Sam Uretsky

Saved from Informed Choices

We're saved! The mainstream media focuses on sensationalism, and so they don't always report the small victories, the quiet but vital efforts to keep the United States where it is today -- with an infant mortality rate in a virtual tie with Lithuania. When it comes to life expectancy at birth (male), we can hold up our heads and shout "we're number 48!" For healthy life expectancy, an American woman can count on almost 69 years -- compared with 73.5 years for a French woman and 75.8 for a Japanese woman. The US has the second worst infant mortality rate in the first world. American babies are three times more likely to die in their first month as children born in Japan, Newborn mortality is 2.5 times higher in the US than in Finland, Iceland or Norway. Statistically, health care in the US is decidedly middle-of-the-pack, but when it comes to expenses, we are number 1. We spend more and get less, and that's the American way.

This hallowed tradition was briefly threatened by a House vote that would have allowed Medicare Part D, the drug benefit plan for the elderly, to negotiate with drug manufacturers for lower prices. This bill was defeated in the Senate -- or at least a proposal to limit debate on the bill was defeated by 42 senators who put our traditions of mediocrity ahead of lower-priced drugs for the sick and the elderly. The bill would also have mandated comparisons of the effectiveness of different drugs. Right now you can get objective evaluations of small appliances, Australian wines, and control top panty hose -- but you have no way of knowing if the drug you're taking for blood pressure is worth the money.

While it isn't fair to single out any single senator for special praise, consider Sen. John Cornyn, R-Texas, who denounced the bill as "a step down the road to a single-payer government-run health care system." Sen. Charles Grassley, R-Iowa, was quoted as saying that the private firms "have more market power than Medicare" because they negotiate for tens of millions of people in private plans, as well as for Medicare recipients."

Everybody in the industry negotiates drug prices -- the Veteran's Administration negotiates drug prices, hospitals with a few hundred beds negotiate drug prices, Wal-Mart negotiates drug prices -- but Medicare Part D isn't allowed to ask for a better price -- Sen. Grassley saw to that.

Sen. Kay Bailey Hutchison, R-Texas, who had been considered to be a swing voter on the issue, on April 23 said that she would vote "no" because the legislation "would limit the number of options" for beneficiaries. This was a red herring because, according to the Congressional Budget Office review of the Bill, Part 2 "... would retain the clause that prohibits the Secretary from requiring a particular formulary or price structure, and it would allow PDPs (prescription drug plans) to negotiate prices that are lower than those obtained by the Secretary.."

The CBO report takes about 2 minutes to read, less if you don't move your lips. It says that the bill wouldn't cost much to implement, wouldn't limit choices, but would provide information about the cost-effectiveness of drugs and the negotiating efficiency of the private insurers. It would, for about $500,000 per year, bring some objective measures to the way we spend money on drugs. It's hard to believe that the senators read the report, and very easy to believe that they spoke to industry lobbyists before they voted.

The US healthcare financing system is an embarrassment. We spend too much for too little. The Medicare Prescription Drug Price Negotiation Act of 2007 (S.3) was a good bill that at worst would have given us objective information about where our money is going. There was a remote chance that implementation of this bill would give us better health care for lower costs.

According to a report from The Commonwealth Fund, the US ranks 15th of 19 nations monitored for quality of health care. They reported that up to 150,000 lives and $100 billion could be saved every year with improvements in the system. Fortunately, our traditional American values have been protected. Thank you Sen. Cornyn et al. What could we have been thinking?

Sam Uretsky is a writer and pharmacist living on Long Island, N.Y.

From The Progressive Populist, June 1, 2007

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