serves the needs of ordinary American families instead of the special interests the Republican Party is in bed with. It remains to be seen if instinctively cautious Democrats-- who, after all, are in bed with many of the same sleazy interests-- have the guts, foresight and will to seize that opportunity. The stand by progressives in the House who will not budge on the public option-- the actual compromise position-- gives real reform another breath of life and a chance to hang on and fight another day. Let's keep up the good work today and show Rahm Emanuel and the Blue Dogs that Democrats don't have to crawl to Insurance Industry CEOs to finance election campaigns. Even if you give just one dollar-- which is what many people did give yesterday, please help us get to $200,000 this week.